Does all chronic pain respond to the same treatment? Two competing theories

Theory 1: chronic pain all responds to the same one-size-fits-all treatment
Theory 2: it doesn't

I'm with theory two. I'm with this theory on the basis of my body, which doesn't act like they said it should at the Centre of Pain Education and also failed to respond to the one-size-fits-all treatment that at least one member of staff there tried to explain to me was best for everybody.

Don't get me wrong, I'm not against centres of pain education. I think the information and treatment they provide can be very useful if you have the right sort of chronic pain or if you didn't know the information they provide before. I've heard people repeat back to me the sorts of things they told us there as information that genuinely has a useful impact on their lives and improved both how they feel about their pain and their quality of life. But I'm not one of them and part of the reason for that is the source of my pain.

My pain comes from having hypermobility syndrome (HMS)* and it turns out that the NHS specialist centre for hypermobility syndrome in London runs its own centre of pain education because the other centres of pain education don't provide the best advice for us, because our bodies don't work like everyone else's and nor does our pain.

This leads me to two possible conclusions:
1. not all chronic pain is the same and not all of it responds to the same treatment, and/or
2. not all pain suffered for longer than 6 months should be classified as chronic pain (hence it not responding well to treatments for chronic pain).

Now, I'm quite happy for them to redefine chronic pain to exclude me and other HMS sufferers (we could call my pain "persistent pain" or "enduring pain" instead if it helped). But for now, I have to conclude that not everything that currently gets called "chronic pain" is that same thing and not all of it responds to the same treatments. And while what I've said so far doesn't entirely rule out the possibility that there are in fact only two types of chronic pain: HMS chronic pain and non-HMS chronic pain, I have my doubts about that too, as I don't see why musculoskeletal chronic pain and neuropathic (nervous-system-based) chronic pain would be the same or respond to precisely the same treatments either. At the very least, I'd say more evidence is required here. Luckily for this blog and unluckily for me, I have quite a broad range of chronic pain, so I can test out solutions for a wide range of chronic pain problems. My types of chronic pain include:

• muscle pain from almost constantly very tight muscles (a side-effect of  my ligaments not doing their job properly and the muscles taking the strain);
• frequent joint pain from my joints hyperextending (= extending too far; hypermobility = double-jointedness) and just generally being prone to injury and healing slowly;
• widespread chronic pain (similar to fibromyalgia), which in my case seems to be related to my central nervous system, as it responds to gabapentin, which is a med used to treat neuropathic (nervous system) pain;
• postural pain problems (i.e. pain that comes from my body not being able to cope with most postures for any length of time) – there's a lot of crossover with my muscle pain here, but I thought I'd mention it separately;
• pain from repetitive movements, such as using a mouse.

Compiling that list, I can't help thinking I'm probably forgetting something. Certainly it's not an exhaustive list of the problems that HMS causes for my body. But it's the ones I can think of that definitely fall into the "chronic pain" category, so for now it will have to do. The key point is, I get lots of sorts of pain, so when I review treatments I'll try and say which types of pain I think they were helpful for for me and if there are other types of pain I think it would work for.

Well, that's my blog's mission set out. In the next post I'll be getting down to business with my first review: the Alexander Technique.

* Just to confuse you, hypermobility syndrome is also known as joint hypermobility syndrome (JHS) and benign joint hypermobility syndrome (BJHS), and some people say it's the same thing as Ehlers Danlos Syndrome - Hypermobility Type (also know as EDS hypermobility type, or sometimes just referred to as EDS), but others don't. Either way, the treatment's the same.