Impairment is the clinical term for a loss of function due to pain or injury.  Being unable to lift more than 10 lbs because of low back pain is an example of impairment.  Disability is closely related to impairment, but is distinct because it involves choice.  Though your impairment may not allow you to lift heavy objects you may still able to sit at a desk. You can take on a job in which lifting isn’t necessary.  In this view, though you are impaired, you are not disabled for a desk job.

I once met a young woman who was employed as a secretary working the switchboard at a rehabilitation center.  She was quadriplegic (paralyzed in her arms and legs), and operated the switchboard and her wheelchair by blowing through a tube. She had help in the morning getting ready to go to work and during the day for meals and personal needs. She worked 9-5, 5 days a week.  Though this young woman was 100% impaired, and could have easily made the choice to be permanently and totally disabled, she chose to work.  She was fortunate to be able to have a job that would accommodate her impairment. Even if that is not possible, her story highlights the fact that impairment does not have to equate to disability.  Though you may be impaired, you can still participate in your life in many different capacities– whether that be through employment, engaging with loved ones, taking up a hobby, or other activities that bring fulfillment.

For people suffering chronic pain, pain intensity is not the only factor that should be considered when treating the patient. Many assume that once the pain is reduced, the patient will go back to living their normal life. However, this is often not the case.

Many chronic pain patients have decreased muscle flexibility and strength, and in addition psychological problems (Schofferman, 2006). Therefore, multi-disciplinary rehabilitation may be an important part of their treatment.

Successful treatment may be reflected as much by improvement in function as in reduction in pain intensity. The capacity for increased activity allows a pain patient to do things otherwise prevented by pain. A patient who was unable to work due to his severe low back pain could after treatment, despite persistent pain,  sit, stand, and walk for longer periods of time. He returned to work to a desk job. Despite residual pain the treatment was still considered successful by the patient because he was able to return to work.

Many chronic pain patients report frustration with the attitudes they face from friends, family, and health care practitioners.  Most often, patients report feeling stigmatized for experiencing pain that doesn’t have a readily identifiable cause.

Pain can have a variety of causes, and there is currently no set standard for diagnosing and treating chronic pain.  This lack of standard creates a confusing and frustrating experience for the patient, and a puzzling case for physicians.  For some, a lack of known etiology causes the patient to place blame on themselves, when in fact, the lack of knowledge is a result of the limits of medical knowledge (http://bit.ly/HFXzhm). 

Blaming oneself can have destructive consequences, including avoiding getting necessary professional help and actively participating in rehabilitation(http://bit.ly/17Supp1).  A strong social support base can reduce feelings of stigmatization and improve coping (http://bit.ly/10chj3G).  Support groups for pain patients can be effective in developing coping skills for depressive symptoms that are frequently experienced in patients living with pain, and boosting self-appraised problem-solving confidence (http://bit.ly/1bfJIFK).

You may have read or heard on the news about the new healthcare laws being put into place.  I have met many people who have said that they have no idea what will happen, so I thought I would provide some information. I am not an expert, nor am I placing an opinion on it. Any or all of this can change tomorrow, so before making any decisions consult your HR administrator, insurance broker, or whoever handles your health insurance needs.

As of January 1, 2014, you will be required to have health insurance. If you do not have health insurance, you will be fined a specific amount (based on your income) every year until you get coverage. The fines increase every year.  However, there are exceptions to this rule, including hardship exemptions, for which you can apply.

Many plans are changing because they don’t meet the minimum requirements set by the law. This may mean that your policy may change as of January 1, 2014. Even if it doesn’t apply to your needs and desires, the new standards require inclusion of items like prescription drugs, maternity leave, and pediatric dental care. Although pre-existing healthcare conditions will no longer be a reason for denying coverage or charging higher premiums, there are a few exceptions to this rule.

For more information, please visit https://www.healthcare.gov/

Studies have shown that obese patients have more problems with musculoskeletal pain than the general population (http://bit.ly/Hh3usQ).  Obesity and pain show a strong relationship even when insulin resistance, inflammation, and pain-related comorbidities are accounted for (http://1.usa.gov/17jGHqj).

A study of 215 fibromyalgia (FMS) patients found that obese patients had greater pain sensitivity, poorer sleep quality, and reduced physical strength and flexibility (http://bit.ly/18TVYy4).  If you are in pain and overweight, losing weight may help reduce your symptoms.  Though this can be achieved through simply taking in fewer calories than you expend, studies have shown that diet and exercise are significantly more effective together than either intervention alone (http://bit.ly/1ezkOEP).

Adjusting your lifestyle doesn’t have to be drastic!  Start by making healthy swaps in your diet: try replacing white bread with whole wheat bread, or try using olive oil or canola oil instead of butter.  Pick up a fruit or vegetable that you wouldn’t normally buy and figure out ways to incorporate it into your meals for the week.

Exercise habits can evolve with a little time and effort.  If you normally walk five blocks in one day, see if you can increase that to six or seven.  Though weight training can be beneficial in building muscle strength and bone density, aerobic exercise is more likely to be helpful if your goal is weight loss.  Simply increasing your physical activity and making smarter food choices can help you lose weight and decrease your pain.