1. Posted by A Yahoo! Health User on Mon, Sep 09, 2007, 8:57 pm PDT

This article seems overly simplistic. It also ignores the fact that these treatments do not work for large numbers of chronic pain patients. I cannot understand this mis-information coming from a John Hopkins doctor. John Hopkins developed the methods for pain management of severe chronic pain.

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2. Posted by A Yahoo! Health User on Mon, Sep 09, 2007, 9:41 pm PDT

Ok,..here we go. What the mind can conceive AND believe,it can achieve. Ah, but yes it is difficult to control ones mind. The monks in Asia pretty much got it down with their meditation techniques(Aervedic Medicine). The key is to believe and understand that your brain can and does control ALL sensory perception of the body. Ah, again...but controlling your mind and controlling your brain are two different things. The answer...well there is not just one answer as the John Hopkins article points out. Whether it be massage, acupuncture, aervedic medicine including meditation, etc., or Western civilization's allopathic drugs and other prescription medications. It comes down to this: If one can take a pill or get a massage, or smell lavendar & mint, etc. and feel better physically (psychosomatic), one can reproduce the same feeling without the stimuli via replicating the neuropathic chemical reactions responsible for that particular better feeling. Of course this is all controlled by the brain. There are no medications that create a response in the brain that the brain cannot create by itself. So, one must "master" his mind first. Hence mastermind - Lol. After one is in complete control of his/her mind, then one can attempt to control his/her brain with the mind. Simple yet complicated.

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3. Posted by A Yahoo! Health User on Mon, Sep 09, 2007, 10:07 pm PDT

I have been in pain since 1991 which started due to a 15 foot fall. It took over a year to find that I had ruptured a disk in my spine (L5-S1). My pain was initially in my left foot and ankle. (I had landed standing up on my feet). It turned out to be "referred pain" My doctors (SIX of them) prior to finding the culprit all were pretty much guessing with suggestions of exploratory surgery, physical therapy or finding ways to "Cope" with the pain. "Perhaps you should find a way to live with this". Pain is a signal that a problem exist. I am willing to bet that over 99% of the time that doctors fail to find a satisfactory explanation for it, the only explanation they offer is: "has to be in the persons head". This is nothing more than an excuse for the truth - "doctors do not have answers for everything", and instead of saying "I don't know and can't figure it out" they tell you it's in your head. I now suffer from pain up and down my spine - I have had two surgeries to repair disk, but my pain is still there. Science has a long way to go, but to tell a patient that "Pain" is in your head is ludicrous. OF COURSE IT IS! The brain is located there and it is telling you, you have a problem! If I lay still, flat on my back, I get a chest pain that mimics my angina. (I have suffered angina many times). If I move (sit up) it goes away. If I cannot move, it becomes excruciating. Sitting up alleviates it almost immediately. No one seems to know why this is. I recently had an angiography and angioplasty (my 10th in 4 years). I have to be put out as no amount of pain killer takes the pain away while I am laying there - if I wake up, I am wanting to die. This last time, (JUST LAST WEEK) (for some un-Godly reason) they failed to use a Perclose to seal the entry site. This meant I had to endure laying on my back for eight horrible hours. The pain got so bad that I thought I was having a heart attack. They gave me 75 MCG of Fercet (spelling) and all it did was make me sleepy - it did not touch the pain. Doctors need to be up front and honest and simply state - "I don't have a clue as to why you hurt" and then just give the patient a "KNOWN" way to get rid of it. Pain = Depression, it's not the other way. Pain also = Stress and "Yes" stress can cause pain, as the chest pain got so bad, that when it got relieved, the "stress" had me contorting my muscles so bad, that they hurt after the original pain left. Your job as a doctor is not easy, but it has been my experience that half the time, doctors are simply guessing. My foot pain was an eye opener for me - MRI's and X-rays were all negative in looking for an injury to my foot (which did swell and turn black and blue from the fall, as I landed on my feet). "I" had to ask for an MRI of my back out of frustration and my doctor tried to give me flack about requesting it. The surgery left me with loss of feeling in my left toes and part of my left calf. Eventually, my neck needed repair as I had herniated C6-C7 bad enough to require a fusion at that level. If anyones pain reaches a level that affects their quality of life, and their doctor tells them they cannot explain a physical aspect that may be causing it, it is clearly understandable that "Depression" will need addressing. You are their only hope - and if you can't I.D. the cause, you should make every attempt to find a way to ease the pain, not frustrate the situation by telling them "Heck, it's in your head" That in itself is depressing! Peace . . .

