The Quandary Of Pain

The Quandary Of Pain

Pain is a universal experience that helps us to survive. A person who can’t feel pain has a significantly reduced lifespan because pain serves a purpose – it tells us when to stop doing something that is harmful to our body. Leprosy is a great example. It is caused by a mycobacterium that creates nerve damage resulting in the lack of ability to feel pain. The reason why people with leprosy, or Hansen’s disease, lose limbs, and have such horrible disfigurement is that they don’t feel pain, so they injure themselves and don’t seek medical attention.1 Pain is the reason most of us decide to go to the doctor, so in some ways, pain is a guardian angel.

Try telling yourself that during your next rheumatoid arthritis flare!

The trouble is that when pain becomes chronic our guardian angel becomes an ogre trying to imprison us at all costs and destroy the life we’ve so diligently set up for ourselves. Chronic pain is a different animal altogether, one that medical science and healthcare has no idea what to do about. In the U.S. the answer typically is to prescribe opioids, and then when people start dying from the treatment, to stop treatment entirely. In other countries, fear of opioids, societal influences, and a pharmaceutical industry that focuses on profit, not low cost medications, has a created situation in which many people have no access to opioids- even in extreme cases like burns and end stage cancer. Consider this: in 2009 two-thirds of major public cancer hospitals in India did not stock opioids, and WHO estimates that 80% of the worldwide population lives in places with limited or no access to pain medications.2,3

Different types and intensities of pain

If pain is a universal experience why, in 2017, are we still dancing around the issue of how best to treat it? Why are so many people suffering needlessly when others are dying from treatment?

These aren’t easy questions to answer, but as someone who has lived with pain for 98% of my life I can say managing my pain has been the focus of my life, and it hasn’t been easy. Pain is complicated. It takes time to figure out how best to minimize it and the answer can be different for every day of the week. Sometimes my pain is caused by weather and that pain is different than the pain I experience when I walk on my ankles that have severe joint damage. The pain of a flare-up is different still. If I was to give a full and complete answer every time someone asked about my pain it could takes hours, depending on the day, and we all know that is just not possible in a medical setting.

The official definition of pain by the American Pain Association is, “an unpleasant sensation that is subjective in its interpretation and has an emotional component associated with actual or potential tissue damage.” That very clinical sounding mouthful says a lot without saying much. It tells me that someone can use the tired old excuse, “It’s all in your head,” when they can’t find a reason for your pain. It also shows me why the medical world is so afraid of it; there are two land-mines in the definition for most doctors- the words subjective and emotional. Science has little time for either of these words and yet here we are. Pain, as the book The War on Pain says, is what the patient says it is.

All of us living with rheumatoid arthritis are stuck in this quagmire and although at times it can feel extremely lonely, you are not alone. There are millions of us standing alongside you, trying every day to ease their own pain. As much as I rely on and admire the efforts of pain researchers and people on the front line treating pain, right now I know that the real expert, the one that will give me the best advice about what to do, is me. Along with the millions of people who live in my shoes, who often give me ideas about new things to try, me and my body are my most trusted advisors when it comes to my pain.

RA Pain

RA Pain

The truth is there is no magic bullet for pain, and there may never be. Instead, there is exercise, rest, heat, massage, hot springs, saunas, acupuncture; there are a myriad of ways you can decrease your pain. Eliminating it totally may not be an option, but I’ve found that when I make the effort on behalf of myself and my life to minimize my pain, I always feel better.

My medical team will do everything they can to control my disease and when I can’t keep my pain down I always have the option, because I live in the worldwide epicenter for opioids, to take medication. But mostly it is me and my lifestyle, one that encourages my pain to let go. And for now, I’m okay with that.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The RheumatoidArthritis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.
View References
  1. https://en.wikipedia.org/wiki/Leprosy
  2. http://www.latimes.com/opinion/op-ed/la-oe-rajagopal-pain-opioids-20150304-story.html
  3. https://www.economist.com/news/international/21699363-americans-are-increasingly-addicted-opioids-meanwhile-people-poor-countries-die

Comments

View Comments (7)
  • 20g6afo
    2 years ago

    I just had my RA doctor give me the third degree for getting pain medication from my family doctor. Long story, my mom was at the Hospice House for 3 months, yes 3 months and before that we took care of her at home. With me having moderate to severe RA I was not physically able to take care of her but I did and I paid greatly everyday and ended up not being able to do anything for awhile. Of course having to pay for just “going” everyday to see her after she entered Hospice. Any way I did around of arguments with my doctor about pain medication, she suggest I go for a massage, acupuncture and etc. with my life upside down with my mom I told her I didn’t have time or money because even though those things help it was still a temporary help just like a pain pill that didn’t help you get better but it was temporary help and that is all. To me it was more appointments and more money and time, for which a pill could help SOME to keep the pain from getting out of control. Needless to say she didn’t like it but after my mom passed away a few weeks ago and I had RLS really bad and for 3 nights straight so I go see my family doctor which is 15 minutes away and she gave me 1 month supply of my pain medication until I went back to see my RA doctor which was schedule, like when do you not have a RA appointment but it is where I normally get pain medication. I had missed 2 appointment to see the RA doctor because of my mom and her condition had gotten worse the day before my appointments, yes both times and I had to counsel. I had my shots that I take for RA just no pain medication so I just tried to manage, it is and was out of control. Anyway at my last appointment she fussed me out for letting my family doctor give me the pain medication and had me sign a paper saying I would only get it from her. My point is I drive an hour and 15 minutes to see her, she does blood work every time I go and I think she could check my blood for any abuse of pain medication or anything else, I don’t get enough to abuse lol it’s not a strong medication or dose just a little better than over the counter stuff. I think most people have signs of drug abuse??? Both my doctors are apart of the same network so they see what the other gives. It is terrible that we are treated this way when there is no cure for RA and like it or not we have to deal pain with it everyday. I hope I can get mine under control soon.

