Cook: Listening to the message of pain

Cook: Listening to the message of pain

November 25th, 2018 by David Cook in Opinion Columns

Dr. Matt McClanahan is photographed in an exam room at Integrative Medicine & Associates on Thursday, April 6, 2017, in Chattanooga, Tenn. Dr. McClanahan approaches treating pain as both an psychological and physical issue.

Photo by Doug Strickland /Times Free Press.

Some day, we will look back and realize how limited and incomplete our understanding of pain has been.

We've prescribed mountains of opioids and millions of surgeries, but pain, especially chronic pain, remains a national crisis. Many of us hurt, deeply and constantly.

"We misunderstand pain," said Dr. Matt McClanahan, an osteopathic family physician formerly with CHI Memorial and the Center for Integrative Medicine.

For most of my life, I misunderstood pain.

With lower back pain that went from bothersome to debilitating, I believed that the solution to my back pain was found, well, in my back. Surgeries were encouraged. Injections performed.

The pain continued.

Then I met McClanahan, 38, and realized my earlier view of pain was like a flat-earth perspective: one-dimensional and faulty.

Today, I am a sort of pain evangelist, a healed skeptic now converted to a new understanding of pain defined now by neuroscience and insight.

Last fall, I could barely walk. Now, I'm 97.5 percent pain-free, running, exercising, working, everything. I no longer view pain as a curse.

But a teacher.

I have McClanahan to thank.

David Cook

David Cook

Photo by Ashlee Culverhouse /Times Free Press.

On Tuesday, Dec. 4, he opens a new center, the first of its kind in the area.

Called the Center for Insight Medicine and located off Lee Highway near Nutrition World, it offers a more complete approach to pain, grounded in neuroscience research and common sense with an emphasis on more accurate diagnosis to facilitate more precise treatment.

This isn't New Age fluff.

"Pain is a call to attention," he said. "It functions more as an alarm generated by the nervous system to indicate you may be in danger."

Imagine a bank with an alarm. Unfortunately, the bank gets robbed, so bank owners heighten the sensitivity of the alarm, making it more reactive and alert.

Somehow, the robberies continue.

So, the alarm gets adjusted, becoming even more alert.

Now, the alarm goes off at the slightest touch. An alley cat. The wind. It perceives threats that aren't really dangerous.

This Bank Alarm Metaphor describes the problem of pain. Our body is the bank. Our nervous system is the alarm.

And our pain is the flashing strobes and blaring sirens — increasingly sensitized over time.

Pain occurs when our nervous system produces this alarm-type response in the body to a perceived threat.

Like chronic back and neck pain.


Recurrent headaches.

Irritable bowel and bladder syndromes.

Chronic fatigue, anxiety and depression.

"Pain is produced by the brain, not the body, when a person's nervous system has concluded the body is in danger and action is required," McClanahan said.

Yes, a broken arm is painful ... because of the fracture. Your brain sends out pain signals to prevent further damage with the message: Go see a doctor!

But what about weekly headaches? Phantom limb pain? Stomachaches before the Big (name-your-stress-here) Day?

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"We now know that pain can be produced by the nervous system in the absence of bodily damage," he said. "This sensitization-type pain is very common, accounts for a large percentage of chronic pain and does not respond well to body-based treatments."

For me, understanding this danger-alarm mechanism meant looking for threats more broadly, beyond just my body or MRI diagnosis. A triumvirate — my past, present tendencies and personality traits — contributed to my pain experience far more than what surgeons suggested.

Sound crazy?

I'm not alone.

"It's also been a joy getting to know Matt McClanahan," said Forrest Simmons.

For years, Simmons, a wealth manager for Keel Point Investments on East Main Street, suffered from "horrific" back pain. He'd undergone two surgeries and was scheduled for a third when he encountered this new approach — first articulated by the late Dr. John Sarno — to pain.

He met with McClanahan and Dr. Alicia Batson, a similar physician in Nashville.

Last winter, he could barely walk.


"Pain-free," Simmons said. "I am back cycling, lifting weights, and even have plans to get back on the tennis courts. In other words, I have my life back. This recovery has been so meaningful and so radically different from any other treatment I have gone through that I wanted to get the word out to as many people."

Long ago, the Sufi poet Rumi once wrote: These pains you feel are messengers. Listen to them.

That listening leads to insight, which is the purpose of McClanahan's practice.

"When the causes of chronic pain are rightly diagnosed and the message understood — I call this insight — then a more complete treatment unfolds," he said. "It opens you up to great growth and a restoration of the capacity to be truly healthy and human."

David Cook writes a Sunday column and can be reached at or 423-757-6329.

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