Archive for the ‘ Pain ’ Category
Pain: Real Life Story – The Pain of It All
The pain of it all
 Cari Weaverling keeps up with her two sons, Tony, left, and D.J. Leate as the pair explore Woodland Park. Weaverling suffers with fibromyalgia and has widespread, chronic pain. She exercises, goes to physical therapy and takes pain medication, but still is always tired. “People say they understand. They don’t understand,” she said. “I can’t go out and play with my kids, just kick a ball with my kids. It’s heart-wrenching.” Karen Nichols/Daily Inter Lake |
For those in the Flathead who suffer chronically, Kalispell clinic offers treatment, hope for healing
Sam Bussey just rolled his ankle.
The rural Kalispell man was a railroad brake conductor in Wyoming two years ago, just walking on the rocks and gravel that held the track.
His right foot came down wrong.
His ankle twisted — radically hard, 90 degrees to the side.
It was a dime-a-dozen misstep that led to a lifetime of crippling pain.
A ghost-like vise-grip feeling constantly crushes the top and arch of his foot. The inside of his ankle sometime feels like exploding. His brain keeps telling him that a knife is stuck in his shin. His foot is purple and red most of the time.
Sometimes, everything feels like it’s on fire — even after four operations.
“I fell pain all the time, but the levels vary in intensity,” the 41-year-old former Kalispell businessman said.
When a doctor or nurse asks a patient about pain, the answer is typically described on a scale of 1 to 10.
Bussey’s pain floats between 4 and 6, with occasional spikes up to 9. Shortly after his accident, he sometimes hit a 10.
He can’t do much except mostly sit at home, and endure, and go stir crazy.
“I always used to think I was a tough guy until this happened. … it sucks. I wouldn’t wish it on anybody. It’s hard to concentrate,” Bussey said.
Some nerves between his ankle and spine won’t shut off. They keep going and going and going in a fired-up pain mode — never stopping.
The condition is called reflex sympathetic dystrophy — frequently triggered by a traumatic event to the body for reasons that aren’t really understood.
It wrecked Bussey’s life.
He can’t work. He lives with his parents. He can barely drive, but doesn’t want to risk it. He frequently can’t fall asleep. He can’t even tightly lace up the shoestring on his right tennis shoe.
It’s maddening.
He has tried physical therapy, injections into the spine and pain medication. He currently takes 20 to 25 pills of a half dozen prescriptions a day.
Bussey felt alone and guilty because he could tell that others looked at him funny, wondering what in the hell he was complaining about.
Last year, an orthopedic surgeon referred him to the Northwest Spine & Pain Center in Kalispell.
About six months ago, the center provided Bussey with a handheld spinal stimulator that he can hold up to a electronic receiver in his lower back. It can decrease the pain when it gets too intense.
The clinic also supplied him with cautious hope — and the realization he was not alone.
Bussey’s goal: Get well enough that he can work again.
Dr. Keith Lara used to be an emergency-room doctor.
The pace was wham-bam-bam-bam.
Stop the bleeding. Stabilize the injuries. Save the lives. Move on to the next patient.
Quick thinking and sure hands counted. Empathy and touchy-feely stuff took a back seat.
Then the 57-year-old doctor ended up in a plane wreck.
Nerve damage turned his right thumb numb and permanently stiffened a couple of fingers. Lara couldn’t work effectively in an emergency room any more.
And his hand hurt really badly for a long time — something that rocked Lara out of his world and into the world of chronic pain medicine. He took pain medication and went through physical therapy.
His new world included leaving emergency medicine and joining the Northwest Spine & Pain Center several months ago.
It’s a world where he stays with individual patients for many months, instead of saying hello and good-bye in one shift.
Patience became more important than speed. Symptoms and causes became fuzzier. Answers were no longer black-and-white.
Dr. Pam Roberts is one of the physicians at the Northwest Spine & Pain Center.
Roberts, 54, is a family physician who began noticing in 1987 that many women patients had chronic pain symptoms — nonstop tension and headaches — and would not talk about them.
