Q&A for How to Understand Someone With Chronic Pain

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What even is chronic pain?

David Schechter, MD
Family Medicine Practitioner
Dr. David Schechter is a physician in Culver City, California. With over 25 years of experience as a family and sports medicine physician, Dr. Schechter specializes in mind-body medicine, preventive medicine, and chronic pain. Dr. Schechter received his MD from New York University and is an attending physician at Cedars-Sinai Medical Center. He was named a Top Doctor by Los Angeles Magazine and Men's Health Magazine. He has also written several books, including The MindBody Workbook.

David Schechter, MD

Family Medicine Practitioner

Expert Answer

"Chronic" is a classification of pain based on time. So chronic pain always lasts more than 3 months, although some people will say it's more around 6 months. This is different from acute pain, which is pain that lasts less than 6 weeks.

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Question

Should people with chronic pain avoid being active? Will that make their pain worse?

Jeremy Bartz, PhD
Clinical Psychologist
Dr. Jeremy Bartz is a Clinical Psychologist in private practice based in Los Angeles, California. Dr. Bartz specializes in treating depression, anxiety, OCD, mind-body syndromes, chronic pain, insomnia, relationship difficulties, attachment trauma, and resolving the effects of narcissistic trauma. He received a Ph.D. in Counseling Psychology from Brigham Young University and completed a fellowship In Pain Psychology at Stanford's premier pain management clinic.

Jeremy Bartz, PhD

Clinical Psychologist

Expert Answer

Actually, patients with chronic pain should try to be as active as is deemed allowable by their physician. There are probably only a limited number of things that are truly off-limits because they could worsen their condition, but they should do other activities (remembering to pace themselves to avoid pain flares). They can come up with a protocol with a skilled pain psychologist.

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Question

Are opioids good for chronic pain?

Jeremy Bartz, PhD
Clinical Psychologist
Dr. Jeremy Bartz is a Clinical Psychologist in private practice based in Los Angeles, California. Dr. Bartz specializes in treating depression, anxiety, OCD, mind-body syndromes, chronic pain, insomnia, relationship difficulties, attachment trauma, and resolving the effects of narcissistic trauma. He received a Ph.D. in Counseling Psychology from Brigham Young University and completed a fellowship In Pain Psychology at Stanford's premier pain management clinic.

Jeremy Bartz, PhD

Clinical Psychologist

Expert Answer

Opioids help in the short run, but they're actually not good for long-term use. In the long run, they make people more sensitive to pain via a process known as opioid-induced hyperalgesia.

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Question

What do people with chronic pain want you to know?

David Schechter, MD
Family Medicine Practitioner
Dr. David Schechter is a physician in Culver City, California. With over 25 years of experience as a family and sports medicine physician, Dr. Schechter specializes in mind-body medicine, preventive medicine, and chronic pain. Dr. Schechter received his MD from New York University and is an attending physician at Cedars-Sinai Medical Center. He was named a Top Doctor by Los Angeles Magazine and Men's Health Magazine. He has also written several books, including The MindBody Workbook.

David Schechter, MD

Family Medicine Practitioner

Expert Answer

Everyone's experience with chronic pain is different, so it's important to talk to your friend or loved one about what they're experiencing. Listen to their experiences and feelings about what they're going through. Do your best to be supportive and understanding of what they're going through.

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Question

How do I cope with chronic pain?

Chris M. Matsko, MD
Family Medicine Physician
Dr. Chris M. Matsko is a retired physician based in Pittsburgh, Pennsylvania. With over 25 years of medical research experience, Dr. Matsko was awarded the Pittsburgh Cornell University Leadership Award for Excellence. He holds a BS in Nutritional Science from Cornell University and an MD from the Temple University School of Medicine in 2007. Dr. Matsko earned a Research Writing Certification from the American Medical Writers Association (AMWA) in 2016 and a Medical Writing & Editing Certification from the University of Chicago in 2017.

Chris M. Matsko, MD

Family Medicine Physician

Expert Answer

Coping with chronic pain can be very delicate. You have to have good support and know your limits.

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Question

Why can't my doctor help me find a treatment for siatica? I have had xrays, MRI and CT scans. I have tried physical therapy and it is always painful.

Chris M. Matsko, MD
Family Medicine Physician
Dr. Chris M. Matsko is a retired physician based in Pittsburgh, Pennsylvania. With over 25 years of medical research experience, Dr. Matsko was awarded the Pittsburgh Cornell University Leadership Award for Excellence. He holds a BS in Nutritional Science from Cornell University and an MD from the Temple University School of Medicine in 2007. Dr. Matsko earned a Research Writing Certification from the American Medical Writers Association (AMWA) in 2016 and a Medical Writing & Editing Certification from the University of Chicago in 2017.

Chris M. Matsko, MD

Family Medicine Physician

Expert Answer

Sciatica is a common problem that causes pain. Doctors shy away from pain medications and favor therapies like epidural placement and surgeries.

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Question

My pain medicine is no longer effective. I have to take the medication every two hours and I will run out before my next appointment to see a doctor. What can I do?

Chris M. Matsko, MD
Family Medicine Physician
Dr. Chris M. Matsko is a retired physician based in Pittsburgh, Pennsylvania. With over 25 years of medical research experience, Dr. Matsko was awarded the Pittsburgh Cornell University Leadership Award for Excellence. He holds a BS in Nutritional Science from Cornell University and an MD from the Temple University School of Medicine in 2007. Dr. Matsko earned a Research Writing Certification from the American Medical Writers Association (AMWA) in 2016 and a Medical Writing & Editing Certification from the University of Chicago in 2017.

Chris M. Matsko, MD

Family Medicine Physician

Expert Answer

You may have become addicted to your pain medication. Pain medications act on mu opioid receptors, which are downregulated by exposure, and decrease the effect of the medication over time. Your schedule of every two hours is very tight. You may want to look for some alternative therapies. Other therapies include relaxation techniques, massage, and physical therapy.

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Question

How can I support my partner with chronic pain?

Peggy Rios, PhD
Counseling Psychologist
Dr. Peggy Rios is a Counseling Psychologist based in Florida. With over 24 years of experience, Dr. Rios works with people struggling with psychological symptoms such as anxiety and depression. She specializes in medical psychology, weaving together behavioral health programs informed by empowerment theory and trauma treatment. Dr. Rios uses integrated, evidence-based models to provide support and therapy for people with life-altering medical conditions. She holds an MS and Ph.D. in Counseling Psychology from the University of Maryland. Dr. Rios is a licensed psychologist in the state of Florida.

Peggy Rios, PhD

Counseling Psychologist

Expert Answer

One of the best things you can do is to get on the same page as to how you can be supportive. Have a conversation about how you're going to communicate about the impact the pain is having on your partner on that particular day.

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Question

How can family members help with chronic pain?

Peggy Rios, PhD
Counseling Psychologist
Dr. Peggy Rios is a Counseling Psychologist based in Florida. With over 24 years of experience, Dr. Rios works with people struggling with psychological symptoms such as anxiety and depression. She specializes in medical psychology, weaving together behavioral health programs informed by empowerment theory and trauma treatment. Dr. Rios uses integrated, evidence-based models to provide support and therapy for people with life-altering medical conditions. She holds an MS and Ph.D. in Counseling Psychology from the University of Maryland. Dr. Rios is a licensed psychologist in the state of Florida.

Peggy Rios, PhD

Counseling Psychologist

Expert Answer

Educate yourself about pain management, both the medical ways the pain as managed, as well as other lifestyle interventions they can use, like practicing mindfulness or taking part in physical therapy or exercises.

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