If you have a pain that just won’t go away, should you go to a pain clinic? If you choose the wrong one you may go from bad to worse. Pain clinics are springing up like Marijuana clinics here in California. Why? Is it because there is concern over suffering or because there is a lot of money to be made on desperate people?
Let me tell you a story about one of my patients, named Jane. This story is true and occurring at an alarming frequency.
A pediatrician asked me to see his girl Friday. She was the best employee he had in 30 years. He told me how over a ten week period this dynamo of 9 years in his employment turned into a zombie, barely able to think no less talk. What happened to Jane?
She told me that she had some back pain that would not go away, so she decided to see a pain specialist. She said, “He briefly examined me and said I had a herniated disc and gave me a prescription for Vicodin” and scheduled me for a series of shots and tests. After a week when that didn’t work, he changed it to Norco and an epidural shot into my spine. Then he changed me to Oxycontin, and finally morphine sulfate.
Jane now in addition to her back pain, she had severe constipation, constant drowsiness, a feeling like she couldn’t think and a loss of her libido. Her recently estranged husband threatened to take their kids away as she had overslept one morning and failed to get their children to school on time.
In a two month period, she had been given five epidural injections of steroids in her spine. At least 10 local injections of steroids and now they were considering putting in a morphine pump. A gadget placed in her body which would give a steady stream of narcotics. Prior to eight weeks ago, Jane rarely drank more than one glass of wine per year. She was the breadwinner and the finest worker my pediatric friend had ever hired.
What happened? Jane got caught up in the spine pain jungle where doctors make their patients addicts and at the same time charge tens of thousands of dollars for worthless injections and when all else fails, they order like they did with Jane a morphine pump. Yes, now Jane will be his patients forever. Forever addicted, forever drugged, forever dependant and forever a failure in life unable to take care of her family no less themselves. Yes, a chronic addict no different than the old opium dens in China 100 years ago. Now we call these “pain clinics”. Luckily not all pain clinics are unscrupulous.
My exam clearly showed all Jane had was a little arthritis, her MRI scan showed no significant disc problems. All she needed was 1-2 weeks of ibuprofen and 4-5 sessions of physical therapy. Neither of which had been prescribed to her. But now such a simple remedy would not work because Jane had a serious problem, she was an addict.
After examining her, I asked her to call her pain doctor. The receptionist answered and was reluctant to tell her the credentials of these so called pain physicians. I took the phone and was told these pain specialist were only general practitioners.
Jane had been caught up in the new age opium mill called the pain specialist clinic.
The American Academy of Neurology and American Pain Academy warn that Narcotics are the last medication choice, and should only be used for severe acute pain for less than 2 weeks. The most commonly used Narcotics that we find are Codeine, Vicodin, Norco, all of which are Hydrocodones. Next are Oxycontin, Percocet, Demerol, and Morphine Sulfate to name a few.
Narcotics don’t treat the problem. They just hide the symptoms. I call them the Ostrich narcotics, as you don’t see the pain but it is still there.
The downsides of narcotics are:
1. constipation
2. drowsiness
3. loss of libido
4. addiction
5. depression
The dependency on narcotics is fierce, and withdrawal symptoms with increased pain perception, cramps and vomiting can be debilitating. The fact is after 2 weeks narcotics effectiveness begin to wane and stronger or higher doses are needed. This is what happened to Jane.
Narcotics play havoc with our normal hormone dopamine and our calmative hormone serotonin which are so important for our body’s natural defense against pain.
Narcotics not only hide the pain, but make us more sensitive to it when they wear off. Yes, in time we are not only addicted physiologically, but pain wise narcotics actually decrease our own defenses and our ability tolerate any pain.
If your doctor keeps re-ordering your narcotic medication, ask him to help you get off them.
The difference between the opium dens of the early 20th Century, and some of the pain clinics today is that the Den is now called a clinic, the Opium are prescription narcotics. Dens were illegal, but are now paid for by private insurance companies who don’t police those who call themselves pain specialists.
Jane is now in a narcotics withdrawal hospital. Why, because she had a simple case of low back pain and was going through a life crisis. Her life is in ruin. How can you avoid this trap? Ask your doctor who he’d send his family to.
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Next, how to pick a good pain specialist