Managing Arthritis Pain
When to Start and When to Stop
It is interesting that I overheard two clinicians speaking recently and this is generally what I heard:
Clinician 1: I got a call from Doctor X's patient while I was on call and he was away. The patient was 2 months after arthritis surgery and was asking for a refill of pain medications.
Clinician 2: What did you do?
Clinician 1: I don't give pain medication to drug seekers.
OK. Now I am only paraphrasing but this happened somewhat like this. It brings up an interesting point. Doctors are often blamed for being on both sides of the problem. I hear that doctors are blamed for prescribing narcotics too freely and also blamed for holding back pain medications in many situations. What is the truth?
There is no right or wrong answer here. The problem is that pain is an individualized problem and while there are numerous guidelines, many patients break out of those guidelines. Additionally, most physicians are not formally trained enough in the science (and art) of pain management. Considering one of the most common complaints any patient has when walking through a doctors doors is, "I have pain," most medical schools have little to no curriculum on pain management.
In my experience as s surgeon for over 16 years I think that most patients are undertreated for their pain. For, example, I see many junior faculty prescribing Oxycodone 5 mg for postoperative pain which is fairly low dose. In general, the current approach to pain management is referred to as "multimodal." This means a combinations of narcotics, antiinflammatories, acetaminophen, ice, exercise, and possibly alternative methods. Most hospitals, though, do not have well-developed pain management services and even fewer have modern cold treatment or ice therapy machines and continue to have nurses put on ice packs at irregular intervals.
Knowing when to start aggressive pain management after surgery is easy. Knowing when and how to stop is more difficult. In a non-surgical setting in the case of arthritis even knowing when and how to start is a challenge.
What has been your experience in the management of your pain -- good and bad?
Dr. K.
Related Topics:
Technorati Tags: arthritis, pain management, health-and-wellness, medicine
It is interesting that I overheard two clinicians speaking recently and this is generally what I heard:
Clinician 1: I got a call from Doctor X's patient while I was on call and he was away. The patient was 2 months after arthritis surgery and was asking for a refill of pain medications.
Clinician 2: What did you do?
Clinician 1: I don't give pain medication to drug seekers.
OK. Now I am only paraphrasing but this happened somewhat like this. It brings up an interesting point. Doctors are often blamed for being on both sides of the problem. I hear that doctors are blamed for prescribing narcotics too freely and also blamed for holding back pain medications in many situations. What is the truth?
There is no right or wrong answer here. The problem is that pain is an individualized problem and while there are numerous guidelines, many patients break out of those guidelines. Additionally, most physicians are not formally trained enough in the science (and art) of pain management. Considering one of the most common complaints any patient has when walking through a doctors doors is, "I have pain," most medical schools have little to no curriculum on pain management.
In my experience as s surgeon for over 16 years I think that most patients are undertreated for their pain. For, example, I see many junior faculty prescribing Oxycodone 5 mg for postoperative pain which is fairly low dose. In general, the current approach to pain management is referred to as "multimodal." This means a combinations of narcotics, antiinflammatories, acetaminophen, ice, exercise, and possibly alternative methods. Most hospitals, though, do not have well-developed pain management services and even fewer have modern cold treatment or ice therapy machines and continue to have nurses put on ice packs at irregular intervals.
Knowing when to start aggressive pain management after surgery is easy. Knowing when and how to stop is more difficult. In a non-surgical setting in the case of arthritis even knowing when and how to start is a challenge.
What has been your experience in the management of your pain -- good and bad?
Dr. K.
Related Topics:
- WebMD Video: Arthritis Drugs Provide the Help Patients Need
- WebMD Video: New Medications Ease Crippling Arthritis Pain
Technorati Tags: arthritis, pain management, health-and-wellness, medicine
Labels: arthritis, pain, pain management
