The Hurt Locker

Is your life boxed in with pain? Dr. Andrea Furlan understands. The sta physician and senior scientist at the Toronto Rehabilitation Institute diagnoses and treats people with a nervous system condition called central sensitization, which helps explain why some people have chronic pain and ultimately turn to dangerous painkillers for relief.

She has also written a book and developed an app called My Opioid Manager, which helps those in pain manage their medications safely. It’s timely information, considering that from January 2016 to June 2018, more than 9,000 Canadians were lost to opioid-related deaths, many of them accidental.

Health writer Diane Peters sat down with Dr. Furlan to talk about medication, chronic pain and the connection between pain and the brain.

Diane Peters: How do you define pain?

Andrea Furlan: The International Association for the Study of Pain has a formal definition I like: “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.” When you burn your finger while cooking and experience acute pain, you can see the damage. But with chronic pain, which affects the patients I treat and is driving the opioid crisis, sometimes there’s no actual damage anymore.

D.P. : What about conditions like arthritis and lupus that cause chronic pain?

A.F. : There are conditions that cause ongoing acute pain. But some people have had acute pain in the past, like a car accident in which they broke a lot of bones but they healed, and they continue to experience pain and depression. They don’t have ongoing tissue damage, but they perceive pain.

D.P. : Is this central sensitization, where there’s a dysfunction in the body’s pain system?