Chronic Pain Treatments for Mind and Body

WebMD Live Events Transcript

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

MEMBER QUESTION:
My cousin said she took the strongest prescription pain medicine she could for her knee pain. When it no longer worked, she then knew it was time for a knee replacement. Is that true?

ARGOFF:
Not necessarily. There's a lot that has to be kept in mind when thinking about joint replacement. The first thing that needs to be clarified is did some medical person tell your relative what was the cause? Did she go for physical therapy? Did she have any injections into her knee? What do you define as the strongest prescription medicine, because I have had numerous experiences when people use that terminology and they're not talking about very strong medication? So I don't have enough details to answer your question as it is.

On the other hand, in the right setting, joint replacement can help alleviate significant joint pain, but I don't have enough information to tell you whether it's right for the person you're talking about.

MEMBER QUESTION:
I have skin pain. I guess it is nerve related. I cannot get an answer for this. However, I am looking for a way to relieve it. My body feels bruised all over when I rub up against things or when someone touches me too hard. I also have a burning sensation on my face and arms (like a sunburn or chemical burn). I have not received any answers for this condition. I know you cannot diagnose, but what you would recommend for this?

ARGOFF:
I would recommend strongly that you see a physician, perhaps a neurologist who specializes in pain management, or a neurologist in general, to first establish what your diagnosis might be. I think it may be necessary for you to see somebody with pain management expertise, and that person might be able to make suggestions that may be helpful to alleviate your pain, but you truly need to have a diagnosis first.

MEMBER QUESTION:
I have seen two neurologists and two rheumatologists. The only thing that has been mentioned is fibromyalgia or STRESS. ... Can STRESS really cause nerve pain like this?

ARGOFF:
No. Where do you live?

MEMBER QUESTION:
Houston, Texas.

ARGOFF:
You should consider traveling up to San Antonio to see John Russell, MD, who is one of the world's experts on fibromyalgia. He's at the University of Texas in San Antonio. Head to their web site and you'll find him there. You can also go to any bookstore and get his handbook on fibromyalgia. That should be helpful also. He will take you quite seriously. He may want to do all kinds of testing on you, but he will do his very best to understand why your skin burns as much as it does. He is also a rheumatologist who truly understands pain.

"If a drug works, even at a lower-than-usual dose, and even if you experience side effects that are tolerable, then it probably makes sense to stay on it."


MEMBER QUESTION:
How damaging to your body can long-term pain medication be? Ultram, to be specific.

ARGOFF:
We don't have enough experience to know if there are any toxic side effects. However, it is not the greatest medicine in the world, and is likely to cause what we call physical dependence. What this means is as time goes on your body cannot live without it, making it not necessarily harmful to you, but making it very difficult to get off of it when you want to. This may be relevant if it sometimes no longer helps you, but if it's helping you and you're not experiencing that particular problem, then there's nothing to worry about.

It would be wise, however, since we don't know everything, for you to have routine blood work done annually, if you're still on this medication, just to be sure everything is OK.

MEMBER QUESTION:
Blood work checking for what?

ARGOFF:
Liver function, kidney, or other abnormalities.




STAY INFORMED

Get the Latest health and medical information delivered direct to your inbox!