Understanding Your Chronic Pain and Finding the Right Treatment
By Dr. Joseph T. Hayes, Board Certified physician with more than thirty years experience in pain management.
What is Chronic Pain?
Chronic pain is often described by the medical community as any pain that lasts for more than three months. This is inaccurate and only tells part of the story. The phenomena of chronic pain is more than just how long it lasts; it's more about how it impacts you.
For example, chronic pain can severely disrupt one person’s entire life and not another person's life. Some people may have very mild back pain, are able to have a good quality of life, and are able to do most of their activities of daily living, including their job. Other people may have exactly the same pathology in their back, including arthritis and disc disease and be severely incapacitated from the pain.
Part of the reason, is that chronic pain can cause permanent changes within the brain that can actually magnify the way we perceive pain.
How do We Treat Chronic Pain?
The best way to treat chronic pain is to choose a doctor who is willing to spend a significant amount of time with you and has compassion for your chronic pain. This doctor should do a thorough history and physical examination to obtain a proper diagnosis and then identify the type of pain.
Once, the doctor has identified the type of pain, they should decide what medication works for you.
- Adjunctive medications- These are drugs originally used for other conditions but have proved to benefit chronic pain patients. Some of these medications improve the perceived intensity of pain. Unfortunately, there is no drug that does not come with side effects. Therefore, it is important for the doctor to weigh the risks involved with the medicine, to see if the patient receives more benefit than adverse affects from the drug.
- Acupuncture and Manual Therapy: This combination of physical therapy and acupuncture has been shown to be very effective with virtually no side effects.
- Opiate Therapy: Some doctors can prescribe opiates for pain management. While its role is limited, and high doses of opiates are never appropriate for chronic pain, there is a small place for opiate therapy in chronic pain. In fact, opiates over a prolonged period of time can actually make the chronic pain worse.
- Epidural Injections: These anti-inflammatory medications will provide short term relief, but are rarely effective and rarely give long-term relief to most chronic pain syndromes.
As you can see, there are usually no easy solutions to chronic pain. There are no magic bullets. Usually the most effective approach is a multi-disciplinary approach oftentimes using a well-trained, experienced physician, physical therapy, occupational therapy, medication, and alternative therapy.
Does Alternative Therapy Work for Chronic Pain?
Epidemiological evidence demonstrates that acupuncture is highly effective for the treatment of most types of pain, especially low back pain and cervical spine pain. The proof is in the fact that acupuncture has been used for over 5,000 years in billions of patients. Alternative medicine that is built on gimmicks and quackery quickly falls by the wayside because over a period of time, people realize they do not work.
Acupuncture stands the test of time, and in fact, is being implemented, in part, into many medical school curriculums and training programs.
How do You Choose a Chronic Pain Doctor?
Choosing the correct doctor can be a daunting task. One wants a doctor who is patient, trained, and experienced in treating patients with chronic pain syndromes. A great pain management doctor should be:
- Up-to-date with all of the clinical research on the different modalities for treating chronic pain.
- Board certified by one of the certification boards in pain management and attend multiple pain management seminars throughout the year.
- Able to spend a minimum of one hour with you, taking a careful history of your pain and provide you with a good physical examination.
Doctor Joseph T. Hayes is the Medical Director of the Hayes Pain Management Center in Pennsylvania. For more information, you can contact Dr. Joseph T. Hayes here.