Chronic Pain

What is Chronic Pain?

Pain that lasts for more than three months is considered chronic. It is a debilitating process that can be a result of arthritis, surgeries, consequences from medical issues such as diabetic, peripheral neuropathy, cancer, shingles, and fibromyalgia. Bottom line- it’s anything that hurts and prevents you from living your life. Whether there is a medical diagnosis or not, if you hurt and it impacts your life, then you have a problem that needs to be dealt with.

As humans beings we desperately want to establish a cause and effect. We have to be able to define what is causing our pain so we, and those around us, can label it. Otherwise, we mistakenly believe, as we might feel others do as well, “it’s all in my head,” just feeling the pain isn’t enough.

“I was in a skiing accident 20 years ago so that must be why I hurt now.”

“I tripped and stubbed my toe last year and my foot has hurt ever since.”

“I haven’t been the same since I gave birth to my kids over a decade ago.”

Some may be true, others not.

When I was a little girl, I remember being told that I couldn’t be sick if I didn’t have a fever. That idea continues to permeate all aspects of society today. If it’s not confirmed by a professional, then it doesn’t exist. All too often, we are raised to believe that emotions are irrelevant and to be denied. Only physical, documentable problems are real. But as humans, we are a composite of our emotional and physical sides. They are both equally part of the whole and treating one without the other devalues and minimizes our humanness. It also prevents discussing many valuable treatment options. Whether there is objective proof or affirmation of our chronic complaints, what we feel and deal with every day must be acknowledged.

Chronic pain and its myriad of associated issues significantly impact our society- medically, in the workforce, through disability, narcotic abuse… It affects everyone. There’s a pretty good chance either you are in pain or someone you know is.

Learn to quantify and describe your pain so that you can see changes and appreciate improvements when they occur. Learn to document where you hurt and words to describe your pain such as: aching, throbbing, intermittent, sharp, radiating, numbness, or burning. This will help you better communicate with your health care providers. I remember trying to explain early on that I had a numbing burning sensation in my thigh. I was told rather rudely that this was just not possible. He went on to explain in a patronizing tone that numbness is the lack of feeling and burning is by its very definition, a feeling which clearly contradicts the other. That provider obviously had no understanding of neuropathic pain. It’s imperative not to be intimidated.

Continue to express your issues and document your concerns regardless of anyone’s reaction  As providers we don’t mean to be patronizing or intimidating, but some are better tuned to chronic pain patients needs then others. Seek those care givers out. Communication is the key. Making sure your provider hears you and that you hear them is essential to proper treatment, compliance and follow up. Take someone with you to your exams. When I am in pain I may forget to ask all the questions I had or didn’t hear all the information I was given. Having another set of eyes and ears is always helpful. It doesn’t mean you will get the answers you want or the diagnosis you seek or the cause you were looking for or a cure; but, in the end, hopefully their thoroughness and honesty will guide you to a healthier, happier life – living with it.

Be aware of what impacts your pain such as lying down, hot baths, stretching, ice packs , exercise, or certain positions. Focus on following reasonable guidelines such as not lifting a 25-pound bag of dog food, moving a 50-pound plant, carrying a 10-pound purse or water bottle everywhere. Stop high-impact activities and change to low-impact activities such as biking, swimming, or using the elliptical.

Seek out a healthcare provider who will perform a complete physical, listen to all your concerns and symptoms, and review your history. Through a comprehensive examination, contributing issues can be evaluated and appropriate tests referred. Don’t walk in with a diagnosis- let your provider come to their own conclusion. Too often, when a patient is adamant what the problem is, they will either accept that and stop looking for alternatives, or spend time arguing that the diagnosis was wrong.

I’ve had patients assure me that their headache was due to a bulging or herniated disc, arthritis or migraines only to find out after a complete examination their temporalmandibular joint was the cause- TMJ. Clenching the jaw and teeth causes severe spasms in that joint and surrounding facial muscles. Medicines for stress, a night guard and/ or muscle relaxants can offer patients with this diagnosis significant relief. Another case was due to chronic sinus pressure and allergies. Low back pain could be due to a renal stone, prostatitis, rectal or pelvic issues. Don’t make assumptions. That’s why you go to a specialist. Let them do their job and more times than not,  you’ll get information that is insightful and helpful.

– Dr. Courtney

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