She became fascinated with the subject and explored it, gradually focusing more of her practice on it, moving 18 months ago to the Northwest Spine & Pain Center.
In the human body, pain is a warning system that something is wrong.
Chronic pain means the hurting won’t go away after a typical healing period — frequently for reasons that are difficult to find.
Much about chronic pain is a puzzle.
Consequently, chronic pain patients often go from doctor to doctor — searching for answers, or even someone who understands what they are going through, Roberts said.
One result is that patients often end up at the Northwest Spine & Pain Center a long time after their symptoms first appear. The center has worked on speeding up referrals to it.
Until recent years, drugs were the standard procedure to deal with chronic pain.
Now, treatments for chronic pain have branched into combinations of medicine and psychology.
“We have to be holistic in approaching pain,” Roberts said. “We are emotional, physical and spiritual beings, and can’t really separate that.”
Besides doctors and nurses, the Northwest Spine & Pain Center also has a psychologist and social workers.
The psychological aspects need to be treated as aggressively as the medical factors, said David Segerstrom, a licensed clinical social worker at the center.
There are several psychological relaxation techniques — which mostly create mental vacations from pain, taking the mind somewhere else.
Attitude adjustments frequently are needed: learning patience, accepting pain’s impacts, knowing that a lifestyle might have to change, and new yardsticks of measuring self-worth might be needed.
No silver bullets exist.
Clear-cut remedies are rare. Mental, physical and medical cures must be mixed and matched. Improvements can take months and years.
“You just chisel away at it,” Lara said.
Roberts said: “If they can think of something other than their pain, then we’re winning the battle.”
Cari Weaverling feels that very few understand what she is going through.
An auto accident hurt her back 14 years ago when she was 17. She had surgery.
And Weaverling, 31, developed fibromyalgia.
Fibromyalgia is a puzzling ailment. No one knows what causes it. Sometimes, the cause could be genetic. Sometimes, a trauma — such as a traffic accident — can trigger it.
Symptoms are widespread chronic pain, ultra-sensitivity to even light touching, and fatigue that sometimes sleep cannot remove.
The American College of Rheumatology says fibromyalgia affects 2 to 4 percent of the population, mostly women.
Roberts was diagnosed with fibromyalgia in 1994. Roberts also suffers from rheumatoid arthritis, an immune disorder that causes a burning pain in joints, and osteoarthritis, which causes moving joints to hurt — all which increased her interest in and empathy for chronic pain patients.
Weaverling constantly hurts all over — some days worse than others. The strongest stabbing pain moves about her body. On the 1-to-10 scale, the pain can range from a 3 to a 10. Doing things is exhausting. Weaverling always is tired.
“Emotionally, it’s draining,” said the wife and mother of two boys, ages 6 and 7.
“People say they understand. They don’t understand. I can’t go out and play with my kids, just kick a ball with my kids. It’s heart-wrenching,” she said.
Weaverling exercises and goes to physical therapy. She takes pain pills, fretting that others will see something wrong with that.
She always wears a fentanyl patch on her body, routinely moving it from one part to another. Fentanyl is a pain-killing drug that enters the body and then the bloodstream.
Weaverling’s family moved from Oregon to Evergreen last year, which is when she hooked up with the Northwest Spine & Pain Center.
“They treated me like a human. I wasn’t some sort of drug addict. They realized what was happening to me,” Weaverling said.
Like Bussey, Weaverling is very cautiously optimistic.
“My ultimate goal is not to be on meds for the rest of my life,” she said.
“Chronic pain has a stigma to it because people don’t believe it’s real,” said Dr. Tristan Sophia, the center’s psychologist.
Common perceptions of pain are that it will go away, Sophia and Segerstrom said.
The socially acceptable way to deal with pain is to gut it out without much help and without whining. “You’re expected to ‘cowboy up,’” Segerstrom said.
Chronic pain patients often feel ashamed, isolated with gloomy moods, low energy and poor appetite.
Depression is common, Sophia said.
