Chronic Pain and PSTD

Living with Pain: PTSD and Chronic Pain National Pain Report — 06 January 2013 By Mark Maginn, Columnist Over the last decade we have seen and heard about the horrors of people living with unimaginable pain and disability. We’ve watched as research after research presents us with conflicting ideas on what pain is and how to treat it. But there is one aspect of pain and its treatment that has barely caught our attention: Post-Traumatic Stress Disorder (PTSD). We hear about PTSD in soldiers returning from war, but it can occur when anyone experiences a traumatic event or sees someone killed or injured. Often they fear being killed or injured themselves, and they are overwhelmed by helplessness and fear. Between 20 to 35 percent of people who survive a traumatic event will develop PTSD. People with chronic pain often have symptoms very similar to those with PTSD. We suffer from anxiety, depression or flashbacks of the medical procedures we endured to reduce our pain. We’re often moody, withdrawn, explosively angry or unaccountably sad. We appear hyper-vigilant and always on guard. We may have recurring nightmares and/or suffer from sleeplessness. Our sexuality lies in tatters and relationships with partners, family and friends deteriorates as we isolate ourselves to cut down the stimuli that can send us over the edge. We may watch TV all day and often sit staring into space. We sometimes become violent with family or friends and often have a higher risk of suicide. Often we turn to alcohol and drugs. Our families watch in dismay as the person with pain gradually becomes unrecognizable. Loved ones may feel punishing guilt for not being able to do more to save someone or come to their aid. It’s also widely recognized that pain is also present in those diagnosed with PTSD. Facing a combination of chronic pain, depression and PTSD, physicians are faced with a difficult diagnosis and confusing treatment options. This disorder often appears in spouses and children of pain patients who gradually become hyper vigilant about the patient’s health. Family members can feel helpless, angry, withdrawn, anxious and sleepless. It isn’t uncommon for the patient or family members to develop suicidal ideation. They too can turn to drugs and alcohol to dull the pain. PTSD in children living with a parent in pain can develop behavior problems at home and in school. Kids may withdraw from friends and previously enjoyable hobbies. Like adults, they can develop sleep and digestive problems, as well as anxiety disguised as hyper vigilance. They may also isolate themselves by disappearing into videogames and television. Nightmares and fears of leaving the house may ensue. Truly, chronic pain is a family disease. People suffering trauma and PTSD often re-evaluate their identities, values and beliefs. They may also rethink their relationships with family and friends. Under this duress, they may make sudden rash decisions that can have a major impact on themselves and others. This can be seen in the prevalence of disrupted relationships and divorce. Not all physicians are aware of or trained in the diagnosis and treatment of patients suffering from PTSD. An assessment of stress and PTSD should be required when they evaluate a patient suffering from chronic pain. Without this assessment the presence of undiagnosed PTSD can be a huge complication – leading to more pain and inadequate treatment. We as pain patients need to educate ourselves about PTSD. A useful discussion of the connection between PTSD and chronic pain can be found here. It’s imperative that we look as closely as we can at our feelings and behavior, those of our caregivers and families, and discuss what we know with our physicians. PTSD is most often treated with cognitive and psychodynamic psychotherapy. Individual, couples, family and group therapy are good treatments options. It is also treated with psychotropic medicine, hypnosis and with eye movement desensitization Reprocessing (EMDR) which shows promise in treating the symptoms of PTSD. In choosing a therapist we should ask the them how many cases of PTSD they have treated, what treatment they use and their success rate. Don’t be shy in asking the therapist questions. When I was practicing I welcomed these questions as they were appropriate and often indicated a knowledgeable and motivated client. If after reading this you or a family member suspects the presence PTSD, it is a good idea to learn as much about it as possible. Good therapists can be found through the National Association of Social Workers, the American Psychological Association and the American Medical Association

Chronic Pain Syndrome

Chronic pain can feel like slow torture, making it difficult for you to go to work, exercise, or even take a shower and dress yourself.

If your pain is out of control, it can also take an emotional toll on you, undermining your self-esteem and coloring your outlook.
Sometimes pain evolves into a poorly understood condition known as chronic pain syndrome. Unlike acute pain, this condition doesn't go away after your initial injury or illness has healed. It's marked by pain that lasts longer than six months and is often accompanied by anger and depression, anxiety, loss of sexual desire, and disability.
Chronic pain syndrome may occur along with conditions that involve long-term pain, including certain cancers, stroke, fibromyalgia, chronic fatigue syndrome, endometriosis, and inflammatory bowel disease. Experts don't yet understand how or even if these conditions are related.
Contrary to some opinion, research suggests that psychological problems alone are not behind chronic pain syndrome. Rather, the syndrome appears to be linked to abnormalities in the interaction between certain glands – the hypothalamus, pituitary, and adrenal glands – and the nervous system, known as a type of stress axis. The abnormalities seen in this stress axis, which controls our reactions to stress, injury, and trauma, may explain why certain people experience pain differently.
Studies have also found that people who suffer from chronic pain have abnormally low levels of endorphins in their spinal fluid. Endorphins are chemicals in the body that help to naturally control pain.

