What is pain management?

Posted by martoof @martoof, Oct 18, 2021

Is pain management (PM) merely *not complaining*? Making pain subside or go away? Distracting oneself from the pain? I ask because I recently went to a pain management clinic, where after a lengthy intake/question process, I was prescribed Vicodin! Any qualified, serious input would be deeply appreciated! Thank you!

Interested in more discussions like this? Go to the Chronic Pain group.

@sueinmn

I am living proof that pain from an incurable illness (osteoarthritis from head to toe) can be eased by therapy. It is not only mental health work, but that is part of it. And it is not only desensitization, but includes physical work to alter some habits which increase pain. Finally, the pain is not necessarily cured, but managed in order to improve quality of life.

There are incurable, intractable pains which are not caused by Central Sensitization, such as some end stage cancers, severe infections, or postoperative pain. Opioids are then a logical choice.

But when chronic pain sets up residence in the body, all kinds of muscles tense, we alter our body mechanics, related nerves react, we tense further and hurt more…the vicious cycle is initiated.

Pain management or desensitization teaches us to break the cycle using physical (PT, stretching, exercise, massage, acupuncture…) mental (counselling, visualization, meditation, faith practices…) medical (meds, injections, braces, surgery) dietary and social strategies.

Do I still hurt? Yes. Does pain affect my life? Some days. Am I glad I learned about it? Yes, I wish it had been around 30 years ago to help my Mom!
Sue

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beautiful response. Thank you!

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@sueinmn

I am living proof that pain from an incurable illness (osteoarthritis from head to toe) can be eased by therapy. It is not only mental health work, but that is part of it. And it is not only desensitization, but includes physical work to alter some habits which increase pain. Finally, the pain is not necessarily cured, but managed in order to improve quality of life.

There are incurable, intractable pains which are not caused by Central Sensitization, such as some end stage cancers, severe infections, or postoperative pain. Opioids are then a logical choice.

But when chronic pain sets up residence in the body, all kinds of muscles tense, we alter our body mechanics, related nerves react, we tense further and hurt more…the vicious cycle is initiated.

Pain management or desensitization teaches us to break the cycle using physical (PT, stretching, exercise, massage, acupuncture…) mental (counselling, visualization, meditation, faith practices…) medical (meds, injections, braces, surgery) dietary and social strategies.

Do I still hurt? Yes. Does pain affect my life? Some days. Am I glad I learned about it? Yes, I wish it had been around 30 years ago to help my Mom!
Sue

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Thank You. I think I have a better understanding now. Your explanation fills in some of the blanks.

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It’s a shame there are cynics who have not found relief for their pain and instead bash a fairly new medical field. Chronic pain is a complicated illness that all who have it can describe varied symptoms and situations of our adventure in pain. Mine started in 1988 and until 2016/17 did I finally find pain control in a combination of buprenorphine patch, baclofen, daily exercise and 2 mile walks, THC and CBD oil, and down to one oxycodone a day. This is success in that I have tolerable pain, normal ADL’s, still can cook, still sexually active at 70. I cannot complain.

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@krisjb1

I watched the video about central sensitization syndrome and feel as if there is something missing between the "causation" portion of the discussion and the part where the patient is desensitized to pain. I can't understand how pain caused by an illness or disease that has no cure such as arthritis or terminal cancer can be alleviated by a course of therapy which appears to be akin to mental health work. While a serious disease or injury is present pain is a warning signal. What am I missing?

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With chronic pain, the body part that hurts is often just the tip of the iceberg. Underneath lay various impacts that often accompany, and may worsen chronic pain, including:

– Emotional distress
– Physical deconditioning
– Fatigue
– Sleep disturbance
– Thinking and memory problems
– Poor nutrition

Lifestyle changes do make a positive impact. Retraining the brain (neuroplasticity) does make a positive impact. No, they do not remove all the pain, but they create healthier ways to approach pain, and recreate pathways in the brain.

An example I learned at pain rehab was to think of a little boy (we'll call him Timmy) who goes to the grocery store with his mom and wants a free cookie at the deli. TImmy throws a HUGE tantrum in the middle of the store, begging for a cookie. His mom has two choices:

1. give in to Timmy and let him have a cookie
2. stand her ground and say no because he has not had lunch

Pain is like a tantrum. If we continue to give in to it and let it have its way, we will lose control and create bad habits. We will not allow ourselves to live our best life possible.

No matter how long you've lived with chronic pain, you can take steps to manage it more effectively and improve your quality and enjoyment of life. Your attitude and lifestyle play key roles in how well you cope with pain.

If you have a negative attitude and view yourself as a victim of pain, pain will continue to control you and consume your energy. If you approach your condition with a positive outlook and openness to change, you're more likely to manage pain successfully.

