by Jenny L. F Andrus, MD – Interventional Pain Management Specialist at OSC
Pain itself is not a primary diagnosis, but a symptom of an underlying problem. It is an alarm signal from our brain that something is wrong and needs to be addressed. An easy analogy is to compare pain and its cause to a security alarm and a burglar. When you are asleep and the security alarm goes off, you are jolted awake and begin searching your house and its surroundings for an intruder. You may be carrying a baseball bat in case you need to defend yourself. You take immediate action to resolve the problem. After you search the house and find that your cat set off the alarm, you can go back to bed, knowing that all is well. However, it wouldn’t be wise to turn off the alarm and get back in bed without investigating the cause of the alarm. The same can be said for pain — it is an important wake-up call announcing that something in your body needs attention.
Some pain is classified as acute, which means it is recent and lasts for a relatively short time. Stepping on a tack causes acute pain, as does breaking your finger, or suffering a heart attack. All of these will cause pain of varying severity and duration. Pain from the tack might be sharp, but very short-lived. Breaking your finger may really hurt and cause pain for weeks after the injury. Having a heart attack may cause sudden, excruciating pain, but once the patient receives urgent medical attention, the pain can be relieved with appropriate treatment. Thankfully, most of the pain we experience in life goes away quickly when the correct remedy is applied.
However, chronic pain is classified as pain that does not go away after suitable medical treatment has been delivered AND a certain amount of time has passed (3-6 months). This time frame may vary, but it is viewed as the “normal” period during which the majority of people affected by the same problem will experience recovery and relief. For these people, the pain is an alarm that they can’t turn off, even if they have taken appropriate action. Some examples of causes of chronic pain are an illness that causes permanent nerve damage, like diabetes; rheumatoid arthritis, or a failed surgery. Sometimes, there is no discernable cause for a person’s pain.
Chronic pain takes an incredible toll on these patients, in some cases costing them their jobs, their family and their independence. They may become depressed or hopeless and turn to substances to address their pain, resulting in addiction for some. The cost to society is estimated to be in the billions of dollars when accounting for lost wages, lost productivity and the price tag for medical care.
The specialty of Pain Management was developed to treat patients who suffer with chronic pain, because these folks need special attention and treatment. As an Interventionalist, I can provide patients with medical care that determines the root cause of their pain and addresses it – either with medication, lifestyle changes, exercise, physical therapy, cognitive behavior therapy, interventional procedures or any combination of the preceding treatments. I will refer a patient for surgery if appropriate.
For some patients, when we effectively treat the cause of the pain and fix whatever is wrong, the pain will go away or diminish. For some patients, the problem cannot be fixed and I help them to manage the pain that they have so that they can live more fully and become as well as possible. There are so many resources that I can use to help patients, that it is extremely rare not to be able to provide some relief to them. Working together with the patient is the best way for us both to achieve mitigation of pain successfully.