Dealing with chronic pain and getting appropriate treatment

If you’ve been a Lucy reader for any amount of time you know that I live with chronic pain. All those years of being a caregiver have taken its toll on my body…in short I’m falling apart.

While I wish that I was aging much more gracefully my silver lining is that I have an amazing doctor that truly gets what I’m going through…it’s not in my head, I’m not a hypochondriac, I’m not attention or drug seeking. It’ real and has a cause.

Today I will spend my morning with him as he cauterizes a few of the culprit nerves responsible for my neck pain. I’ve written about him before but today in his honor of the medication free method of pain relief he will be treating me with and in recognition of the fact that he of all my physicians is the ONE that did not stop until I had a medical diagnosis and a plan for my treatment.

When others were injecting me and trying to kill me with more steroids than someone of my stature should ever have or mindlessly writing me yet another prescription, he was actively looking for answers and actually found them….Thanks doc!

 It is in this spirit that I wanted to share this article that ran in our local paper about him. I have included it here in its entirety:

The Tennessean has focused attention on pain and pain management lately, much of it negative. It’s important to understand that chronic (long-term) and acute (short-term) pain are real medical problems with physiological causes, affecting as many as one in three Americans.

Pain management (or pain medicine) is the medical specialty devoted to the treatment of pain. While any doctor can treat pain, board certification in pain management is a rigorous process.

After completing medical school, an internship and a residency (usually in a field such as anesthesiology, physical medicine and rehabilitation or neurology), a physician can complete a one-year fellowship in pain management. After this, they must study for and pass a comprehensive examination. Only then are they designated as “board certified” in pain management, the highest level of training in the field.

It’s also important to understand that there are many modalities available for the treatment of pain. While some physicians concentrate on medication or “medical management” of pain, others specialize in minimally invasive spinal procedures or “interventional pain management,” designed to interrupt the pain signals before they reach the brain. All of these modalities can be combined with physical therapy and a gradual rehabilitation program. Most patients respond best to a combination of modalities.

Patients need to understand they have options. Don’t be afraid to ask the credentials of your health-care provider! What treatments do they offer? Are they trained in performing interventions? Are they board-certified in pain management? Are they even a physician (If they are, they will have the letters M.D. or D.O. after their names)? Chiropractors (D.C.) and mid-level providers such as nurse anesthetists (CRNAs), nurse practitioners (NPs), and physician assistants (PAs) also offer pain treatment, but receive less training in the diagnosis and management of these problems.

Non-physicians and physicians without pain training are able to advertise themselves as pain-management specialists, and patients may not realize this.

The problems in pain management have been much-publicized. Addiction implies loss of control associated with taking medication. There is treatment available for those who need it, on both an inpatient and outpatient level. Diversion is the theft or sale of prescription medication. It is not so much a drug problem as a criminal activity. It should be reported to local law enforcement authorities.

A “pill mill” is a doctor’s office or clinic that prescribes pain medication without attempting to accurately diagnose or treat the underlying problem. Recently, a law was enacted in Tennessee that regulates pain clinics. This is anticipated to reduce the “street supply” of pain medication, without blocking access for patients who need treatment.

Let’s not be too quick to condemn either the legitimate pain physicians or the patients suffering in pain. You never know when you might need the former — or become the latter!

To find out more about how to find a qualified physician, visit these websites:

1. State of Tennessee registered pain clinics | http://health.state.tn.us/downloadsCertified_Pain_Management_Clinics.pdf.

2. American Chronic Pain Foundation | www.theacpa.org.

3. American Pain Foundation | www.painfoundation.org.

Dr. Hilgenhurst is Board Certified in Pain Management and Anesthesiology. His practice, Precision Pain Care, is located in Smyrna, TN.

You will find an entire library of educational videos on his website, offering detailed overviews of many of the conditions he treat, www.precisionpaincare.com.

Please read my disclosure 
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