Some key lifestyle choices to help you live well with chronic pain may include:

– Becoming more physically active
– Practicing techniques that relieve stress
– Focusing on your abilities, not just your limitations
– Improving communication with family members and friends
– Learning to shift your focus away from pain
– Reducing or stopping reliance on pain medication and medical solutions to pain
– Eating a nutritious diet, and getting the sleep you need
– Speaking to a psychologist
– Scheduling your days, for accountability
– Setting goals

No one says this is easy, it takes diligence. I certainly have my difficult days where I must go back to the drawing board and pull from these tools I've outlined. Regardless of individual underlying causes, chronic pain presents the same for us all, chronic, its never going away, but can be managed.

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@rwinney

With chronic pain, the body part that hurts is often just the tip of the iceberg. Underneath lay various impacts that often accompany, and may worsen chronic pain, including:

– Emotional distress
– Physical deconditioning
– Fatigue
– Sleep disturbance
– Thinking and memory problems
– Poor nutrition

Lifestyle changes do make a positive impact. Retraining the brain (neuroplasticity) does make a positive impact. No, they do not remove all the pain, but they create healthier ways to approach pain, and recreate pathways in the brain.

An example I learned at pain rehab was to think of a little boy (we'll call him Timmy) who goes to the grocery store with his mom and wants a free cookie at the deli. TImmy throws a HUGE tantrum in the middle of the store, begging for a cookie. His mom has two choices:

1. give in to Timmy and let him have a cookie
2. stand her ground and say no because he has not had lunch

Pain is like a tantrum. If we continue to give in to it and let it have its way, we will lose control and create bad habits. We will not allow ourselves to live our best life possible.

No matter how long you've lived with chronic pain, you can take steps to manage it more effectively and improve your quality and enjoyment of life. Your attitude and lifestyle play key roles in how well you cope with pain.

If you have a negative attitude and view yourself as a victim of pain, pain will continue to control you and consume your energy. If you approach your condition with a positive outlook and openness to change, you're more likely to manage pain successfully.

Some key lifestyle choices to help you live well with chronic pain may include:

– Becoming more physically active
– Practicing techniques that relieve stress
– Focusing on your abilities, not just your limitations
– Improving communication with family members and friends
– Learning to shift your focus away from pain
– Reducing or stopping reliance on pain medication and medical solutions to pain
– Eating a nutritious diet, and getting the sleep you need
– Speaking to a psychologist
– Scheduling your days, for accountability
– Setting goals

No one says this is easy, it takes diligence. I certainly have my difficult days where I must go back to the drawing board and pull from these tools I've outlined. Regardless of individual underlying causes, chronic pain presents the same for us all, chronic, its never going away, but can be managed.

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Would like to discuss the little Timmy analogy. I was a very active gardener turning over a 25X40 garden by shovel 2 years ago. It was not easy for a female in her 70's but I persevered with planting and weeding and doing what was needed. I became unable to walk without assistance due to severe pain in one knee which after 6 months traveled to my foot and then to the other knee and other foot. Should I have ignored the pain and continued working? I don't take pain meds. Gardening was my stress reliever.

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@krisjb1

Would like to discuss the little Timmy analogy. I was a very active gardener turning over a 25X40 garden by shovel 2 years ago. It was not easy for a female in her 70's but I persevered with planting and weeding and doing what was needed. I became unable to walk without assistance due to severe pain in one knee which after 6 months traveled to my foot and then to the other knee and other foot. Should I have ignored the pain and continued working? I don't take pain meds. Gardening was my stress reliever.

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I'm sorry to hear of your loss of gardening as a stress reliever, and your chronic pain. I respect your motivation and understand your frustration.

Chronic pain lasts longer than 6 months, beyond the time for healing, and becomes ongoing. When pain begins we have no way of knowing if its acute or chronic. We should definitely not ignore the onset of pain. It's important to listen to our bodies and try to figure out what's wrong.

My analogy of Timmy represents the ongoing nature of chronic pain. When there is nothing left but management of an issue that can not be fixed, healed or cured.

What tools are you currently using for stress relief? Have you been able to find another distraction that you enjoy?

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@krisjb1

Would like to discuss the little Timmy analogy. I was a very active gardener turning over a 25X40 garden by shovel 2 years ago. It was not easy for a female in her 70's but I persevered with planting and weeding and doing what was needed. I became unable to walk without assistance due to severe pain in one knee which after 6 months traveled to my foot and then to the other knee and other foot. Should I have ignored the pain and continued working? I don't take pain meds. Gardening was my stress reliever.

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Wow – sudden pain is your body's "red alert" warning system & should be heeded. Have you figured out the source?

