Posts filed under 'Pain Management'
April 29th, 2009
Pain remains the number 1 reason that people seek medical attention.
More people are affected by pain than cancer, diabetes, and heart disease combined.
Most people would expect to have their pain managed by healthcare professionals, but there are many barriers that impede effective pain management; therefore, pain remains undertreated.
Barriers as listed by the American Pain Foundation:
Patients often do not tell their doctor about their suffering and may worry about using pain medicines based on misunderstandings about addiction and dependence.
Few health professionals are trained adequately in pain assessment and management. It is estimated that only 7% of physicians receive pain management education in their medical schooling.
Less than 1% of the National Institutes of Health research budget is dedicated to pain research.
Lack of understanding about regulatory policies, coupled with the perception that prescribing adequate amounts of pain medicines will result in unnecessary scrutiny by regulatory authorities, contributes to practioner’s reluctance to prescribe medicines for adequate pain management.
The good news is pain and all of these barriers are being addressed on the national level by the National Pain Care Policy Act of 2009. This has passed through the House of Representatives and now needs to be supported to pass in the Senate. Go to www.painfoundation.org and click on “Take Action Now” which is located on the right margin of the website. It is very simple to support this important policy. You will need to enter your name, email address and zip code and the appropriate Senator will be contacted. There is also information on this Policy at the website. You or someone you know will likely be affected by pain at some point in your life. Please, take a minute to improve pain management now.
April 14th, 2009
While reading the HealthyRockford.com section in Life&Syles of last Sundays paper (4/12/09), I began thinking of the vicious cycle chronic pain creates. “Staying healthy as a senior” discussed keeping active in body, mind, and spirit. Chronic pain can interupt all 3 of those living aspects. It is very difficult to exercise while experiencing pain. Many people equate pain during exercise with exercise causing physical harm. In reality, not exercising creates inflexibility and deconditioning of your body. This leads to deterioration and increased pain. And don’t forget the endorphins released during exercise. These are “feel good” chemicals (spirit). Exercise gets your heart pumping and the blood flow to your brain will increase (mind). It is important to exercise regularly. Ask your doctor for appropriate exercise recommendations for your individual needs. It is important to have your pain managed to a level where you are able to function and participate in some exercise activity. This will help your body, mind and spirit.
Pain very often creates isolation. Most people do not want to interact when not feeling well or fear that physical contact may cause more pain. Human beings are social creatures. Isolation does affect both mind and spirit. Pain and depression often go hand in hand. Depression has been shown to increase pain and chronic pain can cause depression. Depression may also have physical consequences.
Pain interferes with sleep. It has been shown that REM sleep is often not reached when experiencing pain. Sleep deprivation may increase the pain experience. Sleep deprivation may have physical, mental and emotional consequences.
The vicious cycle of pain must be broken. Pain is a very complex and individual experience. Find a physician that is willing to work with you to manage your pain so you can function physicially, mentally and emotionally to your fullest potential.
The Kelly Epperson blog spoke to music being good for you. A study done with chronic pain patients confirmed this. It showed that listening to music for 1 hour every day caused a reduction in pain levels. This doesn’t mean “easy listening” music (easy listening music for my stepson would be like scratching nails on a chalkboard), but whatever music you enjoy. So grab your favorite CD, put on those headphones and let the music take you away. While listening it may feel good to sway your arms, your hips or do some fancy footwork (get some physical activity in there) or close your eyes and let the music take you to your favorite place. This may aid in breaking the cycle of chronic pain.
December 8th, 2008
Abuse of prescription pain relievers creates a huge barrier in prescribing and use of morphine or morphine-like substances (known as opioids in the medical world and narcotics in the legal world) to manage pain effectively. This fear of abuse involves healthcare providers, such as doctors and nurses, as well as patients and families/significant others.It is a fact that abuse of prescription drugs has been on the rise. From 1992-2003, prescription drug abuse increased 94% and a 2005 survey revealed that 19% of teens abuse drugs (that’s 1 out of 5 teens); as reported in a 2006 update by the National Center on Addiction and Substance Abuse. Every day 2500 teenagers are first time users of a prescription drug. The biggest reason for the rise in prescription drug abuse is easy access. The latest happening at parties is called “pharming.” Kids are bringing prescription drugs out of their home medicine cabinets and dumping them all together in a bowl, then grabbing a few pills or a handful and taking them. This is a dangerous practice, but many people seem to think it is safer to use these prescription drugs rather than drugs off of the street. This practice involves prescription pain killers and also sedative or anti-anxiety prescriptions.Following is a list of what we can do to prevent irresponsible drug use or misuse if you are prescribed these medications:1. Talk to your teens about the danger of using these drugs. Do this before misuse could begin and repeat often.
2. Never take a prescription pain medicine unless it is prescribed to you.
3. Lock up prescription pain medications and count the number of pills left in the bottle. Prevent the easy access, do not leave bottles of prescription pain killers in plain sight or in a medicine cabinet.
