About Pain

Because no one can determine what another person feels, diagnosing and treating pain is a challenge, making it difficult for family members, friends, the medical profession, and insurance companies to understand. Still, pain can be managed even when the underlying causes of it — such as cancer, osteoporosis or injury — cannot. I believe that patients who continue to be in serious pain for six months after receiving adequate care by local, “affordable” physicians, should look elsewhere for treatment.

Most doctors under-treat pain, either through ignorance of the specifics of pain management, or possibly fear of prescribing narcotics. If you come to me, a neurologist, asking about drugs for your heart, I’ll tell you about 10. A cardiologist could tell you about 27. It’s the same in pain management. Doctors who treat pain know more about how to alleviate pain than those who specialize in diseases that cause pain, including oncologists who treat cancer, among others.

Despite notions current in pop psychology, in most cases, whether or not the source of pain can be identified, pain really is physical. It is not about anger. It is not about stress. When a patient complains of pain and their medical tests reveal no physical cause, it is usually improper for doctors to tell them that the problem is “in their head.” A few nerve problems are clearly related to stress and do warrant psychological help. For the most part, I believe my patients’ pain is real, even when the causes of the pain may not show up on an x-ray or other tests.

All pain comes from injury to or irritation of nerves. Pain ultimately is perceived by and reacted to by the brain. When nerves send signals of pain over a prolonged period of time, these pain impulses literally become part of us, influencing everything we do. They won’t show up as part of the body’s physical structure, but they can lead to significant related psychiatric symptoms. The earlier you treat pain effectively, the easier it will be to control it and prevent it from becoming chronic and endless. Otherwise we, the medical community, may actually help drive some patients with chronic, poorly understood pain syndromes “crazy.”