I sympathize with the loss of gardening as a distraction. Maybe you need to do what I have done after 5 hip replacements, and now wearing-out knees – contract the heavy duty work like turning the garden to someone young. My grand nephews treat it like a workout, and they like the extra cash!
Also, I plant many of my veggies in straw bales, which involve no bending or kneeling, no digging (and little weeding). Then after 2 years, the bales collapse, and you plant right in the resulting compost, again with no digging. And all the herbs go in pots – big ones, that are part of the decor on my patio.

Sue

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Yes, I get the idea. Always hoping for better days though, despite managing and being a trooper. Thank you for your explanation. It clarifies it well.

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@sueinmn

Wow – sudden pain is your body's "red alert" warning system & should be heeded. Have you figured out the source?

I sympathize with the loss of gardening as a distraction. Maybe you need to do what I have done after 5 hip replacements, and now wearing-out knees – contract the heavy duty work like turning the garden to someone young. My grand nephews treat it like a workout, and they like the extra cash!
Also, I plant many of my veggies in straw bales, which involve no bending or kneeling, no digging (and little weeding). Then after 2 years, the bales collapse, and you plant right in the resulting compost, again with no digging. And all the herbs go in pots – big ones, that are part of the decor on my patio.

Sue

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You are lucky to have those helpers. I like the straw bale idea and may give it a go next season. My knees and feet are probably related to Lyme and its auxiliary diseases. I have had many strange health issues over the 30 years since I was infected and knee issues without radiographic images showing any major problem as well as negative arthritis blood test results. This last year and a half has been the longest stretch of knee/foot issues but they now seem to be improving. I can only hope I don't have a relapse of the worst of the worst Lyme which involve severe dizziness and the most painful headache anyone can have as well as inability to eat, drink, think, talk, etc. It has put me down for at least a week once or twice annually for about 5 or 6 years. I have been treated, but antibiotics are only helpful for a short time before issues resume and of course antibiotics have nasty side effects like yeast infections etc.

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@rwinney

With chronic pain, the body part that hurts is often just the tip of the iceberg. Underneath lay various impacts that often accompany, and may worsen chronic pain, including:

– Emotional distress
– Physical deconditioning
– Fatigue
– Sleep disturbance
– Thinking and memory problems
– Poor nutrition

Lifestyle changes do make a positive impact. Retraining the brain (neuroplasticity) does make a positive impact. No, they do not remove all the pain, but they create healthier ways to approach pain, and recreate pathways in the brain.

An example I learned at pain rehab was to think of a little boy (we'll call him Timmy) who goes to the grocery store with his mom and wants a free cookie at the deli. TImmy throws a HUGE tantrum in the middle of the store, begging for a cookie. His mom has two choices:

1. give in to Timmy and let him have a cookie
2. stand her ground and say no because he has not had lunch

Pain is like a tantrum. If we continue to give in to it and let it have its way, we will lose control and create bad habits. We will not allow ourselves to live our best life possible.

No matter how long you've lived with chronic pain, you can take steps to manage it more effectively and improve your quality and enjoyment of life. Your attitude and lifestyle play key roles in how well you cope with pain.

If you have a negative attitude and view yourself as a victim of pain, pain will continue to control you and consume your energy. If you approach your condition with a positive outlook and openness to change, you're more likely to manage pain successfully.

Some key lifestyle choices to help you live well with chronic pain may include:

– Becoming more physically active
– Practicing techniques that relieve stress
– Focusing on your abilities, not just your limitations
– Improving communication with family members and friends
– Learning to shift your focus away from pain
– Reducing or stopping reliance on pain medication and medical solutions to pain
– Eating a nutritious diet, and getting the sleep you need
– Speaking to a psychologist
– Scheduling your days, for accountability
– Setting goals

No one says this is easy, it takes diligence. I certainly have my difficult days where I must go back to the drawing board and pull from these tools I've outlined. Regardless of individual underlying causes, chronic pain presents the same for us all, chronic, its never going away, but can be managed.

Jump to this post

@rwinney That was wonderful analogy of pain and how to help ourselves .This is just what I've gone through I fell hard on my bottom resulting in alot of lower back pain Dr diagnosis is paraphrase I let my back heal now am waiting for my scooter to be built since I can't walk far only in my 1 bedroom apt. But I'm blessed I'm not paralyzed this has happen 2 times now in my life I've escaped being paralyzed Distraction is so important from pain

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@lioness

@rwinney That was wonderful analogy of pain and how to help ourselves .This is just what I've gone through I fell hard on my bottom resulting in alot of lower back pain Dr diagnosis is paraphrase I let my back heal now am waiting for my scooter to be built since I can't walk far only in my 1 bedroom apt. But I'm blessed I'm not paralyzed this has happen 2 times now in my life I've escaped being paralyzed Distraction is so important from pain

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You are one tough cookie @lioness. I'm motivated by you!

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