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Pain Management
What's pain management?
I constantly suffer of back pain, had surgery last year and continue to having, it's like the Doctor doesn't know what to do with me, so he referred me to "Pain Management" and I asked the other Doctor what that was, and he said "just to have another Doctor to prescribe medication for you" It's frustrating when Doctors don't have an answer...
I constantly suffer of back pain, had surgery last year and continue to having, it's like the Doctor doesn't know what to do with me, so he referred me to "Pain Management" and I asked the other Doctor what that was, and he said "just to have another Doctor to prescribe medication for you" It's frustrating when Doctors don't have an answer...
I want to thank you for your "book" written 7/29/10. I have just been referred for pain management myself for a herniated disk (L5-S1). I have been taking advil, but my pain level still reaches 9 and above. It can get so bad my leg just gives out. I have been rather nervous about this decision, so reading your post helped me feel better. I know the first thing is my doctor did request a cortizone shot since the swelling is affecting my core strength. I have been seeing a neuropsychologist for over 3 years for managing pain from fibromalgia and stress (which can trigger pain). I am hoping not to have to take anymore medication than I do already. I have also been on cymbalta and have started the process of weaning off of it. I have hope the pain managment will work. I would love to beable to do things again; get some sense of "life" back. Again thank you for such an informative post.
It was pretty interesting reading your comment, it caught my attention!! and very helpful... :)
You're welcome! Right after I hit the "post" button I realized I wrote a book and was afraid I may have scared you off. LOL! Sounds like you're on the right track and on your way to better living. :-)
The first time I was referred to pain management it took them six months to contact me. I hope that it does not take that long for you. I did not stay on my referring physician either. I kinda wish I handn't gone all those months just waiting. Over the course of the last few years I have learned to be my own advocate and have gotten much better about speaking up and making sure I'm being heard. Don't be afraid to call the doctor's office, find out who they are referring you to, have they made the referral, call the pain doc, find out if they've gotten your records... that kinda thing. Don't be too impatient. But do advocate for yourself if you find the process is taking too long. Good luck! I hope you get a wonderful physician who can help you.
Thank you!! Thank you so much!! You made my day! ;)
I still haven't been contacted by the Pain Management, so I don't know when my appointment is, but I sure will share my experience and let you guys know how it went.
I know I might never be completely pain free, but I am looking for ways to make my "pretty messed up back" feel at least a little better.
Thank you! God bless. :)
I still haven't been contacted by the Pain Management, so I don't know when my appointment is, but I sure will share my experience and let you guys know how it went.
I know I might never be completely pain free, but I am looking for ways to make my "pretty messed up back" feel at least a little better.
Thank you! God bless. :)
Welcome! I'm so glad you found this forum. We have all of us been in your shoes and experienced the same confusion and feelings of helplessness when we were turned over to a pain specialist.
Try not to see your doctor - I assume it's your surgeon? - as "giving up" on you or as a case of abandonment. Surgeons do surgery. When surgery is not the answer they send the patient to a doctor who CAN help. Addiction and tolerance issues are outside the scope of a surgeon's practice.
Over the past two decades, patients who have pain longer than six months have been referred to pain management specialists. The practice of pain management as a separate specialty has evolved rather slowly in the course of medical history, and it's a relatively young one. Historically, general practitioners were responsible for treating chronic pain. Then came the "war on drugs" and the federal government began regulating the only people they could control: legitimate doctors and their patients.
Part of a pain doctor's scope of practice is to educate patients about the risks and benefits of opiate therapy if that is part of the offered treatment protocol. Many pain docs refuse to consider opiate therapy, nor is it a given than every patient will even be treated with narcotics.
Part of a pain doc's job is to identify and hopefully control any addiction issues that can crop up in their patients. They are forced to practice defensive medicine thanks to all the federal regulations in place or risk losing their licenses. The result is that many patients on opiate therapy must have urine tests and pill counts to prove that the medication is not being abused. These things are beneficial to both the doctor and the patient, but it does put one on the defensive to be automatically treated as an addict. It just goes with the territory of opiate therapy so try not to take it personally if it comes up.
There is far more to pain management than opiate therapy, and it should also include psychotherapy with a pain psychologist for the best outcome. Note that the practice is called pain "management" rather than pain "cure." That's a huge distinction. The goal is to hopefully control the pain enough that the patient can continue most of his usual activities in relative comfort. I doubt there is ANY pain patient who can honestly say that they have zero pain at all even with a pain doc on board. If you are asked to see a pain shrink as part of your therapy, do it! Chronic pain impacts every area of life, and a good shrink can help you learn the necessary coping skills to prevent it from taking over. My own pain shrink has helped me cope with pain so much more than the meds, and has been invaluable in educating my husband.
Pain management is about controlling pain as much as medically possible and teaching the patient how to live WITH the pain. We all have to adjust our personal definitions of who we are and what we are - WITH the pain. Life isn't over nor is it hopeless.
Should you be offered opiate therapy at some point, you need to be aware of the difference between physical dependence and tolerance. Physical dependence simply means that your body is dependent on narcotics. If the medication is suddenly stopped, you will experience withdrawal. Withdrawal does NOT mean addiction!
