A website specializing in Lifestyle Modification of Chronic Non-Cancer Pain

If you still aren’t being treated with a combination drug/life style/habit modification program, you can use the following First Aid to help you begin to mold some control of the conditions of your pain’s occurrence.

1. If you have medication that has helped in the past, use it. Do not try to “Bear it.” It doesn’t work. Pain physicians in our program always tell patients that medication should not be taken as needed, because “you can’t chase pain – you’ll always be too late to catch pain before it goes over the top.” So our pain physicians recommend using a dose that would be in the background, not that makes you drowsy, but gives you the ability to function better than if you had taken no medication. Don’t forget, in a qualified pain program , the aim is to restore as much of your functionality as soon as possible so you can get back to working and leading as normal a life as possible.

2. Find a credentialed pain specialist fast:

(a) In larger cities, look up university hospitals; they often have pain programs.
(b) If not, look up Physicians, Anesthesiologists in your local area phone book and start calling until you find one who is Board Certified in pain management.
(c) If that fails, go to the American Board of Pain Medicine website and click on Diplomates. Type in your State, then click Specialty of Origin, and Anesthesiology. Then start calling them.
(d) As another option, go to the American Board of Anesthesiology website, and click on Verify a Physician’s Certification. Then type your City and State and click Search. Start calling them.

3. An assertive attitude is critical in this type of pain, so start working on it.  First stop the panic, it doesn’t help. I know the desperation one can feel when this pain starts climbing, I’m a chronic pain survivor. But panic just makes it worse. If you have no medications that help, then do what’s needed, go the Emergency Room. Take any medical records that you have that deal with your pain. If you don’t, you may be dealt with like an addict, especially depending on the extent of your state of panic. Next, do not go helpless. Your Body needs you, so take charge and get it the best help you can find. Helplessness adds other symptoms that you don’t need. You have take charge. Finally, if you’ve been seeing the same doctor for more than 3 months and you’ve gotten no noticeable increase in your functionality, you have to muster the courage to fire him and find one that is, first of all, qualified and will pursue your goal rather than your doctor’s personal goal. Just being polite with your doctor is not effective treatment for your pain. You need to be assertive (meaning, calming stating what you want, several times if needed, but calmly).  And, if a doctor who has been treating you for more than 3 months insults you or accuses you of being an addict and that doctor lacks any qualifications in pain management don’t be afraid to report him to his Medical Board for practicing outside of his area of practice for more than 3 months and not making an appropriate referral to a qualified pain doctor or pain rehab clinic.

4. Commonsense is also critical in any chronic disorder, use it. If you have a chronic low-back pain syndrome and sit for hours at your computer and your back hurts afterward,  get the point that your body is telling you, “Don’t allow yourself to be immobile for the amount of minutes that it takes for you to begin to feel the first signs of discomfort.” If you have to sit for long periods of time, be sure to have a gel-pack ready when you get back home. Prop up in a comfortable chair, put the gel-pack directly on the skin; it’s a bit painful at first, but in 5 minutes it’s wonderful, cheap, effective analgesia. Use it no more than 15 minutes. And, if you have burning pain, don’t use ice, it can make possible nerve pain worse.

5. Trial and success works; trial and error does not. Remember the details of what worked for you. You are the one who knows best what works for your specific pain, as it happens under specific conditions in your unique life situation, not a doctor, a spouse or a well-intentioned neighbor. Focus on conditions of your pain’s occurrence and what real-world conditions you have to create to get even a little bit of relief on a consistent basis. Don’t forget to screen your current doctor before you start going to just any doctor who says they’ll “try” to help you. Screen your doctor first. What you want is someone credentialed in pain management or pain medicine and who has extensive experience treating chronic non-cancer pain patients on an outpatient basis, and are not “interventionalists,” who put in the morphine pumps and the spinal column stimulators. Both of these treatments, including surgery, are strictly last resorts. If your goal is recuperating as much of your ability to function as possible, even pain doctors have to do more for you than just prescribe pain drugs to help you restore your ability to function, especially get back to work. Pain relieved by drugs alone does not guarantee restoration of function. So identify your goal, find a credentialed pain specialist and start screening them for demonstrated competence in chronic non-cancer pain. If you only have access to a doctor of general medicine, you must someone who is qualified to treat this type of pain. If you don’t, data indicate that your pain will get worse, and create an even broader range of problems for you than just pain. First Aid is what it is, an effort to relieve a crisis. And, for everything, however minor, that works, reinforce yourself with a, “Good job!”

6. Those who have experienced serious CNCP give the best advice. Talk to people with the same type of CNCP you have. Especially those whose break-through pain is very infrequent. Over years of trial-and-success, these types of pain patients will usually have good tips to give you. If your functionality, and pain relief, haven’t moved in 3 months, make an appointment with me for personal advice on an Online Pain Management Consultation.

Dr. Henry E. Adams

AAPM Diplomate in Pain Management