Find Help for Chronic Pain: Q&A with an Osteopathic Family Physician

 We’re sharing the information from her presentation and the following Q&A below in the hopes that you, too, will benefit from her expertise!

What is Chronic Pain?

– Chronic pain is pain experienced for more than three months

– Chronic pain impacts more Americans than cancer, diabetes and heart disease COMBINED

– More than 76 million Americans live with pain every day¹

– When pain is not properly managed, it’s difficult to live productively – just one of the reasons why addressing chronic pain is so important

What Causes Pain?

– Medical conditions – arthritis, muscle aches and pains, etc.

– Injury or trauma

Wintertime Woes

– The winter months can mean more pain, especially for people 45 and older

– Freezing temperatures, slips and falls on icy ground, and shoveling snow are top triggers for winter aches and pains, especially common among older adults

Celebrating in Pain?

– Two out of five Americans admit that if they experienced physical pain during the holidays, they would wait until the holidays were over to talk to a physician

– While the holidays are hectic, ignoring or under-treating your pain comes at a high price because it can lead to more pain

Holiday Chores Are More Appealing?!

– 50% of Americans put talking to a physician about pain at the bottom of their holiday to-do list, preferring some other holiday chores instead, including:

1) Taking down holiday decorations by themselves (55%)

2) Shoveling snow on their own for an hour (44%)

3) Waiting in line to return or exchange gifts on the day after Christmas (33%)

Don’t Let Pain Get in the Way of Your Holiday

– Pain does not have to prevent you from enjoying the holidays

– No matter what time of year, it is important to talk to your physician about the cause of your pain

– Managing your pain is not a “one size fits all diagnosis”

– Comprehensive care, including appropriate use of pain medications, can help you find relief and enjoy the holidays

Visit osteopathic.org/pain to take our “Living with Pain?” quiz and download a pain checklist to discuss with your physician

1 National Center for Health Statistics. Health, United States, 2006 With Chartbook on Trends in the Health of Americans. Hyattsville, MD: 68-71

Q&A Session with Dr. Jennifer N. Caudle, osteopathic family physician

Q: I’m in chronic pain, and my MD has not been able to help. I’ve been thinking about visiting a DO. Can you tell me how a DO approaches chronic pain differently from an MD to treat it more effectively? Will visiting a DO help me when an MD hasn’t been able to?

A: There are two types of licensed physicians – MDs (medical doctors) and DOs (doctors of osteopathic medicine). We both do four years of medical school, attend residency programs and have to take board certification tests. Our training is similar, but DOs believe in a comprehensive approach to the patient. We look at the entire patient to make a diagnosis and treatment, and we are also trained to use our hands. A DO could be a great option if your MD hasn’t been effective. You want to look for a DO who does manipulation (hands-on treatment) in their office. It’s an added benefit of being treated right when you go to the office.

Q: What do you do about the pressure to use medications?

A: We have lots of ways to deal with chronic pain. There are medications for nerve issues, pain, etc. But there are other options – aqua therapy, physical therapy, ultrasound, aerobic exercises. Remember that with chronic pain, often times a multi-factorial approach is great. Having a dialogue with your doctor is important.

Q: Going to a doctor is expensive. Multiple visits means it’s going to cost more. How can I treat my pain without spending so much money?

A: One of the things I find it’s important to do as a doctor – ask patients if they’re able to afford their medications and visits. Broach the topic of what you’re able to do. If you have financial restrictions, talk with your doctor so you can come up with a plan that works.

Q: How do you exercise through pain, and should you?

A: The question becomes, what is the cause of the pain? I would need a diagnosis of the problem to better be able to guide. Your diagnosis is going to determine what is recommended. Depending on the injury, exercise might not be recommended. People with arthritis would benefit from low-impact activity, while those with something like an ACL tear should stay off their injury and avoid exercise.

Q: When is it appropriate to visit a DO – for any type of pain or just certain types?

A: You can think of MDs and DOs, in terms of medical knowledge, skill and standard of care, as the same. However, DOs can use Osteopathic Manipulative Treatment (OMT) – hands-on manipulation – to treat most types of pain. Anything from back pain to knee pain to pain from pregnancy, etc. We also use OMT to treat headaches, upper respiratory infections and things like that – it’s broader than just pain treatment and is appropriate for all ages, from kids to adults to elderly patients.

Q: What are your suggestions for helping adult parents with their pain? Should we go to the doctor with them?

A: With some patients, they feel like it’s honorable to “deal” with the pain. That’s not true. You don’t have to suffer with pain all the time. There are options. The first step is to find out if your parents are in pain – they’ll often keep quiet about it because they don’t want to be a burden. Ask them, talk with them frankly about it, and if they’re in pain, take them to the doctor.

Q: When should I see a DO as opposed to a physical therapist?

A: Physical therapists rehab injuries, but they’re not as involved on the front end in diagnosing the injuries. If there are questions about the underlying cause, that’s the time to see an MD or a DO. Based on your diagnosis, a DO will decide if OMT is appropriate, and they can do that right in the office, and decide from there if you need to see a physical therapist.

Q: How does a DO compare to a chiropractor – which isn’t a physician but also treats people with that very hands-on approach?

A: Both chiropractors and DOs use their hands to diagnose and treat common musculoskeletal issues. The difference is the philosophy and how we treat a patient.  As doctors, DOs are equipped to deal with your whole person and anything that might be causing you pain.

Q: How can stress affect your body and result in chronic pain?

A: How you feel mentally affects the entire body, which is why – in my practice – I find it’s really important to pay attention to what’s going on in someone’s life. It can exacerbate pain you might have. Stress manifests in different ways, and everything in the body affects each other. It’s important to have both a healthy body and a healthy mind.

Q: I suffer from migraines. What could a DO do for me?

A: We know of a number of triggers for migraines, and there are a number of OMT techniques we use for migraines. Headaches don’t just affect the head – they affect the neck and scalp as well. OMT is a great way to help with migraines.

Q: Is it possible to actually make a condition worse by “pushing through it” as opposed to taking it easy?

A: Yes, there are certain causes of pain in which “pushing through it” is problematic. Pain can be caused by injury or trauma. With trauma in particular, it’s really helpful and wise to get that pain checked out. You want to make sure nothing is broken or ruptured, and that exists with regular pain from other conditions, too. The most important thing with chronic pain is to understand why you have it. Only when we know the diagnosis and cause can we say if it’s okay to keep going with your regular activity.

Q: I’m having chronic hip pain, and my MD said it’s inflammation. What can I do?

A: Inflammation is a very broad term. It doesn’t mean anything specific, other than there’s an area of reactivity in the body. Something is aggravated (joint, muscle, etc) – and the body is trying to work to fix it. Why is this happening now, what is going on and how can we fix it? It’s important to be affirmed in how you feel. You can go back to your doctor, try a new doctor or go to a specialist to find out what’s going on.