Chronic Pain

You Are Responsible For Your Pain Relief

Chronic pain is a true epidemic in the U.S. and worldwide.  What has caused this epidemic?

No one really knows why this has happened.  Perhaps the combination of longer life expectancy, worsening environmental exposures, epidemic obesity, the ability to rescue people with serious diseases and injuries, and a burgeoning population has foisted this pain epidemic upon humanity.

Statistics about chronic pain are not promising.  Not only is the number of people with chronic pain increasing but the treatment of them has proven to be insufficient.

The medical profession has been unable to keep up with the need for effective treatment of chronic pain.

If you or a loved one has chronic pain you will soon realize you are responsible for your pain relief.

The likelihood is that your pain will become a lifestyle and no one will assume responsibility for your pain.  You own your chronic pain.

There are many explanations that have been offered to explain this impotence or even antipathy by the medical profession for treating chronic pain. However, explanations don’t relieve the pain that you may be feeling.

We can place blame onto many people, organizations, and health care systems but that doesn’t relieve a person’s pain.  I am suggesting that you stop the “blame game” if you want to get relief.

I practiced pain management for nearly 27 years as a board certified specialist in Internal Medicine.  I came to realize that many of the things I had been taught about pain really pertained to acute pain.

The management of chronic pain was poorly taught in my era of medical education (and is still poorly taught).

Indeed, chronic pain management is a fairly recent development in medicine.  In the U.S., Dr. John Bonica is considered one of the “fathers” of American pain management.

Dr. Bonica was a prolific wrestler in his younger years and sustained injuries resulting in chronic pain (no doubt developing his empathy).  He went to medical school after his wrestling career.

After serving as an Anesthesiologist in the United States Army in WW II,  he devoted his civilian medical career to the study and treatment of pain. The principles and practice of chronic pain management, as taught by Dr. Bonica, served as the template that I used in my treatment of chronic pain patients while I was in practice.

I want you to obtain as much relief as possible for your chronic pain syndrome.  Let me share with you 7 secrets to obtaining relief from your chronic pain.


1)  You will need an accurate diagnosis: 

Without an accurate diagnosis of the cause for your chronic pain you will not obtain the relief you otherwise could.  Over and over in medical practice I encountered patients that had been incorrectly diagnosed.

How are you to know if your diagnosis is correct?


As most Doctors have not had official training in chronic pain, they are mostly unqualified to treat it.  

You wouldn’t go to an Obstetrician if you had heart disease would you?  You will need to have your chronic pain diagnosed by a Doctor trained in diagnosing and treating chronic pain.

You need a Doctor who really understands chronic pain.

One way of discerning whether your Doctor really understands chronic pain management is to ask this question, “Doctor, what is the mechanism for my pain?”  An accurate diagnosis always gives evidence of what the mechanism is for generating the pain.  

When the mechanism for the pain generation is understood a proper therapeutic program can be recommended.

2)  You will need some form of medical insurance:

The diagnosis and treatment of your chronic pain syndrome will require some way of financing the diagnostic studies and treatment modalities.  This can be problematic no matter what country you are in.

health insurance

Pain Management is expensive.

There will be many forces working against you.  All insurance companies put limits on what they will pay for diagnosis and treatment (even if you reside in a country that has socialized medicine).

Most medical systems will cover acute medical costs because there is a financial endpoint for their involvement.

Chronic pain is often a lifetime commitment on the part of the agency responsible for paying for your care.  You are a financial liability when you have chronic pain.

There will always be some type of limitation that will be imposed on your care.  Full disclosure of this to you is often not forthcoming.

I recommend for you to use your medical insurance to make an accurate diagnosis and begin therapy. The continuation of long term therapy may become your financial responsibility.

Sorry for the “naked truth” of what I am saying.

3)  You will need to do your own research:

If you have chronic pain you will need to become an educated consumer of health care resources. Read everything you can get your hands on about your malady and how to treat it.

health research

Please do not rely on your health care providers to be your only source of information.

