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Five Biggest Mistakes Chronic Pain Patients Make

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Businessman holding his lower back in pain

Mistake #1:  Expecting a doctor to know how to eliminate pain

Physicians receive, on average, less than two hours of training in medical school about pain.  One recent survey of primary care physicians at academic medical centers (supposedly the most up to date and best qualified of physicians) found that only 34% felt competent to treat pain.  Physicians who are “pain specialists” are usually anesthesiologists.  As one astute physician told me, “Anesthesiologists are not even trained to work with conscious patients.”  Physicians actually know very little about the biggest pain generators: muscles, the mind/body connection and poor diet.

Mistake #2:  Taking opioids

Prescription painkillers, also known as opioids, including hydrocodone, oxycodone, methadone, morphine and fentanyl, are highly addictive, even for pain patients taking them as directed.  According to Dr. Andrew Kolodny, Executive Director of Physicians for Responsible Opioid Prescribing, it takes only a week for a person to become dependent on opioids.  Dependence means that there are unpleasant withdrawal symptoms when the drug is discontinued.  Dependence can rapidly progress to tolerance (needing more and more of the drug to avoid withdrawal symptoms and to achieve the same effect) and addiction.  Millions of Americans have become addicted to prescription painkillers and 500,000 have died from opioid overdoses.

To make things worse, there is no evidence that opioids are effective for chronic pain.  Studies have found that chronic pain patients who take opioids have more pain, more disability and lower quality of life than similar pain patients who do not take opioids.

Mistake #3:  Relying on MRI results to determine the need for spinal surgery

Numerous studies since the 1990s have found that almost everyone has abnormal disc findings on an MRI, including bulging, herniated and degenerated discs.  The older the person, the more likely they are to have multiple abnormalities.  Most of these people have NO PAIN, leading researchers to conclude that the connection between abnormal disc findings and back and neck pain is largely coincidental in most cases.

Mistake #4:  Not moving

Muscles appear to be the main pain generators.  Some experts have estimated that as much as 90% of pain is caused by muscles, because they are stiff, weak, in spasm or contain trigger points that can cause pain.  Many people in pain are afraid to move because they are afraid of re-injury.  Fear of moving is called kinesiophobia.  Not moving causes muscles to become weak and stiff and activates trigger points, all of which causes more pain.  In addition, exercise causes the body to produce endorphins and endocannabinoids, the body’s natural painkillers.  Gentle aerobic, stretching and strengthening exercises can be very beneficial for pain sufferers.

Mistake #5:  Ignoring the mind/body connection

Chronic emotional stress can cause physiological changes in the body that can create, exacerbate and/or maintain pain.  These physiological changes include increased muscle tension, reduced peripheral blood flow, suppression of healing, digestion and immune response.  Positive emotional states, including relaxation, love and laughter can reverse these physiological changes and also encourage the body to produce more natural painkillers.

For more information, read The Truth About Chronic Pain Treatments: The Best and Worst Strategies for Becoming Pain Free

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