Explaining Chronic Pain to Your Doctor

By María

As I typed the title of this article I had to pause for a moment to think if it was too silly. I mean, most doctors should understand the concept of chronic pain, shouldn’t they? At least to me if I suffer from a chronic disease with endless pain and decide to see a specialist, I take for granted that my doctor has an idea of how chronic pain feels like. Maybe he or she has not dealt with a week long (or longer) migraine attack or suffered the pain of sciatica or back pain, but the doctor must have some idea.

Ideally things should be like that–where most doctors are so synced with the patient’s needs and suffering that there is no reason to doubt they know what we go through every or almost every day. In reality the story is very different. Many physicians do not understand what chronic illness and chronic pain truly feels like. At least that is my experience.

Every physician that I have visited until today has told me that chronic pain is defined as any type of persistent pain or discomfort in the body that lasts more than twelve weeks. In the migraine world, chronic migraine is diagnosed when a patient experiences migraines for more than 15 days in a month. It can be consecutive days or not. In the United States health insurance companies follow these principles.

As a chronic migraineur since the age of 8, I have met several doctors throughout my life. Some of them are amazing and some of them are far from decent. However, all of them have something in common: they do not quite understand the living nightmare it is to feel pain on a daily basis.

I do not blame them. It is very hard to ‘feel’ what another person is feeling and going through. Even if it is a similar symptom, every person feels pain in a different way. When referring to migraines, each one is different from the other even in the same person so it can be tricky to accurately express yourself. Some migraines have auras; some do not. Some people experience nausea, vertigo, fatigue, and even depression. It is a complex neurological disorder that is hard to understand and to explain. Trying to put into words not only the pain and discomfort but also the challenges we face like not being able to live a normal life can be really challenging.

Again, and I am going to repeat it, there are amazing doctors and healthcare providers out there who DO understand chronic pain. You can feel their empathy, their understanding, their knowledge about the topic but in my experience most of them do NOT understand it.

I have seen many doctors in many countries. In most cases their treatments have not been successful because sooner or later my migraines always came back. I said to myself, “I have to find a better professional.” I never lost hope because I knew my path to healing was somewhere out there in the future, but not being able to find relief made me angry and frustrated. It was worse, as I grew older my migraines got more severe.

The last neurologist I saw literally told me that he had ran out of options for me under his sleeve. I left his office extremely frustrated and angry. I decided I needed to find the cause of my pain and not just disguise it. For awhile I have been seeking the answer to what is causing my chronic migraines and every treatment I had tried so far seemed to be targeting  the symptoms but not the cause.

Just to exhaust all my options I went to see a pain management specialist. This doctor was an anesthesiologist that worked with patients that dealt with chronic pain of any kind. I was not very hopeful but it was worth trying. He did give different options that I have not heard before.

He suggested that I should consider Radiofrecuency Ablation. RFA consists in putting some kind of electrical device in my lumbar spine that sends impulses to my nerves by radio waves used to heat up a small part of the nervous system decreasing pain signals from a specific area. 

The second option he gave me was to try it Sphenopalatine Ganglion (SPG) Block, which is one short, minimally-invasive procedure that is effective at treating some acute and chronic facial and head pain. This option seemed viable, but very expensive. It was going to be difficult to prove to my insurance company that I truly needed this procedure.

The third option I was given was Transcranial Magnetic Stimulation. TMS is a method in which via electromagnetic induction a changing magnetic field is used to cause electric current to flow in a small region of the brain. For this treatment I had to go to the doctor’s office or buy or rent a device to do it at home everyday. Again, it is an expensive treatment that did not solve the mysterious cause of my migraines. 

Just for the record, all the options cited above are not mainly used to treat or prevent migraines. They have seemed to have caused improvements in patients who suffer from depression, arthritis, back pain, and other chronically painful illnesses but there is not much research yet of their impact on migraine patients.

After evaluating these more radical solutions offered by my physician, I was absolutely sure about my theory. Most doctors simply do not understand chronic pain and do not study what is the cause of the problem, what is originating the nonstop pain. They DO want to help their patients feel better, but they do not give proper assessment to the root of the problem, they disguise it, put a little makeup on it.

Maybe it just me, but this is how I have felt for a long time: misunderstood and frustrated. I believe many of the chronic disorders that patients deal with on a regular basis can be solved by approaching them from a different perspective, especially by asking their cause or origin.

Has your doctor considered your lifestyle? Stress levels and how you handle them? Your sleeping habits? Your eating habits? Your personal relationships? The human body and mind are complex and it would be helpful if healthcare specialist would consider it all as a whole. Many of the drugs that we take could be avoided in order to feel better in a more natural way.

I am not saying that medication is not sometimes necessary. I am just saying it is not the ONLY way. More doctors from every field should try to guide patients through healthier and better lifestyles before prescribing medication or as part of any necessary treatment. Let the body do its job because it is a very efficient and well engineered “machine.”  

 

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