Where is the Chronic Pain Czar?

Approximately 100 million people in the United States experience chronic pain. That’s 1 in 2.5-3 individuals. 

25 million of these people have moderate to severe chronic  pain

45% of individuals with chronic pain have  depression 

25% have co-existing anxiety based disorders 

15-28% have co-occuring substance use disorders 

49% of Veterans with PTSD have chronic pain

How to Reduce Chronic Pain for Individuals 

1.Pain is a subjective experience

2.Perceive pain as a ‘challenge’ vs despair

3.There are at least 5 ways to measure pain-Physical l, Cognitive Appraisals,Emotions,Life Stressors,Fortitude 

4. Identify Your Pain Scale Measurements

5. Identify realistic goals/ Everyones Challenge is Different- Major goal is to reduce pain level scale Measurements from 7-9 to 2-4 over time.

6. Accept or Defend Against This Challenge

Weigh the Advantages and Disadvantages 

7.If accept, work through loss (Way it was before chronic pain versus way it is now). If reject,note short and long term consequences.

8. Appreciate the multidimensional approach to pain management

9. Weigh Advantages and Disadvantages of each Pain Managwment Strategy

10. Determine Your Commitment/Choose which strategies would work best for you

11.Act on Your Plan

12. Evaluate how it’s going

13. Maintain pain management strategies to reduce average negative pain scales and improve positive ones over time

How to Reduce Chronic Pain for Medical Specialists

1.Help patient realize that pain is a subjective experience-phenomenological approach

2.Join with patient to perceive pain reduction as a ‘challenge’ vs despair 

3. There are at least 5 ways to measure pain, not one.  A. Physical B.Cognitive Appraisals C. Emotions D. Life stressors

E. Fortitude (Strengths)

4.Assist patient to interpret his/her Pain Scale Measurements

5. Help patient establish realistic goals while affirming that everyones challenge is different. Note realistic expectations of reducing pain scale levels as best as possible to 2-4 vs. 7-9 for negative scale ratings and 7-9 vs 2-4 for positive ones.

6. Explore with patient whether s/he will accept or defend against this challenge/Have patient weigh the advantages and disadvantages without judgment

7.If accepts,help patient work through loss. If rejects,explore short and long term consequences 

8. Help patient appreciate the multidimensional approach to pain management. Pain Management Lifestyle is Different for each person. 

9. Have patient weigh the advantages and disadvantages of each strategy

10. Help patient choose specific strategies/ determine his/her commitment

11.Have patient act on his/her plan

12. Help patient evaluate how it’s going

13. Maintain ability of patient to keep on track of monitoring pain measures while acting on specific pain management strategies. 

Sound Familiar?

“Pain is inevitable; suffering is optional”

M.Kathleen Casey
Yes, you have chronic pain. Don’t let anyone tell you differently. While they try to minimize it, the pain continues to exist. It has been with you well over three months. The pain may be sharp, stinging or a dull ache. It can be a tingling sensation throughout your fingers and your toes or a feeling of stiffness or heaviness or  an achy feeling that seems to come and go with no rhyme or reason. You want to scream in agony,  pray for relief, cry from constant suffering as you lay there in bed covered in a blanket or while sitting up or walking even short distances. 

   Others who don’t have chronic pain just don’t seem to understand. They try to comfort you and reassure you but it just doesn’t do any good. The pain just eats away at your inner core. They tell you to live with it, be strong or ignore it. It”s just so easy for them to say these things when you still have the pain. You become more irritable, angry and hypersensitive to everything they say. You think, ” Oh, it’s so easy to give suggestions”. Meanwhile, the pain increases even when you do what your doctor, nurse practitioner,  physical therapist or chiropractor tell you to do. You take medications given to you by your pain specialist that may ease the pain for a bit but soon thereafter it comes right back to haunt you. You think and worry about the future. That the pain will only get worse. That it will always be like this and you will never get better no matter what you try. 

        You think about what you did to deserve this.  You feel such guilt for anything you said over the years and for what others around you have had to endure. And then you apologize  continuously to others and to G-d. And the pain still eats away and you don’t know why. Such thoughts generate constant anxiety and depression. Life stressors seem unbearable. They are so intense that,at times, you feel like its not worth living, that you simply want to die. You withraw in your bed hoping that the next day will bring you some relief, and it doesn’t. 

    Believe me! If you’ve experienced any of these thoughts or feelings you are not alone! In fact, there are presently at least 100  million people in the United States who suffer from chronic pain.That’s approximately 1 in 3.5 people. In addition, approximately 25 million describe their pain as moderate to severe chronic pain. And that’s just the physical ratings of pain. Institute of Health 2011 Reliving Pain in America. Washington D.C. , Dzau VI,Pizza PA JAMA 2014, Walk D, Pollack-Tunis M. Med Clinical Nurse. Arn 2016..

The purpose of this blog is to help you,your loved ones and your medical specialists help reduce chronic pain. This blog is dedicated to the millions of people who suffer with chronic pain. It can be joined by anyone with such a condition and to those caretakers who’ve had to endure feelings of helplessness and powerlessness trying help alleviate pain. This includes those in the medical profession from Primary Care Physicians to Specialists like Physicians, Clinical Nurse Practitioners, Physician Assistants, Physical Therapists,Chiropractors and Pain Anesthesiologists who treat chronic pain.

Dr. George Beilin is a Licensed Psychologist who specializes in helping people be resilient by accepting and pursuing a Pain Management Lifestyle.  He has over 45 years in clinical practice and is on the Lahey Allied Courtesy Privilege Staff of Lahey Beverly Hospital. Dr. Beilin was the Chief Psychologist for the Lahey Pain Management Center in Danvers Ma.  In addition, he leads a free chronic pain support group for the sixth year at Lahey Beverly Hospital.