Navigating the Medical Maze With Chronic Pain

Approximately 100 million people live with chronic pain. Chronic pain is defined as pain that lasts 3 to 6 months after the initial injury, surgery or physical trauma. In some cases, chronic pain has no known cause which makes obtaining a diagnosis and proper treatment plan a bit of a maze.

Here are some steps to take to help with the medical maze that often accompanies chronic pain:

Step one

When an individual feels pain and pain-related symptoms, such as tingling, throbbing, aching and swelling, medical attention is usually warranted, especially if the pain intensifies or worsens over time. The first step in obtaining a proper diagnosis (if the pain does not require immediate attention which would require a visit to an emergency department) is to make an appointment with a primary care provider (PCP). A PCP will take a medical history of past injuries, surgeries, medications and any other current or past conditions. An overall physical exam is typically performed to rule out any potential underlying illnesses that could be the cause of pain. Depending on the medical opinion of the PCP, a referral to a specialist may be provided. It is important to note that a chronic pain diagnosis requires that an individual has dealt with pain for 3-6 months or longer.

Step two

The next step involves seeing a specialist. The type of specialist an individual is referred to depends on the location of the pain and any test results from the primary care physician. Some of the most common specialists an individual may be referred to include, but are not limited to, the following:

• Rheumatologists
• Orthopedists
• Neurologists
• Doctors of internal medicine
• Physiatrists (Doctors of physical medicine and rehabilitation)

A specialist also takes a medical history, often asking very similar questions to the PCP. They also typically perform a physical exam, which may differ from the PCP’s exam; an exam with a specialist is often more in-depth. Depending on the specialist’s findings, more tests may be ordered, such as a CT scan or MRI. The specialist may also refer the individual to another medical specialist.

After consulting with a specialist, the hope is to receive a diagnosis and a treatment plan. However, this isn't always the case; oftentimes, individuals endure multiple appointments and undergo numerous tests before a proper diagnosis and treatment plan is secured.

Step three

Pain management is complicated and is often a process of trial and error. While medication is the most common treatment option for chronic pain, a multitude of other treatment options are available. Deciding on a treatment plan is a process that involves both the health care provider and the individual. Generally, six treatment categories for managing chronic pain are available:

• Medications
• Interventional procedures (nerve blocks or injections)
• Rehabilitative and occupational therapy
• Pain psychology
• Complementary alternative medicine (acupuncture, massage, etc.)
• Self-management (diet, exercise and lifestyle changes)

Useful tips while navigating the medical maze

Finding doctors, securing appointments, undergoing tests and receiving a proper diagnosis does not happen overnight; it can be a lengthy process. Until a pain management plan is in place, some tips to deal with the pain include, but are not limited to, the following:

• Learn stress management techniques
• Practice pacing oneself, even on the good days
• Set realistic goals
• Try to keep moving
• Use distraction
• Eat healthy
• Keep a pain log or use an app like PainScale