I have had the pleasure of explaining and teaching the tenets of complicated pain to many hundreds of professionals as patients. It can often take hours or days to grasp the totality of the model. Below is a bullet point “Cliff’s Notes” version to help to quickly get the basics.

Core principles:

• The natural course of painful conditions is to resolve or recede.
• When a painful condition resolves or recedes with appropriate care over an expected timeframe this is considered “simple pain”.
• When pain fails to resolve or recede with appropriate care over an expected timeframe, it is understood that there are complicating factors interfering with natural healing.
• When pain fails to resolve or recede as expected due to complicating factors, this is considered “complicated pain”.
• Complicated pain continues to have the potential to resolve or recede if all of the complicating factors are identified and addressed concurrently.
• There are four major complicating factors which the model refer to as:
  1. bio-mechanical pain
  2. hyper-sensitization
  3. metabolic inflammation
  4. inertia
• If even one of the complicating factors remains unaddressed, this will interfere with the effectiveness of care or treatment directed at other factors.
• Treating one complicating factor while ignoring any other active factor makes good and appropriate treatment appear to be ineffective or paradoxically worsen the pain.
• The four complicating factors may be likened to a combination lock with four tumblers; all four tumblers must be addressed to “unlock” the pain. The complicating factors are often referred to as “the four tumblers” to reinforce this key metaphor.
• For those with complicated pain, the process of addressing the complicating factors must be ongoing and simultaneous, requiring active and ongoing practices and strategies on the part of the person experiencing pain. For this reason it is termed a recovery process. The model is called “Complicated Pain Recovery”™.
• Complicated Pain Recovery™ is not synonymous with pain treatment. Pain treatment is provided by licensed personnel, requiring specific training and expertise (i.e. medical doctor, chiropractor, physical therapist, psychologist, etc.).
• Complicated Pain Recovery™ is offered to individuals in pain through an educational and coaching process. This process does not involve diagnosis or treatment.
• Training and expertise to provide Complicated Pain Recovery™ educational and coaching services is provided solely through Compaire Consulting, LLC, which develops and maintains the standards and processes to designate an individual as Certified Complicated Pain Recovery™ Coach and a facility as providing a Certified Complicated Pain Recovery™ Treatment Program. Compaire Consulting, LLC has the right both to designate and rescind certification.