FAQ Category: Pain


After seeing countless doctors and going through tons of diagnostic tests for my back pain over the past five years I have been sent to a psychiatrist. I am not crazy. I know that I am not making up my pain. Why does everyone think I need to see a psychiatrist?

It sounds like you have what the medical field calls chronic or persistent pain. This is a complicated diagnosis but one that can be managed with a team approach to care. In other words, at the very minimum, a doctor needs to be on board to manage your medication, a […]


I have chronic low back pain that does not seem to respond to opioids, despite me being on a heavy dose. I don’t like the way they make me feel or the dependence on the drugs itself. Is there a better option for managing my pain?

The recent consensus within the medical field is that a team approach is most important when managing chronic or persistent pain. Additional drug options for pain management that are recommended you first try are: Tramadol, Nortryptyline or an alternative TCA/SSRI, or lidocaine. You can ask your doctor about any of […]


I’m concerned about my wife. She has chronic low back and leg pain that she takes several pain pills (narcotics) for. She’s also got high blood pressure and high cholesterol. So she takes pills for that, too. Then there’s a pill for her low thyroid and another that’s a blood thinner. How can she get any pain relief with all that crap in her system?

You raise a very good point and one for which there isn’t a clear or simple answer. But let’s talk about some of the factors involved. Physicians want their patients to experience good pain control with the fewest side effects possible. We may all be the same species (i.e., humans), […]


I’m at a cross-roads when it comes to helping myself get out of a downward spiral of pain, pain, and more pain. My doctor considers me a chronic pain patient and probably a crock. But my pain is real. I’m not making this up. And I’m not trying to get out of anything. Unfortunately, I’ve exceeded what my insurance company will allow for treatment of this problem. Is there any hope that the system will change to help people like me?

There is always hope that change will come in various segments of the health care delivery system. Funding to support the help needed by patients with chronic pain is certainly an area that could use a shot in the arm so-to-speak. Right now, there are 116 million adults in the […]


My brother was in a motorcycle accident that left him with severe damage to his left leg. It’s been two years now since it happened and he still seems to be emotional numb. Depression was a major problem before and has only gotten worse after the accident. Is there any way to shake him out of his misery?

There’s an old saying, Pain is inevitable but misery is optional. That might be an easier idea to swallow when you aren’t in pain compared to when chronic, persistent pain colors every minute of every day. And usually, along with constant pain comes anxiety, depression, and decreased physical function. Negative […]


My father was involved in a major car wreck that has left him despondent and almost non-functioning. Even though it appears to us that he could do more, he doesn’t. How can we help him get back into the swing of things?

It is well known that psychologic distress after severe injuries can have profound effects on recovery. When physical activities are restricted by injury, chronic disability can develop. Such conditions can have both personal as well as social implications. For example, only one out of every two patients goes back to […]


I tried hypnosis for a few months to help with my terrible neck, shoulder, and back pain. Didn’t seem to do the trick. Someone else suggested mindfulness meditation. What the heck is that?

Chronic pain is managed in many different ways by different patients under the care of a trained health care professionals. One of those approaches is called psychosocial treatment. Psychosocial treatment recognizes there are psychological, emotional, spiritual, and social factors that affect pain perception. Techniques such as hypnosis, relaxation, meditation, and […]


I suffer from chronic low back pain. I notice that I’ve started saying things to myself like, “I can’t do that because my back won’t let me” instead of ignoring it like I used to. I think I’m losing ground and I don’t know why. How can I get back to a more positive frame-of-mind?

Many people who suffer from chronic pain of any kind share your experience. Pain can be tiring. Over time, the effects of chronic pain can wear down even the most positive, optimistic folks. But the good news is there are ways around this and trained professionals to help you. Counselors, […]


My mother-in-law has had a couple of operations and always seems to struggle with intense nausea afterwards. Now she’s scheduled for a total knee replacement and scared silly about the nausea and throwing up afterwards. I saw a TV special that talked about using acupuncture to avoid these complications. Does this really work?