“They feel they’re not being listened to. They feel they’re not being believed. There’s incredible frustration there. … Everything is affected. They can’t think of anything in life but pain,” Sophia said.
However, Sophia is aware of only one patient who has apparently given up on getting better. The rest don’t expect miracles, but they cling to hope.
Sophia said: “The human spirit is amazing.”
An anti-depressant, Cymbalta, recently has neutralized much of the chronic pain that Bill Ludwig endured for about 20 years.
Ludwig, 77, the retired principal of Trinity Lutheran School in Kalispell, has been a diabetic for 40 years.
Twenty years ago, diabetic neuropathy hit Ludwig.
Roughly once a week, intense hammering and throbbing pain would hit the nerves of one of his ankles and feet — alternating between legs.
Each attack would last roughly 24 hours. During an attack, Ludwig couldn’t sleep at night. During the day when he was a principal, an attack would lay him up in his office. He and the staff just worked around the attacks.
“You’re in such pain, you can’t even hold a conversation,” Ludwig said.
Nothing but 24 hours of time could stop each attack.
Ludwig and his wife loved to travel — especially to ancient historical sites in Europe, Israel and Syria. The diabetic neuropathy hampered those trips.
“I’ve been praying for decades: ‘Lord, let them come up with something,’” he said.
Then researchers found that the anti-depressant Cymbalta can neutralize pain from diabetic neuropathy.
Ludwig began taking Cymbalta last December.
He still gets an occasional intense pain attack — only now several weeks separate each bout.
“When I went seven weeks without pain, it was paradise.”
Reporter John Stang may be reached at 758-4429 or by e-mail at jstang@dailyinterlake.com
Pain – Your Options: Pain Management for Children With Chronic Illnesses
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Introduction |
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Distraction |
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Message |
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Heat |
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Relaxation Techniques |
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Therapy |
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Medication Management |
Introduction
As a parent, you want to protect you children from everything that can harm them. You teach them not to talk to strangers. You make them look both ways before they cross the street. But sometimes there are unfortunate things that you, as parent, cannot keep your child from experiencing. Unfortunately, chronic pain is something that many children endure.
Illnesses that involve chronic pain affect children around the world. As a parent, you may feel helpless to support your child through pain flare-ups. You wish you could kiss the pain away, and make it all better. Although that may not be possible, there are some things that you can do to help your child get through painful episodes.
Distraction
This is a commonly used strategy that can help a child get through a painful episode. The type of distraction you would use depends upon your child’s interests. If your child likes music, art, reading, television, talking on the telephone, or other activities, then you could encourage your child to practice these activities during painful episodes. The ability of the mind to focus on an activity rather than on pain is powerful. The same distraction technique may not work all of the time, and it is okay to try different techniques with your child, until there is one that your child enjoys and is willing to participate in.
Massage
During some periods of pain, massaging the area of the body that is affected can help ease the discomfort. There are some massage techniques that can be used by the parent and the child that can help relieve pain. These techniques can be taught to the parent by a trained massage therapist, so that massages can be done at home. Some hospitals have massage therapists on staff who can teach parents how to effectively massage children at home. Check with your local medical facility to see if this service is offered.
Heat
First check with child health care provider and confirm that using heat would be okay to try with your child. Applying a heat source such as a heating pad to the part of the body that is in pain can be beneficial to the child. Every child is different, as is every situation – some children may not like this technique, whereas other children will find relief from it. Heat can be applied using a heat pack, warm bath, or a whirlpool which has the added benefit of the water moving and providing a stimulation that is similar to a light massage.
Relaxation Techniques
There are a number of relaxation techniques that can be used to help children manage their pain. Guided imagery, progressive muscle relaxation, and music therapy are some examples of relaxation techniques that can assist a child with pain management. These techniques can be taught to the family by trained professionals. Check with your medical center to see if these services are offered.
Therapy
Unfortunately, a child suffering from chronic pain may also experience both physical and emotional stress. If a child has a painful disease, the child can become afraid of experiencing pain and discomfort. For some children, the repeated cycle of experiencing pain can lead to anxiety and depression.
