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How to effectively communicate pain to doctors?

May 20, 2014 4:03 PM

I've been dealing with chronic joint and back pain for a few years now and have tried the usual physical therapy, chiropractors/sports-medicine, exercise, diet, etc, etc. However, over the past several months (since my car accident, a high-speed head-on which totaled my SUV) it's become impossible to ignore and I've ended up seeking treatment and trying to actually determine what's at the root of the issue - but also trying to relieve the pain.

My GP sent me to an ortho, the ortho sent me to a rheumatologist, the rheumatologist sent me to pain management, etc, etc, etc. Throw in a few physical therapists, psychiatrists, pyschologists, etc.
The rheumatologist says I have fibromyalgia. We tried several different medications (all of which I'd tried over the years) to no avail. Psychotropic medications tend to render me unable to function, even at doses well below the typical therapeutic minimum. Anti-inflammatories don't help much at all. The only thing that DOES help is actual pain medication, but when I mention this I'm told that it's dangerous and unnecessary/unethical and that I'm drug seeking, or that I should just deal with it - that "aches and pains" are just part of getting older.

I desperately want to know what's causing this and I want a permanent solution, if possible, but in the near-term I need someone who understands that I can't be in pain day and night. I don't know what to say beyond what I already have, I don't know how to make my point more clear - it doesn't feel like anyone listens, or cares to listen.

The last time I saw my GP, she brought a print-out from the state's central prescription registry and said "Hey, you're only 31 and you've gotten 3 prescriptions for narcotics. This is really bad."
For real?

How can I effectively communicate my pain to my physicians without garnering the (seemingly) automatic "drug-seeking" response?

May 20, 2014 5:45 PM

I understand your predicament and I have experienced the suspicion of just being a drug abuser from pharmacies when I go in a day too early for my medications. I try to tell the doctors and pharmacists that my pain isn't on a time clock and some days I need a little more to manage the pain before it becomes unbearable.
I would recommend you find another GP. No doctor should refuse you medicine that is available and one that works. If you are in pain, he/she has an ethical obligation to provide you what works and if that is a narcotic then so be it. I wouldn't take no for an answer from you doctor, say your quality of life is poor due to the pain and insist you want the pain medications that you know works. They have to give it to you.
I have been on narcotics for 6 years now and they are the only thing that makes my life bearable. I would recommend you inquire about Lyrica, its a non narcotic drug that works well for me but it can leave you with a floaty or dizzy feeling when you are on higher doses. I also recommend you try prescription muscle relaxers to help sleep and relax when at home resting.
I had a lot of success with the treatment from a Osteopath, they tend to treat you in a holistic approach, like muscular/skeletal and your organs etc as their thought is you body works in harmony and not as individual units. I found them to be much better than a Chiropractor but its hard to find a good one and they can be expensive.

May 21, 2014 7:21 AM

Thank you for your reply, Craig - it's good to know I'm not alone in feeling that way, sometimes!

May 22, 2014 1:20 PM

You are definitely not alone. I have jumped through so many hoops/drugs trying to avoid narcotics (I work in healthcare). But it is time for the narcotics, my quality of life is degrading really quickly.

May 22, 2014 3:51 PM

Definitely not alone: I think many chronic pain sufferers aren't taken seriously by doctors. I've had to switch GP's several times and a friend has similar experiences. Keeping a pain diary like as with this app may help communicate, by the way: showing my doctor a chart with pretty colors finally convinced him that when I say I'm in pain all the time, I do actually mean ALL THE TIME (they kept asking me, 'yes, but when does the pain occur?'). I'm thinking not many people go to the lengths of faking a pain diary for month just to gain access to drugs.

Jun 09, 2014 8:21 PM

my GP refered me to pain specialist which I had seen 13 years ago after a back/hip injury and because I now have facet joint damage, osteoarthritis and bulging discs in my spine. I can t use paracetamol because it's damaging my liver, I can t take NSAIDS because it affects my asthma. I currently take either tramdol or codiene and lyrica (pregabalin) as well as amitriptaline.
I told the specialist about the pain diarys I was using (1free, that's this and 1 that was 69p). he seemed to not know about the pain diarys/apps but was very interested, I took it in to show him and he's was quite positive about it as a way forward for both doctors and patients. so what I would say is, show it to your Doctor or specialist. I think these apps and people who use them are people who are being positive and pro-active about their pain and how to best address and manage it.
at the very least, this app has helped me to know I am not alone with it!

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