If you have chronic pain from fibromyalgia (FMS), chronic fatigue syndrome (CFS or ME/CFS), or any other cause, you've probably been frustrated at some point with the quality of pain treatment you've gotten from a doctor.
There's a good reason for that. Even though pain is the most common complaint doctors hear, most doctors aren't terribly well equipped to assess and treat it. Why is that? During all those years of medical school, the American Pain Foundation says medical schools spend about one hour teaching young physicians to understand and treat pain. One hour, on a topic that can derail your life.
According to a study published in the New England Journal of Medicine, one third of hospital patients felt their pain was not well controlled. It's no wonder that those of us who only get a doctor's ear for a few minutes a few times a year, and aren't typically observed by health-care providers when we're at our worst, have less-than-adequate pain control.
Here are some statistics I find interesting, not to mention troubling:
- At least 76 million Americans are in chronic pain
- Pain costs the U.S. about $100 billion a year in medical care and lost productivity
- The U.S. has an estimated 1 pain specialist for every 21,000 pain patients
- Only 2% of NIH research money is spent on pain studies
On top of all that, in spite of everything researchers have learned in recent years about pain and pain relief, pain treatment has hardly improved at all.
How can we use this information, other than to fuel our anger and frustration? In a couple of ways. First, on a personal level, we can understand what both we and our doctors are up against, work to improve our communication with them, and push for the pain management we need. Second, on a broader level, we can support the efforts of advocacy groups working to secure more research funding and better physician education. Here are some articles that can help you with both of these things:
How well is your pain managed? Is it because of your doctor, or your own efforts? Have you had an experience with an actual pain specialist? I'd love to hear your story, either here or in About.com's Fibromyalgia & Chronic Fatigue Syndrome community forum (under Newsletter & Blog Topics).
Suggested Reading:
- Drug Treatments for Fibromyalgia
- Drug Treatments for Chronic Fatigue Syndrome
- Alternative Treatments for Fibromyalgia & ME/CFS
Photo © Andersen Ross/Getty Images
You can place some of the responsibility on the DEA. People with pain are commonly assumed to be either present or future drug addicts.
Addiction is an insatiable drive to use a drug because of the pleasure it affords and the side effects of craving that pleasure.
Addiction is very rarely encountered among patients with pain because the pain takes up all the “active ingredients”. Being pain-free for a time may seem like pleasure, but it is not what recreational drugs users are looking for.
Tolerance is the need to receive increasing doses of opiates in order to maintain analgesic effect. Because of this, patients with chronic pain are often accused of drug-seeking behavior as they may come to need more of the opiate.
When a patient is in severe pain and seeks medication that relieves that pain, drug-seeking behavior is quite normal and understandable. It is not a warning signal of addiction.
Dependence is the development of withdrawal symptoms when the opiate is suddenly discontinued. Dependence is not a problem as withdrawal symptoms can easily be avoided by making sure that the patient does not run out of medication. Dependence is not limited to opiates, either. There are many drugs that warn against suddenly discontinuing them.
It is unfortunate that people with pain as so often lumped together with people with addictions.
Glen,
You’re exactly right. A recent study showed there’s only a 3% risk of addiction in legitimate pain patients without a history of addiction. Meanwhile, laws and attitudes victimize those of us with chronic pain by stigmatizing us and frequently denying us the medications we need in order to function.
Thanks for your comment!
My pain treatment against this kind of pains is (it sounds simple, but it helps) taking a bath in REV Epsom salt (from CVS). Soaking the Magnesium helps to relieve the pain a little bit, and especially people who suffer from chronic fatigue need that extra-Magnesium. Dianne
I agree with Glen 100%. I have to beg my general practitioner for 50 mg tramadol and yet he prescribes enough Xanax to sink a battleship. I’m lucky if my GP gives me between 10 and 12 tablets per month, no refills of course. He claims he doesn’t want to start a dependence problem, more likely he doesn’t want the DEA all up his ass for writing pain med scripts. Treatment centers aren’t filled to the brim from tramadol abusers. Why do the Feds have to scare the crap out of our physicians and prevent them from keeping their patients comfortable? And did you know that Drs. are more apt to give pain meds to men rather than women? If a gal needs an opioid, she’d better find an oncologist.
