RSD In the News : FWD: RSD World News- Reclaiming your Life In Spite of Chronic Pain

RSD In the News : FWD: RSD World News- Reclaiming your Life In Spite of Chronic Pain
Choose another message board
Prev Discussion Next Discussion Delete

Reply
Recommend Delete Message 1 of 1 in Discussion

From: byrd45 (Original Message) Sent: 4/30/2005 1:46 PM
Original Article:
http://www.mayoclinic.com/invoke.cfm?id=PN00048
Reclaiming your life in spite of chronic pain

When you get injured or have surgery, you expect to hurt for a while,
but you know that in time, you'll heal and the pain will leave. If you
have a medical condition - from arthritis to heart disease to shingles
- you recognize discomfort as a symptom and trust that treatment will
help. While you wait for your body to mend, pain medication provides
relief.

Chronic pain is different. Sometimes, it's an aftereffect of an injury
that appears to have healed. Sometimes, it's a lingering symptom of a
past illness. And in some cases, chronic pain develops out of the
blue, with no link to trauma or disease. However you try to explain
it, chronic pain is something of a mystery. Tests and examinations may
uncover nothing abnormal, but your body's distress is real.

Over time, physical pain takes an emotional toll, making your body
hurt even more. Anxiety magnifies unpleasant sensations, and sleep
problems leave you feeling weak and helpless.

Persistence, poor response to treatment, unknown cause, sleep
disruption and emotional fallout - these are the hallmarks of chronic
pain. And the longer you've had it, the less likely it will be to
disappear, whatever you do. But chronic pain doesn't have to rule your
life. Here's how to take control.
Find the right care

If you've been going from doctor to doctor, now's the time to settle
on one and build a good relationship. The right doctor could be a
family physician or a specialist with expertise in your underlying
condition - for instance, a rheumatologist if you're dealing with
arthritis or a physical medicine expert (physiatrist) if you have back
pain.

Or you may want to work with a pain management specialist. If you have
a primary doctor, he or she may be able to refer you to one.
Otherwise, major hospitals and multispecialty group practices are
likely to have pain management specialists on staff. If a hospital has
a pain clinic, you can find a pain specialist there. If not, check
with the hospital departments that may have a pain management
component - physical medicine, anesthesiology and psychiatry.

When selecting a pain specialist, look for someone who:

* Is knowledgeable about chronic pain
* Wants to help
* Listens well
* Makes you feel at ease
* Encourages you to ask questions
* Seems honest and trustworthy
* Allows you to disagree
* Is willing to talk with your family or friends
* Has a positive attitude toward life and your condition

Even if you're working with a pain specialist, you need a primary
doctor to manage your overall health. Keep both doctors informed about
the details of your condition, and make sure they both have access to
all your records. It's particularly important for every doctor you
consult to know what pain medication you're on, who's prescribing it
and what, if any, additional drugs you take for other reasons. Sharing
this information reduces the risk that you'll accidentally overdose on
pain medication or experience a dangerous drug interaction. Once your
pain is under control and you're on a stable regimen of medications,
your primary care doctor can provide ongoing prescriptions.
Take back your life

When you have chronic pain, it can dominate your thinking, sometimes
in ways that aren't obvious. To become informed about your condition,
for instance, you may spend a lot of time monitoring pain-related
publications and Internet newsgroups. Of course it's important to
understand what's happening to your body and perhaps connect with
people who have similar problems. But constantly reading and talking
about pain keeps you focused on what's wrong when you could be finding
ways to build on everything that's still right.

How can you shift your focus? Start by setting simple, measurable,
reasonable and attainable goals. Think about times when your pain has
gotten out of control, and figure out how to keep it from overwhelming
you again.

For instance, if you often have to take extra doses of pain medication
at night because you've forgotten to take a scheduled dose during the
day, ask your doctor about changing your dosing schedule or otherwise
simplifying your regimen. Then set a goal of using your medication
exactly as prescribed for two weeks, with the understanding that
you'll call your doctor if problems arise.

Once you've gone two weeks on a stable regimen, make it your next goal
to stick to the schedule for two more weeks, then for four. In time,
these simple steps will add up to a big change. You'll have
established one of the most important parts of an overall pain
management plan, perhaps for the first time since you developed a pain
condition. Now you can move on to new goals.

Another example: Your back pain is as bad as ever, and your doctor
says it will stay that way unless you do a simple set of exercises at
least once a day. You're embarrassed to admit it, but you've never
been able to complete the exercises without getting short of breath
and making your stiff knee act up.

In this complicated situation, you might burden yourself with an
unrealistic goal - get on the stick and do the exercises, for
instance. But here's an attainable goal: Come clean with your doctor.
Exercises for back pain should not leave you breathless. If they do,
you need your doctor's help to find out why and take care of the
problem. Another goal might be to ask for a referral to a physical
therapist or exercise trainer who'll show you the best techniques for
strengthening your back muscles without straining anything else.

In both examples, the process is the same. You identify an obstacle
that prevents you from taking a step toward feeling better. Then you
find a way around the obstacle and go on to the next challenge.
Make further progress

Many other habits and thought patterns may contribute to a constant
struggle with pain. When you identify these contributors, you can get
busy neutralizing them by setting and reaching new goals. Some
possible targets:

* Irregular sleep, such as napping in the evening and staying
awake most of the night
* Unhealthy food choices
* Smoking
* Drinking alcohol
* Using recreational drugs

After months or years of nearly constant pain, you may have developed
habits known as "pain behaviors." You express pain in your movements,
facial expressions, words and tone of voice, often without even
realizing it. Occasionally, you complain directly about your pain, and
you avoid normal activities out of fear that they'll make you hurt
more. Unfortunately, the time you spend resting and protecting painful
areas actually does more harm than good.

The other problem with pain behavior is the sense of helplessness it
gives you and conveys to the people around you. If your display of
pain makes your spouse and children less demanding - and perhaps even
more caring - it's only natural that you'll be less inhibited about
letting discomfort show. You may come to believe that unless you're
suffering, you don't deserve their attention and consideration.

No one sets out to follow this pattern, but it often emerges, and
getting out of it takes a lot of self-awareness and emotional
strength. Family and individual counseling may be helpful. If you can
identify and isolate specific pain behavior, such as staying in bed
for much of the day, you may benefit from setting and reaching goals
that address that behavior one step at a time.
Take control

All your planning and goal setting should have one overarching aim -
to put chronic pain in its place. You don't want it and you don't
deserve it, but it's there. You could let it disrupt your career and
damage your relationships. Or you could learn new ways of coping that
keep it in check and free you to enjoy the full life you're entitled
to have.

Changing won't be easy. No habit - whether it's a way of thinking or a
behavior - yields to will without a struggle.

To gain control, you'll have to take a clear-eyed look at how pain has
distorted your feelings. That soul-searching, in itself, might be
painful. And even when you've largely gotten the better of chronic
pain, you'll still have bad days and still occasionally feel overwhelmed.

But if you persist in your efforts and get support from friends,
family members and trusted medical personnel, your overall outlook
will improve. You may not conquer chronic pain, but you can learn to
see it as an unpleasant circumstance that sometimes requires
accommodation but never threatens your spirit or dominates your life.


By Mayo Clinic staff

PN00048

June 17, 2004