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Say no to pain

» A multidisciplinary approach

» The fifth vital sign

Pain is part of the human experience—and fortunately, it is often fleeting. An aspirin will soon ease a headache, and a hot compress soothes a strained muscle.

But what happens when pain doesn’t go away? Whatever the source, chronic pain can disrupt sleep, work and eating habits. Persistent discomfort can lead to depression, affect your relationships and severely compromise the quality of your life. If your pain has lasted for more than three months with no relief, you need help from a pain-management specialist.

Chronic pain can be caused by a number of underlying problems such as postsurgical recovery, physical injury or a disease such as cancer. Some conditions are in and of themselves painful, such as migraines, neuropathy related to diabetes or herpes zoster (sometimes known as shingles).

However, not all pain is easily linked to a diagnosis. Laboratory and imaging tests for your condition may be negative, but that doesn’t mean your pain is imaginary. Your doctors should take seriously your perception of pain. Talk to your primary-care physician or specialist and ask for the intervention of a pain-management specialist. You don’t need to suffer in silence.

A multidisciplinary approach

When you are seen by pain-management experts (physicians and other healthcare specialists trained to deal with chronic pain), you’ll be evaluated to establish a cause, symptoms and related problems associated with your pain. Pain-management treatment is based on a multidisciplinary approach; that is, experts from different fields—anesthesiologists, nutritionists, physical therapists, even psychiatrists—may be called in to evaluate and coordinate the overall treatment approach. Here are some things they may recommend:

  • Immediate relief. The number-one concern is to immediately eliminate the pain stimulus by either medication, injections, epidurals or other anesthetic interventions. Even if this intervention is not curative, the pain cycle can be broken temporarily. This immediate relief can be an important part of your long-term management and provide a desperately needed boost to your morale.
  • Ongoing regimen of therapies. Working with the primary-care physicians and other specialists in your life, a pain-management expert will recommend an ongoing regime that can significantly reduce chronic pain. Frequent rounds of steroid injections may be the answer for some; other patients can benefit from a self-administered pump designed to increase pain medication when the patient feels it is necessary. Pain-management experts also may use ablative nerve blocks, implantable nerve stimulators, skin patches and biofeedback. Nonsteroidal anti-inflammatory drugs and certain psychotropic drugs such as antidepressants can have a definite impact on pain tolerances as well. Other approaches include physical therapy or acupuncture. Your options will be evaluated based on your particular medical history and condition.
  • Mental health and therapeutic support. Chronic pain can change your outlook on life and the way you deal with problems and relationships. Often, therapy and other mental-health interventions can provide an important avenue for coping and adjustment.
  • Better dialogue with your doctors. Traditionally, there has been a stigma associated with narcotics and pain medications, the worry being that they may lead to addiction. However, pain management specialists work with fellow healthcare professionals as well as the patient to counter that prejudice, dispel notions of addiction and see that no one stays in pain.

The fifth vital sign

More and more healthcare practitioners are viewing pain as a “fifth vital sign”—something that requires monitoring just as temperature, blood pressure, respiration and pulse rate do.

The Joint Commission on Accreditation of Healthcare Organizations, an organization that accredits hospitals and healthcare facilities, offers standards for monitoring a patient’s pain. These standards will encourage healthcare providers to focus on pain and should significantly improve its treatment for hospitalized patients.

Finally, pain management or palliative care, which means treating the symptoms without necessarily seeking a cure, is playing a big role in easing the terminally ill patient’s pain. Today’s experts have the medications and means to ensure that terminally ill patients can live out their days comfortably. Pain-management physicians can be called on to work with hospital, hospice and at-home patients to achieve that goal.


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