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4. Posted by A Yahoo! Health User on Mon, Sep 09, 2007, 10:26 pm PDT

In more cases then you relize pain could be mentaly blocked down to something very minor I have a very high pain tolorance due to mind controll. which is not always good I'll explain that later. now I will give you a for instance I have lived my life for 41 years and since I was a child I have had a problem with one of my kidneys I've been to the doctor on several ocations when I was a teen and they couldn't find anything wrong or just didn't look hard enough I guess because I wasn't screaming with pain like most people would well the pain would come and 3 or 4 days later it would go away for 2 or 3 weeks to a cpl of months. Finaly about 2 years ago I broke down and drove myself to the Hospital during a sever atack. I was in such incredible pain. when they gave me the paliminary they ask me on a scale from 1 to 10 what was my pain level I told them way past 10 then because I wasn't screeming they thought I had something minor. When I was finaly seen 6 hours later I described my pain to the Doc then he sent me for a scan just in case. He didn't think I was in much pain but just wanted to have a internal look so to speak. Finaly after they seen the scan they brought me some very strong pain killer. The Doctor told me he was sorry for not believing me about the pain being so intence and he ask me how can you take that kind of pain without showing emotion because I had a 12 centameter mass in the back of my kidney. They actualy thought it was cancer. I just told him that I just got a high tolerance to pain after all I had lived my life with this and more they did more test that reveled that the tube on the back of my kidney closes up and wouldn't let my kidney empty they wanted me too have corective surgery but with my finances and no insurance just cant oford it so they left me with the warning that it will eventualy turn into cancer but I still live with the pain and no medications so I'll just deal with it untill it finaly kills me. I guess it causes me to be depressed most of the time. If I didn't have this kind of controll they would probibly help me. There has been allot of other instances that was just the tip of the iceburg. On the majority of pain I can totaly block it but once or maybe twice every 2 to 3 months I guess maybe my mind gets weak then I have to hunt up a pain pill then usaly only a half of one. I do really sacrafise in other areas sleep I think would be on top of the list then the controll interfers with my sex life the second I spend so much of my mental energy blocking pain it also blocks good feelings also or at least the majority of especialy the lower intence ones giving me oral is virtualy inposible. That is very discuriging for my wife she trys alot but has only accomplished her goal about 3 times in 2 years.

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5. Posted by A Yahoo! Health User on Mon, Sep 09, 2007, 11:54 pm PDT

Then how can u say that our brains are incredibly powerful, and that power can make us feel better or worse, depending on how it is used. Using this method you say could achieve a much greater degree of comfort if you treat your mind in addition to your body. Either by using the power of the brain to convince your self this pain will reduce. If you use this to lighten your pain then to believe it will if this is true, then by using this method it would work to much higher degree.

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6. Posted by A Yahoo! Health User on Tue, Sep 09, 2007, 4:39 am PDT

A good way to battle pain is to get out and dance -take line dance or contra dance classes. You can dance without a partner and it's good exercise and a lot of fun! You'll forget about the pain and you'll be uplifted emotionally. It really helps.

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7. Posted by A Yahoo! Health User on Tue, Sep 09, 2007, 6:50 am PDT

I would add these common sense measures: increase sleep to at least 8 hours a day, change diet so that PH is basic and calories are substantially reduced (for the overweight), drink lots of water, and increase exercise. These may not cure the symptoms or underlying condition entirely, but they certainly won't hurt and they will give your bodies own natural defenses a better chance of functioning. There may well be an underlying disease that may call for medication. Also, even if the medical community cannot pinpoint the cause of your pain, if you are running a fever, you may have some kind of infection and a broad spectrum antibiotic may help. I think that at one point, stress was thought to cause ulcers. Now, I believe it is understood, that at least some ulcers are caused by bacterial infection. That is not to say that stress may not exacerbate the condition, only that medication may need to be part of the treatment.

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8. Posted by A Yahoo! Health User on Tue, Sep 09, 2007, 7:58 am PDT

I am a 40yo Female who has suffered from Migraines (and other types of headaches) since at least age 10. I also suffer from depression (diagnosed and treated for 5 yrs). Over the last two yrs I have been having chronic headaches 28-29 days of the month. I would appreciate any more feedback you could offer. I have tried many medications, seen neurologists, and have tried accupuncture. I am at my wits end living daily like this. Please send feedback of any type that you think might benefit me. Sincerely, Mary-Ann Noyes

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9. Posted by A Yahoo! Health User on Tue, Sep 09, 2007, 8:05 am PDT

The problem with your Pain Management suggestions Dr. Levy, is I've never seen a doctor or hospital who won't embellish the truth to favor their own selfish interests to milk medicare and medicaid for all they can so they can treat, treat, treat, treat, treat and the only thing it accomplishes is to create white coat stress that raises both me and my wife's blood pressure, physical and mental pains such as that evil St. Mary's Health Systems. But they're all the same way in america. Everybody's justifying their actions useing that Jesus Myth as a shield for all their wicked evil desires. Is there not one honest doctor left? Donald D. Woods.....Knoxville Tennessee