Symptoms of chronic pain syndrome

Symptoms vary from person to person, but may include any or a combination of:

• Low back pain
• Headaches
• Joint pain
• Muscle aches
• Burning or tingling pain in different parts of the body
• Jolts of sharp pain

Treating chronic pain syndrome

Medications aren't the only way to manage chronic pain, and they typically don't work when used alone. In most cases, you can better manage chronic pain syndrome with a combination of different therapies to reduce both pain and stress.
These are possible treatment options:

• Behavior modification, such as cognitive behavioral therapy
• Acupuncture
• Psychotherapy
• Biofeedback
• Hypnosis
• Occupational therapy
• Physical therapy
• Relaxation techniques, such as meditation, visual imagery, or deep breathing
• Medications to help control pain, such as anti-inflammatory drugs, antidepressants, anticonvulsants, and opioids
• Nerve blocks
• Surgery to treat any underlying conditions

 

Lifestyle changes and chronic pain

Lifestyle changes are often used to ease chronic pain, as well as physical and mental health problems that may come with it. Managing stress, for example, may help control your pain by improving your mood.
These are other ideas:

• Get regular, low-impact exercise, such as walking, cycling, swimming, or yoga.
• Get plenty of sleep on a consistent schedule.
• Avoid napping during the day.
• Quit smoking, if you smoke.

Getting up and moving around is one of the most important things you can do because not moving can result in additional pain and disability.
Although treatment and lifestyle changes can help reduce pain and allow you to resume many of your daily activities, these therapies often can't rid you of pain entirely. Working with your doctor to determine the appropriate treatment plan can help get your pain to a level that is bearable.

Finally

Hello and thank you. It was October 2005 and i was having severe neck pain and had noticed a small lump on my left jaw line but gave it no concern because my neck pain was severe and had been caused by a blown out disc around c-6, c-7 so that meant surgery and 3 months of work and a change of career,so i worked as long as i could until it became to unbearable, i think this is when my problem with prescription drug abuse got started, my doctor had no problem giving me Vicodin by the bucket, had made it capable for me to work so i just never gave to much thought to take a hand full of Vic's everyday. I managed to work up until January of 2006 when my legs started being affected by the Damaged disc. Comeback soon and often as i update, Thank you, god Bless

Tips For Head & Neck Cancer Patients

Hello and Thank You. As i sit here and try to figure out how i want to write 'My Story' i thought i would give some helpful tips to those who may have just been diagnosed with head & neck cancer or who are going through treatment right now,i think some may be helpful with any type of cancer. I ask you to please be patient, i'm definitely not a writer. 1. Get a second opinion and find out all you can about your cancer, mine was Squamous Cell Carcinoma that started on my left tonsil and metastasis to my Lymph Nodes, it was cause from 'Drinking and Smoking for over 20 years. 2. STOP DRINKING ALCOHOL AND SMOKING 3.Don't put off any appointments or treatments or surgery you may need, getting the cancer out of your body is the top priority. At the time i was diagnosed my cancer had already went to stage 4 in my lymph-nodes so i was in surgery in less than 2 weeks. 4. If your going to have radiation treatment your going to need to make a decision, if you have head and neck cancer the radiation treatment is going to destroy your teeth, so if i were you, have them all pulled, i didn't and now i suffer with severe toothaches and teeth that are breaking off, you can try to save your teeth but it is very unlikely you will. 5. NEVER MISS A TREATMENT OR A APPOINTMENT (i know i said that earlier) 6. As painful as cancer is you must try to get through it with the minimum amount of pain killers, the doc will give you just about anything you want for pain, the downside, Prescription Drug Addiction and speaking from experience i believe this is just as bad if not worse than having cancer, your cancer may go in remission, your addiction will stay with you for many years after.Ive been in remission for about 5 years, a Rx addict for over 6 years with no end in site. 7. Rely on family and friends to help you, physically and mentally, draw strength and hope from a Higher Power. NEVER GIVE UP HOPE, GOD BLESS Please, your donations to this site will be appreciated and needed. I ask you to come back soon and often,your comments, suggestions or question are important, so don't be shy. Thank You and God Bless

