BEING THE QUARTER BACK

One thing is for certain, at least, from my experience, if anyone had the ability to take your pain away completely, it more than likely would have already been done. In fact, if you suffer from a chronic pain syndrome, the most important person involved in the treatment of your pain is and will be you. Not only is this a fact, but you simply must accept this as a responsibility that no one else can take over for you. You must be the "quarterback " in your pain treatment program.

Doctors and therapists, as well as counselors, can be tremendously beneficial in your treatment process and education, but you own your pain syndrome. You are in control of your body and thoughts 24 hours per day and these two demand a responsibility that only you can provide.

Your most important tasks will be to educate yourself as to the breadth and depth of information that you need to control, reduce and hopefully resolve your pain syndrome. In addition, and perhaps even more importantly, your behavior will either have a positive effect on the resolution of your pain or it will have a negative effect. You must identify those behaviors, whatever they are, that are facilitating the perpetuation of your pain syndrome and your suffering and then you must eliminate those behaviors from your daily repertoire. You must be completely compliant with any treatment regimen that your doctor or therapist initiates for you. (Otherwise, you will not know for sure whether it could be helpful or not.) Part of the treatment process will include some trial and error and your job is to follow through thoroughly and completely every day, one day at a time. Again, if you expect someone else to take your pain away, you are probably going to continue to be disappointed.

You must be completely honest with your healthcare providers or they will hampered in prescribing appropriately for you. If you fail in your compliance, you must let the health care provider know that you did not carry out your end of the treatment as you should have, and then determine yourself to complete compliance. Again, some therapies may not be helpful. This includes both medications and physical treatment, but you will not know, and your health care provider will not know, unless you follow through appropriately, thoroughly and honestly.

You must develop coping skills to allow you to follow through on a day by day basis. Nobody said this was going to be easy. The truth is that it is difficult. You may need to seek support groups, other persons going through similar experiences, or other health or mental care professionals to help you through the process successfully. If you remain passive, one thing is for certain, your pain and suffering will likely not get better.

Physicians like patients who take the initiative to learn and to follow through appropriately. When you show your healthcare provider that you are passive and dependent, he or she will not be encouraged that they can help you because they know that you are the key to your treatment. You need to demonstrate the initiative and determination to help in the development of the treatment plan and to follow through in the treatment process.

You must use your physician and/or therapist as medical adviser and educator, but understand that they have time constraints which do not allow them necessarily to provide on a one on one basis all of the education that you need. You may have to do some of this on your own, but they can direct you to information sources which would be appropriate for you.

One of the most difficult aspects of chronic pain to come to grips with is its dual nature. There are peripheral aspects to the pain, that is, at the area of the body that is painful, and there are central aspects to the chronic pain syndrome which relate to the spinal cord and brain and their functioning. Many people have come to me with chronic pain syndromes and have told me that other physicians have told them that it is all in their heads. While this may not be 100% correct, nevertheless, there is some reality to this and you must educate yourself to understand the effects of psychological and emotional factors on your pain. In addition to this, behavior is very frequently a significant contributor to the perpetuation of chronic pain. These areas may include periodic over-doing it, improper posture and lifting techniques, poor presence of mind during everyday activities and a multitude of other consequential factors. You must educate yourself so that you can develop an understanding of these perpetuating factors and systematically eliminate them from your behavioral repertoire.

In general, it is my experience that patients who successfully control and resolve chronic pain demonstrate the above positive characteristics and are active in their own treatment. Passivity will only get more of the same.

Be the quarterback in your own pain education and treatment program.