Carol, you are SO right about everything! Heck, everyone has been right on the nose about everything here. I guess we, who are being abused (I’m serious; we are BEING abused!) by “the system” know its pitfalls far too well. Here in the South, the problem is mind-boggling and probably unfixable. Once you get north of the Mason-Dixon line, I’ve found that pain treatment improves across the board. I have an exhausting trip every month across that line, due to the DEA, to see my pain management doctor. Fortunately, he is very much worth it! He is a holistic pain management physician, and his practice reflects it. He doesn’t “only” distribute “drugs”! He dispenses much more than that, and the best thing about him and his treatment team are their compassion. I CRIED the first day I met him. He was so unlike the jerks I’ve been used to seeing down here!
Carol, you are SO right about everything! Heck, everyone has been right on the nose about everything here. I guess we, who are being abused (I’m serious; we are BEING abused!) by “the system” know its pitfalls far too well. Here in the South, the problem is mind-boggling and probably unfixable. Once you get north of the Mason-Dixon line, I’ve found that pain treatment improves across the board. I have an exhausting trip every month across that line, due to the DEA, to see my pain management doctor. Fortunately, he is very much worth it! He is a holistic pain management physician, and his practice reflects it. He doesn’t “only” distribute “drugs”! He dispenses much more than that, and the best thing about him and his treatment team are their compassion. I CRIED the first day I met him. He was so unlike the jerks I’ve been used to seeing down here!
BTW — Dr B’s “bath remedy” involves sea salts and baking soda, but basically we’re looking at the same principle!
I wish you all as pain-free a day as possible!
*gentle hugs*
I fortunately have a doctor who actually encouraged me to let him write me a prescription for a pain med! He says it is about “quality of life” and if I’m in pain, what kind of life is that????
Foxy
BooYah Glenn…well addressed and right on target.
I have fibro. and an injury that will keep me on Ultram for the rest of my life. While I have taken it for almost 3 yrs. now, I do not abuse it and continue to take it 4-6 hrs. as needed. Yes, i’m addicted, but it’s not contributed to getting a high from the medicine…it’s because taking it is the only way I can get through the day and function…and even with it i’m still in pain.
Wake up Doc.!!!
I agree with most of these comments. This is the first time I have ever posted a comment on any web site, but chronic pain is something I live with every minute of every day.I too,am lucky to have a doctor who understands that there is always going to be a need for an increase in my medication after working with me for 20+ yrs. I also would like to say that I am soooo tired of being referred to as a meth head since I do not do illegal drugs and the people who say that
generally don’t have a clue. Another thing I agree with is the fact that I don’t remember ever getting “high” off my pain medication. Not being able to take it when I need it leads me to not understand how some people can go to a doctor, convince them they need large amounts of pain medication and then sell or trade them away for other things. They make it so hard for those of us that really do need our medication. I am sooo tired of being judged by people who probably would’nt know REAL pain if it kicked them in the face.
I have had awful problems here in NM. The doctors dont get it…I had one doctor tell me Valium would help with my pain and the anxiety from it…WHen I told him I have adverse
reactions to valuium he wrote a prescription for DIAZEPAM>>>>thats the generic form HELLO.
I also had one doctor tell me to choose between the medication he wanted to prescribe which would make me sleep all night and be unaware of pain etc til morning. We had already dicussed the fact that
I am the single mother of a special needs child (who was about 2 1/2 then) that at times with no warning will vomit several qimes in the night…and I am afraid of her choking should I not hear her. THis “docotr” wnated me to choose?
Here in the “Land of Disenchantment” I have been passed from one doctor to the next and then passed again. All I hear is “we dont know” ” It may not be as bad as you think”.
THis chfonic pain fibromyalgia whatever name they want to call it this week has already cost me the job I loved for so many years. It has prevented me form getting a full time job of anykind,
Thank God I have a part time one that helps keeps the lights on and buys the everyday necessities
Is helath care this awful all over the country?
Also due to a congential hip issue which baffles the brains here…If I hear one more time “if it was a sports related injury we would know more how to handle the pain”…Its still the same kind of problem with the same kind of pain…HANDLE IT GEEEEEEEEEEEZ
Angry in NM—-what area of New Mexico do you live?
I live in 4 Corners area—I might be able to help with a doctor that might help you.
I thank my lucky stars I have a doctor who, if he doesn’t always understand my pain, at least acknowleges I have it. I have taken Tramodol for over eight years for my FM pain. I take it at fairly low dosages, 50mg late in the day. If I am in really bad pain I take more. If I am in 4 alarm pain my doctor perscribes something stronger. My problem with these stronger pain meds is that I wish there was more research into meds that didn’t have such awful side affects. I hate narcotics that make me feel whoozy and make my stomach upset for several days after taking them, an don’t necessarily take care of the severe pain. What I do like about the milder pain meds like Tramadol is that they help with the pain without making me sick in the process. I think it is a crime to not perscribe pain meds for a person who is in severe pain. It is torture. When I am in pain I want relief, now. I demand it. The longer bad pain persists the harder it is to control, and the worse the pain.
