Low Tolerance

We all have different tolerances to different things such as food, exercise, or how long we can put up with some people. Personally, I have a very low tolerance for avocados, therapists who think they can release fascia, or those who take offence at everything they read on social media.

Our levels of tolerance both physical and psychological are due to many things such as our genetics, our exposures, our experiences, and even our education. Some people can tolerate exercise more than others simply because they do more of it, some people can tolerate mental stress more than others due to previous experiences with it, and some can tolerate other people better simply because they have more emotional intelligence.

However, it is clear that more of the human population is becoming more intolerant of more things such as race, gender, political views or differences in opinions on social media! And many are also becoming more and more intolerant of any effort, exertion, difficulty or discomfort in their lives.

Our World Today

Most of us living in the modern developed world have a life of incredible convenience and comfort. A world where we have ample access to food, water, shelter, and wifi. A world where you have technology and gadgets to make your life easier and effortless. A world where you can buy a device to put your socks on in the morning, a duvet that makes your bed, or a machine that opens your jars. We don't even have to go to the supermarket anymore to lift jars off shelves and carry them in a basket with home delivery and even unpacking services on demand.

We are now living in a world where effort and exertion have mostly been removed, where any struggle or strain is considered unnecessary and often avoided. Don't get me wrong, this modern-day lack of difficulty does has some amazing positives, I for one am not complaining about WiFi, my central heating, or my online grocery delivery service. But its the sheer amount and volume of convenience we have in our lives today that has its drawbacks.

One of these drawbacks I think is that we have lost sight of what is actually difficult, hard, or inconvenient. What we now consider challenging these days simply is not. Losing your wifi signal, missing a meal, or having to walk up the stairs because the elevator isn't working are not really issues, yet our lifestyles and lack of exposure to them often make them feel so when we encounter them.

Pain Today

This I believe is no different with our experiences of pain or injury. Having a sore knee, an irritated shoulder, some low back pain, or a twisted ankle are not serious medical issues that need assessment, treatment or even to be worried about. Yet they often are by many, many people, for various reasons, the main one being again our modern convenient lifestyles and ease of access to healthcare! 

Most of our grandparents would not or could not see a doctor or therapist for such things, instead, they would have accepted that things hurt from time to time and they tend to ease on their own if they just ignore them and carry on. Unfortunately many have lost this stoical attitude, belief and trust in their bodies and its ability to look after itself and so seek assessment advice and treatment for things too often and too soon!

If we were to look back just a couple of generations we would see that many people would NOT seek medical attention for simple back, knee or shoulder pain. Of course this was for many due to less access, but I also think it was due to a difference in culture and attitude towards pain as well.

I often ask myself when I have a pain or an ache, what would my great grandad do... and most of the time it would be… ignore it and crack on!

But many now think that ALL pain and discomfort should be checked and treated immediately, and I think ALL of healthcare needs to do a better job changing this. I think a lot of things that hurt dont need assessment or treatment and instead need to be tolerated for a period of time until they improve on their own.

After 20+ years of working in healthcare I truly believe that trying to reduce and remove many pains too soon, too quickly, and too unnecessarily we are contributing to our population and society in becoming less and less tolerant and resilient to normal experiences of pain and discomfort.

Now don't get me wrong, I don't think anyone in pain has to be happy about it! Pain is unpleasant, frustrating, and, well… just a pain in the arse! And I do understand that many in pain maybe confused and uncertain about why they have it, and if and when its going to go away, and so seeking some advice is perfectly natural. It just that many don't need that pain to be removed or reduced with medications, massages, or any other treatments.

Instead healthcare professionals should be doing a better job at advising and reassuring those in pain carefully and compassionately that their pain is normal, safe and can be, and should be worked with rather than got rid of! However, this is not easy to do, and its not well rewarded or incentivised for many healthcare professionals to do, and so its often not done. Instead treatments that temporarily reduce or remove the pain are often recommended often unnecessarily!

A pain free life?

If you want your body to give you less pain in life, you simply cant abuse the crap out of and expect it to be happy. Unfortunately many people now think being healthy is easier in this easy modern convenient life we have. It's not. Just the opposite in fact!

To be healthy these days there is still the same genetic lottery to get through first to avoid any disease or disability. But if you have got through this with good fortune then congratulations, but now the hard work begins.

To put this as clearly and simply as I can good health has to be earned with some hard work, self-control, and self discipline, and the inconvenient truth is that many painful conditions today are often consequences of our convenient lifestyles.

However, regardless, of why things hurt from time to time the key point I want to make is that often nothing needs to be 'done' for many episodes of pain other than reassuring the individual it's not serious, it will ease with time, and they will not damage themselves if they feel some pain on movement and they should try to carry on as normally as possible.

Unfortunately, many healthcare professionals just don't feel comfortable or able to tell people in pain this for either financial or egotistical reasons. Personally, I think many musculoskeletal conditions are over-treated with healthcare professionals pandering to patients while natural history makes them look good.

Frustrated

Please don't think this is just me being a mean, grumpy uncaring old man, this is just me trying to be as open and honest as I can be after decades of trying to help people in pain. But my biggest frustration with this situation are the healthcare systems that are screwing things up royally.

There is no doubt that our modern healthcare services have improved hugely and helped humanity hugely by reducing disease and pathology and increasing survival rates and lifespans in many. But our healthcare systems have also inadvertently caused harm and detriment to many by making many in pain feel broken, fragile, less resilient and less tolerant to pain due to its over assessment and over treatment.

If you want some proof of these harms just go look at the BMJ global burden of disease studies where you will see how low back pain now consistently causes more disability and costs society far more than any other medical condition across the world, despite many so called advances in its assessment and treatment. Modern healthcare is just not helping people with many musculoskeletal pains or problems, in fact its making them worse!

In summary what healthcare is currently doing for musculoskeletal pain just isn't working and something needs to change. Personally, I think this should start with more healthcare professionals recognising that they over assess and over treat it. And also more of us recognising and accepting that pain sucks but it is inevitable, but suffering is optional.

As always thanks for reading

Adam