Addiction is a psychological problem involving cravings for the euphoric feeling of narcotics. Behavior such as taking more than prescribed or obtaining additional prescriptions from multiple doctors or even buying them on the streets continues and escalates despite negative consequences. Because identifying these behaviors is part of a pain doc's job, other doctors such as surgeons are more comfortable referring their chronic pain patients to a pain practice.
Your surgeon has simply determined that his skills cannot help you so he is sending you to a doctor who CAN help. He obviously believes you're in pain and thinks you need more long-term medication or other treatment than he can provide. If your goal is to be completely pain free, you will be disappointed. If your goal is to see improvement, then you're on the right track. I hope you check back in with us and share your experience. Keep an open mind and I think you'll be doing much better and very soon. :-)
Try not to see your doctor - I assume it's your surgeon? - as "giving up" on you or as a case of abandonment. Surgeons do surgery. When surgery is not the answer they send the patient to a doctor who CAN help. Addiction and tolerance issues are outside the scope of a surgeon's practice.
Over the past two decades, patients who have pain longer than six months have been referred to pain management specialists. The practice of pain management as a separate specialty has evolved rather slowly in the course of medical history, and it's a relatively young one. Historically, general practitioners were responsible for treating chronic pain. Then came the "war on drugs" and the federal government began regulating the only people they could control: legitimate doctors and their patients.
Part of a pain doctor's scope of practice is to educate patients about the risks and benefits of opiate therapy if that is part of the offered treatment protocol. Many pain docs refuse to consider opiate therapy, nor is it a given than every patient will even be treated with narcotics.
Part of a pain doc's job is to identify and hopefully control any addiction issues that can crop up in their patients. They are forced to practice defensive medicine thanks to all the federal regulations in place or risk losing their licenses. The result is that many patients on opiate therapy must have urine tests and pill counts to prove that the medication is not being abused. These things are beneficial to both the doctor and the patient, but it does put one on the defensive to be automatically treated as an addict. It just goes with the territory of opiate therapy so try not to take it personally if it comes up.
There is far more to pain management than opiate therapy, and it should also include psychotherapy with a pain psychologist for the best outcome. Note that the practice is called pain "management" rather than pain "cure." That's a huge distinction. The goal is to hopefully control the pain enough that the patient can continue most of his usual activities in relative comfort. I doubt there is ANY pain patient who can honestly say that they have zero pain at all even with a pain doc on board. If you are asked to see a pain shrink as part of your therapy, do it! Chronic pain impacts every area of life, and a good shrink can help you learn the necessary coping skills to prevent it from taking over. My own pain shrink has helped me cope with pain so much more than the meds, and has been invaluable in educating my husband.
Pain management is about controlling pain as much as medically possible and teaching the patient how to live WITH the pain. We all have to adjust our personal definitions of who we are and what we are - WITH the pain. Life isn't over nor is it hopeless.
Should you be offered opiate therapy at some point, you need to be aware of the difference between physical dependence and tolerance. Physical dependence simply means that your body is dependent on narcotics. If the medication is suddenly stopped, you will experience withdrawal. Withdrawal does NOT mean addiction!
Addiction is a psychological problem involving cravings for the euphoric feeling of narcotics. Behavior such as taking more than prescribed or obtaining additional prescriptions from multiple doctors or even buying them on the streets continues and escalates despite negative consequences. Because identifying these behaviors is part of a pain doc's job, other doctors such as surgeons are more comfortable referring their chronic pain patients to a pain practice.
Your surgeon has simply determined that his skills cannot help you so he is sending you to a doctor who CAN help. He obviously believes you're in pain and thinks you need more long-term medication or other treatment than he can provide. If your goal is to be completely pain free, you will be disappointed. If your goal is to see improvement, then you're on the right track. I hope you check back in with us and share your experience. Keep an open mind and I think you'll be doing much better and very soon. :-)
I hope everything goes good for you with pain management .For a lot of us PM has given us our lives back .This forum has also been helpful for a lot of us .It is so good to talk to others who have CP and can understand where you are coming from .I hope you will continue to post and let us know how things go for you .
Take care
Melissa
Take care
Melissa
Pain management is great (if you have the right one.) They do all kinds of things and I find for me they don't get as frustrated as my surgeon. He just wants to operate and it's all better. CP is a long road. This is a great resource. Good luck with your appointment.
Well thank you so much, now I know what to expect when I go to pain management!!
Thank you! God bless.
Thank you! God bless.
Hi! Welcome to the pain management forum. We are all chronic pain patients who share our stories and give support and advise based on our experiences. We are not doctors.
A pain management specialist is a doctor who can perform procedures such as injections, rfa etc. She also can prescribe what drugs she feels are appropriate to your treatment. They have lots of tricks up their sleeves. Other doctors don't want to prescribe long term narcotic pain killers. This is where the pain management doctor steps in. But they also perform procedures to lessen your pain.
As is true with all doctors, not all are created equal. So I hope you find one you like. Again, welcome to our forum. I'm sure that another member will be able to answer your question much better than I.
Sara
A pain management specialist is a doctor who can perform procedures such as injections, rfa etc. She also can prescribe what drugs she feels are appropriate to your treatment. They have lots of tricks up their sleeves. Other doctors don't want to prescribe long term narcotic pain killers. This is where the pain management doctor steps in. But they also perform procedures to lessen your pain.
As is true with all doctors, not all are created equal. So I hope you find one you like. Again, welcome to our forum. I'm sure that another member will be able to answer your question much better than I.
Sara
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