Chronic Pain

Chronic pain, in the absence of any discernible physical cause, is the most common reason for lost workdays in this country, yet doctors remain unsure about what causes the complaint, how to treat it, or even if it exists.What do you do when the scans, blood tests and exams indicate nothing wrong, but the patient is incapacitated?"Its a terrible dilemma," said Dr. Kathleen Foley, director of the pain service at Memorial Sloan-Kettering Cancer Center in New York. "Pain is what people say it is. And if you start with the concept that you should believe the patient, then how can you say it is real or unreal, and how do you prove it?"

A new survey of integrative medicine centers shows that the most commonly treated ailments are chronic pain, gastrointestinal conditions, depression and anxiety, cancer and chronic stress. The survey was conducted at 29 centers, including the University of Maryland Center for Integrative Medicine , by the Bravewell Collaborative , a nonprofit foundation that advocates for and researches integrative medicine. This kind of medicine purports to treat the whole patient - physically, emotionally, spiritually, etc. -- through use of alternative and complementary therapies such as acupuncture and massage.

What would we do without pain? You'd pick up a hot frying pan and burn yourself badly if it weren't for an almost instantaneous reflex that makes you drop it. You might walk miles on a sprained ankle doing further damage except for the body's protective signal that says stop.Pain is the body's early warning system that alerts you to anything from appendicitis to a heart attack.Despite its importance, pain can ruin people's lives. You could live with a stuffy nose or stiff joints, but pain gets your attention and can dominate every waking moment.

The scene that played out before Navy began football practice Monday afternoon in Annapolis was different than other moments during the past four years when Jabaree Tuani tried to motivate his teammates. Depending on Tuani's position in the pecking order of team leaders, the 6-1, 265-pound defensive end has spent much of his career encouraging or castigating, his words and body language usually fitting perfectly to the circumstance surrounding the Midshipmen. This time, as Navy (4-7)

Take an aspirin and call back in, well, a few years. That's how long it may take for the next generation of painkillers to arrive.But they are coming, and researchers say these new and powerful substances -- born from the most advanced knowledge of how pain messages travel from the periphery to the brain -- will revolutionize pain treatment for chronic conditions such as migraines and arthritis."

After 10 days of testimony and less than two hours of deliberations, a Baltimore County jury awarded $4 million this week to a 35-year-old woman who said she has suffered chronic pain and partial paralysis since 1998 because a doctor in Fallston General Hospital's emergency room delayed sending her for back surgery. Linda McAlexander, a Harford County resident who worked as a real estate loan processor, had an established diagnosis of lumbar disc disease when she went to the emergency room in June 1998.

OXYCONTIN is a remarkable prescription drug that has made life bear- able for millions of cancer patients and others with severe chronic pain. It's also a synthetic opiate that is one of the most widely abused and deadliest street drugs, linked to hundreds of deaths and a spreading wave of addict crime. In a rare step against a single medication, the Drug Enforcement Agency is cracking down with a plan to limit distribution to physicians. More than 6.5 million prescriptions were written for the drug last year, many for "nonmedical" reasons, the DEA warns.

America is seriously divided about controlling chronic pain, which afflicts more than 50 million people and costs the country $100 billion a year. On the one hand, we grossly under-treat it. Management of chronic pain and the pain of dying patients is arguably the most egregiously neglected field of medicine. On the other hand, as a society, we have become obsessed with the war on drugs - and the fear of addiction to opioids (narcotics). Pain patients who were functioning well on morphine-like drugs such as oxycodone (OxyContin)

The crash that grounded Linda Berl had nothing to do with the Piper Cherokee that she flew to shuttle needy Eastern Shore patients to local hospitals. What got her was a low-altitude tumble from the front porch of her Delaware home in 2001 that left her with a broken leg and persistent, debilitating pain. "Sometimes I'll feel like my foot is on fire," she said. "It feels very deep, like it's in my bones." The pain dominated Berl's life for years, but now the 47-year-old Smyrna resident hopes to return to flying with the help of a spinal cord stimulator -- a device that Johns Hopkins doctors implanted under the skin of her back to override pain signals traveling from her body to her brain.

Despite sweeping new warnings that the nation's most popular painkillers can harm hearts, stomachs and skin, many Americans are going to go right on taking them, saying the relief is worth the risk. The popular arthritis drug Bextra last week became the second Cox-2 painkiller pulled from the market while the Food and Drug Administration pinned its highest warnings on Celebrex and nearly 20 other common prescription-strength drugs such as Mobic, Motrin, Naprosyn and ibuprofen. The move tainted trusted remedies and replaced them with nothing but confusing alternatives, prompting many patients to count pills and ration what's left of medications that have worked for them.

