My endeavor to be a Pain Management specialist started in 1991. Although, I have been a board certified Interventional Pain Specialist treating patients since 1998, it never fails to surprise me that all this time that I’ve concentrated on becoming the best doctor I can be, there are many people who don’t understand what it is that I do. The people who need Pain Management, don’t know that such help exists.
“We must all die. But that I can save him from days of torture, that is what I feel as my great and ever new privilege. Pain is a more terrible lord of mankind than even death itself.” – Sir Albert Schweitzer, MD (1931)
Dr. Schweitzer, Nobel Laureate and humanitarian, made that statement after practicing medicine for 20 years in the African jungle. Ironically, when I decided that my medical career would be devoted to the same it was because of a similarly impressionable moment. I saw for the first time, a woman who had Chronic Regional Pain Syndrome. CRPS is a crippling pain disorder that affects the arms and/or legs. The slightest touch on her left leg caused screaming pain. Her leg was thin, pale, cool and dry with shiny skin. She couldn’t stand on it or walk.
An anesthesiologist performed a Lumbar Sympathetic Block to “quiet” the nerves that caused the vicious pain cycle to continue. The injection was temporary;however, the patient was pain-free afterwards and was grateful for the reprieve. The procedure was tedious and involved the injection of potentially dangerous medication. The doctor taught me about the injection and how to avoid complications or identify them before they became disastrous while he was treating the suffering woman.
I was in awe of the breadth of knowledge the doctor had in understanding the pain syndrome, the treatment and risks involved and the ability to perform the procedure safely while simultaneously preserving and expressing his compassion for this woman. He never lost sight that she was the most important person in the room from every aspect of her care. It left a heavy impression on me that patients deserve to be treated in a sympathetic and dignified way despite the seemingly more important mental task that a doctor is engaged in at the same time.
Mentions of and treatments for chronic pain have been recorded since Babylonian times. Over many centuries, many pain theories were formulated and revised. In the 1950′s, Dr. John Bonica, Professor of Anesthesiology at the University of Washington wrote the first edition of “The Management of Pain”, thus legitimizing an entirely new field of medical specialty. He then founded the International Association for The Study of Pain (IASP) in 1973 by bringing together scientists and physicians from 13 countries who were all dedicated to improving the knowledge of pain, education of health care providers and improving care of patients with chronic pain. The IASP is now composed of 123 countries and 6500 members that provides the bulk of the pain research and information today.
Pain Management is for anyone who has a pain that just won’t go away. Essentially, sooner or later, all of us will have a chronic pain that we will need help managing. As generations continue to live longer than the previous ones, we are more susceptible to the consequences of bodily degeneration. Nearly daily, I hear the sentiment that “getting old is not for the faint of heart”. We don’t die at the age of 35 due to tuberculosis or other maladies that modern medicine has learned to treat and cure. However, there’s no cure yet for osteoarthritis or degenerative spine disease or cancer– all of which are more prevalent as we age. The real key is not to live longer but to live livelier.
Managing pain means learning how to tolerate it and keep the intensity to a low-level so as not to affect the rest of a person’s well-being. When crucial aspects of our lives are affected, such as independence, social relationships and emotional state, we should take action and seek treatment. If a person’s pain problem is lasting longer than the time it takes for an injury to heal and/or she has seen her primary care physician with sub-optimal results, then it is time to seek the opinion of someone who is specifically trained in the diagnosis and treatment of chronic pain.
The Medical Advocate
