Coping with Pain
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/ Categories: WELLNESS, 2022

Coping with Pain

The Journal of the International Association for the Study of Pain estimates as many as 18 million Americans suffer from chronic pain on most days. It can be caused by headache, surgery, cancer, trauma, arthritis, nerve damage, and neck or back injury. Sometimes the cause is unknown or continues long after the initial cause of the pain has healed. The pain can go on for months or years and can lead to anxiety, depression, fatigue, insomnia, mood swings, irritability, and other difficult psychological conditions.

Once you have worked with your primary care provider and specialists to identify and treat the cause of the pain, you can try these options for coping with the pain in any order that makes the best sense to you and your provider.

Medical Approaches

Each of the many medications used to help with pain come with side effects. 

  • Acetaminophen can harm the liver if used excessively or improperly.
  • Ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) can cause kidney damage in certain patients.
  • Muscle relaxers can provide relief in some cases, but they may cause drowsiness, dizziness, headache, and other side effects.
  • It’s best to develop a system that includes these medications when needed.
  • Antidepressants are being prescribed for those with chronic pain. Often, the benefits outweigh the side effects.

SPECIAL NOTE:

A few of the drugs often turned to for pain come with major concerns and should only be used with careful supervision from a medical provider.

  • Opioids come with a great risk of addiction, tolerance, dependence, and a paradoxical increase in pain. This factor alone makes them undesirable for many patients, even for short-term use.
  • Cannabis is not approved by the Food and Drug Administration. It is associated with acute adverse effects including anxiety, nausea, panic, disorientation, impaired attention, short-term memory, and driving performance.

Physical and occupational therapy can be a great drug-free way to cope with chronic pain. Movement can help restore strength and confidence. Often, the symptoms of chronic pain are reduced. Therapy is a safe, even fun, way to navigate pain.

Similarly, mental health counseling can help patients think more positively, process past events, and implement helpful changes. Through talk therapy people often come to understand how unconscious forces contribute to their pain.

Pain Management Programs combine imaging and anesthesiology technologies to target the source of pain and relieve it.  Services offered include joint injections, nerve blocks, spinal cord stimulation, and others.

Do-it-Yourself Ideas

Many people find that concentrating on improving their overall health is a great way to make progress against chronic pain.

Many people find it beneficial to focus on relaxation.

  • Don’t try to do too much. Create a daily schedule that includes a few priorities and time for rest and self-care.
  • Create the conditions for good sleep.
  • Learn stress management techniques that work for you, including deep breathing, yoga, meditation, listening to music, walking in nature, playing with kids or pets, and others.
  • Getting interested in a new hobby can also be beneficial. More than a distraction, hobbies and interests get us thinking positively about the future.
  • Strong relationships help us cope with pain too. Meet up with friends and family or join a pain management support group.

Complementary Medicine

Complementary medicine can be as simple as treating the site of your pain with heat or cold or enjoying a cup of restorative tea. If you are receptive, you can also try massage, reiki, acupuncture, biofeedback, guided imagery, or hypnosis. Each has been shown to be an all-natural method for achieving pain relief.

It is unlikely that any one of the tips above will resolve your pain entirely. A personalized system of pain-management habits you do on a routine basis will be most powerful in helping you live a healthy and fulfilling life.

Joshua Tobe, MD, is an anesthesiologist and interventional pain management specialist at SVMC Anesthesiology, part of Southwestern Vermont Medical Center and Southwestern Vermont Health Care in Bennington.

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The Latest Testing Information

The world of COVID-19 testing is very complex and changing rapidly. But gratefully, unlike early on in the pandemic, tests are available for everyone who wants one, whether they have symptoms or not. Below is a list of common questions, along with answers from SVMC’s Laboratory Services Director Karen Bond and SVMC’s Director of Perioperative Services Tanya Cowder, MSN, RN, CNOR.

What are the reasons someone may get tested for COVID-19, even if they don't have symptoms? People without symptoms of COVID-19 are being tested when they are admitted to SVMC, before being discharged to other facilities, before scheduled surgeries, or because they may have been exposed to the virus. Primary care providers are also able to order a test for those who need to return to work or school or to end quarantine or isolation. And anyone can be tested through the Vermont Department of Health's Pop-Up Clinics.

What types of tests are available for detecting active cases of COVID-19? SVMC offers Polymerase Chain Reaction (PCR) testing that is processed at both outside labs and our own lab, depending on how quickly results are needed. PCR, which was pioneered by American biochemist Kary Mullis in 1983, actually amplifies and detects the presence or absence of small gene sections. In this case, it determines whether or not COVID-19 is present.

The specimen is most often taken from deep in the nose-throat passageway (nasalpharyngeal). Patients experience eye watering and a burning sensation for 30 seconds or less. The test can also be taken from inside the nose (anterior nares), depending on the patient population. The most common type of test, like those administered both at SVMC’s drive-up testing station and at the Vermont Department of Health’s Pop-Up Clinics, is greater than 90% sensitive (meaning that the test picks up the virus, if it is present) and greater than 90% specific (meaning the test detects the COVID-19 virus, as opposed to other viruses).

How do I get my results and what should I do? Results are usually provided by a primary care provider within 48 hours. Your primary care provider will share specific directions regarding what you should do next. The Centers for Disease Control and Prevention is sharing this table, which provides a synopsis of tests, what results mean, and guidance for what to do. If the test is positive, the Vermont Department of Health may call before the primary care provider to initiate contact tracing.

Are all of the tests sufficiently available? Yes. Anyone with an order from their primary care provider can be tested at the drive-up testing site at SVMC. Anyone can be tested at the Vermont Department of Health's Pop-Up Clinics. Visit https://humanresources.vermont.gov/popups for times, dates, and locations. Tests for inpatients at the hospital are also in adequate supply.

Important Note: Remember test results offer a snap shot of the current active viral load. A negative test result doesn’t reveal whether you have been exposed in the past or predict whether you will be infected in the future. Whether or not the result is positive, we should all continue to wash our hands frequently, wear masks when in public and in proximity to those outside of our household, and stay 6 feet from others.

What about antibody tests? Antibody tests (serology) are also available. It does not tell you if you have active disease. Antibody tests check for antibodies that appear in the blood between about 1 – 3 weeks after symptom onset and may remain as long as a lifetime. Antibody tests may be positive while a person is infected. It is not yet known whether these antibodies protect against reinfection with the COVID-19 virus. For many other similar viruses, antibodies are protective for years or longer, but we do not yet have adequate data to know for COVID-19. Patients who would like the test would get a referral from their primary care provider and come to the SVMC Lab to have blood drawn. Results are delivered by the primary care provider.

Those who receive a positive antibody test or who have recovered from COVID-19 may qualify to donate plasma with the American Red Cross. The plasma, which includes antibodies, may help those fighting the disease. Learn more at https://www.redcrossblood.org/donate-blood/dlp/plasma-donations-from-recovered-covid-19-patients.html.

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