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My approach to treating pain

I've begun writing a discussion of treating chronic pain, intended for a person with pain (or their families) as an adjunct to other types of treatment they are receiving. This is an enormous topic, and it certainly won't be possible to do it justice in the limited space available here. But I hope it will be helpful as a guide, provided you're under the care of a good physician. Unlike the Healthful Hints section, intended for patients I'm seeing in my practice, these articles on treating pain are for a more general audience.

I would appreciate your letting me know any comments, additions, or criticisms, or if something was not clear, using the feedback form at the bottom of each page. I'm delighted to note we're developing a vigorous discussion in the reader comment area.

Chronic pain is any painful condition that lasts for months or years. I won't talk here about pain due to cancer, because it behaves very differently. I've divided this the topic of chronic pain into several brief articles. They are summarized below with links to the more detailed discussions:

The problem with chronic pain is that with most patients, either there is no single clear cause of their pain. Sometimes the cause is obvious, but they're not better. Moreover, most patients with pain improve over time. If you're still hurting, then often the most helpful question is, "Why aren't you better?" The usual problem is that an entire system of factors keeps the pain going, including one that isn't polite to talk about. It's also important to learn the central role of the nervous system in keeping pain going.

Though most patients with pain have the myofascial syndrome, it's important to know a little about the three major categories of pain, and the different approaches each requires. Many people have been told they have fibromyalgia but aren't sure just what this is.

The majority of patients with pain spend too much of their time resting, because it hurts to exercise. This is a trap: for many people, the more you rest, the more you hurt. But overdoing it also makes you worse. The answer is called functional restoration: slowly and gradually improving your physical condition so that you become fit, flexible, and strong.

Also, it's critical to address depression if present. Even if you're not depressed, antidepressant medications are often tremendously effective. Acupuncture and deep tissue massage are often helpful. If pain tends to make you tense and frustrated, biofeedback and meditation/relaxation training are critical to recovery.

Finally, check out the reader comment and discussion area for pain medicine.

Last updated Fri, Nov 25, 2005

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