Living With Pain
Some people with chronic pain are seeking help from pain management specialists.
Defining Pain continued...
According to Donald's specialist, Sanford Silverman, MD, of Comprehensive
Pain Medicine in Pampano Beach, Fla., pain is the body's way of warning against
greater injury (such as a sore thumb when hit by a hammer), or to indicate that
something is wrong (such as chest pain for a heart attack). There is a point,
though, when the suffering becomes unnecessary, such as when an injury has
healed and damaged nerves continue to bombard the brain with messages of pain.
At that stage, pain is a medical condition unto itself, a concept little
"There are a lot of people out there where pain is a disease, and it
significantly affects their life; they have to live with it every single
day," says Silverman. "For most other people, pain is a transient
The result of this unawareness: Many patients and doctors think constant
suffering is just something you have to live with, and, thus, little is done to
try to relieve it.
Another common misconception -- many people, including doctors, believe that
painkillers are addictive, so they avoid using them. When used responsibly,
painkillers are an effective and safe way to tackle chronic pain.
It may be obvious that someone is hurting, but measuring physical distress
is far from being an exact science. Despite efforts to quantify pain, or to
determine its biological history, the fact remains that it is subjective, and
people have different tolerances to it.
"There isn't a machine that I can hook you up to that absolutely tells
me the amount of discomfort you are having," says B. Eliot Cole, MD,
director of education at the American Academy of Pain Management. "So we
wind up looking at X-rays, at CT scans, at MRI scans for evidence [of disease]
that we think correlates with causing pain."
Newer techniques reportedly include muscle imaging with ultrasound that can
locate taut bands and trigger points, and EMG/NCS, a device using electrodes on
the skin to identify trouble areas in muscles and nerves.
For his part, Silverman uses various methods to diagnose pain. He asks
patients to give their discomfort a number from zero to 10 (zero representing
no pain, and 10 being the worst), and to describe what they're feeling. The
words patients use -- such as throbbing, shooting, squeezing, sharp, hot, cold,
and itchy -- give him clues to what is wrong. He also uses his own eyes to spot
apparent physical damage and X-ray equipment to detect any internal
abnormalities. In addition, he tries to find out what else is going on in the
"If [patients] do have a bona fide psychological problem -- not because
of the pain, but it's a part of them -- that's going to affect the way ... that
the pain is perceived," says Silverman, who notes that some people find it
hard to separate physical pain from their emotional conflicts. A patient's
problems with work, marriage, and sex, for instance, may affect the ability to
cope with bodily distress.