A child may not want to participate in some activities that they used to enjoy because they are afraid that they will experience pain and will not be able to enjoy the activity. Sometimes, a child may feel anxious about leaving a medical facility because they fear that they will experience pain, and not be near medical personnel who can help the child during the pain episode. This anxiety is not only seen in the children; parents can also share the same feelings. This anxiety may cause the parent or child to limit the child’s activities and take away from the child’s quality of life. If a child sees a parent getting anxious and becomes anxious, the parent may inadvertently reinforce the child’s feelings of anxiety. Therapy can help a family through such emotionally stressful times.
Therapists can help families learn coping skills that encourage focusing more on the child and less on the illness. This could lead to improvements in the child’s quality of life.
Medication Management
If your child receives treatment at a hospital, the hospital’s medical staff will consider possible treatments that are available to your child. Depending on the diagnosis, there could be many avenues of treatment to explore. In other cases, there may be precious few alternatives to treat your child’s illness. Whatever the case may be, as a parent, discuss any questions you may have with the medical team that treats your child. Do not be afraid to ask questions for fear of it being perceived as a “stupid” question. Or if you have asked the question already, but did not understand the answer, ask again, until you have an answer that you understand.
Regarding pain medicine prescribed for your child, some medications may be given while the child is in the hospital, and some may have to be administered at home. A parent should know the proper dose of medications, and the number of times the child would need to take it. If your child is old enough, begin teaching your child about their medications – the dosage and purpose of the medication, etc.
Also, If you child has any allergies, make sure your child has those memorized! Being knowledgeable about your child’s medications is a key component of pain management. Knowing which medications work best for your child and any adverse effects that medications may have caused will help the medical staff determine the best treatment plan for you child.
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Pain Special Events/Observances
September 1-30, 2006
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Pain Awareness Month - The American Society of Pain Educators (ASPE) will launch a month-long calendar of educational events focused on pain management education for healthcare providers during Pain Awareness Month, September 2006. Demonstrating its commitment to improving pain management through education the ASPE will present an unprecedented month of educational activities; dinner meetings and live, web-based events with key opinion leaders speaking about a multiplicity of pain management-related topics. Register today and demonstrate your commitment to helping your patients achieve better health outcomes! Visit www.painawareness.org or call 888-ASPE-REG. |
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September 6-9, 2007
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Pain Week - Pain Week 2007 is a national conference Organizations and corporations interested in partnership |
Pain Tip Sheet – Arthritis, Exercise, and Treatment
There are over 100 forms of arthritis and other rheumatic diseases. These diseases may cause pain, stiffness, and swelling in joints and other supporting structures of the body such as muscles, tendons, ligaments, and bones. Some forms can also affect other parts of the body, including various internal organs.
Many people use the word “arthritis” to refer to all rheumatic diseases. However, the word literally means joint inflammation; that is, swelling, redness, heat, and pain caused by tissue injury or disease in the joint. The many different kinds of arthritis comprise just a portion of the rheumatic diseases. Some rheumatic diseases are described as connective tissue diseases because they affect the body’s connective tissue–the supporting framework of the body and its internal organs. Others are known as autoimmune diseases because they are caused by a problem in which the immune system harms the body’s own healthy tissues. Examples of some rheumatic diseases are:
- Osteoarthritis
- Rheumatoid arthritis
- Fibromyalgia
- Systemic lupus erythematosus
- Scleroderma
- Juvenile rheumatoid arthritis
- Ankylosing spondylitis
- Gout
In this article, the term arthritis will be used as a general term to refer to arthritis and other rheumatic diseases.
Should People With Arthritis Exercise?
Yes. Studies have shown that exercise helps people with arthritis in many ways. Exercise reduces joint pain and stiffness and increases flexibility, muscle strength, cardiac fitness, and endurance. It also helps with weight reduction and contributes to an improved sense of well-being.
How Does Exercise Fit Into a Treatment Plan for People With Arthritis?
