It's Not About Pain - It's About Living
I think we need to change our conversation with our doctors about pain because it’s not really about pain, it’s about getting our lives back. It’s about being productive and healthy and happy and feeling like doing the things we both want and need to do. It’s about the ability to enjoy life again. Pain has the power to take all of that from us.
Fellow contributor Wren wrote about non-opioid pain techniques in her recent article, My RA Toolbox. I know that she’s gone to classes about alternate methods for pain management, so she has a wealth of information on the subject, examples of which she uses in her article.
Pain - a time thief
But I couldn't help but notice that these alternative pain management methods steal an inordinate amount of time away from patients. While you’re soaking in a hot tub, or meditating, or doing exercises like Tai Chi, or reading, or doing acupuncture, or any one of the myriad other methods that are now being promoted instead of pain medication, you aren’t living your life – you’re dealing with your pain. How do you do these things when you have fulltime commitments like a job or a family? While these methods have been found to be effective, people are still putting their life on hold to deal with the situation.
So our goal, therefore, is to get our life back.
Pain Management: A personal decision
I believe strongly that decisions about pain management are personal to be made in conjunction with your doctor. However, I will comment that pain medications are designed to work quickly so that you can feel better and get back to the important things in your life.
After reading medical news and patients stories, the other thing that I believe is that while doctors are now legally more restrictive in prescribing opioid medications, they are also more cautious in prescribing non-opioid pain treatments that can provide a great deal of benefit to patients. This seems contrary to a study recently reported in the Journal of the American Medical Association (JAMA)demonstrates comparable results when treating chronic back or knee and back osteoarthritis pain with either opioid or non-opioid pain medications.
To quote the study, “The opioid regimen began with immediate-release morphine, hydrocodone/acetaminophen, and oxycodone, but the regimen could advance to sustained-action morphine and oxycodone, and on to transdermal fentanyl. The nonopioid approach began with acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDS), but it could move on to topical analgesics and finally to drugs requiring prior authorization such as pregabalin and duloxetine.”
The people I know who suffer from chronic pain don’t seem to care whether a treatment is opioid or not – they just want something that works. While all medications have side effects, if patients can get effective pain management without the roadblocks currently imposed by opioids, then that may provide a path to long-needed relief. Further, the FDA has fast-tracked a new non-opioid pain medication, tanezumab, signaling the government’s willingness to provide new options for patients. (The approval of tanezumab is anticipated this year.)
It is up to us, as patients, to initiate these discussions. Stating that you are in pain is one thing. But it’s a different conversation if you say, “I need something that will work quickly so I feel well enough to go to work.” Obviously going to an hour-long Tai Chi class is not going to get you to work on time. And while you might also employ alternative pain management approaches on an ongoing basis, having this type of discussion with your doctor will provide the opportunity to look at more expedient pain relief.
Right now, what RA tips would most be helpful for you?