Foxy, Your doc sounds like my first pain manager. He said the same thing about quality of life. This was 2 1/2 years ago that I went to see him. I was looking for therapy, never would have dreamed that I needed pain meds to manage my life. Now, I am thankful to him. I do see a different doc now, a holistic one in Cincinnati Ohio. He carries on the meds for me. In fact, just increased by on tab per day. I am only 41 and am worried about using these for the rest of my life. Sandy
when you cannot depend on doctors to help you and you happen to get some help …..the law says you are doctor shopping and The DEA well say you are breaking the law……so they past a law honoring a drug abuser….Ryan Haight act…which makes us criminals….thank you congress for not investigating this before you made this a law….so I sit here and cry with pain….
The only thing I know for sure, is that to manage pain, one should respond to it actively, and act positively to restore as much of your quality of life as is possible. I came across the post of a lady who had suffered from back pain, which doctors couldn’t cure for years and then she enjoyed playing golf. She could manage her pain because she took matters in my own hands…
I am hoping to reach Sharon in Nashville. Or anyone who can recommend someone with some care and compassion that isn’t afraid to be a doctor and follow the Hippocratic oath to do no harm. We are a military family that just retired to the KY area (for husband’s school)and I am having the WORST time finding help. You see, I have severe abdominal adhesions and excruciating back pain from that and the surgery they performed to help with the adhesions. It has been for over 24 years and never,NEVER have I had the experiences in getting the (lack) of care and compassion that I have gotten here! I am NOT a drug seeker or an addict. I don’t get high from my medication and nor do I want to. The origin of my illness is not from depression. Yes, I am sad and frustrated that I can’t find help and I am in constant,debilitating pain. Wouldn’t you be? I have a medical condition that is well documented and have had the quality of my life drastically decrease again since we arrived here. Before we left our last duty station, I had been working with a doctor and we had FINALLY gotten the right combination of medication and my days were awesome. You see, I have tried EVERYTHING else available(physical therapy,tens unit, accupuncture and pressure,massage therapy and so on) and this was the best conclusion that we were able to obtain. Yes, there were bad days but the good ones FAR outweighed them. I was able to go to work and perform daily living items that left me feeling so good. Now, I can no longer spend anytime doing anything. I wake up in excruciating agony-that is when I am able to fall into any kind of sleep. I wonder if I were a diabetic, if the DEA and those in charge, would withold my insulin. I was told that if I wanted to get better,I need to take shots in the abdomen on a regular basis and all would be well. When I said I wouldn’t do it(I had shots in my back at the last duty station with negative results) so I was told that I was there seeking mind altering medication and that most of this doctor’s cancer patients didn’t get the types of meds I am on. Well, I truly feel sorry for this doctor’s cancer patients then. I wish I didn’t have to take medications. I wish that I could wake up in the morning and not be in pain, go to work, go to the gym or barn and not be in pain, come home and make love to my husband and not be in pain…Don’t they get it-I DON’T WANT TO BE IN PAIN!!! But I am, just like if I was a diabetic, I am having to live with it. This affects my family’s life too. My husband is so frustrated seeing the way I am treated (or not treated)and having to wake up with me crying and not being able to help. My adult children hate that I can’t get the help I need either. The state of Kentucky has basically set out on a witch hunt and they are going to get everyone in their way. I am willing to go wherever I have to go to get help. I have even considered flying back and forth to our old duty station,a day there and a day back, if that means I will get help. Please, there has to be a way for people in my condition and those with even worse pain, to get the help they need. We don’t want to escape life-we just want to be able to live it.
I’m so sorry to hear you’ve been put in this horrible situation! Here’s
what I was able to find on Co-Cure’s “Good Doctor” list for FMS & ME/CFS:
Louisville, KY
Dr. John Baird
Healing Options
1101 Herr Lane
Louisville, KY 40222
Tel: (502) 339-6550
(FMS “Dr. Baird specializes in alternative therapy for fibromyalgia. He
suffers from FM himself so he understands the symptoms that are a part of
FM. I began seeing Dr. Baird four months ago and feel better now than I
have in many years.”)
Saundra Newton, PT
Hands On Physical Therapy, PSC.
