Defeat Chronic Pain Now!: Groundbreaking Strategies for Eliminating the Pain of Arthritis, Back and Neck Conditions, Migraines, Diabetic Neuropathy, and Chronic Illness

528 Pages·2010·7.04 MB·English

by  Charles Argoff

DEFEAT CHRONIC PAIN NOW!
GROUNDBREAKING STRATEGIES FOR ELIMINATING THE PAIN
OF ARTHRITIS, BACK AND NECK CONDITIONS, MIGRAINES,
DIABETIC NEUROPATHY, AND CHRONIC ILLNESS
BRADLEY S. GALER, M.D.
Co-founder of American Academy of Neurology Pain Medicine
Special Interest Group. Named one of the leading doctors in pain
management by the Best Doctors in America
CHARLES E. ARGOFF, M.D.
Co-founder of American Academy of Neurology Pain Medicine
Special Interest Group. Professor of Neurology, Albany Medical College;
Director, Comprehensive Pain Program, Albany Medical Center
CONTENTS
INTRODUCTION: A SILENT PANDEMIC
1 | Recognize and Relieve Your Chronic Pain
CHAPTER 1 Beating Your Back Pain
CHAPTER 2 Getting a Grip on Neck Pain
CHAPTER 3 Conquering Arthritis (OA/RA)
CHAPTER 4 Repressing Neuropathic Pain
CHAPTER 5 Obliterating Headaches (Migraine/Tension-Type/Rebound)
CHAPTER 6 Fighting Fibromyalgia
CHAPTER 7 Overcoming Cancer Pain
2 | The Most Effective and Cutting-Edge Treatments For Chronic Pain
CHAPTER 8 Understanding Medications for Pain
CHAPTER 9 Nerve Blocks and Other Interventions
CHAPTER 10 Active Physical Therapy is Essential
CHAPTER 11 Psychological Treatments for Everyone
CHAPTER 12 Multidisciplinary Pain Clinics Put It All Under One Roof
CHAPTER 13 Caution: Surgery, Only When Necessary (A Rare Event!)
3 | Understanding Your Pain
CHAPTER 14 What is Pain? Why Do We Experience It?
CHAPTER 15 A Brief Tour of the Nervous System
CHAPTER 16 Laboratory Tests for Chronic Pain (A Cautionary Tale)
CHAPTER 17 Stress Affects Your Pain, And It’s Real
APPENDIX: HELPFUL WEB SITES
ACKNOWLEDGMENTS
ABOUT THE AUTHORS
INDEX
Introduction: A Silent Pandemic
Chronic pain is a silent pandemic, affecting people all over the world, regardless
of age, ethnicity, or race. It is a condition that acknowledges no boundaries.
Chronic pain is one of the most common medical problems, especially among
those of us who are approaching “middle age”! We bet that if you ask anyone
you know—whether at work, in your church, or at your child’s Little League
game—you will find that he or she either suffers from chronic pain or has a
family member or good friend who does. Everyone knows someone who suffers
from chronic pain.
It has been estimated that about one-third of all Americans suffer from
chronic pain. That means about 105 million people in the United States are
living with conditions including chronic back and neck pain and migraine
headaches. A study published in 2003 found that approximately 150 million
Americans took medications—including both prescription and over-the-counter
drugs—during the previous months to relieve their acute and/or chronic pain.
As our population ages, these numbers are going to increase. Indeed, chronic
pain is a bigger health problem than most other medical conditions that get more
“airplay.” Because you cannot see it, chronic pain is easy to ignore and discount;
because it attracts less attention, it receives less government funding for
research. Insurance companies compound this problem by frequently denying
appropriate medical care for chronic pain sufferers—and that’s a shame.
Another unbelievable and scary fact is that most doctors are not properly
educated in the management of chronic pain. Pain courses are rarely if ever
taught in medical schools. During their years of internship training and
residency, doctors are seldom instructed in how to properly diagnose and treat
chronic pain. And who suffers as a result of this lack of education? You do.
Since the mid-1980s, during our last years in medical school, we have
devoted our careers to helping people who are suffering from chronic pain (in
fact, that’s how we met and became friends and colleagues). We have been
blessed to learn from pain experts worldwide and privileged to work alongside
some of the best pain management providers of all time. Indeed, we were lucky
enough to be trained by and work with the “Hall of Famers” of pain
management.
However, we have also witnessed far too much bad pain management over
the past twenty-plus years, and we feel it is our obligation to help anyone who
will listen. That’s why we combined our knowledge and experience to write this
book, a personal “survival guide” for chronic pain sufferers. Our aim is to
present all the important facts—the good, the bad, and the ugly. We want to give
you real answers to your tough questions.
Many of you may be given the wrong advice by undereducated or selfish
doctors and other professionals, or be prescribed the wrong medication or
treatment based on overzealous pharmaceutical, supplement, or device
companies. Many of you face roadblocks to obtaining appropriate care from
your insurance companies. This is unacceptable—you are already suffering
enough!
You don’t have to fall victim to the uninformed doctors, insurance companies,
workers’ compensation systems, drug companies, and device makers who all
want to make a buck either by selling you a “cure” or by making
recommendations based on their narrow worldview about chronic pain. You
need to empower yourself with knowledge about your disease so that you know
more than these “deciders,” most of whom are not truly educated on the subject
of chronic pain. If we can spare you more pain and suffering by teaching you all
there is to know about your pain—and warn you about what and whom to look
out for—we will have done our duty as pain management doctors.
To that end, we’ve written in layman’s language as much as possible
throughout the book, particularly in Part 1, which addresses the specific pain
conditions in detail. Why? Because this book is our offering to you—the patient.
You are the one living with chronic pain, and it is your right to have the
information you need—in a way that you can easily understand—so you can be
an active participant in resolving it. Start with Part 1, where you’ll find chapters
covering specific types of pain. We’ll tell you what treatments have been shown
to work and highlight the most cutting-edge developments. In Part 2, we’ll cover
treatments and therapies in much more detail—and with a bit more medical-
speak, but don’t worry, this important information is also written to serve you,
the patient, the ultimate “decider” of care. Finally, don’t skip Part 3! We discuss
what pain is, why we all have pain, how one experiences it, how factors like
stress affect it, and how your nervous system works. While there may be a few
sections that bring back unpleasant memories of high school biology, this section
teaches you (in easy-to-understand words) the key basics behind how pain works
in the body. Again, our aim is to help you by giving you in “plain English” the
most important information about pain that we have learned over our multiple
decades of being pain doctors.
This book is not intended to replace the services of a physician. Any
application of the recommendations set forth is at the reader’s discretion. As
every person’s medical condition is unique, the reader should consult with his or
her own physician or specialist concerning the recommendations in this book.
We wish you all the best, and hope you find some pain relief and start
enjoying life again.
PART 1
Recognize and Relieve Your Chronic Pain
CHAPTER 1
Beating Your Back Pain
Myofascial dysfunction is the most common—and most misdiagnosed—
culprit.
PRESCRIPTION BACK PAIN
the for
Although most people fear they have a herniated
(bulging) disc that will require surgery, the majority of
back pain sufferers do not have a herniated disc, and even
if they do they do not need surgery.