Chronic Pain: Ask The Expert
Here, Steven J. Litman, MD, ASA/PM, ABIPP, FIPP, section chief, Pain Management, St. Charles Hospital, discusses chronic pain and the advanced techniques which help alleviate it.
What is chronic pain?
Chronic pain is pain which lasts more than a few weeks. It can be a general pain or occur in your back, neck, head, knee, hip, ankle elbow, or hand.
How do I know when it is time to see a pain management specialist?
If you have pain that does not go away or does not respond to over-the-counter pain killers. You should also reach out if you’ve had a month of physical therapy or chiropractic care and your pain score is 4 out of 10 or higher. It is important to see a physician who is specializes in the management of pain and is board certified in pain management. Your specialist should take a multidisciplinary approach and use interventional techniques to help you find relief from pain while decreasing your dependence on medications.
What are interventional pain management techniques?
Interventional pain management techniques deal with pain at the source. For example, one interventional procedure uses x-ray images to find the precise location on your body causing pain so that specialists can apply relief to that exact spot. Physicians who can perform these precise procedures while patients are lightly sedated support communication between the doctor and patient. This is important because patients often feel safer when they can talk with their doctor during a treatment. They also have more peace of mind when these advanced procedures are performed in a hospital or ambulatory surgery center.
What else can I do to manage pain?
Be your own health care champion. Keep a file of medical records, a CD of MRI’s, a copy of consultations, lists of medications, allergies and surgeries.
Keep it as simple as possible. Choose one physician to oversee the care of your chronic pain, use one pharmacy and minimize your use of opiate and benzodiazepines pain medicines.
After surgery, limit how long you take opiates to avoid developing addiction-related problems. Use non-opioid pain medications before and after surgery to limit how often use opioids and your dosage.
Remain active. Exercise, swim, walk.
Quit smoking. Smoking dries out the discs in the spine and this can increase back pain.
If you are overweight or a diabetic, consult with a registered dietician. Diabetic nerve pain may be decreased simply by controlling blood sugar. A registered dietician can also design a weight loss plan for you. Studies show that losing weight can help relieve hip and knee pain that comes from carrying too much weight.
Finally, psychologists and social workers can help you identify behavioral tools to manage depression when it occurs and find ways for coping with chronic pain. They can help you think about your pain differently and focus less on your disability and more on the pride you get from employment, volunteerism and charity work.