Sometimes, the best healing power is just a plain old conversation that gives back some control to those who are lost.
This one word sends shivers down a physician’s spine because this diagnosis is usually given to those with chronic pain that is resistant to most treatments. Doctors instantly know that there are no quick fixes for a patient with this diagnosis, and many are often afraid of or are frustrated at the patient. There is even controversy amongst physicians whether Fibromyalgia even exists or if its a constellation of other rheumatologic conditions. When I was in residency, I have to admit I questioned it’s validity as an actual disease. But that was before I met people who suffer from Fibromyalgia.
Many who suffer from Fibromyalgia are usually lonely and depressed because not only do they suffer from chronic pain, but also suffer from being rejected by friends, family members, and even doctors. They go from one specialist to another, taking pain medicine, getting countless labs and imaging done to figure out reversible causes to their pain. They have a constellation of symptoms ranging from severe pain all over their body to sleep disturbances. They live in a state of pain that I will never know or experience.
Pain, anxiety, depression, and fatigue are all subjective. Trying to objectify a subjective complaint is difficult to do in clinical research because there are no measurable data to record. This is why Adrenal Fatigue is also just as controversial in the medical arena.
Who cares if it’s “real” or not? The issue is this: there are a large group of people with similar symptoms who have trouble finding answers. I believe it’s my duty as a physician to help them find that answer. However, for patients with fibromyalgia, no two patients feel exactly the same and they shouldn’t be treated the same. One type of medicine may work for one person but not for another.
This is why the power of conversation has far more healing capabilities than a prescription. To get to the root of healing, we as physicians have to understand perception. The perception of pain is very complex. But one thing is for sure. My validation of a patient’s pain with the recognition of their very real disease becomes a huge relief of my anxious patient. The next step is to get to the root cause of their suffering and refocus the patient on the source. This is definitely not easy and does take time. By helping patients focus on all the reasons they are depressed or anxious, their perception of pain is alleviated. By helping patients establish a good diet and a tolerable exercise plan drive their mind away from “I can” and into the realm of “I will.”
Here are a few things I have found useful in my patients with chronic pain:
- Find out how food affects their pain. Many times, when a patient eats junk food, their pain level increases. This may have to do with how the food affects the body overall and not necessarily related to pain.
- Go wheat free. This is certainly unconventional but I am shocked to find that many of my fibromyalgia patients (without celiac disease) actually derive significant benefit from this method. I read into this and have found that many people have reported this phenomenon.
- Start an exercise regimen. This is tough with chronic pain patients but it is necessary for not only physicial conditioning (leading to improved overall function and lessens the preception of pain), but also psychological empowerment (which also lessens the perception of pain).
- Stop their cholesterol medicines. I have now started taking those with chronic pain off of their cholesterol medicines (for those who have never had a heart attack or stroke) because the side effect of statins can be confused with their muscle pains. It may even cause chronic pains that were blamed on fibromyalgia or even old age.
- Increased frequency of office visits. I tend to follow my chronic pain patients much more frequently to discuss their overall pain tolerance and mood. I find that they smile more and more after each visit which in turn empowers me to help them.
Share this post if you know someone suffering from chronic pain.
Dr. Cheng Ruan