Health Issues
Blog #1
Chronic Pain
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The Gale
Encyclopedia of Medicine defines pain as an unpleasant feeling that is conveyed
to the brain by sensory neurons. Pain is further defined by perception,
subjective interpretation of the discomfort as well as the actual awareness of it.
Pain can come from injury or illness and can often be accompanied by depression
as well as be felt without an apparent cause.
Acute pain is
associated with such things as broken bones, cuts, headaches or muscle cramps.
This type of pain typically resolves once the illness, injury or source has
been eliminated.
Chronic pain
is pain that continues to plague an individual even though the illness, injury
or source of pain has been removed and as lasting longer than six months. Persons
suffering from this sort of pain may be victims of syndromes like fibromyalgia,
neuropathic pain or phantom limb pain. Diagnosis chronic pain is often
difficult as many have syndromes that cannot be confirmed by laboratory tests.
It is
estimated that one in three people in the United States will experience chronic
pain at some point in their lives. Of these people, approximately 50 million
are either partially or completely disabled.
Treatments for chronic pain range from physical therapy to narcotic
analgesics and many levels of non-prescription and prescription only drugs.
Because many of the narcotic drugs are highly addictive, physicians are often
reluctant to prescribe them as a maintenance drug. However, the Drug
Enforcement Administration established guidelines in 2004. They now work with
physicians to ensure that drugs are not overprescribed, and that those who
truly need these opioid medications are able to receive them in a way that will
prevent abuse.
However, drugs
are not always effective at controlling pain. There are also site-specific
steroid injections that may provide temporary relief. At this point, the
patient may elect to try a neurostimulator or an intrathecal pain medicine
pump. Nancy Soto, a certified medical assistant at the Rio Grande
Pain Center says that no amount of stretching, walking, muscle strengthening or
weight loss will resolve the pain. She goes on to say that chronic pain,
especially from herniated discs, is always going to be there (Deiner 2008).
An open letter
from a patient suffering from chronic pain on spine-health.com
is very enlightening. A person suffering from this type of pain may look normal
to us on the outside while they may actually be in excruciating pain. As
someone who is married to a person suffering from chronic pain I highly
recommend reading this article. Many of our patients may have this problem and
the comments made by this man may help us to have better compassion and
understanding of the feelings of chronic pain sufferers. Two comments stood out
to me: “If you want to suggest a cure to me, please don’t” and “In many ways I
depend on you, people who are not sick”. This is where we can be of service to
the sufferer: listening, offering our care and kindness, and providing respite
from pain by distracting their minds for as long as they can handle it.
Physician
Philip Pizzo, former dean of Stanford’s medical school, posted his personal
journey of on Standford Medicine blog, Scope.
The most interesting comment he made concerned the fact that the physicians and
specialists he visited are circumscribed in seeking answers, often rushed and
that the specialists are so specialized that their thinking is very narrow and
confined to their personal knowledge base. Therefore, they do not think outside
their personal expertise. Because he was a physician, he was able to keep
asking and seeking answers. His concern and mine are that the average person is
not afforded this same luxury and often ends up settling for less.
An article written
by Robert Addison, M.D. in 1984 calls chronic pain a syndrome and calls it one
of the most frustrating and difficult challenges in a physician’s practice. He
implies that the suffering, which he puts in quotations, is actually a
psychological illness leading to excessive talk about pain and decreased
activity, increased anxiety, inappropriate medication and eventual
unemployment. He further calls it a pain behavior pattern that should be broken
and that only then would the patient begin to relearn well behavior and
experience relief.
Hogwash! Let’s
hope that 20 years later physicians are more compassionate than this. While I
do agree that a chronic pain sufferer may be overly focused on their pain, I
believe that their pain is real. I further believe that we can help by
providing distractions such as music, an arts practice or meditation to help
them, even if the relief is temporary.
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| Standford University Scope Blog |
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| The Healthcare Blog |
Deiner,
Paige Lauren. The Monitor. Monday,
February 18, 2008. Retrieved from http://www.themonitor.com/life/valley_life/chronic-pain/article_49101f5f-a1f2-5956-b36d-86b52a073296.html
Addison,
Robert G. September 10, 1984 The American
Journal of Medicine pgs. 54-58.
Participating in
activities you enjoy.
September 2009. REPRINTED NOVEMBER 2011
NIH
PUBLICATION No. 09-7411. Retrieved from http://www.nia.nih.gov
Barrett, J., & Odle, T. G.
(2006). Pain Management. In The Gale
Encyclopedia of Medicine (3rd ed., Vol. 4, pp. 2757-2761). Detroit:
Gale. Retrieved from http://go.galegroup.com/ps/i.do?id=GALE%7CCX3451601192&v=2.1&u=gain40375&it=r&p=GVRL&sw=w&asid=47f0981f6013f1df7302b138ae2f9781
Chronic Pain. (2009). In P.
Korsmeyer & H. R. Kranzler (Eds.), Encyclopedia
of Drugs, Alcohol & Addictive Behavior (3rd ed., Vol. 1, pp.
304-306). Detroit: Macmillan Reference USA. Retrieved from
http://go.galegroup.com/ps/i.do?id=GALE%7CCX2699700111&v=2.1&u=gain40375&it=r&p=GVRL&sw=w&asid=4a6e0040626dcd2505717a2c49ed73b0
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