Word: chronicic
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Some physicians are convinced that there are distinct characteristics that make some people more susceptible to chronic pain. Drs. David Richlin and Leonard Brand of Presbyterian Hospital in New York City list the following traits: low motivation, poor self-image, lack of pride in accomplishments, dependency on others...
Unfortunately, the psychological element in chronic pain has often led physicians to dismiss their patients' complaints. Says Fields: "Many doctors and nurses believe that if a person responds to a placebo, the pain can't be very bad. This is a terrible mistake." Only about 5% of chronic pain patients are hypochondriacs or hysterics, according to Psychiatrist Anthony Bouckoms of Massachusetts General Hospital. "Pain itself is the reason people suffer; it is not psychopathology," he avers. And yet the most frequent question Bouckoms hears from pain patients is: "Tell me, doctor, is it all in my head...
People with chronic pain often wind up on a medical merry-go-round: psychiatrists tell them that their problem appears to be physical; internists and surgeons tell them they ought to have their head examined. Western doctors, trained to cure acute illness, are often frustrated by patients with vague pain that refuses to go away. So are the families, who quickly tire of hearing complaints. Dejected, guilt-ridden and increasingly isolated, many pain patients eventually seek care outside standard medicine: herbal treatments, chiropractic, faith healing and, too often, quackery. Says Fields of U.C.S.F.: "They fall through the cracks...
...tried everything from strong doses of codeine to psychic counseling to relieve pain "that felt like someone was tightening my head in a vise." She finally found relief with calcium channel blockers, originally developed for heart patients. Antidepressive drugs like the tricyclics are frequently recommended for shingles and chronic lower-back pain. Antiseizure medications like Dilantin, commonly used to treat epilepsy, can help calm the spasmlike facial pain of trigeminal neuralgia...
Those millions of Americans who suffer from chronic pain have cause to be thankful for Bonica's tenacity. He has helped make much of the medical profession aware of both the compassion and the specialized approach needed to deal with the agony of pain. Twenty-three years ago he helped found the University of Washington Medical Center's Clinical Pain Service, in Seattle, which has be come a model for similar clinics across the country. Here, sufferers from chronic pain can be examined by medical specialists in a variety of fields, from orthopedics to psychiatry, in an attempt...