People with chronic pain have usually seen a family doctor and several other specialists
as well. Eventually they are referred to neurologists, orthopedists, or neurosurgeons. The
patient/doctor relationship is extremely important in dealing with chronic pain. Both
patients and family members should seek out knowledgeable specialists who neither dismiss
nor indulge the patient; physicians who understand full well how pain has come to dominate
the patient's life and the lives of everyone else in the family.
Many specialists today refer chronic pain patients to pain clinics for treatment. Over 800
such clinics have opened their doors in the United States since a world leader in pain
therapy established a pain clinic at the University of Washington in Seattle in 1960.
Pain clinics differ in their approaches. Generally speaking, clinics employ a group of
specialists who review each patient's medical history and conduct further tests when
necessary. If the applicant is admitted, the clinic staff designs a personal treatment
program that may include individual and group psychotherapy, exercise, diet, ice massage
for pain (especially before bedtime), electrical stimulation techniques, and the use of a
variety of analgesic but nonnarcotic drugs. The aim is to reduce pain medication and so
improve the patient's pain problem that when he or she leaves the hospital it is with the
prospect of resuming more normal activities with a minimal requirement for analgesics and
a positive self-image.
Contrary to what many people think, pain clinic patients are not malingerers or
hypochondriacs. They are men and women of all ages, education, and social background,
suffering a wide variety of painful conditions. Patients with lower back pain are
frequent, and so are people with the complications of diabetes, stroke, brain trauma,
headache, arthritis, or any of the rarer pain conditions. The majority of patients
participate for 2 or 3 weeks and usually report substantial improvement at discharge. One
young man who had suffered painful chest injury as a result of a factory accident said he
literally "felt taller" after his pain clinic experience. Follow-up at 3- to
6-month intervals, and at lengthier intervals thereafter, is an essential part of the
program, both to evaluate the long-term effectiveness of treatment and to initiate a
further course of treatment or counseling if necessary.
Pain clinics have the virtue that they bring together people with pain problems that have
left them feeling isolated, helpless, and hopeless. But not everyone with a pain problem
may need the support of a group or residence in a hospital. The important factors are that
the pain patient -- and the family -- understand all the ramifications of pain, and the
many and varied steps that can now be taken to undo what chronic pain has done. As a
result of the strides neuroscience has made in tracking down pain in the brain -- and in
the mind -- we can expect more and better treatments in the years to come. The days when
patients were told "I'm sorry, but you'll have to learn to live with the pain"
will be gone forever.
Voluntary Health Organizations
Several lay organizations are directly concerned with pain problems. They are excellent
sources of additional information, research updates, and specific help and referrals:
P.O. Box 850
Rocklin, CA 95677
1-916-632-0922
7979 Old Georgetown Road, Suite 100
Bethesda, MD 20814-2429
1-301-652-4948
428 West St. James Place, 2nd Floor
Chicago, IL 60614
312-388-6399
1-800-843-2256 (Toll free in the U.S.)
1-800-523-8858 (Toll free in Illinois)
In addition, many organizations concerned with specific diseases, such as arthritis or
heart disease, provide information and advice about attendant pain problems
Pain Clinics
While there is no official certifying agency accrediting pain clinics throughout the
country, there are many excellent clinics, often affiliated with university-associated
medical centers. Your family doctor or university medical center may be able to refer you
to reputable clinics nearby.
NINDS Information
For additional information concerning NINDS research on pain write:
National Institute of Neurological Disorders and Stroke
Building 31, Room 8A06
National Institutes of Health
9000 Rockville Pike
Bethesda, MD 20892
1-301-496-5751
http://www.healthtouch.com
All pages Copyright � 1997 by Medical Strategies, Inc.