Chronic Pain Syndrome | Arthritis Information

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Long article, but very informative...........

 
http://emedicine.medscape.com/article/310834-overview
Indeed, very informative.
 
I'm reading it from a psychological point of view, considering patients who seem to have a grossly exaggerated perception of pain. [Let me say here and now that I am sure that there are a number of people who have chronic pain....and with good reason. But I'm thinking in terms of those people who express chronic pain without evidence in diagnostic workups.]
 
There's one part of the article that I feel is very important for doctors to pay attention to:
 

Appropriate caution must be taken during treatment of patients who exhibit any of the following behaviors:

Why is this important? I know of one woman who runs to the ER for a paper cut [not really, but you get the idea]. At last count she was seeing 2 RD's, 1 PCP, 1 Endocrinologist, 3 Orth Surgeons, 2 Pain Management Specialists, a Chirpractor, an Alternative Medical group that promotes some unusual exercises as a way of "relieving pain," sees a naturopathic physician for bio-identical drugs, then there's the dermatologist, the pulmonologist, and I'm sure I've forgotten some..................................she's sees all of them at least once a month.

Some are aware that she sees multiple doctors.  And yet they keep on prescribing stuff for her.
 
The woman lives in her house with her meds taking over the entire kitchen and dining room. She has no friends. Her human interaction comes from her healthcare providers. Very sad.
 
She refuses to see a psychologist.
 
It's important to keep in mind that there's a huge difference between genuine chronic and psychological pain.
 
Good article.
Its an irrational fear of mine that my doctor will not believe I'm in pain...despite having verifiable joint damage. Weird, I know..I feel very lucky that both my RD and PCP recognize the fact that I have chronic pain and that they treat it appropriately. If the day ever came that my doctor didn't believe that I was experiencing pain, I'd fire him.
 
I looked long and hard for this RD and he really knows his stuff. I have a tendency not to complain; I "stuff" my pain. So when he asks me how I'm doing and I reply, "Fine!" he always probes deeper. He's pretty savvy and can read me.
 
 
I am also quite famous for not reporting pain. My tattoo artist told my husband that I must have a lack of pain receptors because I'm just not normal.

My RD told me 6 or so months ago that it was time for me to get real about my disease. I think he was frustrated with my under-reporting skills..   I would like to get a handful of new joints, a cure for RA and just be done with it already.... sigh....Why is it your RD thinks you need to get real about your disease? Why would he say that?Because I was still asking him if he was sure I had RA. That's what I hate about being sero neg. If I had numbers I think I could have wrapped my brain around it faster. So I was VERY reluctant to add mtx to the mix. By the time I moved to enbrel I was less reluctant. The pain and swelling had made a believer out of me. His comment was made in frustration.... when I was still in the 'I can't possibly have RA phase'.




edited to correct stiff finger spelling mistakes
leila2009-11-13 16:45:36I haven't had my Rhematoid Factor checked in several years.  The last two tests were negative.
 
But that's not the ultimate criteria for diagnosing RA anyway [RF being positive]. Here's the diagnostic criteria for adults [must have 4 of the 7 in the list]:
 
http://www.hopkins-arthritis.org/physician-corner/education/acr/acr.html#class_rheum
Yeah...no matter how many of these things I look at, it always seems that I have RA.   

Thanks for posting this one. Lots of good info!
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