Saper noted that thinking about chronic pain can also make patients feel worse, which has been shown by advanced imaging on the brain. "When you focus on your pain, you turn off your brain's center for blocking pain," he said. "When you're distracted, that center goes on. So the more you 'poor me' your pain, and the more you complain and talk about and think about and obsess about your pain, the more it is likely to hurt."
Warfield said no one should continue to be frustrated by chronic pain. "I would certainly encourage them to talk to their physicians," she said. "Together with a primary care doctor, it's worth a consultation with a pain clinic."
Saper added that pain specialists must have a lot of intellectual curiosity to face the challenges. "A good pain doctor's got to have a global sense of a person's brain, their mind, behavior, and have compassion, trust," he said, "but he or she also has to know all this other stuff about how the body feels pain. There are thousands of illnesses that cause pain."
Katz said his group will continue to work with patients referred from other pain clinics and to send them there when they need services his center does not provide. "In the holistic approach, as the name implies, there almost is no defined boundary other than what good judgment dictates, so we have many more options. On the other hand, there's no question they can do things we can't.
"When medicine is functioning well, there really shouldn't be any us and them," he said, adding, "Unfortunately, there's enough pain and enough business to go around."