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10. Posted by A Yahoo! Health User on Tue, Sep 09, 2007, 8:36 am PDT

This article is too simplistic. As I recall, 42% or so of all chronic pain patients DO NOT present with comorbid psychiatric disorders. When doctors give this sort of advise, they appear to dismiss the reality of these patients situations. Even though pain is "all in your head" it IS a signal that something is seriously amimss. Medicine has had a long history of claiming that patients' pains are due to stress (remember ulsers?) that are actually due to a legitimate disease process. TAKE PAIN COMPLAINTS SERIOUSLY AND DO NOT WRITE THEM OFF AS "PSYCHOGENIC"! Patients with severe, poorly controlled chronic pain often present with major depression like signs and symptoms. Severe pain often impairs these patients' cognative abilities, including their ability to concentrate. Until their pain is under control, their ability to participate in their own treatment is diminished. These patients DESERVE medical management of their pain. Only after their pain is under adequate control, is it possible to determine if they still have psychiatric symtomology. Your colleagues at Johns Hopkins have shown that these patients, when appropriately selected and monitored, can benefit from long-term opiate treatment and that abuse of opiates in this population is rare. Opiates are generally quite safe and well-tolerated. Patients with severe chronic pain rarely "get high" from their opiate medications. The most common problem colleagues who follow this protocol have is that many patients are reluctant to properly use their medications, caused by uninformed reporting on this topic. Good pain management requires a multidisciplinary approach. This includes physical therapy/supervised exercise, vocational counseling, appropriate lifestyle changes, occupational therapy, etc. I am suprised that you failed to mention the importance of advising pain patients to engage in an appropriate exercise program. Appropriately vigorous exercise encourages the body to release endorphins, nature's painkillers. Not only can endorphins control pain, they can lift depression. Many pain patients are deconditioned and could benefit from a period of physical therapy or supervised exercise. I am also disappointed that you failed to mention the need for couples/family counseling. I recall that approximately 80% of relationships terminate within two years of a partner being diagnosed with chronic pain. We must remember that pain affects the entire family and that the needs of caregivers, spouses and children need to be addressed. It is extremely stressful to be a caregiver, to have a spouse have to cut back on working hours or take a less demanding job or to watch a parent suffer. As a class, antidepressents are not particularly well tolerated and only appropriate when managing pain of neurogenic origin. The tricyclic antidepressents, the only class of antidepressents proven to modify moderate pain of neurogenic origin, have significant side effects. Approximately 1/3 of patients given these medications will discontinue use of these medications due to side effects. Also, many patients experience diminished effectiveness of these medications for pain management after about three weeks of use. This is why antidepressents are no longer used as a first-line treatment for pain of neurogenic origin. The anticonvulsants, even though they are not that easy to tolerate, have a better track record. Consult with the pain management experts at your own school before posting on this topic. You are misrepresenting yourself as an expert in pain management when you clearly do not posess this level knowlege. SHAME ON YOU!

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11. Posted by A Yahoo! Health User on Tue, Sep 09, 2007, 9:07 am PDT

Several of the people who posted comments gave bad advise. Janet, partner dance, where you are going to dance with unfamiliar partners, is generally not appropriate for many pain patients. Partner dances can be especially difficult for many pain patients and others with hidden disabilities because many people do not respect the needs of the disabled. Janet, you're right in that it is a good idea for pain patients to be active. If you are actively involved in an activity, many times you will be distracted from your pain and you will feel better. dr_cnk is clearly not a doctor anyone should go to. Alternative/wholistic medicine has a very bad track record. It is rarely evidence-based and there are many practices that are downright dangerous. Homeopathy, reiki, aromatherapy are just placebos. There is a long history of quack treatments for chronic pain conditions, going back to "Lydia Pink" and snake oil. Whenever scientifically-based medicine does not have a cure for a chronic disease the quacks step in.

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12. Posted by A Yahoo! Health User on Tue, Sep 09, 2007, 2:44 pm PDT

I like the idea of talking with someone about your depression, but these days ever counselor out there costs so much money it is virtually impossible.

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13. Posted by A Yahoo! Health User on Tue, Sep 09, 2007, 4:16 pm PDT

I am 35 years old and i have arthritis.I dont concider that all my pain is physcological. But anyways thanks for your web page. Please send me the latest information you have on arthritis.

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14. Posted by A Yahoo! Health User on Tue, Sep 09, 2007, 11:28 am PDT

Good informative article

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15. Posted by A Yahoo! Health User on Sun, Nov 11, 2007, 5:11 pm PST

my doctor finally realized my pain wasnt in my head it is fybromalgia and my blood pressure is staying high he says nothing to worry about but all my family has high blood pressure i wish there was more that could be done for everyone god bless

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