New science is changing the way we think about chronic pain

Breakthroughs in pain science have led to a whole new way to diagnose and treat chronic pain. The global standard for disease classification (ICD-11) now names two categories of chronic pain: primary and secondary pain.

These guidelines were only introduced in January 2022, and, currently, there are very few US doctors with the training to rule in a primary pain diagnosis.

What is primary pain?

Primary pain is pain that is driven by the pain signaling network and can exist even in the absence of tissue damage - causing changes in the brain’s pathways and very real pain.

This is actually a very common problem. Sometimes, the pain signaling system can become overly sensitized, and sound red alerts even when there is no danger; like a fire alarm without the fire.

Because it’s the signaling system that is misfiring, treating painful body parts alone will not generally make any significant or long-term reduction in pain.

How do I know if I have primary pain?

Indicators of primary pain fall into two categories: rule out and rule in. Ruling out is when imaging and other clinical tests are conducted, and nothing is found that can adequately explain symptoms. The second category is “rule in” Some positive indications of primary pain can include:

Pain that has lasted for more than six months

Multiple areas of pain or uncomfortable symptoms

Pain that varies in intensity from day to day

Pain that intensifies during times of stress

History of past chronic pain experiences

History of adverse childhood experiences

History of treatments, injections, or surgeries that have failed to stop the pain

Learn how you can meet with a provider trained in the latest ICD-11 codes today

Primary pain is a “good news” diagnosis.

Our brain is very good at learning - that's one of its main jobs. But sometimes, the brain can get a bit overzealous and learn to signal pain when it is not supposed to — kind of like a bad habit.

A chronic primary pain diagnosis is considered to be a good news diagnosis - because a brain that learns to produce pain can unlearn it too. By addressing our thinking, feeling, and behavioral patterns, we can train our brains to change our experience of pain and, in many cases, reverse it completely.

Learn about our primary pain recovery program here.

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