Chronic Pain: Living With Pain (cont.)
For his part, Silverman uses various methods to diagnose pain. He asks patients to give their discomfort a number from zero to 10 (zero representing no pain, and 10 being the worst), and to describe what they're feeling. The words patients use -- such as throbbing, shooting, squeezing, sharp, hot, cold, and itchy -- give him clues to what is wrong. He also uses his own eyes to spot apparent physical damage and X-ray equipment to detect any internal abnormalities. In addition, he tries to find out what else is going on in the patient's life.
"If [patients] do have a bona fide psychological problem -- not because of the pain, but it's a part of them -- that's going to affect the way ... that the pain is perceived," says Silverman, who notes that some people find it hard to separate physical pain from their emotional conflicts. A patient's problems with work, marriage, and sex, for instance, may affect the ability to cope with bodily distress.
Penney Cowan remembers all too well how terrible she felt the first six of the 30 years she's endured fibromyalgia. "I was completely nonfunctional," she says. "I was afraid, didn't know anything, and was blindly going forward hoping someone's got the magic bullet for me."
As Cowan realized, however, there is no perfect solution for her pain. So she decided to learn as much as she could about dealing with the discomfort. Her active involvement not only eased her misery, but also inspired her to establish the American Chronic Pain Association, a group dedicated to educating healthcare professionals and the general public about pain management.
From her experience, Cowan says people who take an active role in their treatment tend to have better quality of life, reduce their sense of suffering, and feel more empowered. Strategies she recommends for active learners include seeking a well-qualified pain specialist or program and looking up information about medication and treatment from reliable sources such as the Cleveland Clinic and Mayo Clinic.
Experts say it's also helpful to know that relief may come from one or a mix of strategies, which can include medication, physical therapy, surgery, and/or psychological therapy. Seeking a pain specialist is reportedly only one part of a comprehensive solution.
Originally published Jan 29, 2003.
Medically reviewed Oct. 8, 2004.
SOURCES: American Back Society Conference Highlights, David Fishbain, MD, Orlando, December 2001 • Donald Small, patient • Sanford Silverman, MD, Comprehensive Pain Medicine, Pampano Beach, Fla. • B. Eliot Cole, MD, director of education, American Academy of Pain Management • Penney Cowan, founder and executive director of the American Chronic Pain Association • WebMD Public Information with The National Institute of Arthritis and Musculoskeletal and Skin Diseases: "Questions and Answers about Fibromyalgia."
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Last Editorial Review: 3/21/2005