Exercise is one part of a comprehensive arthritis treatment plan. Treatment plans also may include rest and relaxation, proper diet, medication, and instruction about proper use of joints and ways to conserve energy (that is, not waste motion) as well as the use of pain relief methods.
What Types of Exercise Are Most Suitable for Someone With Arthritis?
Three types of exercise are best for people with arthritis:
- Range-of-motion exercises (e.g., dance) help maintain normal joint movement and relieve stiffness. This type of exercise helps maintain or increase flexibility.
- Strengthening exercises (e.g., weight training) help keep or increase muscle strength. Strong muscles help support and protect joints affected by arthritis.
- Aerobic or endurance exercises (e.g., bicycle riding) improve cardiovascular fitness, help control weight, and improve overall function. Weight control can be important to people who have arthritis because extra weight puts extra pressure on many joints. Some studies show that aerobic exercise can reduce inflammation in some joints.
Most health clubs and community centers offer exercise programs for people with physical limitations.
How Does a Person With Arthritis Start an Exercise Program?
People with arthritis should discuss exercise options with their doctors and other health care providers. Most doctors recommend exercise for their patients. Many people with arthritis begin with easy, range-of-motion exercises and low-impact aerobics. People with arthritis can participate in a variety of, but not all, sports and exercise programs. The doctor will know which, if any, sports are off-limits.
The doctor may have suggestions about how to get started or may refer the patient to a physical therapist. It is best to find a physical therapist who has experience working with people who have arthritis. The therapist will design an appropriate home exercise program and teach clients about pain-relief methods, proper body mechanics (placement of the body for a given task, such as lifting a heavy box), joint protection, and conserving energy.
Pain Relief Methods for People With Arthritis
There are known methods to help stop pain for short periods of time. This temporary relief can make it easier for people who have arthritis to exercise. The doctor or physical therapist can suggest a method that is best for each patient. The following methods have worked for many people:
- Moist heat supplied by warm towels, hot packs, a bath, or a shower can be used at home for 15 to 20 minutes three times a day to relieve symptoms. A health professional can use short waves, microwaves, and ultrasound to deliver deep heat to noninflamed joint areas. Deep heat is not recommended for patients with acutely inflamed joints. Deep heat is often used around the shoulder to relax tight tendons prior to stretching exercises.
- Cold supplied by a bag of ice or frozen vegetables wrapped in a towel helps to stop pain and reduce swelling when used for 10 to 15 minutes at a time. It is often used for acutely inflamed joints. People who have Raynaud’s phenomenon should not use this method.
- Hydrotherapy (water therapy) can decrease pain and stiffness. Exercising in a large pool may be easier because water takes some weight off painful joints. Community centers, YMCAs, and YWCAs have water exercise classes developed for people with arthritis. Some patients also find relief from the heat and movement provided by a whirlpool.
- Mobilization therapies include traction (gentle, steady pulling), massage, and manipulation (using the hands to restore normal movement to stiff joints). When done by a trained professional, these methods can help control pain and increase joint motion and muscle and tendon flexibility.
- TENS (transcutaneous electrical nerve stimulation) and biofeedback are two additional methods that may provide some pain relief, but many patients find that they cost too much money and take too much time. In TENS, an electrical shock is transmitted through electrodes placed on the skin’s surface. TENS machines cost between $80 and $800. The inexpensive units are fine. Patients can wear them during the day and turn them off and on as needed for pain control.
- Relaxation therapy also helps reduce pain. Patients can learn to release the tension in their muscles to relieve pain. Physical therapists may be able to teach relaxation techniques. The Arthritis Foundation has a self-help course that includes relaxation therapy. Health spas and vacation resorts sometimes have special relaxation courses.
- Acupuncture is a traditional Chinese method of pain relief. A medically qualified acupuncturist places needles in certain sites. Researchers believe that the needles stimulate deep sensory nerves that tell the brain to release natural painkillers (endorphins).
- Acupressure is similar to acupuncture, but pressure is applied to the acupuncture sites instead of using needles.