4. Never share prescription pain medicines with others, this is illegal.
5. Do not take higher or more frequent doses than prescribed. Call your physician for unrelieved pain.
6. Do not take prescription pain medicines with alcohol, which can cause bad side effects.
7. Do not combine sedatives or anti-anxiety drugs with pain medicines; this can increase toxicity.
8. Do not use opioid medications as sleeping pills; this can suppress breathing during sleep.
9. Dispose of unused or expired prescription pain medicines in “yucky stuff” such as used kitty litter or used coffee grounds.
There is a major prescription pain medicine abuse and diversion problem, but it is highly unlikely that a person in pain will abuse prescription pain medicines. The abuse occurs when these drugs get into the hands of others. When doctors are hesitant to prescribe opioids to people experiencing moderate to severe pain, due to possible abuse, it has been said that the “war on drugs becomes the war against pain.” Be responsible with your prescription pain killers.
Go to www.painfoundation.org and www.notinmyhouse.com to learn more.
October 29th, 2008
Caution should be taken when using over the counter NSAIDs. NSAIDs are nonsteroidal antiinflammatory drugs such as aspirin, ibuprofen, motrin, aleve, and naprosyn to name a few. Serious gastrointestinal (GI) complications occur in 1-4% of NSAID users each year. These serious events such as bleeding or ulcerations can occur without any warning. NSAID induced events result in an estimated 100,000 hospitalizations and 16,500 deaths each year in the U.S.. These risks are greater with a history of peptic ulcer disease, taking steroids and anticoagulants at the same time, high-dose NSAIDs, and older age. Drinking alcohol while taking NSAIDs may increase the risk of the gastrointestinal complications.
NSAIDs are hard on your kidneys. NSAIDs can cause and or aggravate hypertension, heart failure, edema (fluid retention), and kidney problems.
NSAIDs may cause an increased risk of complications in people with known cardiovascular disease or existing cardiac risk factors. The cardiovascular complications could possibly include myocardial infarction (heart attack), stroke, heart failure, and hypertension. Ibuprofen may interfere with the cardioprotective effect of a daily aspirin dose. It is recommended, by the American Heart Association, for patients taking immediate release low-dose aspirin and ibuprofen, to take the ibuprofen at least 30 minutes after the aspirin or at least 8 hours prior to the aspirin dose. Naproxen has not been shown to interfere with the cardioprotective antiplatelet effect of low dose aspirin.
NSAIDs are effective analgesics for many different types of pain, especially pain due to inflammation. It is safest to take NSAIDs at the lowest dose for the shortest time they are needed. If you take NSAIDs regularly each day for longer than 10 days to 2 weeks, you should consult with your physician, especially if you have known risk factors of heart disease, gastrointestinal problems such as heartburn, reflux or ulcers. or kidney problems. Don’t assume over the counter medication is safe.
October 6th, 2008
There are two very popular over the counter analgesics (pain relievers). Acetaminophen, also known as Tylenol, and NSAIDs (nonsteroidal anti-inflammatory drugs) such as aspirin and ibuprofen. People assume these type of medications are very safe because they can be purchased withouth a prescription, but this is not true. In this blog I will discuss acetaminophen. I will discuss NSAID use in a future blog.
There is 325 mg in regular strength acetaminophen and 500 mg in each extra strength pill. The maximum daily recommended dose for a short period of time is 4000 mg/day. Acetaminophen is hard on your liver. A study has shown taking 4000 mg of acetaminophen regularly, for a prolonged period of time, to cause an elevation in liver enzymes. The American Liver Foundation issued a warning in July 2006 recommending people not to exceed 3000 mg of acetaminophen each day for a prolonged period of time. This means if you take acetaminophen regularly for several weeks, the maximum dose per day should not be over 6 extra-strength tablets. Pediatric dosing is determined by the child’s weight; it is important to follow label directions and/or check with your physician for infant and young child dosing.
Alcohol is also hard on your liver. If you consume alcohol regularly, you should not use acetaminophen without speaking with your doctor. Also, acetaminophen should not be used by persons with liver disease.
A 2005 multicenter study indicated acetaminophen overdose to be the cause of 42% of acute liver failure. Acetaminophen is included in over 200 over the counter combination medications; such as cold, allergy, flu and headache medications. Acetaminophen is also included in combination pain medications such as vicodin, norco and percocet, to name a few. It is the unintentional overuse of acetaminophen that accounts for most of acute liver failure. Be aware of the content of pain medications you are taking and read labels when purchasing over the counter medications to avoid overuse of acetaminophen. Acetaminophen can be an effective medication for mild pain if taken correctly. It is the number one recommendation for pain in the American Geriatric Society guidelines.
September 17th, 2008
This may sound like a silly question if you are experiencing pain, of course you are aware of your pain, but lucky people without pain may not give this a thought. 1/5th to 1/3rd of the United States population suffers with persistent pain. It would be safe to assume that 1/5th to 1/3rd of the Northern Illinois population also suffers with persistent pain. So, it is important for Northern Illinois to be aware of pain.
Although treatments are available today to manage or greatly ease most pain, pain is undertreated. Undertreated pain weakens the immune system and slows recovery from disease or injury. Undertreated pain increases the workload on the heart. Undertreated pain results in longer stays in the hospital, increased emergency room visits, and leads to unplanned clinic visits. Uncontrolled pain ruins a persons quality of life; affecting almost every aspect of life including sleep, work, and social and sexual relations.