Acupuncture as a healing tool has been around for many, many years. In fact, it is one of the oldest medical arts. The use of modern acupuncture is increasing in popularity for pain and other health conditions. Nausea after surgery is one of the areas that has been studied quite […]


I am new to the area of chronic pain but just got a job in a clinic where we help patients complete questionnaires about their pain. I’d like to learn a bit more about how these tests help and maybe how to view them a little bit more critically. We are using the painDETECT, ID-Pain, and Neuropathic Pain Scale.

There are quite a few questionnaire-type screening tools being used to assess chronic pain and in particular, nerve or neuropathic pain. A recent review published on these questionnaires included the Leeds Assessment of Neuropathic Symptoms (LANSS), the Neuropathic Pain Questionnaire (NPQ), the Neuropathic Pain Scale (NPS), the Douleur Neuropathique en […]


I work in a pain clinic and we use the Neuropathic Pain Scale (NPS) as part of the intake testing. We are specifically looking for any evidence that the patients’ pain is coming from the nervous system. What do other groups use? Is the NPS the best choice?

As you have probably discovered, nerve pain (also known as neuropathic pain) can be difficult to diagnose and measure. For some time now, neuroscientists have been working on finding easy and simple ways to identify and quantify neuropathic pain. So far, they have come up with several screening tools in […]


Can you tell me the difference between regular acupuncture and electronic acupuncture? I see our local healing center offers both. I’m just wondering if either of these might help me with my chronic low back pain. After all these months of pain, pain, and more pain, I’m desperate enough to try just about anything.

Acupuncture has been used in various forms for thousands of years. Records show that sharp stones were once pressed against the skin in areas of pain to help give relief. Since that time, silver sticks and fine stainless steel needles have been used as well. Fine needles of various materials […]


I am the manager of a large civilian rehab center. Without a VA center in our area, we are starting to see a large number of returning soldiers for chronic pain problems. What can be done to prevent this painful suffering or at least manage it for our returning soldiers?

Pain relieving medications are the first line of treatment. Sometimes more than one drug is used in combination called multimodal pharmacology. Tylenol still remains a very effective nonnarcotic pain reliever. Nonsteroidal antiinflammatory drugs (NSAIDs), antineuropathic (nerve pain) medications, antidepressants, along with opioids (narcotics) are available tools used for pain control. […]


Do you think people with fibromyalgia are hypochondriacs? I have two friends and two family members with this diagnosis and they never stop complaining about it. I can’t help but wonder if all that yammering just keeps them focused on the problem and not the solution.

One of the universally recognized key features of this condition we call fibromyalgia is widespread body pain. The person with fibromyalgia often says, “It hurts all over.” With pain everywhere and a host of other symptoms that characterize fibromyalgia, we might all find ourselves complaining (or at least commenting) on […]


I have a friend who is constantly complaining about her back pain. Yet she’s out there running marathons and never seems to stop driving herself. It just seems like there’s a disconnect between what she says and what she does. Can you help me understand this? I find I’m losing patience with her whining given the fact that she can do things I can’t do and I don’t have any pain.

People with chronic low back pain often have to learn to live with it because all efforts to get rid of it or control it have failed. There seem to be two different ways people with chronic low back pain respond to their situation. They either avoid activities that might […]


The pain clinic I’m going to for my low back pain has finally figured out it’s coming from my sacroiliac joint. They have suggested doing radiofrequency ablation on the nerves that are causing the pain. How well does this treatment work?

Pain from the sacroiliac joint can be referred to the low back pain, leg, sacrum, pelvis, or buttocks. It can be difficult to trace and even more problematic getting rid ot it. For the last 10 years, radiofrequency denervation (using radio waves to destroy nerve tissue) has been used when […]


I’ll be honest and say I think I may be slightly neurotic and that’s why I have so much trouble recovering after even the slightest injury. Are other people like this? What can I do to change the way my mind operates?

You must have some specific thoughts in mind or examples of how your thinking goes that leads you to make these observations about yourself. Without some idea of what those are, we can fill you in on some research that is being done in this area regarding chronic pain sufferers. […]