Chronic Pain Management - The Doctor-Patient Relationship
According to Dr. Mehmet Oz, we are in a pain renaissance. His piece as the cover story in Time Magazine deals not only with chronic pain, but with the way that chronic pain is perceived by physicians around the globe. As The Pain Center took on the critical relationship between a patient and pain physician with the latest Pain Channel episode, Time Magazine and Dr. Oz were working up an entire Health Special on Chronic Pain.
What Dr. Oz calls a "pain renaissance," we at The Pain Center have been experiencing for years. Chronic pain is not "just about your bad back or arthritic knee. People with chronic pain are twice as likely to suffer from depression and anxiety as those without….If pain affects body, mind and spirit, then treatment must address these three pillars of the human condition."
Many pain physicians are specialized in anesthesia and "pain management," but in today's chronic pain environment, that just doesn't cut it. In today's environment, where 76 million people, children, adolescence and adults, live with chronic pain, pain doctors must have specialized expertise in a variety of disciplines. For example, at The Pain Center of Arizona, pain doctors specialize in cancer pain, pain from fractures, nerve based pain, pediatric pain, chronic pain in African Americans, osteopathic medicine, CRPS pain, spinal cord stimulation, disc compression pain, neurological disorders, and much more. The days of simply specializing in "pain management" and relying on one physician are far gone.
Exercise and stretching can often help alleviate pain. Medications such as anti-inflammatories (the ibuprofen family), opioids and antidepressants are effective in the short term, but there are worries about long-term use. Pain-relief medication is one of the most abused areas of the pharmacopoeia. More extreme interventions — surgery, cortisone shots, nerve blockers and local anesthetics — should be explored as a last resort.
One of the best imports from Eastern medicine — acupuncture — comes from a time before ibuprofen and Bengay. Not everyone agrees on how acupuncture works, but physicians believe it activates endorphin systems, and many consider it a highly effective complementary therapy.<.blockquote>
Pain management involves a multidisciplinary team of experts, and a project manager (your pain physician) who can bring everyone together to reach a common goal. Today, the most important piece of that puzzle, however, is the doctor-patient relationship. As we've shown in our recent Pain Channel episode, the importance of a patient's relationship with their physician is above all the most essential and fundamental aspect of pain management.
According to Dr. Oz, physicians can predict a pain diagnosis related to injury but are otherwise working largely in the dark, reliant on patient narrative. When a patient feels comfortable enough to share intimate details of their pain, exactly what the pain feels like, when it occurs and where it occurs, a pain physician can better understand what the diagnosis might be.
This is where therapies such as yoga, acupuncture, and psychology play a key role. These forms of therapy can help to connect a person to their pain and help them become more aware of their body, thus enabling them to explain in more detail whether the pain is a burning or aching, a shooting or throbbing.
So what does the future hold? Some researchers are exploring the pain-control power of mind quieting and focusing techniques that athletes use to improve performance and that Buddhists preached thousands of years ago. Meditation may benefit chronic-pain sufferers by reducing the emotional impact of their condition. A settling, transcendent state puts the pain in perspective and helps it dwindle in importance. The American Chronic Pain Association (theacpa.org) has a five-minute relaxation exercise that can be effective at helping you let go of the physical stress that exacerbates pain.
As recently as 20 years ago, chronic pain was dismissed as purely psychological — a symptom of a greater mental problem — and it was treated with a terrible blitheness. But today we recognize that pain is a disease. I'm sure 20 years from now, increased understanding will result in even greater advances — and even greater relief. I love a good renaissance.
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