Prince Didn't Need to Die — The Tragic Price of Pain

As he did so often in life, Prince is once again offering us the opportunity to heal a problem that desperately needs to be fixed.

It's suspected that Prince is unfortunately one of the 15,000 Americans who die each year with prescribed narcotics being a contributing cause. He had severe hip pain that didn't go away after his hip replacement surgery. To deal with the pain, he took the narcotic Percocet. It helped, but not enough. And so he joined the 33% of Americans who suffer needlessly with pain.

Why do I say needlessly? Because despite modern medicine having many incredible strengths, it's absolutely horrible at treating pain itself. As physicians, we're taught very well on how to treat the kinds of emergencies that show up in hospitals — mainly because that's simply where we're trained. Heart attack? Hot appendix? We're right on top of it. But pain itself?

Except for using a few medications to mask pain, or narcotics for cancer-related pain, physician training for pain management is woefully inadequate. I discovered this first hand when I came down with fibromyalgia in medical school. It forced me to drop out of school and left me homeless for almost a year. It also forced me to learn the basics of pain management — on my own — while experiencing what it was like to be on the other side of the white coat.

Decades later, medicine is still clueless. Sadly, the war on drugs having failed, the government has now declared a war on people in pain, and the pain specialists who use narcotics to treat them. The debate is being framed as "Is it better to leave people in chronic pain suffering, or get them addicted on narcotics?" The whole way the debate is being framed is idiotic. An alternative? If it helps move the national discussion on pain in the direction of asking the right questions, Prince's death may help countless millions of people. So in honor of his memory, here is a much better approach.

Nowadays, people with pain, and the physicians who treat them, face a Sophie's choice: suffer with pain or use potentially addictive narcotics. Sadly, the new government "war" is pressuring pharmacists and doctors to treat people in pain as if they were drug addicts, while threatening doctors with being arrested if they even appropriately prescribe the needed pain medications. Fortunately, there's a "door number three" to choose from.

Unlike infections, pain is not an outside enemy. Rather, like the oil light on our car's dashboard, it's part of our body's monitoring system that tells us when something needs attention. Different kinds of pain tell us different things. To extend the analogy, medicine treats the flashing oil light by either putting a Band-Aid over it, or by trying to disable the flashing red light. We never even think about simply putting oil in the car. Which is the safest and best way to make the annoying flashing light go out.  

Looking at Prince's case, it was likely that the hip replacement didn't work because it didn't address the real underlying problem. Studies and clinical experience have shown that what we see on x-rays frequently have little to do with what's actually causing a person's pain. For example, my guess is that many marathon runners, who have absolutely no pain at all, would probably have hip x-rays that look worse than Prince's.  

Often, the actual cause of hip pain comes from the muscles and ligaments surrounding the hip. By simply treating these, the pain might go away without the need for surgery or narcotics. Sadly, most physicians are simply not trained in doing an exam for muscle (or myofascial) pain. So despite it being the cause of the majority of pain in this country, an examining physician rarely even considers it.

My experience with having fibromyalgia, which begins as widespread muscle pain before morphing into other kinds of pain, helped me learn how to diagnose and treat tight muscles. Muscles are like a spring. They take more energy to relax than to contract. That's why after a hard workout you come home and say "Honey, my muscles are so tight," instead of complaining how loose and limp they are.

The brilliant work by the late Prof. Janet Travell, the godmother of pain management and the White House physician for presidents Kennedy and Johnson, taught us the importance of treating the underlying causes of our muscle's energy crisis. This includes treating structural issues by releasing tight muscles, as is done in many forms of bodywork including chiropractic and osteopathic manipulation. In addition, it's necessary to treat the underlying biochemistry to restore adequate energy in the muscles. Our published research showed that by treating with what we call the "S.H.I.N.E.® Protocol" (optimizing Sleep, Hormones, Infections, Nutrition, and Exercise as able), 91% of people with fibromyalgia pain improve. Usually dramatically! Dr. Travell also found that treating these issues often significantly helped improve muscle pain in general. 

Similarly, research has shown that treating the root causes can also be very effective for migraines, arthritis, and a host of other chronic pains. 

One problem with this is that treatments are generally very inexpensive. So research in this area doesn't get very much attention. But they do offer the potential of treating chronic pain very effectively and safely.

Prince's death is a tragic loss. Yet, it also provides us with a powerful opportunity. Of the many fitting tributes to Prince as an artist that he's most certainly due, why not add this one? It's time to apply the extensive but ignored research on treating the root causes of pain. Doing so can prevent tens of thousands of needless deaths, and eliminate the unnecessary suffering of millions.