To some pain management may seem like the worst thing. To others pain management may seem like the best thing; (although honestly I don’t think I’ve ever heard anyone say that). To me? pain management is a pain in the arse!
Pain Management can be extremely beneficial to somebody like myself i.e. someone with chronic pain. It helps someone with chronic pain to better manage the pain and the symptoms to live their life as best as they can alongside their pain. Personally I have had a long relationship with pain management, I have had some great results, I’ve had some alright results and then I have felt let down despite all my work I’ve had some fairly devastating results (please do continue reading as this does get brighter!). However, despite my mixed results through pain management there are definitely things I can take away from it. I do feel that most people don’t take much away from pain management as I think they expect too much and don’t make the most of what they get out of it; but the clue is in the title pain management. It is to help you manage your pain not to cure it.
Pain Management is a tool that can be used by those with chronic pain. It is essentially there to teach you how to live your life the best you can with your pain.
There are several steps within pain management and you may try some of these before you reach a pain management clinic. In my experience the one thing I can always guarantee you will have tried before reaching a pain management clinic is cognitive behaviour therapy also known as CBT, or at least something like it i.e. some form of psychology sessions. Again these techniques are used to help you learn to live with your pain and to learn how it impacts your daily life but it’s mainly there to teach you to think about your pain in a specific way. However, and this is a big however… I disagree with a lot of these approaches. Anyone who knows me well will be nodding with a little laugh right now because they know how strongly I personally feel about this. As I said I have found some benefits, which goes to show that even the most dubious can find benefit… if done correctly. I do not nor do I believe that anyone else will benefit from being told that if they think positively about their pain it will go away or be less problematic – I wont go any further because this is a WHOLE other topic and blog post.
When dealing with pain I can almost guarantee that you’ve tried every over-the-counter medication/Painkiller there is and inevitably when they don’t work because they are not strong enough to go up against your pain so, you seek advice from your GP. Some people may speak to their rheumatologist or consultant but more often than not you go through your GP first.
A GP will quite often encourage you to try something like paracetamol which you have probably already done (and it stood no chance against your chronic pain). As well as an anti-inflammatory the most common thing being ibuprofen. Depending on how well your GP knows you, your conditions and how long you’ve been suffering they may prescribe you something such as codeine or a medication that contains codeine. However, no matter what combination they try they never really touch your pain and when it does the relief you get doesn’t last very long. When I say your relief doesn’t last very long I’m talking about the relief you get between each dose but also the relief you get overtime. As overtime your body often becomes too used to the medication and you no longer get relief from it.
Eventually your GP, rheumatologist or consultant will advise that they will refere you to a pain management clinic. If like me, you will be very surprised when this referral is offered as you never knew a pain management clinic existed. Plus given the fact that you suffer from chronic pain you would have assumed that your doctor would have mentioned or referred you sooner. I should say here that pain management clinics are slightly more common now compared to what they were 10 years ago.
Again in my experience a pain management clinic was offered when I was most desperate. This does not necessarily mean this is where my pain was at its worst but this is when we were getting the least success with any other treatment and were running out of treatment options. Therefore, for some people, including myself pain management clinics are a last resort.
When you attend a pain management clinic, they may offer CBT or some form of psychological therapy. Although you have usually covered this basis before they like to make sure that you have covered all possible roots before you are offered anything else. This does make sense as you wouldn’t want to take on a new medication or heavy treatment on if there’s something you can do beforehand.
Some pain management consultants will offer you other forms of medication. When I first saw a pain management consultant I was about 15 we discussed a few options however these weren’t anything I looked into until I was around 18. These medications quite often include things such as tramadol, gabapentin and pre-gabalin. However, depending on your circumstances and your pain these medications may not always be the best form of treatment. Despite being in severe amounts of pain there was a lot of thought that had to go into whether or not I wanted to try these types of medications. Therefore, if you are thinking of trying a higher more impacting type of medication I would urge you to really think about the side-effects and weigh up the pros and cons first. This is something the consultant should do with you and it’s probably done on your behalf before the medication is offered. However, if they don’t, do make sure this is a discussion you have. You may even decide that this is something you need to think about personally before you make the decision. As most things when it comes to health and medications always make sure you have as much information as possible.
A consultant may not always offer medication straightaway and for me the medication wasn’t what we are looking to try first. In a lot of cases your local pain management clinic can offer an outpatient course that runs over a number of weeks. You work with the consultant, physiotherapists, occupational therapists and other medical professionals along with other people like you with chronic pain to learn how to deal with your pain on a daily basis and to how to live your life the best you can.
Sometimes this isn’t always an option or there is not an appropriate group for you to be a part of. This was the case for me therefore I was offered a three-week inpatient pain rehab course. This is similar to an outpatient course however, less hospitals run this and it is much more intense although the aim remains the same. I don’t want to go into too much detail about this now as this is something I’d like to do later on in my blog but most people do this again as a last resort hoping for answers and it is a very intense program but some people can get some real benefits from it.
Bare in mind that pain management clinics are specifically for those with chronic pain. Although many people with chronic pain have many other conditions they have to deal with, this is specifically set up to help you learn to live daily life to the best of your ability with pain. The service and clinics have been set up by great doctors that really understand chronic pain therefore they are some of the best treatment a sufferer of chronic pain can receive.
If you live with chronic pain or know somebody that does you will know the stigma that is attached to it. Therefore, personally I feel that even when things are really tough and you are at your lowest point remember, these doctors and clinics can’t cure you but these are the people that really care and really want to help you live a better life with pain.
These views are my own, based on my own experience of Pain Management as well as my view on other cases I have heard about or seen. Others may have had different experiences and any individual looking to be seen by Pain Management Clinics/Consultants may have a different experience to me. These services may not be open to all chronic pain suffers depending on your own circumstances and/or your location/local services.