  • kat-elton author
    2 years ago

    Hi there- people in chronic pain are between a rock and a hard place right now. My husband has dealt with a very similar situation recently. Doctors are being pressured to not prescribe opioids anymore because of the number of deaths associated with them, and because chronic pain is so misunderstood and easy to ignore, people in pain are suffering immensely. I’ve lived with pain for over 46 years and never in my life has our relationship to pain, and the treatment of it, made any logical sense.
    These are the tough facts, yet another challenge that people with RA have to handle. I’m so sorry you are dealing with this right now, especially given the fact that you are going through such a hard time in your life right now. I think the best way to handle doctors around this issue is to be very descriptive about why and how you use your medicine. It sounds like you were getting through a very tough time and needed the pain meds to help you with this. If your doctor can’t understand this maybe you could try to find another rheumatologist who works better with you.
    I sure hope you find relief soon! Can you take some time just to focus on your own health and comfort? For me, my emotions affect my pain and when I am grieving or sad, my pain can feel overwhelming so helping myself to feel better emotionally also eventually ( not always immediately) helps my pain. Maybe it would be a good time to ask for extra help from friends and loved ones so that you can take the time you need to feel better.
    Please take care and thanks for commenting and telling us your story because a lot of people are feeling the way you do… XO

  • Connie Rifenburg
    2 years ago

    Speaking of different kinds of pain.. I am experiencing a type of pain now that seems to be directly related to the drop or rise in barometric pressure. I live in FL and right now, we’re facing a huge hurricane, Irma, about to land itself somewhere in FL, but ahead of it, the weather is changing and my pain is growing exponentially!

    I don’t seem to remember my RA reacting this way in the beginning, and so I’m beginning to believe that it must be the addition of the osteo arthritis to the mix of problems that has been causing this “new” type of joint pain related to weather.

    It is particularly bad in those joints that have the least amount of “padding” left..bone on bone and in those joints effected by the RA in other ways such as being deformed. I am very cautious with my oxy, although I use it regularly 1 am; 1 pm, for the past 3 yrs, I am able to use it more frequently if needed but 99% of the time I don’t.

    The kind of pain I’m talking about doesn’t seem to respond to “more” pain medication. I wonder if there is a reason? Heat mostly, cold sometimes, seem to be the best practice for me, but I wonder if others here have the two types of Arthritis and if so, are you affected by the weather? I’m tempted to just try to use tylonol and see if that assists the opiod enough to get through the worst of the weather changes without upping my narcotic dosage.

    Thanks for bringing this issue up and now, having the knowledge that people in other countries go without any pain medication causes me to cringe for them and what they are enduring..and to appreciate the pain relief I DO have for the most part.

  • Richard Faust moderator
    2 years ago

    Hi Connie. Hope you weathered the storm o.k. My wife, Kelly Mack (a contributor here) just got out of Florida yesterday after finally getting a flight. A lot of members of the community agree with you about the barometric pressure. Here are a couple of articles from contributors about the effects of pressure changes:

    https://rheumatoidarthritis.net/living/sorry-cant-today-barometric-pressures-changing/

    https://rheumatoidarthritis.net/living/the-storms-in-joints/.

    Wishing you the best. Richard (RheumatoidArthritis.net Team)

  • kat-elton author
    2 years ago

    Hi Connie! First of all, I hope you fare well during the big storm- the rest of the country is pulling for you and thinking about you. Secondly, I am with you- the barometric shifts affect me to a huge degree, I’ve always said I would be a great weather forecaster! Humidity is another thing my body doesn’t seem to like. Whether or not we know why this happens isn’t that relevant in the moment but I sure would like to understand the reason weather affects us so much. I’ve found that it is a specific kind of pain that it causes- achey, sore, but not always heat so maybe the mechanism behind the pain doesn’t respond to meds because the cause is more mechanical? Just a guess…..
    I’m glad you get at least some relief and that you have other things in your pain toolbox besides medication because as we all know meds are only one piece of a very large puzzle for being healthy with RA!

    Take good care!
    🙂

  • Lawrence 'rick' Phillips
    2 years ago

    I think the main truth is that pain varies as much as RA and maybe more. Thank goodness we humans are even stronger than RA or pain. (most days anyway)

  • kat-elton author
    2 years ago

    I agree Rick-minute to minute, hour to hour, pain can change, it’s our job not to let it get the best of us!

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