Is Your Doctor's Philosophy of Pain Management Right For You?

Pain is typically classed as either chronic or acute.interventions offered by primary care physicians
Chronic pain (CP) is very different from acuteand pain management specialists, many
pain (AP). AP sufferers know that the discomfortnon-medical interventions may contribute to this
is self-limiting. Daily pain is 'the norm' for CPend. Some examples of "non-medical" treatments
sufferers, and this expectation contributes tofor CP are:
depression. Doctors treat AP sufferers differently*rest
than they treat CP sufferers. If the pain is short*stretching
term, Doctors are more likely to prescribe opioids*hot/cold compress applications
because the risk of dependency is reduced with a* biofeedback
shorter treatment time. For long term pain, many*hypnosis
clinicians are cautious about prescribing opioids,*weight reduction
occassionally to the point of doing nothing. In a*exercises specifically designed to strengthen
recent interview with Paula Moyer for Medscape,supporting muscles and encourage proper body
Scott M. Fishman, MD (Professor ofalignment.
Anesthesiology and Pain Medicine, Chief of the*acupuncture/acupressure
Division of Pain Medicine, University of California,No one treatment is effective for all types of
Davis) stated that in two recent cases, physicianspain. Effective pain management may involve a
were actually charged with elder abuse forcombination of methods, including opioids (codeine,
providing inadequate pain management.tramadol, morphine, etcetera), non-opioid drugs
Avoiding opioid medications, however, can lead tolike nsaids (ibuprofen, naproxen, acetaminophen,
the over-prescription of other medications thataspirin, etc.), and "helper drugs," aka adjuvants,
may be toxic, such as NSAIDS or (in somesuch as antidepressants (sometimes effective in
patients) COX-2 inhibitors.treating fibromyalgia pain), topical/local anesthetic
The ultimate goal is to return the individual to assprays, muscle relaxants, and others.
functional a state as is possible. Besides medical