Pain Management

Fear of Re-Injury Makes Injury Last Longer, Delays Return to Work

When people experience a musculoskeletal injury, one that involves muscles or bone, recovery depends on many things ranging from the obvious (treatment) to the not-so-obvious (fear of movement causing pain). While most people who are injured at work are able to return to their position within a reasonable amount of time, up to 20 percent do not recover quickly and live with prolonged pain and disability, resulting in a delayed return to work.

Topical Ketamine Promising in Relieving Allodynia from Complex Regional Pain Syndrome

Complex regional pain syndrome is a little understood but very painful syndrome that can begin after a seemingly minor injury. What makes this syndrome even more puzzling is the allodynia, severe pain results from a relatively harmless action, such as brushing lightly against the affected limb. Because it is neuropathic, or nerve pain, it is particularly hard to treat.

Here's an odd one for you. My mom had shingles and has lots of pain still. Her doctor prescribed Neurontin. I have fibromyalgia and muscle pain that can make it impossible to move. My doctor also prescribed Neurontin. But we have two different kinds of pain. Then, I read that it's really a drug for epilepsy. What is going on?

When medications are first developed, they are usually developed to treat a specific issue. Once the medication is approved for use for that issue, doctors and researchers sometimes notice that other problems may improve when they prescribe the medication to their patients.

I've heard about somatic pain, which is pain that is really in your head but you feel it in your body. How do you deal with that?

Somatic pain isn't really pain that is in your head, although that is an easy way to look at it. Somatic pain is a process of a mental or emotional feeling or stress that becomes a physical feeling. The feeling is very real to the person and the brain is interpreting it as very real.

When I get stressed, I get very nauseated and may throw up. My doctor says it's in my head, but it seems very real to me. I don't do it on purpose. Is it really all in my head?

Without a thorough examination, it wouldn't be possible to say if your nausea is physical or "in your head," but either way, that doesn't mean that your nausea isn't real. Stress and other factors can make our body believe that it is ill or in pain; it's part of the overall reaction.

I have chronic pain in my back that no-one has been able to diagnose. I know some doctors say it's in my head, particularly because it hurts more when I'm stressed. What can I do?

Living with chronic pain can be difficult, particularly if you don't know the cause. You don't say what types of doctors you've seen but it may be worth your while to see a pain specialist. Most pain specialists are anesthesiologists, doctors who specialize in relieving pain.

How do doctors decide if a pain is real or imaginary if there's no proof, like a broken bone, or something?

Pain is a very individual experience and while some people are able to cope with intense pain, others have difficulty coping with what some may consider to be mild pain. Add to this that pain is not always caused by a specific thing, such as a broken bone, a cut in the skin, or a mass in the body and you will see that pain is very complex.

Doctors May Do Better With Clearer Understanding of Somatisation

Somatisation (also spelled somatization) is the process of a mental or emotional feeling or stress becoming a physical feeling. Researchers often wonder about somatisation and psychosomatic behavior because it's a puzzling part of the human body and mind. Not only is it puzzling, it's very common. Many people experience somatisation at some point, with fatigue and nausea for example.

Should Somatization Be Removed as Diagnosis?

Somatization occurs when you feel something physical as a result of an emotional or stressful feeling, but some doctors feel that the term is being used too much and not appropriately. In fact, many doctors believe that the term does not belong in medical terminology.

I took an on-line survey that was supposed to help a well-known pain clinic understand my pain and help design a special pain management program just for me. The test took all of 90 seconds. How can they possibly have enough information to know what I need?

That's a good and very valid question. Pain is a difficult thing to measure. There's no lab test that can put it into an absolute number like a white blood cell count. Yet with 50 million chronic pain sufferers in the United States alone, there's got to be a better way to measure pain than the visual analog scale (VAS). Using this scale, patients assign a number from zero to 10 to rate their pain (zero is no pain, 10 is the worst pain).

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