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July 28, 2005 A University of Michigan Health Minute update on important health issues. Enduring chronic pain: ‘Nobody should have to suffer when treatments are available’ UMHS pain specialist helps patients find ways to live with their chronic pain |
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ANN ARBOR, MI -Simone Orton – once a runner, baseball player and figure skater – found herself curled up in a fetal position during a bout of agony so powerful, she wondered if she would ever live a pain-free and active life again.
Her muscles were twitching from head to toe. The woman who prided herself on not letting anyone know the extent of her pain was vomiting repeatedly and moaning. Her terrified husband rushed her to the emergency room. Orton had lived with chronic pain since an accident at age 12 that crushed two of her vertebrae. Many doctors told her that nothing serious was wrong with her in the years that followed. Some doctors suggested that the problem was all in her head. She persisted, until a rheumatologist finally diagnosed her with a kind of arthritis known as ankylosing spondylitis, which caused her spine to fuse together and to be completely solid. Even after the diagnosis, however, Orton continued to suffer, often in silence. But this trip to the hospital altered everything. The peak of her pain was so high that she thought she might die. Doctors and nurses struggled to get her pain under control. And on day six of her nine-day hospital stay, Orton, now 42, had a fateful meeting with Carmen R. Green, M.D., associate professor in the U-M Medical School's Department of Anesthesiology and pain specialist at the U-M Health System's Center for Interventional Pain Medicine. Green “walked in and took over,” Orton recalls. “At that point she didn't feel I was adequately being taken care of, pain-wise.” Green developed a pain-management plan for Orton that included regular fine-tunings of her pain medications, as well as ways to deal with the mental and social burdens associated with living with chronic pain.
Pain also is an issue that typically receives varying amounts of attention, depending on a patient's demographics, she says. “The pain complaints of certain populations, including the elderly, minorities and women, do not receive the same attention as those of, in general, Caucasian men,” Green says. “Our research at U-M is focused on how age, race and gender influence the pain experience. We also look at how those factors influence health care providers' decision-making as it relates to pain.” One-fifth to one-third of Americans live with pain, Green says. This number is increasing rapidly due to high rates of obesity and inactivity, improvements in medicine and technology that allow people to live longer, and other societal changes. For instance, someone who would have died from a car accident or cancer 20 years ago now may be able to live a long life. “Despite the fact that we can save and prolong their lives, we now may end up treating them for chronic pain problems,” Green says. But treatments are available, including medications – ranging from over-the-counter medicine to prescription-only opioid analgesics – as well as psychological counseling for the depression and anxiety that often accompany chronic pain, relaxation training, physical therapy to improve a person's function and mobility, and more. In addition, many types of nerve blocks are available to treat many painful conditions. “We have a lot of things in our tool box,” Green says. “Nobody should have to suffer from pain when so many treatments are available.” And how is Simone Orton doing? The woman who once needed a wheelchair when her pain and arthritis were at their most debilitating is back on her feet, continuing with an active lifestyle and in control of her pain. “I'm doing so well that at my last visit with Dr. Green, she said she didn't need to see me for three months,” Orton says. “It felt like a graduation.” Facts about chronic pain:
For more information, visit these web sites: U-M Health Topics A-Z: Chronic pain www.med.umich.edu/1libr/aha/aha_chrnpain_crs.htm American Chronic Pain Association: American Pain Foundation: National Pain Foundation: Pain and addiction: National Chronic Pain Outreach Association: Chronic pain information page, National Institute of Neurological Disorders and Stroke: University of Michigan Health System News Releases Pain's generation gap: Among both blacks and whites, younger adults don't cope as well with pain as their elders, but blacks feel it worse www.med.umich.edu/opm/newspage/2005/pain.htm Prescription pain medications hard to find in pharmacies serving minority neighborhoods U-M studies reveal racial differences in chronic pain experience and pain treatment Study: Racial, ethnic disparities found in all types of pain www.med.umich.edu/opm/newspage/2003/painstudy.htm
Written by Katie Gazella
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Far too many people suffer from chronic pain without receiving adequate treatment, Green says. “Pain is a thief in the night; it steals people's livelihood,” she says. “Pain is under-treated. It really is a public health crisis. If we do not do something about the pain epidemic, it's going to significantly impact this society.” 