PHYSICIANS: Update Your FREE Profile DOCTORS DENTISTS HOSPITALS Back to Search Results Home› Find a Doctor› Find a Otolaryngologist› Michigan (MI)› Detroit›Dr. Ho-Sheng Lin, MD Get your best doctor match. Use our search tools to filter by quality, patient feedback, insurance and more. Find Your Best Doctor Match Dr.Ho-Sheng Lin, MD Otolaryngology, Board Certified Male, Age 45, Graduated 1994, Yale University School Of Medicine 1 4100 John R St Detroit,MI48201 Get Phone Number Get Directions You May Also Like •Diabetes Can Affect Hearing •Over-the-Counter Drug Risks •Seasonal Allergies Quiz About This Provider Background Phone & Address Patient Satisfaction Appointments Patient Satisfaction 100% patients would recommend Dr. Lin. Based on 3 Healthgrades Patient Satisfaction Surveys 100% View Survey Results › Fill Out a Survey About Dr. Lin › Awards and Recognition Dr. Lin is a Healthgrades Recognized Doctor. 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All hospitals are not alike and your risk of complications—and even death—can be significantly lower at one area hospital than another. Whether your... Read More -------------------------------------------------------------------------------- Healthgrades Hospital Quality Ratings Dr. Lin has admitting privileges at these hospitals: Viewing 1 of 4 • • Crittenton Hospital Medical Center Harper University Hospital Oakwood Hospital and Medical Center Beaumont Hospital - Grosse Pointe Crittenton Hospital Medical Center Harper University Hospital Oakwood Hospital and Medical Center Beaumont Hospital - Grosse Pointe Crittenton Hospital Medical Center Harper University Hospital Beaumont Hospital - Grosse Pointe 468 Cadieux Road, Grosse Pointe, MI 48230 Get Directions » View Full Profile Overview Hospital Quality •4 5-Star Ratings •4 Awards This Year •71% Patient Experience View All Quality Hospital Quality Ratings & Awards Patient Safety View Safety Ratings › As Expected Patient Experience View Experience Ratings › 71% Would Recommend Healthgrades Ratings & Awards are FREE for your personal use. No Registration Required. 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You acknowledge that, in providing you access to and use of this Site and the Site Materials, we have relied on your acceptance of this User Agreement. Date Last Updated: July 15, 2011 I've read and agree to the HealthGrades Terms & Conditions View Ratings & Awards ViewView Dr. Lin's Hospitals Patient Satisfaction Patient Satisfaction Surveys TIP: What Patients Say About This Doctor Learning what patients say about this doctor can give you a good sense of what your own experience might be like with this doctor. View patient survey results to see how patients responded to a range of questions about the care they receive at this doctor’s practice. If you’ve been treated by this doctor, please take a minute to complete the survey. Your insights can prove valuable to other patients—as well as the doctor. Patient Satisfaction Surveys Based on 3 patient experience surveys, 100% of patients would recommend Dr. Lin. View Survey Results › Fill Out a Survey About Dr. Lin › ViewView Dr. Lin's Patient Satisfaction Appointments Appointment Preparation|Appointment Information|Accepted Insurances TIP: How to Get the Most Value from Your Appointment Your relationship with your doctor is a partnership. The better able you are to communicate your needs and understand your options, the more productive your appointment will be and the more likely you are to get the treatment you need. Before the appointment, research your condition and the treatment options available. Write down your symptoms and their dates of onset. List the questions you want answered. The time you have with your doctor is all too brief. A little preparation will help you make the most of it. Appointment Information Get Phone Number Accepting New Patients: Yes Before You Visit Dr. Lin •What to Do When Your Eyes Are Itchy •10 Ways to Allergy-Proof Your Home •How Diabetes Affects Hearing Accepted Insurances•Aetna •Assurant Health •Blue Cross and Blue Shield •CIGNA •Coventry Health Care •More Establishing a Partnership With Your Doctor Establishing a good working relationship with your doctor can make a difference in your health and the health of your family. Make sure you: Choose a doctor with whom you are comfortable talking. Your doctor may be helping you make life and... Read More ViewDr. Lin's Appointments More Doctors Like Dr. Lin Showing 10 out of 219 doctors who match: OtolaryngologistWithin 50 miles of Detroit, MI 48201 Dr. George H. Yoo, MD Otolaryngologist Same location as Dr. Lin View Profile Dr. Douglas D. Strong, MD Otolaryngologist 0.16 miles away View Profile Dr. Lyle G. Waggoner, MD Otolaryngologist 0.16 miles away View Profile Dr. Walter M. Belenky, MD Otolaryngologist 0.18 miles away View Profile Dr. Gregory J. Kruper, MD Otolaryngologist 0.27 miles away View Profile Dr. Nathan A. Deckard, MD Otolaryngologist 0.27 miles away View Profile Dr. Michael J. Frett Jr, MD Otolaryngologist 0.27 miles away View Profile Dr. Gerald R. Jeyapalan, MD Otolaryngologist 0.27 miles away View Profile Dr. Dev P. Kamdar, MD Otolaryngologist 0.27 miles away View Profile Dr. Kelvin M. Kwong, MD Otolaryngologist 0.27 miles away View Profile View All 219 Matches > Find Otolaryngologists Near Detroit, MI Cleveland, OH Detroit, MI Ann Arbor, MI Toledo, OH Beachwood, OH Dearborn, MI Southfield, MI Livonia, MI Novi, MI Westlake, OH Next Section Dr. Lin's Background Providers By SpecialtyHospital and Group PracticesProcedures About Us | Press Room | Quality Center | Contact Us | Careers | Advertise With Us | Sitemap | Better Medicine | User Agreement | Legal Disclaimer | Privacy Policy | Advertising Policy © Copyright 2012 Health Grades, Inc. 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Karmanos Cancer Center Of Detroit Michigan

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