We take for granted that we will feel good most of the
time. When pain strikes, we feel bad. Pain interrupts
our work, our recreation, and our relationships with our
families. Comfort, that is, not being in pain, is one of
your goals if you are sick and should be one of the
goals of treatment for the doctor who is treating you
for any illness, but especially for an illness
associated with chronic pain.
Once the cause of your pain is found and proper
treatment is started, the pain may serve the useful
function of keeping you at rest so that the injury or
illness can heal. But if the pain comes from an illness
that is incurable and will never heal, the pain loses
its usefulness and becomes harmful. This type of pain
keeps you from normal activity, and inactivity decreases
your strength.
Why pain can become worse: There is a "wind-up
phenomenon" that causes untreated pain to get worse.
Nerve fibers transmitting the painful impulses to the
brain become "trained" to deliver pain signals better.
Just like muscles get better at sports with training,
the nerves become more effective at sending pain signals
to the brain. The intensity of the signals increases
over and above what is needed to get your attention. To
make matters even worse, the brain becomes more
sensitive to the pain. So your pain feels much worse
even though your injury or illness is not getting any
worse. At this point, pain may be termed chronic pain.
And it is no longer helpful as a signal of illness.
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Treating lifelong pain: Unfortunately, many illnesses do
not have known cures. The treatment of illnesses such as
diabetes and high blood pressure is often lifelong. In
these chronic illnesses, as in the treatment of chronic
pain, your goal is to live as normally as possible.
Sometimes medication is needed for the rest of your life
in order to achieve that goal.
Chronic pain is no different from diabetes or high blood
pressure. If you need to be on pain medicine for the
rest of your life, you should not be said to be
"addicted" to pain medicine any more than a person with
diabetes who needs to be on insulin for the rest of his
or her life should be said to be "addicted" to insulin.
Some doctors are reluctant to use powerful pain
medications to treat pain even when other medications
have not worked. If your doctor is reluctant to
prescribe medication in this situation, and you have
chronic pain, talk with another doctor or get a referral
to a pain specialist. |
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