The more you know about your pain syndrome the more you will be able to evaluate the appropriateness of your chronic care.  Furthermore, you will be able to suggest new therapies to your pain practitioner.

The accountability this creates is healthy for you and your healthcare provider.

4)  You will need a unique medical practitioner:

Chronic pain management will require a unique relationship with your health care provider (HCP).Most HCPs are accustomed to disorders with clear end-points.

empathy and doctor

Short term acute care has clear end-points where the patient either recovers or they go into the terminal phase of their terminal illness and expire.

The end-points in chronic intractable pain can be ambiguous, which confuses most Doctors.

A long period of suffering with multiple visits is not the usual situation with HCPs.  Under the circumstances usually found in chronic pain management, the HCP will often “install” artificial emotional boundaries.

This is manifested as not being on emergency call for their patients, recorded messages, very brief office visits, stereotypical responses to requests for changes in therapy, etc.

ou will need a chronic pain management practitioner who is empathic (click here to read my post on this topic).  That is, they will need to be able to evaluate your pain from your perspective.

This is contrary to the way most medical practitioners are trained. Medical training emphasizes objectivity over empathy.  This is important when a medical practitioner is continuously faced with new medical mysteries and the objective is to discover the correct diagnosis for a patient’s symptoms.

An emotionally “clean slate” is necessary for each new set of acute symptoms presented to the HCP.

In the case of chronic pain, the diagnosis is usually readily established (or should have been).  The clinician in these cases will be responsible for years of symptom management. 

If a Doctor cannot enter into an empathic relationship with their patient they will not be effective at understanding the incapacitating nature of chronic pain (click here to read my post on how chronic pain effects every aspect of a person’s life).

The diagnosis is not usually in question. The actual focus of the pain management clinician is ministerial.  The relationship may be for a lifetime.

Empathy is more important than objectivity in chronic pain management.

5)   You will need to maintain an open mind:

As I have already emphasized that a chronic pain patient must educate themselves as much as possible about their disorder, it is also important that you keep an open mind. Changes in therapy, new therapies, side effects or complications of old therapies all factor into the management of chronic pain.

There will be times when a change is recommended and you don’t agree with your HCP.

Their recommendation is based on a multitude of considerations which means you need to listen to them.

6)  You will need to have patience:

More than likely you didn’t develop your chronic pain over night.  It is understandable that you would want the discomfort controlled as soon as possible.


It is rare to be able to control a patient’s chronic pain on the first visit.

Prepare yourself for a period of transition with your pain HCP when you first see them.  It is reasonable to ask when they think your pain will be “controlled.”

Chronic pain is considered adequately “controlled” when, on a scale of 1 – 10, the patient reports the chronic pain as a 5 or less rating.

It was rare that I was unable to bring a patient’s pain rating down to a “5”.  Persistence in adjusting the therapies will nearly always result in relief.

7)  You will need to take responsibility for your own relief:

self care

The most important “secret” to effective pain management is that you are responsible for your pain relief.

Your pain HCP cannot possibly know all the variables that effect your pain.  Furthermore, you may discover therapies that will help you that your HCP had not considered.

Think of you and your pain HCP as a team.

You will need to be brutally honest with your HCP.  If you begin to lose control of your medications you must inform your HCP (even if you risk experiencing more pain).

If you refuse to do this you are jeopardizing your long term relationship with your pain HCP.

They could be accused of “making” you an addict and you could be accused of being one. There is always an alternative way to treat your pain, so be responsible.

Final Remarks

I have discussed 7 “secrets” to effective pain relief.  The idea that you are responsible for your pain relief is the most important “secret”.  



I trust you have found this article useful.  If you have further questions or comments please leave it below.

I would love to hear from you and will respond to you promptly.

Wishing you healing and much joy,

Dr. Jeffrey Bado, D.O.

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