How Often Should People With Arthritis Exercise?
- Range-of-motion exercises can be done daily and should be done at least every other day.
- Strengthening exercises should be done every other day unless you have severe pain or swelling in your joints.
- Endurance exercises should be done for 20 to 30 minutes three times a week unless you have severe pain or swelling in your joints. According to the American College of Rheumatology, 20- to 30-minute exercise routines can be performed in increments of 10 minutes over the course of a day.
What Type of Strengthening Program Is Best?
This varies depending on personal preference, the type of arthritis involved, and how active the inflammation is. Strengthening one’s muscles can help take the burden off painful joints. Strength training can be done with small free weights, exercise machines, isometrics, elastic bands, and resistive water exercises. Correct positioning is critical, because if done incorrectly, strengthening exercises can cause muscle tears, more pain, and more joint swelling.
Are There Different Exercises for People With Different Types of Arthritis?
There are many types of arthritis. Experienced doctors, physical therapists, and occupational therapists can recommend exercises that are particularly helpful for a specific type of arthritis. Doctors and therapists also know specific exercises for particularly painful joints. There may be exercises that are off-limits for people with a particular type of arthritis or when joints are swollen and inflamed. People with arthritis should discuss their exercise plans with a doctor. Doctors who treat people with arthritis include rheumatologists, orthopaedic surgeons, general practitioners, family doctors, internists, and rehabilitation specialists (physiatrists).
How Much Exercise Is Too Much?
- Unusual or persistent fatigue
- Increased weakness
- Decreased range of motion
- Increased joint swelling
- Continuing pain (pain that lasts more than 1 hour after exercising)
Should Someone With Rheumatoid Arthritis Continue To Exercise During a General Flare? How About During a Local Joint Flare?
It is appropriate to put joints gently through their full range of motion once a day, with periods of rest, during acute systemic flares or local joint flares. Patients can talk to their doctor about how much rest is best during general or joint flares.
Are Researchers Studying Arthritis and Exercise?
Researchers also are looking at the effects of muscle strength on the development of osteoarthritis. Studies show, for example, that strengthening the quadriceps muscles can reduce knee pain and disability associated with osteoarthritis. One study shows that a relatively small increase in strength (20-25 percent) can lead to a 20-30 percent decrease in the chance of developing knee osteoarthritis. Other researchers continue to look for and find benefits from exercise to patients with rheumatoid arthritis, spondyloarthropathies, systemic lupus erythematosus, and fibromyalgia. They are also studying the benefits of short- and long-term exercise in older populations.
Resources
National Institute of Arthritis and Musculoskeletal and
Skin Diseases Information Clearinghouse
National Institutes of Health
1 AMS Circle
Bethesda, MD 20892-3675
Phone: 301-495-4484 or 877-22-NIAMS (226-4267) (free of charge)
TTY: 301-565-2966
Fax: 301-718-6366
http://www.niams.nih.gov/
The clearinghouse provides information about various forms of arthritis and rheumatic disease and bone, muscle, and skin diseases. It distributes patient and professional education materials and refers people to other sources of information. Additional information and updates can also be found on the NIAMS Web site.
American Academy of Orthopaedic Surgeons
P.O. Box 2058
Des Plaines, IL 60017
Phone: 800-824-BONE (2663) (free of charge)
www.aaos.org
The academy publishes brochures on arthritis and other subjects. Single copies of a brochure are available free of charge by sending a self-addressed, stamped (business-size) envelope to (name of brochure) at the address above.
American College of Rheumatology
1800 Century Place, Suite 250
Atlanta, GA 30345
Phone: 404-633-3777
Fax: 404-633-1870
www.rheumatology.org
This association provides referrals to doctors and health professionals who work on arthritis, rheumatic diseases, and related conditions. The association also provides educational materials and guidelines.
American Physical Therapy Association
1111 North Fairfax Street
Alexandria, VA 22314-1488
Phone: 703-684-2782 or 800-999-2782, ext. 3395 (free of charge)
www.apta.org
The association is a national professional organization representing physical therapists, allied personnel, and students. Its objectives are to improve research, public understanding, and education in the physical therapies.