Share your good news and events with the community. Contact Laurel Leader editorial assistant Pat Farmer, paf1@patuxent.com , or phone and fax 410-332-6653. Blood drive - Sponsored by Laurel Lions Club, American Legion Post 60 and Medstar Health Blood Donor Services, Tue., Oct. 4, 2:30-7 p.m., American Legion Post 60, 2 Main St. For appointments, call Donald Danneman, 1-888-757-7040. Walk-ins welcome. National Active and Retired Federal Employees Association - Chapter 422 luncheon meeting, Wed., Oct. 5, 11:30 a.m., upstairs, Main Street Sports Grill, 531 Main St. Rebecca Miller, of Maryland Relay, explains telecommunications access of the Maryland Department of Information Technology and shows latest in audio aids for those with hearing disabilities.

These groups meet regularly. Alzheimer's Caregiver Support Group - Third Wednesday, 5:30 p.m. at Lighthouse Senior Living at Ellicott City, 3100 N. Ridge Road, Ellicott City. 410-465-2288. Bereaved Parents, USA - Third Wednesday, 8 p.m. For parents and siblings who have lost a child or sibling of any age. First Presbyterian Church of Howard County, 9325 Presbyterian Circle, Columbia. 410-321-7053. Breast Cancer support group - Third Wednesday, 7-8:30 p.m. Claudia Mayer Cancer Resource Center, 10710 Charter Drive, Suite G050, Columbia.

I think it's fantastic that Rev. Milton Williams is sticking his neck out on behalf of addicts in Baltimore by proposing to open his clinic to more people in serious need of methadone treatment ("Pastor to open on-demand methadone clinic at church," June 24). One thing the article did not mention is that methadone does not make addicts high but reduces cravings that lead to drug-seeking behavior and crime. However, it's imperative that readers know that methadone is also a highly effective primary treatment for chronic pain.

I read with trepidation Meredith Cohn 's article "Maryland seeks to tackle prescription drug problem: Legislation would create monitoring system" (April 2). As someone who has lived with chronic, intractable pain for more than 30 years, this is a topic that directly affects me and thousands of other Marylanders who count on prescription medicines as a part of a comprehensive pain management program. I am all for reasonable measures to curb drug abuse that do not trample the rights of people with pain.

I am writing in response to the article published today by Nancy Rosen-Cohen "The Quiet Epidemic: Prescription Drugs Destroys Millions of Lives." Please provide balanced coverage to the 76 million Americans who live with chronic debilitating pain who use opioid medications responsibly so they may continue to be productive working mothers, fathers, husbands and wives. Pain affects more Americans than diabetes, heart disease and cancer combined according to the National Center for Health Statistics.

It's the lightning season again. Bolts from the sky kill more than 50 Americans each year, on average. Nine have died so far in 2009. Most are young males, and a third are struck at work. Ninety percent of those hit by lightning survive, but often with chronic pain, brain injury and thought-processing problems. Hear thunder? Go inside. Stay off (and unplug) hard-wired computers, phones or games.

The June letter from the Baltimore Health Department alerted physicians, nurses and other providers to a significant increase in methadone-related overdose deaths. The letter from Dr. Laura Herrera, a deputy city health commissioner, raised the possibility that the overdoses involved prescriptions for pain. It was a cautionary reminder that health care providers should educate their patients about the proper use of methadone and the lethal risks of taking extra doses. Dr. Herrera was right to be concerned: Methadone-overdose deaths of city residents have risen from seven in 1995 to 74 in 2007.

It is often the silent patients who suffer the most - those who don't wince, cry or writhe. For them, debilitating pain is not something to fear; it's a fact of life. "The quiet ones scare me the most," said Dr. Paul W. Davies, director of the pain management program at Anne Arundel Medical Center. "They've been in pain so long, they've become disassociated with it." Davies' 6-month-old program is an indicator that the treatment of chronic pain - once limited to a handful of institutions - has become a staple at community hospitals and larger centers as well.

Pain is the No. 1 reason people seek medical help. Acute-onset pain suggests a medical emergency and immediate medical assistance is necessary. Chronic pain has a significant impact on human life. According to Dr. Zhaoming Chen, the best way to control chronic pain is a multidisciplinary approach that includes complementary and alternative medicine. Chen, chairman of the American Association of Integrative Medicine and a physician at St. Agnes Hospital, offers several easy ways to help people deal with pain.

On tonight's House, the cranky doctor finally gets a patient he can relate to. In this new episode, House (Hugh Laurie) and his team try to figure out what's wrong with a man suffering from chronic pain - something House has lived with for years. No word on whether the patient is also an insufferable jerk. Meanwhile, Foreman and Thirteen (Omar Epps and Olivia Wilde) deal with their budding relationship, and Cuddy (Lisa Edelstein) gets a lesson in juggling work and parenthood. The medical mystery show now in its fifth season celebrates its 100 episode next month.