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Pain Management and Me(?)


This thread is to ask a general opinion of whether I should seek a pain management program and how to approach this with my doctor.

I have read some of the stories here and it further adds to another dilemma I have considered for a long time.

My major hangup about seeking attention from a pain management specialist is what I consider to be a relatively minor injury compared to the horrible diseases and injuries that others suffer. Call it guilt or whatever you want, but my injury seems petty or unworthy compared to the pain others have to put up with. A big part of me says "you're tougher than this" but at the same time I have seen my life and my happiness crumble because of issues related to my pain. Please, give me your honest opinion about who should seek a pain specialist's help.

A little backstory:

I'm a 27 year old man and for over three years I have been dealing with a shoulder injury I sustained while mountain biking. I basically took a jump and landed wrong (on the back of my shoulder) which tore my shoulder ligaments, cracked a few ribs, and gave me a nice concussion. I sustained a grade IV Acromioclavicular separation (AC Seperation) which affects my shoulder. I re-injured my shoulder close to a year after my initial injury and have had three surgeries (about one a year) since.

I now find myself in a precarious situation; I am essentially as fixed as I can get (I forgot my Orthopedic Physician's exact terminology) but I still have constant pain.

Over these last few years I have been prescribed Norco and occasionally Oxycodone for my pain. At times I felt dependent on the pain medication, not to abuse nor to simply have the drug-- instead, to keep the pain away. I don't believe I am an addict but at the same time I believe I need pain medicine to function. I find myself in constant fear of doing something to cause greater pain in my shoulder.



  • sandisandi Posts: 6,343
    edited 08/18/2013 - 12:58 PM
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    As to your question about whether or not to seek treatment with a pain management doctor, after reading your post, the answer is yes. Just as you went to an orthopedic surgeon to treat the shoulder problem, you also need to seek out a specialist to treat the pain as well. A good PM doctor will balance treating your pain , with maximizing your functional capabilities as well.
    I personally see a pain management doctor who is also a physiatrist, because for me, they are all about maximizing my function while treating the pain and keeping it manageable. There is no such animal as pain free once there is a chronic injury and surgery is no longer an option but a good goal to reduction of pain is about a 50% improvement from your baseline pain levels.
  • I think you should also seek pain management. Most of us will never be at a 0 on the pain scale (1-10, 10 being hospitalized), but use medications and other modalities to try and maintain a lower level of pain. In my case, my surgeon wants me to be at a 2-3 every day which of course doesn't happen, not every day. And there are spikes when the medication wears off. I'm not on a time-release medication, just an immediate release and have been for years.

    Yes, I'm dependent upon them, but when I've tried cutting down, which I have a bit the last couple of months, it's a bear to just get out of bed, forget about working.

    So, I'm just seconding what Sandi said. You never mentioned whether you were in PT, but I'm assuming you've tried everything as that's a usual course of action before a doctor gives up and says that's the best you'll ever feel.

    Take care and I hope you find yourself feeling better on a regular basis.
  • Hi and welcome but sorry you are here. Yes, see a pain management specialist. It took me a long time to see one after my Neurologist suggested going to one. Once I did I was mad with myself that I waited so long! My PM Dr was able to do Trigger Point Injections to help the knots and spasms in my back muscles (traps/lats). He is also better with medication and trying different things. Also, please do not make yourself feel "unworthy" of being here. You are in pain. You sustained a major injury You live day to day in pain and you are young. You need to get your pain under control the best you can now because you have a lot of living to do!!!
    Best of luck!!!!
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