Arthritis Foundation
1330 West Peachtree Street
Atlanta, GA 30309
Phone: 404-872-7100 or 800-283-7800 (free of charge) or
call your local chapter (listed in the telephone directory)
www.arthritis.org
This is the major voluntary organization devoted to arthritis. The foundation publishes a free pamphlet on exercise and arthritis and a monthly magazine for members that provides up-to-date information on all forms of arthritis. Local chapters organize exercise programs for people who have arthritis, including People with Arthritis Can Exercise (PACE) and an aquatic exercise program held in swimming pools. The foundation also can provide physician and clinic referrals.
PACE Catalog Center
Arthritis Foundation
P.O. Box 9020
Pittsfield, MA 01202-9945
Phone: 800-PACE-236 (722-3236) (free of charge)
This center sells PACE exercise videotapes at two levels, basic and advanced. Each videotape is approximately 30 minutes long and includes a warm-up section, a gentle or moderate exercise routine, and a rhythmic movement sequence to help improve endurance. The videotapes are available for $19.50 per tape, plus shipping charges.
Lupus Foundation of America (LFA)
1300 Piccard Drive, Suite 200
Rockville, MD 20850
Phone: 301-670-9292 or 800-558-0121 (free of charge)
www.lupus.org
This is the main voluntary organization devoted to lupus. It also provides information on arthritis and exercise.
S.L.E. Foundation
330 Seventh Avenue, Suite 1701
New York, NY 10001
Phone: 212-685-4118
www.lupusny.org
This foundation supports and encourages medical research to find the cause and cure of lupus and improve its diagnosis and treatment. It also provides information on arthritis and exercise.
National Fibromyalgia Partnership, Inc.
140 Zinn Way
Linden, VA 22642-5609
Phone: 866-725-4404 (free of charge)
Fax: 540-622-2998
E-mail: mail@fmpartnership.org
www.fmpartnership.org
This organization devoted to fibromyalgia provides information on arthritis and exercise.
Spondylitis Association of America (SAA)
P.O. Box 5872
Sherman Oaks, CA 91413
Phone: 818-981-1616 or 800-777-8189 (free of charge)
http://www.fmpartnership.org
This nonprofit, voluntary organization helps people who have ankylosing spondylitis and related conditions. SAA sells books, posters, videotapes, and audiotapes about exercises for people who have arthritis of the spine.
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About Pain
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Introduction |
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Acute Pain |
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Chronic Pain |
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A Symptom of Many Diseases |
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Talking to Your Doctor About Pain |
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How Social Workers Can Help |
Introduction
Throbbing, burning, aching, stinging–the terms patients use to describe pain are often different because pain is personal and subjective and influenced by age, gender, race/ethnicity, and psychosocial factors. The International Association for the Study of Pain defines it as an unpleasant experience associated with actual or potential tissue damage to a person’s body.
There are two basic forms of physical pain: acute and chronic.
Acute Pain
Acute pain, for the most part, results from disease, inflammation, or injury to tissues. It is immediate and usually of a short duration. Acute pain is a normal response to injury and may be accompanied by anxiety or emotional distress. The cause of acute pain can usually be diagnosed and treated.
Chronic Pain
Chronic pain is continuous pain that persists for more than 3 months, and beyond the time of normal healing. It ranges from mild to severe and can last weeks, months, or years to a lifetime. The cause of chronic pain is not always evident, although it can be brought on by chronic conditions such as arthritis and fibromyalgia. Chronic pain can often interfere with a patient’s quality of life, sleep, and productivity.
