The Lived Experience of Persistent Pain

When is the last time you read a quantitative study regarding individuals that you treat that have persistent pain? Compare that to a quantitative study that was regarding individuals that you treat that have persistent pain. I will admit that my balance is drastically shifted one direction, partially because the volume of published research is quantitative, but also because of my interest usually moves that direction as well. I’m currently taking my qualitative class as part of PhD program and gaining a greater appreciation of the value within qualitative research and has generated me to think about this interesting contrast.

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We now understand pain is an unpleasant sensory and emotional experience. Which makes me wonder why does it seem like we don’t study and understand the experience the person is going through as much as we seem to study the sensory and emotional physical aspects of pain? Of course it is difficult to wrap ourselves around the experience of pain that an individual may be experiencing because we can’t fully enter into their experience. Also it also seems like qualitative research doesn’t usually give you direction on what and how to treat the condition. (While qualitative can give you direction, I think many of us have this false assumption) I will assume many of you, like myself, like a study that seems to give me direction on what intervention to use to relieve someone’s physical dysfunction and pain.

Many of us probably shy away from qualitative research as it doesn’t seem very objective or scientific. We want statistics to show us the p-value to know if a difference exists or not, not just someone’s written account of a lived experience. But I find it interesting that from a treatment perspective many of us would agree that much of our clinical reasoning for diagnosing comes from the subjective interview (much of that is similar to qualitative research). We use our objective tests (quantitative-type of research methods) usually to verify our early hypothetico-deductive reasoning model developed through the subjective interview and pattern recognition.

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There seems to be evidence that the context of the situation with the psychosocial variables does have some stronger correlations. If this is the case, I wonder if we should spend more time trying to understand this experience.

We understand that many of the objective findings of those in chronic pain often time have limited correlation to the pain one is experiencing the suffering an individual is going through. There seems to be evidence that the context of the situation with the psychosocial variables does have some stronger correlations. If this is the case, I wonder if we should spend more time trying to understand this experience. Not only through our subjective interview of the patient, but also through qualitative research methods. If we are evidence based in our care of individuals living in pain, maybe we should have some more “evidence” of what a lived experience of pain is about? If you are like me I have my own opinions, but shouldn’t those be matched to evidence that is out there? Maybe searching out some of the studies that are out there on qualitative experiences may shed some insights on how to care for individuals going through their pain experience? Could there be common themes that may assist us in better understanding this lived experience and lead to better outcomes by adjusting treatments to match the individuals experience?

Okay, your turn, what say you?

via Dr. Kory Zimney, PT, DPT

Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!

Keeping it Eclectic...