Imagine slamming your fingers in a car door. After you scream and remove your smashed hand, you will have excruciating pain for several hours. Eventually it will turn into a dull ache. Within a week or two the pain should be gone and your only reminder might be a few purple fingernails.

Now imagine instead that the pain never goes away. Every morning you awake in agony and every evening you just pray you will be able to get some sleep despite the discomfort.

Millions of Americans face that kind of chronic pain. Some suffer from rheumatoid arthritis, others from a mysterious condition of soft tissue called fibromyalgia. Damaged disks in the back are a common cause of torment.

Such pain is often poorly treated. Specialists acknowledge that too many people suffer for fear of becoming addicted to powerful pain medicines. They also bemoan the lack of comprehensive pain management by adequately trained health professionals.

One reader shared his story:

“Several years ago I injured my lower back. Later arthritis developed at that location.

“For years I bounced around from doctor to doctor, trying traction, steroid shots, physical therapy, and every anti-inflammatory medication they could prescribe. I could not get any relief. Anti-inflammatory drugs kill my stomach and I just can’t take them.

“Finally I found a doctor who listened to me. She said that arthritis medicines do the same thing to a lot of patients. She reviewed my charts, saw what I had been through and tried something different. Vicodin gave me instant relief and I was pain free for over two years. One capsule in the morning: pain free all day; one capsule in the evening: pain free all night.

“My doctor moved her practice out of state and I am again in pain, unable to perform at work and unable to sleep. I’ve visited two doctors and both refuse to prescribe Vicodin. Why can’t they see that anti-inflammatory drugs don’t work for me? I am afraid for my family. We are one paycheck away from welfare and I can barely function. My back is killing me. I cannot continue this way for the rest of my life.”

We heard a different story from Susan. She was stricken with rheumatoid arthritis at 20, and for years struggled with unrelenting pain daily. Every joint in her body ached, from her head to her feet:

“At the age of 37 I decided suicide was the only answer for me. I felt like it was me versus the world and pain–and pain had won.”

Susan finally found a doctor experienced in treating pain who listened to her. Together they experimented with medications and doses until they found a regimen that worked for her:

“I got my life back. Now I am energetic and productive again.”

Proper treatment of chronic pain requires a team of pain specialists able to orchestrate medications, physical therapy and psychological support. People should not forego pain relief for fear of addiction. Studies show that carefully controlled use of narcotics, when used for chronic pain, can be safe and effective. Pain patients should not have to suffer in silence. Instead they deserve compassionate pain management.

We have interviewed a number of experts about pain management over the years. Here are links to some of those shows:

805: Overcoming Pain

835 Ancient Moves for Joint Relief

724 Chronic Fatigue and Fibromyalgia

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  1. 4terry
    Reply

    Thanks for the comments. My pain doc seems uninterested in PT, although he has tried mightily to find a pain med for me. Will press him for PT script.

  2. VCF
    Reply

    Antidepressants have helped my fibromyalgia but we have had to switch a few times due to side effects, same with Lyrica.
    I also have had an L4-L5 microdiscectomy & am 66 now. Epidural injections did little to help. I found a PT who performs dry-needling ( worked well) and on this last round of PT, he did something called ASTYM.This has finally cut my pain to around 2-I can walk straighter now and can ride in a car longer now too. Remember you may need “tune-ups” from the PT every so often. I hardly ever need more than a Tylenol, but I keep Percocet for flare ups when I have over done things.You must stop the pain quickly or it will continue longer, which is a well-known fact to those in the pain management field. My advice, keep looking for the right therapy that helps you manage your pain–you must be an active participant in your management.

  3. Jim
    Reply

    I have a co-worker who suffers from fibromyalgia. I recommended turmeric which has helped me with several problems caused by inflammation. She was afraid to try it. A week later her neurologist suggested that she try it and described great results other patients were having. I find this remarkable and a sign that the medical profession may be softening it’s stance regarding natural and organic treatments. Very encouraging, and may help some of the people posting here who are suffering terribly. Do not take turmeric if you are on any type of blood thinner. Can be very dangerous. I take 500mg. twice a day, and a tbsp. of apple cider vinegar twice a day and have virtually no joint pain. I’m 65.

