Daily Gratitude: Another post on “pain”.  One reason people have trouble embracing the neuroplastic or mind- body approach and understanding of chronic pain is that doctors are kind of “caught in the middle”. It goes way back. Patients want “answers” but they also want fixes – quick fixes. Usually a pill or a shot or even surgery to help them feel and get better – yesterday!  Instant gratification at its finest. So, doctors everything they can to find an answer for you. They do lab and xray and fancy studies. They try to find anything they can to figure out what’s  wrong so you can have an answer (a diagnosis) and they can prescribe a treatment plan.  The majority of patients would NOT accept a diagnosis of neural circuit (or neuroplastic) pain disorder because they would think the doctor was saying it was “all in their head”. As an aside, I feel sorry for the poor old brain because it is the cause of all pain (even when there is some structural abnormality involved, the pain sensation is generated by the brain). It’s not the brain’s fault it happens to reside inside the skull – aka the head.  Anyway, what people who specialize in neuroplastic pain medicine have discovered is that in back pain, for example, the presence of abnormal X-ray findings does NOT automatically correlate with someone’s pain.  I’ve seen many a person with totally normal radiological studies that were completely incapacitated by their back pain. And then I’ve seen the most horrible looking back X-rays in an infantry soldier working full time carrying over 50-100 pounds on his back.  My own recent experience cemented that for me. As part of the evaluation for my fractured clavicle they got X-rays of my shoulder.  This is what the report says: “End-stage glenohumeral (shoulder) osteoarthritis”. So I looked up what this meant: “final phase of a progressive joint disease where the cartilage in the shoulder joint has worn away, causing bones to rub directly against each other. This leads to severe pain, significant loss of movement and function, and a grinding or clicking sensation.”  So what you’re asking? Well I may have some clicking at times but I have great use of my shoulder (well at least I did before this injury and intend to after it’s healed too). I do weight training and have no problems with my daily activities.  This is a perfect example of how the findings don’t always correlate with your symptoms. You have to look beyond the obvious, digging deeper into the well – the well of the mind! If you do, you’ll have a much better chance of recovering than if you just stick to X-ray or lab findings.  Don’t blame your doctor though. Patients don’t accept this so they have learned to look for something everyone will believe