I was told September is “Pain Awareness Month.” Pain is strictly an individual concept, especially for chronic pain patients. Medicine uses a blank line that is 10 centimeters long, numbered 0 to 10 with smiley faces to crying faces, as well as other methods to measure pain. None of these methods are really appropriate for measuring pain across all patients. Or have been shown the ability to cross reference to another person’s pain. There is no consistent way to deal with an individual’s chronic pain, because what can be an 8 to one person is a 3 to another.
Pain, especially chronic pain, can break up a family or a family can find a way to endure it. Friends can remain friends or friendships can be completely lost from lack of understanding. Successful lives can be completely cut short do to difficulty with functionality, or possibly never started. Simple activities can become impossible to accomplish, such as making dinner. People in pain are sometimes thought to be lying or exaggerating to get out of life. Pain can also lead to depression. At its worst pain can lead to a rapid dwindling life or to suicide.
There were no classes in Medical School or instruction during residency on how to deal with patients in pain. Even in pain management we look for a cause and cure. I work with surgeons and pain management physicians, that if the patient doesn’t fit their ingrained protocol these intelligent people have no clue what to do or recognize the pain. I must admit sometimes I have no clear answer to decrease a person’s pain, but I do recognize a person’s pain. Most doctors when I started thought people in chronic pain had a psychiatric problem. Most Work Comp doctors still belief this.
Acute vs. Chronic Pain
We break pain in to acute or chronic pains. Acute pain has a cause: sprained ankle, appendicitis, tooth abscess, or broken bone. The injury gets better or a doctor can do something to help improve it. There is an end in sight. To a chronic pain patient, an acute pain can be devastating. Chronic pain is said to last more than three months (Tell that to a patient in severe pain for a week). Chronic pain is called pathological pain. At this time there is no direct cure for some pains: diabetic neuropathy, Lyme Disease, multiple sclerosis, Complex Regional Pain Syndrome (CRPS), Post Surgery Pain, and the list goes on.*
*I do not mean to diminish any of my patient’s pain from head to toe by not listing their diagnosis or diagnoses.
I could talk/write about pain for hours. I have to apologize to some people in pain because after reading a history I have nothing better to offer than their current physician. So I guess, even I fit into the category of intelligent people with no clue sometimes. A patient should have their own treatment plan. The plan should be made between the patient with their physician or physicians and support teams. If you have pain, we can talk. I will accept you have pain and in most cases I will try to come up with a plan to help. I would like to thank the people who have trusted me to be their physician.
by: Dr. Michael A. Castillo
