For many people, managing chronic pain is a constant battle. In addition to dealing with the pain, it's hard to know which treatments to rely on: how much to depend on pain medication versus other options, when to turn to spine surgery, which type of spine specialist to see, etc.
Careful attention to pain management is a critical component of your recovery. Severe back pain can lead to difficulty maintaining an active rehabilitation program, depression, sleeplessness and other challenges, which in turn can prolong and make a painful back condition worse.
Back Pain Problems are Complex
Compared to other medical conditions, there are relatively few standardized approaches to diagnosis and treatment of back pain problems. While some diagnoses are relatively straightforward (such as tumors, infections, fractures), for many conditions there is little agreement among spine specialists about a diagnosis and treatment plan. Therefore, it's important for you to take a proactive role as much as possible in finding and maintaining a pain management approach that works for you. See Understanding Low Back Pain (Lumbago).
Pain Management is Often a Process of Trial and Error
Pain is experienced very differently for different people. Likewise, the effectiveness of a particular treatment will often differ from person to person. For example, a particular medication or injection for a herniated disc may provide effective pain relief for some people but not for others. While it can be frustrating at times, it's important to remember that it may be necessary to try several treatments before you find effective pain relief. The treatment of pain often boils down to a trial and error process. See Pain Management for Chronic Back Pain.
Chronic Pain is Different from Acute Pain
It is important to note that chronic pain is very different from acute pain. Unlike acute pain, with chronic pain, the level and extent of pain does not correlate to the level and extent of tissue damage. For example, severely degenerated discs may not produce much pain at all and discs with little degeneration can produce severe pain. Therefore, giving your physician a clear description about the level and nature of your pain is essential for an accurate diagnosis and appropriate treatment plan. See Chronic Pain as a Disease: Why Does it Still Hurt? and Modern Theories of Chronic Pain.
Pain Medicine/Pain Management is a Growing Specialty
Many types of physicians like anesthesiologists, neurologists, physiatrists and radiologists complete specialized fellowship training in pain management after their residency and other training is completed. A pain medicine specialist who treats back pain may be a medical doctor or a doctor of osteopathic medicine and usually practices in a pain clinic or an integrated spine clinic.
Some spine surgeons also specialize in pain management. While the majority of spine surgery is performed to correct an anatomical lesion (which in turn should relieve pain), these surgeons perform surgery focused just on treating chronic pain. Typical surgeries may include implanting spinal cord stimulators or pain pumps to relieve chronic pain that has not responded to other treatments. Many patients who have this done have already had back surgery but it has not relieved their chronic pain (failed back surgery syndrome). See Specialists Who Treat Back Pain and Integrated Spine Clinics for Back Pain Treatment.
Don't Forget to Take Good Care of Your Emotional Health
Chronic pain can interfere in all aspects of your life, including your emotional health. Dealing with severe pain can naturally lead to depression, sleeplessness, feeling too overwhelmed to continue with treatments, etc., and it's often as important to seek appropriate treatment for these symptoms as it is for your symptoms of physical pain. Psychologists who specialize in helping people cope with chronic pain can be an essential part of a comprehensive treatment program. Many integrated spine clinics have a psychologist who specializes in chronic pain on staff, and most physicians can refer you to one. See Effective Coping Strategies for Chronic Back Pain.
While dealing with severe pain is a difficult experience physically, emotionally, financially, practically, and in many other ways, it will help if you can try to proactively manage the process of seeking medical attention for your pain as much as possible. Ultimately, participating in the decision-making process about your medical care should help you find more effective pain relief and have a better experience overall.