Progress in Treating Pain

UNTIL recently few doctors knew very much about pain, and many still don’t. Dr. John Liebeskind, a former president of the International Pain Foundation, observed a few years ago: “I don’t think there is a medical school in the world where more than four hours out of four years are spent teaching students to diagnose and treat pain problems.”

Breakthroughs in understanding pain, however, have coincided with greater efforts in treating it. Thus, the outlook for pain sufferers has brightened. “We can all be grateful,” American Health magazine reported, “that medicine now recognizes that chronic pain is no mere symptom, but a treatable disease in itself.” This view has contributed to a tremendous increase in the number of clinics devoted to treating pain.

Where Pain Is Treated

Dr. John J. Bonica opened the first multidisciplinary pain clinic in the United States. “By 1969 there were only 10 such clinics in the world,” he reported. But the number of clinics devoted to treating pain has increased dramatically in the last 25 years. There are now over a thousand pain clinics, and a representative of a national chronic-​pain outreach association said that “new ones open nearly every day.”a

Think of what that means! “Now patients who used to have to travel hundreds or thousands of miles to get relief from serious pain can find it close to home,” noted Dr. Gary Feldstein, an anesthesiologist in New York City. If you are the one suffering, what a blessing it can be to receive help from a team of specialists trained to treat pain!

Linda Parsons, the wife of a traveling overseer of Jehovah’s Witnesses, suffered from back pain for many years. She sought help from one physician after another, yet her pain continued unabated. One day in May last year, in near desperation, her husband picked up the phone book and looked under pain. Listed was the phone number of a pain clinic not far from where they were serving in southern California. An appointment was made, and a few days later Linda met with a doctor to receive her initial consultation and evaluation.

Arrangements were made to treat Linda as an outpatient. She began visiting the clinic three times a week for treatment and also followed a treatment program at home. In a few weeks, she began to feel marked improvement. Her husband explains: “I remember her saying almost in amazement one evening, ‘I can’t believe that I hardly feel any pain.’” Within months, regular visits to the clinic could be discontinued.

The help Linda received to manage her pain is similar to that provided by many multidisciplinary pain clinics. Such a clinic employs the expertise of a team of health professionals, which, according to Dr. Bonica, is “the best approach to dealing with chronic pain.” How, for example, was Linda treated for her pain?

How Pain May Be Treated

A clinic brochure describes the procedure on arrival: “Each individual is evaluated by a physician to assess the basis for the pain and then realistic goals and treatment programs are outlined. . . . Specialized techniques and approaches are used to aid the body in releasing ‘endorphins’ (naturally produced chemicals in the body) to diminish pain and anxiety and avoid drug dependence.”

Among the treatments Linda received were acupuncture and TENS, which stands for transcutaneous (across the skin) electrical nerve stimulation. She received electrical stimulation treatments at the clinic and was provided a small TENS unit to use at home. Biofeedback​—a procedure in which the patient is taught to monitor his body responses and modify them to reduce the impact of pain—​was also employed.

Physical therapy, including deep tissue massage, was a feature of the treatment regimen. In time, but only after Linda was ready for it, an exercise program in the clinic’s gymnasium was introduced, and it became an essential part of treatment. Exercise is vital, since it has been found to restore endorphins depleted by chronic pain. The challenge, however, is to help people in pain to manage a beneficial exercise program.

Many chronic-​pain sufferers coming to clinics are taking large amounts of pain medication, and Linda was no exception. But soon she had been weaned from her medication, which is an important goal of pain clinics. Linda experienced no withdrawal symptoms, yet that is not unusual. Pain expert Dr. Ronald Melzack noted that in “a survey of more than 10,000 burn victims . . . , not a single case of later addiction could be attributed to the narcotics given for pain relief during the hospital stay.”

Since there is often a major psychological aspect to chronic pain, clinics try to help patients, in effect, to unlearn their pain. “What you think about,” explained Dr. Arthur Barsky, a professor at Harvard Medical School, “what you expect, how much attention you pay to feelings​—all these things have a tremendous influence on what you in fact feel.” So patients are helped to concentrate on matters other than their pain.

Prospects for Cure

Are these new pain clinics the answer to mankind’s pain problems? Though the pain-​treatment methods described here can be helpful, one must use care in choosing a competent clinic or pain specialist. Even then, expectations must be realistic.

To illustrate with a typical success story: Stephen Kaufman, a former Olympic weight lifter, was left almost an invalid because of chronic pain suffered when a mugger shot him in the neck. After eight months in a pain-​treatment program, he was able to return to work full-​time and eventually even to competitive weight lifting. Yet he said: “Half the time, my toes burn like they’re in boiling water.”

So despite all the exciting progress, it is obviously beyond human capability to fulfill the Bible’s promise: ‘Pain will be no more.’ (Revelation 21:4) How, then, can that goal be achieved?

[Footnotes]

[Pictures on page 9]

Methods of treating pain, including electrical nerve stimulation

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Courtesy of Pain Treatment Centers of San Diego