  4. Maria
    Reply

    Seeing these stories of unmitigating pain gave me pause to tell my story. In 1995, about four months before my decision to retire at the age of 64, I began to experience stabbing pains that would occur spontaneously and would hit me every 10 to 15 seconds and sometimes last all night long or for half a day. I would occasionally run a low grade fever and my doctor would prescribe an antibiotic which would work for a couple of months and then it would start all over again. Blood work did not reveal anything. One thing that I had noticed was when I would drive any distance, I would be very stiff for about ten or fifteen minutes when we would stop for breaks. This went on for 17 years. While caring for my very ill husband in early 2010, I had a really bad spell and went to Express Care and the Dr. there asked me how long I had been troubled with it and I told him about 17 years. He asked me if I was ever told I might have Polymyalgia Rheumatica (PMR). He gave me a prescription for Prednisone 30, 20, 10 mgs (one week of each). By the third day of the 20 mg of Prednisone, I was absolutely pain free and felt like a new person. It held me for 10 weeks. I even sent him a thank you note. However, my doctor still was not convinced because my ESR rate was never significantly elevated. He insisted I was suffering from fibromyalgia which just did not fit my overall picture. I had even been to a rheumatologist who at one point prescribed a maintenance dose of Minocycline which seemed to be effective for about three months. I had even tried acupuncture. I have been getting along on a 5 mg daily dose for a couple of years now and my doctor wants me to go off of it and every single time I lower the dose, I run into trouble. When I got down to 2 1/2 I ended up having a stroke. Now I am determined to take it till I die. I am almost 83 and without it I do NOT want to live!!

  5. MO
    Reply

    Does anyone know of a medication for spinal cord nerve damage besides Lyrica? The Lyrica does help some but very little.

  6. Warren
    Reply

    I fell down my basement stairs in the early 1990s and have had excruciating back pain ever since. Just after my injury, one doctor told me that I was malingering (even though disabilitity payments instead of a paycheck reduced my income by over 50%) and another one told me that it was all in my head.
    These medical professionals looked at X-rays and MRIs, but never listened to me and understood that pain does not necessarily show up as a physical anomaly.
    I had chiropractic treatment that helped keep me mobile for several years. But all chiropractors are not created equal and the results ranged from excellent to negative. After my injury I went to an acupuncturist. Acupuncture relieved the pain very well. However when I finally got onto disability Medicare, acupuncture was not covered by this government program even though almost all other insurance companies provide this coverage.
    I was left to endure my agony.
    I have also been to pain management doctors. I have had enough epidural steroid injections to start my own clinic. They have helped for from one day to several months. But the pain always gradually returns. One narcotic pill-pushing doctor had me so zombied out on morphine that I didn’t even know my name. Others refused to provide me with any narcotic pain medication for fear of being arrested by the DEA.
    I have finally found a great medical team. I have a psychotherapist who helps me deal with the depression that comes from constant pain. I also found a pain management doctor who actually listened to me. He heard me when I told him that the pain was constant. He prescribed Fentenol transdermal patches and I have been reasonably functional since then. I am far from pain free – but I can finally manage the pain. I control it now; it does not control me.

  7. WP
    Reply

    There is a simple exercise you can do to treat/prevent plantar faciitis. I found it in the UC Berkeley Wellness Letter, Jan 2008:
    “Exercises that stretch your calf muscles are usually recommended. But research has found that the following simple plantar fascia stretch may be even better. Sit and cross your legs so the affected foot rests on the opposite knee. Then grab the base of the toes and pull towards the shin, so you feel the stretch across the sole; hold for 10 seconds. In the study, people did this 10 times, three times a day for 8 weeks.”
    I’ve done this exercise since 2008 and have had no episodes of plantar faciitis. After doing it for several months, I reduced the frequency to two stretches once a week.

  8. dar
    Reply

    These past 40yrs have been filled with pain from many motorcycle vs car mishaps, roof/tree & ladder falls, bruises, Rh arthritis, asthma, a third degree foot burn&CO poisonings&more which have been forgotten from all those concussions…
    The FIX: Rolfing, Osteopathy, Low-level laser therapy (LLLT), TCM, a vegan diet& supplements [the keystone being magnesium] have reduced the aches by 90%…even with this devilish burn that is in it’s eleventh month of slow-as-a-snail healing…no drugs…No MDs…no infection…

