Overcoming Pain

Why people experience chronic pain, and the power they have to de-intensify it

Talking Away the Pain

It may be cheap, but sometimes talking works.

The majority of patients with chronic pain experience some measure of relief only when they have effective communication with their physician. To this end, the American Pain Society enthusiastically supports patient outreach and education programs. It is important for patients to engage in productive two-way discussions with their physicians about pain.

Officials of the American Pain Society realize that undertreated, or untreated, pain is a huge public health issue in the United States. A major reason for this treatment failure is the failure of communication between doctor and patient. There may be no communication about pain.

While patients are being encouraged to be more forthcoming about their pain complaints, so too are physicians encouraged to be empathic listeners, and active elicitors of the patient attitude toward chronic pain. Physicians need to learn the true intensity of the pain their patients feel, and appreciate how that pain affects, and perhaps ruins, an individual life and the lives of loved ones who must live with those who live with pain.

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It is not a far step to take to understand that treating the pain might be only the first step in patient well-being: there is also a human being to be treated.

A patient must not feel intimidated, and talk openly about the pain. Simultaneously, the physician must also address the benefits and risks of treatment for chronic pain, including the discussion, for example, of addictive medications. Physicians also must assume a more aggressive stance regarding the monitoring of pain treatments, reducing dosages over time when a patient's pain appears to be improving.

Unfortunately, reducing dosages of the more addictive pain relievers can leave the doctor-patient relationship riven in more than a few instances; but this is a blog subject in and of itself.

As pointed out by the American Pain Society, chronic pain has the propensity to alter sleep, cause depression, and damage self-esteem. The provider treating chronic pain must also know how to treat the concomitant mood disorder; this can have a great impact on the perception of pain. Of course, poor sleep often increases the pain a patient experiences.

I realize that talking about talking is easy, and that the reality of rushed and harried physicians often creates a milieu not conducive to meaningful interaction about the issues discussed above. One can only ask for a little more effort, on the part of provider and patient. This alone can create a nice foundation for further exploration of the pain of pain in future appointments.

 

 

 

 

Mark Borigini, M.D., is a board-certified rheumatologist who has devoted his career to treating illnesses that cause chronic pain and disability.

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