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Pain is Personal

January 12, 2015

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Pain can be acute, pain can be chronic. Pain is physical, pain is emotional.  Pain can be debilitating, pain can lead to despair.  Those in severe, lasting pain want to be heard, to be believed, to be understood, to be validated.   But more than anything, they will go to all extremes to find relief from their pain.

Pain is caused by injury, by illness, by lifestyle choices, by life circumstances, and by as many triggers as there are experiences to pain.  There is no single, simple, “one size fits all” answer or relief from pain.

And so, of course, a large percentage of patients that visit their primary care provider are seeking relief from pain.

When prescribed medications haven’t provided relief, some patients may resort to taking medications prescribed to others, or to self-medicating with illegal drugs.  Or, if they have become “tolerant” to the medications they have taken over a period of time, they may seek another provider, and another, to obtain the prescriptions they have come to depend on.  An extremely frightening fact:  approximately 45 people die every day from prescription drug overdose in this country, and these deaths are attributed to people who are using the drugs as prescribed, with doctor supervision.

As many pain medications can be highly addictive, health care providers are appropriately cautious in managing the pain needs of their patients.  They may require periodic drug screens, “pain contracts”, and/or other referrals to closely manage and monitor their patients’ care.  Patients, in turn, may interpret this treatment as a distrust in the doctor/patient relationship, thus, leading to a breakdown in open and honest communication, of course a key component in the pathway toward wellness.

Our Vista Hill SmartCare teams, who partner with health clinics in rural communities, are tasked with assisting patients with “pain management”.    Many patients that are referred to us live in pain daily.  They may not be able to work.  It may have compromised their relationships, their daily activities, their sleep.  They may even have suicidal thoughts.   We know that there are no magical cures, no secrets to pain management.  We do our best to listen and encourage, to help our patients incorporate lifestyle changes that may enhance the treatments they are undergoing.

It is strongly recommended that those in pain be receptive (and have access to) an integrated approach to care, considering incorporating such practices as acupuncture, reiki, yoga and other movement, aromatherapy, meditation, massage,  and other healing methods in addition to or instead of prescribed pain medication treatment, that can have the side effects of nausea and constipation, disrupt one’s immune system and sexual function, and cloud  thinking and functioning, in addition to the risk of addiction.

A key component to managing pain is taking an active, participatory role in treatment and regaining a sense of control, especially when feeling at such a loss of control over the pain and access to medication that the patient may feel they need.

Our SmartCare teams are looking forward to incorporating “Pain Schools” at our partnering health clinic sites, thanks to the development of an integrative system by Kim Swanson, Ph.D., Behavioral Health Consultant at St. Charles Family Care in Richmond, Oregon.  Her 4 week curriculum encourages participants to better identify and define their pain, chronicle their pain symptoms in a pain diary, to learn and incorporate coping skills such as breathing techniques, pacing, progressive muscle relaxation, reframing fear,  guided imagery and meditation, and  learning to set realistic goals, improve relationships and communication skills, addressing sleep hygiene, and exercise.

In partnership with our patients and health providers we hope to improve the quality of lives of those who experience pain, regardless of origin.

Pamela Sachs, LCSW

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