A CONSUMER’S GUIDE TO PAIN MANAGEMENT

April 21, 2009, 4:56 am

Let us look at the so-called ’store-front window of the pain supermarket’ to see the range of individual treatments, their advantages, disadvantages and factors which would prevent their use as well as their approximate costs and where these treatments can be obtained.

Take for example, Mary, 33, an ex-kindergarten sister, who had exhaustively sought relief for a chronic back pain problem.

‘Mismanagement by the medical profession has made my life miserable with unbearable pain for the past five years!’ was how she angrily described her problem.

Mary had a long history of lower back pain which had involved two operations in which the individual vertebrae or spinal bones were fused together. Despite the operations on her lower back she was dissatisfied about the continuing level of pain and how it was disrupting her life.

She also complained of severe pain in the neck and shoulders. Her misery was made complete by deterioration of the cartilage at the back of both kneecaps known as chondromalacia patellae.

When admitted to hospital, her pain symptoms were related to her long-term orthopaedic problems and what she described as ‘the lousy cards life’s dealt me’.

After her surgery things had gone spectacularly wrong, with numerous post-operative complications including wound infection. When her knees began to fail, she began swimming to relieve the-pain. But the swimming brought on a painful condition of both shoulders — ‘frozen shoulder’.

She was then re-admitted to hospital where she was told that her original fusion operation was a failure. The second fusion operation was carried out in an attempt to correct the pain in her lower back.

This was as unsuccessful as the first operation in relieving her pain and she was then referred to a psychiatrist. Shortly after this she became acutely suicidal with homicidal thoughts towards her child.

Mary was transferred from a private hospital to the in-patient pain programme with a three-month history of depressive symptoms including persistent lowering of mood, tearfulness, difficulty in getting to sleep, waking early, loss of energy, poor appetite, a weight loss of seven kilos and loss of interest in everything, including physical activity. She had also ‘frightened off her treating psychiatrists — so difficult was she to

manage. b

Initially, Mary was very prickly, with a caustic tongue, very difficult to manage and very defensive, suspicious and hostile towards doctors after her past experiences.

After her first week in the pain program she was still difficult but coming around to the viewpoint that she might as well try any last resort to climb out of the depths that she had fallen into due to her chronic pain experience.

The breakthrough for Mary came with one of the main features of the pain program — patients being given the opportunity to experience a number of different techniques including laser acupuncture.

Within the first few sessions she noticed an improvement in her pain levels. She reported that her pain was becoming more and more acceptable and within the four weeks of the pain program she had minimal levels of pain.

Now, instead of depressing everyone, Mary was a general inspiration for new in-patients. On discharge, she was having weekly treatment. After six months, she had progressed to having treatment monthly.

Today she has continued to improve. Her previous constant demands for pain medication and treatment became far less and her relationship with her husband and son are greatly improved.

She is still taking medication but it has fallen to controllable levels. She is very happy with the results of the treatment and has now gone back to being involved in a kindergarten part-time.

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