  9. Liz
    Reply

    I was diagnosed with Fibromyalgia in 2006. In 2004 I started having severe back pain. Degenerative disk disease, spondilotisis, arthritis and when I saw docs they all said surgery was my only alternative. I put it off having watched family members suffer with the results of surgery without much relief. Then in 2011, 1 month after turning 50, my vertebrae in my lower back collapsed and I had no choice.
    I had the surgery. 6 months later my upper spine had a 2 inch gap that needed to be fixed by placing 2 inches of cadaver spine to repair it. The surgeries helped but with other problems the pain is still unbearable. I’ve been through several physical therapy programs which helped get me walking again but the pain is always there.
    I was already in severe pain from arthritis in my feet making it nearly impossible to walk over the last 18 years and the back problems just put it over the top. I always thought of myself as a pretty tough broad. I delivered my son without pain meds and when I had a total hysterectomy in ’09, I refused the epidural and went with general anesthesia so I wouldn’t aggravate the back. I was up walking around with no pain 2 hours after recovery.
    This has me begging to die. I sometimes wish I had cancer because then I know it would be ending soon. I’m on oxy and morphine but I am so exhausted trying to get them every month. The pain clinic takes 3 or 4 hours to get seen and then I have to go around to different pharmacy’s to find the medication.
    Some days I have to go to 4 or 5 pharmacy’s to get it filled. Sometimes waiting overnight or longer to fill it. I am made to feel like a dope addict and am left broken and crying in the pharmacy. It is so humiliating.
    I would just like to be able to get through my life with a level 5 pain. I hate taking the meds and going to the docs. We won’t even talk about the peeing in a cup to prove whatever it is they want to know. Thank god for my wonderful husband. I just wish it wasn’t destroying his life too. Though he never complains. Why is this country so backwards?

  10. CM
    Reply

    I hope the person whose doctor moved away will find new doctor soon. I have RA and I am a cancer survivor. My rheumatologist and oncologist listened to me and prescribed pain meds.
    I take them as needed. Perhaps these specialists could be of help to the reader. Good pain control is essential maintaining the quality of life and continuing to work.

  11. S.W.
    Reply

    I have fibromyalgia and cervical radiculopathy, meaning the nerves coming from my cervical spine have pain that radiates across my upper torso and down both arms to my thumbs and hands. I also have arthritis in my shoulder joint and rotator cuff problems as a result. As fibromyalgia amplifies pain, I feel it more intensely.
    For four years I used oxycodone 15mg. four times daily and I was on a roller coaster of being in and out of pain all day as the effects of the pills don’t last more than three hours for me. My mood went up and down as well. My pain management doctor did not want to prescribe the 5 to 6 oxycodone I really needed every day so I was stuck with four, which was very inadequate.
    I was also seeing a psychiatrist for depression and found out he had become certified to prescribe Suboxone, a powerful pain killer, mostly used to help people get off of opiates. It stays in the system for a long long time and I’ve been able to take two tablets in the morning and be comfortable for 24 hours. It has been a miracle medicine for me. I haven’t had to increase the dose in three years of taking it. If I have a powerful pain crisis I sometimes have to take more for a couple of days. No more being on a roller coaster in and out of pain all day long, and my mood going up and down too with the pain.
    Not all doctors can prescribe Suboxone. Usually it is an addictions specialist, which my psychiatrist also is. Be sure the doctor is certified to prescribe it before asking him/her for it. You don’t have to be “getting off” an opiate to take it.

  12. 4terry
    Reply

    I have had serious back pain for years. I have had 4 epidurals over 2 years. They work on the stabbing pain, but not on the deep ache. Unfortunately, I am unable to tolerate almost all serious pain killers (including pain patches), so my only recourse has been Tylenol which seems to work for me where ibuprofen doesn’t. If there are any new pain meds out there that don’t cause nausea and dizzyness, I would really like to know.

  13. CGB
    Reply

    Recently I took my dear 90+ year old friend to the ER, again. We thought she had another UTI. She was trembling, weak and needed a wheelchair to get to the car and inside the hospital.
    They ran numerous tests and everything was fine. She was in such pain from her spinal stenosis that it produced other symptoms. Finally the ER physician assistant excused himself to study her pain medications. When he came back he said that he was pretty sure she was undermedicating for terrible back pain. She was cutting her pain pill in half because of fear of severe constipation that pain medication often produces.
    The doctor said that at her age the quality of life issue demanded that she not be in such pain. He said she could find some way to deal with the side effect but that she needed the full doses of narcotic she was prescribed.
    That turned out to be just the right advice. She has not had the terrible pain episodes since she has taken her full prescriptions for pain medication.

  14. LPW
    Reply

    I also went from doctor to doctor with Fibromyalgia pain with no relief. A Rheumatalogist prescribed Dolobid for me and it worked. I’ve never heard of anyone else who has used this drug. Why?

  15. GW
    Reply

    Don’t forget about the benefits of acupuncture. I have had off and on issues with plantar fasciitis for 15 years and last fall it was the worst it’s ever been. At one point I was on crutches and then a cane. The cortisone shot didn’t help at all, physical therapy gave me temporary relief, custom orthotics helped a little.
    After 7 months of it I was fed up. I had never tried acupuncture but was getting desperate. After only 2 sessions I had my life back. I wore high heeled sandals for the first time in a year yesterday and experienced no pain. On occasion if I overdo it (usually shopping/errands on hard concrete surfaces) I ice my heel and I’m good to go again. It’s been 3 months since my last treatment.

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