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Thread: You have chronic pain: Now what?

  1. #1

    You have chronic pain: Now what?

    You have chronic pain: Now what?

    You have chronic pain: Now what?
    After years of uncertainty, you've finally learned what's causing your discomfort. Perhaps it's arthritis, fibromyalgia or any number of conditions. The result is the same. It's chronic.

    Knowing the source of your pain isn't enough to alleviate your discomfort. There aren't any quick fixes for chronic pain. And often, there's only so much doctors can do. You're the key ingredient. If you want your life to improve, you need to take steps to manage your pain.

    Understand your role

    The first and most important step in controlling your pain is accepting the fact that you may always have pain. Some people can significantly reduce or eliminate their pain. But if you're like most people with chronic pain, your pain always will be a part of your life.

    Managing chronic pain isn't about making your pain disappear. It's about learning how to keep your pain at a tolerable level. It's about enjoying life again, despite your pain. And it's about accepting that only you can control your future.

    Find the right doctor

    Being in charge of your pain doesn't mean that you can't or shouldn't look for help from others. A doctor can be especially helpful when you have questions or need assistance. But make sure it's a doctor who understands your condition and communicates well with you.

    The right doctor for you could be your family physician or a specialist who's overseeing your condition. Or you may want to see a physician or a psychologist who specializes in pain management. If you're not sure where to find a pain specialist, ask your doctor to refer you to one.

    When selecting a doctor, in general, look for someone who has these characteristics:

    Is knowledgeable about chronic pain
    Wants to help
    Listens well
    Makes you feel at ease
    Encourages you to ask questions
    Seems honest and trustworthy
    Allows you to disagree
    Is willing to talk with your family or friends
    Has a positive attitude toward life and your condition
    Before selecting a new doctor, however, check with your health insurance provider to make sure that the doctor is covered under your policy.

    Learn about your condition

    Finding the right doctor isn't the end of your job. It'll take teamwork to manage your pain. To make this easier, make an effort to learn all that you can about your condition and your pain. One place to start is with the information provided in this Pain Management Center.

    In addition, check the reference areas at your local library for medical dictionaries, books on health topics and health magazines. You also can browse through the health section in your local bookstore.

    It's important to be informed about your health, but don't overdo it. Spending too much time reading about your condition or discussing your pain can be counterproductive. It draws your attention to your pain, instead of away from it.

    Describe your pain

    Accurately describing your pain will help your doctor learn about the pattern of your pain, make a diagnosis, plan treatment and follow your progress. You can help in advance of your doctor's appointment by preparing yourself to answer these questions:

    Where is the pain located?
    How long have you had pain?
    Does the pain come and go or is it continuous?
    How long does the pain last?
    What makes the pain better?
    What makes the pain worse?
    What is the intensity of the pain? You may be asked to rate your pain on a scale of 0 to 10, with 0 indicating that you have no pain at all and 10 indicating that the pain is the worst possible.

    Pain scale

    What does the pain feel like? You can use words such as stinging, penetrating, dull, throbbing, achy, nagging or gnawing. Be as specific and descriptive as possible.
    Has the pain changed since your last visit with your doctor?
    What medications or treatments have you tried for the pain? How effective were they?

    How you feel pain

    Set goals

    Everybody differs in the amount of pain that they can tolerate. A level of pain that is unbearable for you might be acceptable to another. Your doctor may help you determine your tolerance for pain by having you rate your pain on a pain intensity scale. Then you can set a goal for where you'd like to be.

    For instance, if you rate your pain as 6 out of 10 on average and you decide you can tolerate 3 out of 10, then you and your doctor have a more tangible goal to work toward. You may not be able to get your pain level down to a zero, but usually you can make progress.

    Focus on one pain problem at a time. For example, you may have both back and knee pain, but your back pain is worse. Start by treating your back pain and then, once your back pain is tolerable, work on your knee. The time it takes to reach your goal depends on your diagnosis, but people often see progress during the first several months. After that, you may work toward a general pain management goal.

    Understand your treatment

    Continue to be involved in your care when your physician recommends specific treatments for you. Ask why certain treatments are being proposed and find out their risks, benefits and alternatives. Be careful about accepting medications, injections or other recommendations without being aware of what each entails. Any intervention brings a chance of both benefits and complications. Talk with your doctor to ensure that the balance is in your favor.

    Expect to commit some time to the treatment process. You may try a variety of treatments before your doctor finds one that works for you, so don't become discouraged if the first treatment isn't as effective as you had hoped. Your doctor may adjust your treatment over time, as he or she monitors how your body reacts to various regimens. People usually make progress in the first 2 to 3 months.

    Maintain contact with your primary doctor

    If you do seek specialized pain treatment, usually through a pain clinic or pain center, stay in touch with your primary care doctor. Your pain physician focuses on your chronic pain and generally won't monitor other health concerns that you may have or make sure that you receive routine health screenings, such as a mammogram or a prostate exam. Your primary care doctor manages your overall health.

    Make sure your primary care doctor and your pain physician communicate openly. They both should know what pain medication you're taking, who's prescribing it and if you're taking additional medications unrelated to your pain. This decreases the chances of overdose or negative interactions between medications.

    Ask your pain physician to send a copy of your records back to your primary care doctor. Often pain physicians will prescribe and adjust medications while determining the correct combination and dosage. Once you're on a stable regimen, your primary care doctor can provide ongoing prescriptions. This allows your primary care doctor to ensure that your medications and therapies are all compatible.

    Take control

    Most importantly, take responsibility for your pain. Don't become emotionally dependent on your physician. He or she should be compassionate but not overly sympathetic or enabling. Your doctor or pain physician can help you learn to manage your pain, but ultimately you're the one in control.

    March 11, 2002

  2. #2

    Accept your pain?

    "The first and most important step in controlling your pain is accepting the fact that you may always have pain. Some people can significantly reduce or eliminate their pain. But if you’re like most people with chronic pain, your pain always will be a part of your life."

    There's good information in this article but whenever I see the philosophy of "accept your pain" and "always part of your life" it doesn't seem rational to me. Since words mean different things to different people, I went to the dictionary to see what the official definition is. The first definition of accept is "to receive gladly". I think that explains my reaction to this expression.

    I got information from the American Chronic Pain Association (Society?) and it came with steps for dealing with pain. The first one was acceptance. I never went back to them.

    Steps that make much more sense to me:

    1. Recognize you have to manage the pain (to manage - "to direct, control or handle") and that's your #1 priority in life FOR NOW.

    2. Tell yourself constantly that "someone somewhere is doing something that will help you someday". Don't buy into the fatalistic philosophy that you will have this for the rest of your life. You have it NOW. It's impossible to predict what you'll have or won't have the rest of your life, and to do so is folly. The only indisputable fact is that there is research going on and your will to live needs to be sustained by a faith that IT WILL HELP YOU.

    3. Get joy out of life wherever you can find it and know that as you are doing that, others are working to help you. You can't see them, you don't know who they are or what they are doing, but IT IS HAPPENING.

    These work for me!


  3. #3
    Good advice Calico. I've found that a lot of pain advice can be quite belittling and patronizing.

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