Hotline to focus on pain control

Pain can drive even a reluctant patient to seek medical attention. It's one of the most common complaints doctors and other healthcare providers hear. And while at least some degree of relief is usually possible, the patient's role is as important as anything medicine has to offer.

"The patient has to be willing to do the work," says Dr. Christopher Caldwell, who has completed an Anesthesia Pain Medicine Fellowship and is board-certified in neuromusculoskeletal medicine and osteopathic manipulative medicine. "We work hard to make the patients a very informed part of their treatment."

Pain — from nerve damage to cancer pain to backaches, from acute injuries to chronic conditions — is the topic of Saturday's Deseret Morning News/Intermountain Healthcare Hotline. From 10 a.m. to noon, Caldwell and registered nurse Claudia Campbell, both of the Intermountain Pain Center at Cottonwood Hospital, will take phoned-in questions.

The best pain care, says Campbell, clinical director of the center, takes an integrated approach to pain treatment that looks at the whole patient and all aspects of the patient's experience with pain. She describes an iceberg. The tip is what the patient perceives and feels, but there's a lot below the surface that must be considered, too, including psychological and spiritual factors.

Mental or emotional pain can demonstrate itself as physical pain, usually tied to existing injury. Someone who suffers headaches may find they become much more intense. Someone who typically tolerates lower back pain may not do so in the midst of a relationship that's dissolving and the need to move, for instance. "It intensifies pain," says Campbell, "but true psychogenic pain is pretty incredibly rare." Pain, in turn, can increase the stressors that increase the pain, creating an unfriendly cycle.

The tools to deal with pain cover a range, including oral medications, injections, nerve blocks and use of technology. The whole-person approach also takes into consideration the fact that many people who experience pain become depressed.

"And some people allow the pain to be their complete and total vision of their day," Campbell says.

Frequently, pain patients have put their lives on hold, allowing the pain to dictate what they do and how they do it. Many become sedentary because they've learned to associate movement with pain or they fear re-injury. Regaining mobility and embracing activities are important parts of getting better, and rehabilitation is a strong focus of pain treatment, they say.