4919 – C Dixie Highway
Louisville, KY 40216
Tel: (502)449-0333
Fax: (502)449-7167
(”She still specializes in Fibromyalgia and chronic pain conditions, but
has expanded her knowledge in enhancing the immune response. Also see
patients with TMJ disorders, chronic headaches, osteoarthritis and other
spinal dysfunctions. Patients with Post Traumatic Stress Disorder report
additional benefits, as well. She has helped me more then anyone.”)
Stanton, KY
Dr. Charles Noss
Family Practice
Main Street
Stanton, Ky. 40380
Tel: (606) 663-2511
(Dr. Noss is a highly respected physician, trusted by countless hundreds,
in his many faithful years of professional health care. When he diagnosed
my fibromyalgia, he had patiently and carefully studied my history,
symptoms, and diagnostic testing, to rule out other disease processes. He
now keeps very close contact with my condition to study the progression of
the disease in order to adjust my care as needed.)
I hope one of these doctors can help you! It’s so frustrating, unfair,
and inhumane that someone with debilitating chronic pain can be denied
medication.
I find it very unpleasantly ironic that at the same time I moved into an area with huge fluctuations in Barometric air pressure and temperature, which has made my chronic pain skyrocket, I also moved into the worst area for the treatment of chronic pain I have ever been in! Through my unfortunate process of having state insurance, then commercial insurance, then state insurance again, I have pinpointed another issue: DOCTORS HERE USE PAIN MANAGEMENT REQUESTS AS AN EXCUSE TO DISCONTINUE SEEING PATIENTS RECEIVING STATE INSURANCE (TennCare). When I had commercial insurance, doctors were “compassionate,” and “really seemed to care,” for a change…then DURING MY RECENT APPOINTMENT when my doc realized my commercial insurance was cancelled and my primary insurance was now my state insurance, his attitude toward me INSTANTLY…no exaggeration here…turned from “caring” to “burdened and irritable,” and he told me to take more meds than prescribed since I was just hit by a drunk driver, and to call when I ran out. When I did, he said that was “strike one” for requesting an increase of dose over the phone. At first, I thought he must have just forgotten he told me to do that, but when I explained it to his nurse, she talked to him and called me back, and with a nasty attitude, she did that IRRITATING thing where they keep repeating what they say rather than acknowledging the point I am making is legitimate…UGH!!! I finally find a doc who doesn’t treat me like I’m making everything up, and then he turns into the rest as soon as I’m poor again (because my husband left me cuz he said he couldn’t deal with being responsible for a disabled wife anymore). It’s all about the money here in the South, folks. If you have it, you can get just about anything you want for your pain, but if you’re poor, you’re doomed to suffer endlessly because nobody gives a crap… because the state doesn’t “pay” them enough to care. You gotta love the health care system in this country that encourages people to become doctors so they can live in million dollar houses rather than to help people.
im 38 years old now i was diagnoised with chronic myofacsial pain syndrome,fibromyalgia,chronic fatigie syndrome,severe osteophorosis my bone age is like a 70 year old,plus i have over 150 trigger&tender points,plus i have other problems i got sick in 03 i grew worse i had to quit my job and school and give up my apartment and move back home,i am so bad with pain i have been in bed for 3 years, i have been to pain DRs here in WV, and they wont help me they help drud addicts ,i have been to so many drs for help i even had one DR tell me he didnt care if i died, ive been laughed at, looked at as a drug addict from drs all because i need pain meds, i have been on hydrocodone since 2001, and it doesnt work anymore, i go to a dr now that only gives me 3 pain pills a day it doesnt help my pain,im so depressed ,my life has been taken from me ,one day i was fine the next my world was turned upside down, my parents have spent there entire life savings sending me to drs out of state that said they can help me they didnt ,they are broke,just live on disability,and i get SSI and aWV ins card everyone that has this knows these drs wont take state ins,im in desprate need of help, with a good pain DR, and a DR that specializes in my illness, if any one can please help with any info, my email is hdebbiepsalms23@aol.com thank u.Debbie
it is no wonder wv has become the capital for street drugs those with chronic pain are denied almost no access to pain medications. i would love for doctors to experience my pain for one week their silly views of individuals with pain would surely change its no fun for every joint to ache, bones burn like fire and pain literally consume you life those who really dont need pain meds have made it impossible for us who cry 24/7 with terrible pain to obtain adequate treatment let the dear doctors hurt they deserve it for being so insensitive lets face it they know the difference between people with true pain and the fakes. testing will surely show why most people hurt and with that evidence what more do they need other than to suffer themselves for a awhile it would be a different world ill bet, ill bet, ill bet