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Dealing With Chronic Pain? Here’s What You Need to Know

Amit Gupta, DO News

Pain is something we all want to avoid, but the reality is that every one of us experiences some sort of pain now and then. Fortunately, most of the time it is temporary pain that goes away on its own or with a little help from over-the-counter remedies.

Millions of people, however, are living with pain that isn’t temporary, and it often makes life miserable. This type of pain, known as chronic pain, can interrupt every part of daily life: work, family, personal care, recreation—even simple pleasures like having a nice meal out or going to see a movie.

When it comes to chronic pain, there is some bad news, but there is even better good news. The bad news is that, most of the time, there may be no way to reverse the damage that is causing the pain. The good news is that wherever there is pain, there is usually a medical procedure to help alleviate it.

The goal of pain management is not to completely eliminate pain—which is possible only in rare situations—but to reduce pain to the point where it fades into the background. Well-managed pain enables a person to get back to work, activities, family events and daily life in general.

If you’re dealing with chronic pain, it is important that you take an active role in your care and seek out a diagnosis for the cause of your pain. Treatment without an accurate diagnosis is like a boat without sails. It will not give you relief.

In terms of diagnosing pain, many patients immediately think of getting an MRI or an X-ray. These imaging options are useful, and they are often part of the process of diagnosis. However, they should not be the first step in determining the cause of pain. Instead, a thorough physical examination—what physicians call a history and physical—should be conducted first to determine a diagnosis. After that, your physician may choose to confirm the diagnosis with an MRI or X-ray.

Because there are a wide variety of sources for pain, treatment also varies. For instance, the treatment for one of the most common types of chronic pain—the pins-and-needles sensation of sciatic pain in the legs—typically includes an epidural injection. This minimally invasive procedure takes just 15 to 20 minutes in an outpatient surgery center, and the effects usually last two to three months.

The constant, dull pain of arthritis in the neck and lower back can be treated with radiofrequency ablation, which is also a brief, minimally invasive outpatient procedure. This treatment typically calms the pain for six months to a year.

Often, physicians recommend physical therapy as part of the treatment process, in order to strengthen core muscles and prevent further injury and pain. Because there is a strong psychological component to dealing with chronic pain, it can also help to have some counseling along with physical treatment. My clinic, for instance, has a clinical psychologist on staff who helps patients deal with the anxiety, frustration and depression that often accompany chronic pain.

One of the most important aspects of treatment, however, might surprise you. While you might expect your doctor to put you on opioid pain medications, change the ones you’re now taking or adjust your dosage, a major goal of treatment is actually to minimize—if not eliminate—these medications. There is a time and a place for medication, but opioid pain relievers were not initially meant to treat chronic pain.

Opioids—such as Vicodin, Norco, Dilaudid and Percocet—are often given for pain as temporary help for patients who visit an emergency room or their physician, but they should not be considered a permanent solution. People can build tolerance to these opioid medications because, as the effectiveness of the drug declines, the pain sufferer needs higher and higher dosages to get the same amount of relief. They learn to rely on opioids as a treatment for their pain, and addiction can follow.

If you’re dealing with chronic pain—whether or not you are taking opioid pain relievers—it’s very important to seek out a physician who will provide a proper diagnosis for your pain then point you toward non-opioid solutions to reduce your pain.

Amit Gupta, DO, is a graduate of the Brigham and Women's Hospital Harvard Medical School Pain Management Fellowship. He is an interventional pain management specialist serving Simi Valley and is on the Simi Valley Hospital medical staff.