Unfortunately, there are many barriers that prevent effective pain treatment. Most healthcare professionals have little or no training in pain management. Yet, pain is the number one reason people seek medical treatment. People often believe that the opioid (morphine or morphine like substances) medications are addictive and produce euphoria. It is a fact that when properly prescribed by a healthcare professional and taken as directed, these medications give relief-not a “high.” There is not a physiologic measure of pain, so a person’s report of pain must be accepted. These are only a few of the many barriers.
Pain doesn’t discriminate. Most likely it will affect you or someone you care about at some point in your life. Pain relief has a positive impact on life and health. It is imperative that effective pain management be a concern and a priority in Northern Illinois. Responsibility for pain management lies with the person in pain and the healthcare team. Communication and education are key. You are invited to a FREE community event titled “Pain in Illinois-The State of Affairs” on Tuesday, September 23rd from 4:30-6pm at Our Saviors Lutheran Church, 3300 Rural St, Rockford. Light refreshments and door prizes included. Registration to 815-387-8310 appreciated.
August 25th, 2008
I meet with the Chronic Pain Support group at SwedishAmerican Hospital on the second Monday of each month at 10am. These individuals are terrific weather forecasters. Some experience pain fluctuations with slight changes in the barometric pressure. Severe weather changes, such as thunderstorms, cause the most increase in pain before and during the storm. Weather related joint pain actually has a physiologic explanation. There are sensory nerves in joints called baro-receptors. These respond to changes in atmospheric pressure, especially when there is low barometric pressure. Low barometric pressure occurs when the atmosphere changes from dry to moist. Arthritic joints have less cartilage to provide cushion, so people with arthritis are prone to feel these changes more readily. So, the next time someone with chronic pain states they can feel it is going to storm, don’t think it is “all in their head”, think it is in their joints and grab an umbrella!
July 31st, 2008
Several years ago the American Pain Foundation (APF) developed the following “Pain Care Bill of Rights.”
As a person with pain you have the right to:
*have your report of pain taken seriously and to be treated with dignity and respect by doctors, nurses, pharmacists, and other healthcare professionals.
*have your pain thoroughly assessed and promptly treated.
*be informed by your healthcare provider about what may be causing your pain, possible treatments, and the benefits, risks, and costs of each.
*Participate actively in decisions about how to manage your pain.
*have your pain reassessed regularly and your treatment adjusted if your pain has not been eased.
*be referred to a pain specialist if your pain persists.
*get clear and prompt answers to your questions, take time to make decisions, and refuse a particular type of treatment if you choose.
Note *these are not always required by law.
The American Pain Foundation website is a reliable source of pain management information with links to specific pain entities www.painfoundation.org
July 22nd, 2008
Medical research has shown that people with long-lasting muscle, bone or joint aches and pains are usually lacking in Vitamin D. Vitamin D is available in 2 forms–D3 and D2. D3 has been found to work better for most people. Another name for D3 is cholecaliciferol. Look for either on the label. A good amount to start with is 1600 IU each day. A good multivitamin usually contains between 400-800 IU of vitamin D3. Add a 1000 IU vitamin D3 supplement to this to total 1600 IU. Do not take more than 2000 IU of vitamin D3 without talking to your healthcare provider first. It may take weeks or even months before improvement is noticed. Be patient and continue taking your Vit D3 supplement each day. If you are taking any of the following medicines, talk to your healthcare provider before starting on Vit D supplements: anticonvulsants, medicines for HIV/AIDS, barbiturates, glucocorticoids or corticosteroids, digoxin, hydroxychloroquine, rifampin or thiazide diuretics. Also talk to your healthcare provider before starting Vit D supplements if you have any of the following conditions: liver or kidney problems, kidney stones, irritable bowel, Crohn’s or celiac disease.
Supplemental vitamin D for chronic musculoskeletal pain is inexpensive with favorable benefits and minimal, if any, risks involved. For more information go to: http://Pain-Topics.org/VitaminD
June 23rd, 2008
Chronic pain is very complex, it invades every aspect of a person’s life. A person with chronic pain not only has the experience of the physical distress, but psychological, social and emotional distress accompanies this illness. Then, add to it the financial burden this may cause. The chronicity of the physical distress is a constant reminder of the life changing effects pain has created.
SwedishAmerican Hospital began hosting the American Chronic Pain Association (ACPA) Support Group in April of 2006. The group meets on the second Monday of each month from 10:00 to 11:30, in Conference Room D. The ACPA mission is “To facilitate peer support and education for individuals with chronic pain and their families so that these individuals may live more fully in spite of their pain.”
More people suffer from chronic pain than cancer and heart disease combined. Research has shown that a person’s beliefs and coping skills can positively or negatively impact the experience of pain. If individuals can think differently about their pain, they may gain a sense of control over it, instead of pain controlling them.
For information regarding the chronic pain support group contact Beth Moore, Facilitator. (815) 247-8885
For more information regarding chronic pain go to www.theacpa.org
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