Chronic pain can limit daily ac­tiv­i­ties

The News-Times - - ADVICE/GAMES - Keith Roach, M.D.

Dear Dr. Roach: What is the dif­fer­ence be­tween chronic pain and acute pain? How can I best de­scribe my chronic pain when it is vari­able in in­ten­sity but neg­a­tively im­pacts so much of my life and my ac­tiv­i­ties? Are there things my doctor should con­sider or sug­gest in my treat­ment or in com­mu­ni­cat­ing with me?

P.P.C.

An­swer: Acute pain is usu­ally due to an in­jury or in­fec­tion, and we ex­pect heal­ing to oc­cur rel­a­tively quickly. Chronic pain is ex­pected to go on for at least six months. In some peo­ple, acute pain is not treated ad­e­quately at the time of in­jury, and the brain and body learn to be in pain chron­i­cally.

The rea­son for pain is per­fectly ob­vi­ous in some cases, but in oth­ers, it is not pos­si­ble to iden­tify the ex­act cause of pain. Most times, pain is due to dam­aged nerves (neu­ro­pathic pain); in­jury or de­gen­er­a­tion in the mus­cu­loskele­tal sys­tem (os­teoarthri­tis and many kinds of back pain); in­flam­ma­tory pain (due to in­fec­tion or in­flam­ma­tory dis­eases like rheuma­toid arthri­tis); and com­pres­sive pain (such as kid­ney stones or can­cer).

Chronic pain af­fects many parts of your life, as you cor­rectly note, and an ex­pe­ri­enced doctor will ask about the ef­fect of pain on your so­cial life, mood (depression is very com­mon), re­la­tion­ships, sleep, ex­er­cise and oc­cu­pa­tion. Peo­ple with more se­vere prob­lems will have lim­i­ta­tions in their ac­tiv­i­ties of daily liv­ing.

Many peo­ple with chronic pain have al­most given up com­mu­ni­cat­ing the scope of the prob­lems they have, as they don’t like “com­plain­ing” all the time, or they feel their loved ones are tired of hear­ing about it. How­ever, get­ting a thor­ough his­tory of the ef­fect of all these di­men­sions of pain is im­por­tant for your doctor. Ques­tion­naires like the Brief Pain In­ven­tory ad­dress more ar­eas of func­tion than a typ­i­cal 1-10 pain scale, and may be use­ful to mon­i­tor re­sponse to treat­ment.

Ex­perts in pain man­age­ment are more likely to have the knowl­edge and ex­pe­ri­ence to com­mu­ni­cate about pain ef­fec­tively, and truly ef­fec­tive treat­ment for chronic pain requires un­der­stand­ing it.

There can be pain with­out suf­fer­ing. Suf­fer­ing is the emo­tional com­po­nent brought on by fear: “How bad am I go­ing to hurt to­day? Will I ever be able to work again? All of my re­la­tion­ships are suf­fer­ing.” Learn­ing to live a func­tion­cen­tered life is key in the treat­ment of chronic pain. It isn’t easy and requires a mul­ti­dis­ci­plinary ap­proach.

The time of pre­scrib­ing pain med­i­ca­tions, es­pe­cially opi­ates, with­out a com­pre­hen­sive plan for long-term pain man­age­ment, should be over. Dear Dr. Roach: I’m a 79-year-young fe­male and take one 200-mg tablet of mag­ne­sium ox­ide be­fore bedtime to keep leg cramps at bay. I sleep re­ally deeply and won­der if it has side ef­fects? Tak­ing the MagOx daily seems to help me get a good night’s rest.

J.L.

An­swer: Mag­ne­sium ox­ide in the low dose of 200 mg is quite safe for most peo­ple. It is of­ten used as an antacid at up to four times that dose. Di­ar­rhea is the ma­jor side ef­fect. In peo­ple with kid­ney dis­ease, mag­ne­sium should be used only at the advice of a physi­cian.

It doesn’t help ev­ery­one with leg cramps, but it is ef­fec­tive for some peo­ple, anec­do­tally. I have not heard of it mak­ing peo­ple sleep more deeply.

Read­ers may email ques­tions to: ToYourGood­[email protected] .cor­nell.edu or mail ques­tions to 628 Vir­ginia Dr., Or­lando, FL 32803.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.