A Symptom of Many Diseases
Pain often accompanies diseases of the bones, muscles, joints, and skin, which affect millions of Americans. Most of these diseases are chronic and may cause lifelong pain. In certain cases, such as with some rheumatic diseases, the sources of pain may include inflammation of the synovial membrane (tissue that lines the joints), the tendons, or the ligaments; muscle strain; and muscle fatigue. A combination of these factors contributes to the intensity of the pain. Muscle inflammation characterizes other painful disorders such as polymyositis (characterized by inflamed and tender muscles throughout the body, particularly those of the shoulder and hip) and dermatomyositis (characterized by patchy red rashes around the knuckles, eyes, and other parts of the body, along with chronic inflammation of the muscles).
In other cases, such as with myofascial pain syndromes, the cause of the pain is unknown. Myofascial pain syndromes affect sensitive areas known as trigger points, located within the body’s muscles. It is important to consult with a physician to help determine the cause and treatment for your pain.
Talking to Your Doctor About Pain
Pain is managed by the patient and his or her health care providers. In order to help assess the cause and treatment for your pain, a doctor will usually do the following:
- Take your medical history
- Review any medications you are using
- Conduct a physical examination to determine the causes of pain and how this pain is affecting your ability to function
- Take blood and/or urine samples and request necessary laboratory work
- Ask you to have x rays taken or undergo other imaging procedures such as a CAT (computerized axial tomography) scan or MRI (magnetic resonance imaging)
There is no medical test that can convey the level of pain you are feeling. Only you can describe your pain. In order to provide an accurate description of your pain, it may be helpful to share the answers to the following questions with your doctor:
- How long have you had pain?
- Where is the pain located?
- Does the pain come and go or is it continuous?
- What makes the pain better or worse?
- Has the pain changed since your last visit with your doctor?
- What medications or treatments have you tried for the pain?
After you have been evaluated by your doctor, he or she will discuss the findings with you and design a comprehensive management plan for your pain. There are currently many treatment options available for pain, and scientists believe that research can help lead to more and better treatments for pain in the future.
How Social Workers Can Help
There are highly trained, licensed clinical social workers who expertise in pain management. They can help you locate resources for help, teach skills and strategies to enhance your life such as relaxation techniques and breathing exercises. They can also help you take your medicines correctly — taking the correct doses as scheduled. To find a licensed clinical social worker in your area, click here.
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Pain Current Trends – Eight Facts Everyone Should Know About Cancer Pain
Here is a list of some common cancer pain fears and the facts to help cancer patients and their families.
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Fear | Cancer Causes severe pain that cannot be relived. |
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Fact | Cancer can cause pain. For some, the pain can be severe. What’s important is that almost all cancer pain can be relieved. |
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Fear | Patients who take pain medicine will become addicted. |
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Fact | Addiction is a common concern, but in fact it rarelyoccurs in persons with cancer who take medicines for pain control. |
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Fear | When you use pain medicine your body becomes used to its effects pretty soon it won’t work anymore. |
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Fact | Pain medicines like morphine do not stop working even if they are taken for weeks, months, or longer. If pain increases, the dose of medicine can be increased as much as needed, or other medicines can be used. |
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Fear | If you talk about pain, people will think you’re a complainer. |
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Fact | Asking for pain relief is not “complaining.” Suffering in silence can wear patients down and make them less able to take part in treatments and daily life. |
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Fear | Talking about pain will distract your doctor from working ot cure your cancer. |
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Fact | Talking about pain will help the doctor provide the best care for the cancer. Pain can get in the way of sleep, rest, and meaningful activities, which are all important to quality of life and to the body’s ability to fight disease. |
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Fear | It’s easier to put up with pain than the side effects that come with pain medicines. |
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Fact | Pain medicines like morphine do cause side effects in some patients. Constipation is very common, and patients should ask their health care providers for advice on how to treat it. Nausea can be treated and will likely go away on its own in a few days |
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Fear | Pain Medicine will make you feel “out of it.” |
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Fact | Patients may feel drowsy or “out of it” for a few days after starting pain medicines like morphine. With continued, regular use of the medicine, this feeling will usually go away after a few days. |
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Fear | If your pain is relieved, you won’t know what’s going on with your cancer. |
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Fact | Pain is only one of the clues that tells what is going on with the cancer. Many other tests can be done. |
