Author Topic: Pain Management  (Read 3477 times)

partgypsy

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Re: Pain Management
« Reply #50 on: May 03, 2021, 09:57:58 AM »
yes. I've had chronic neck/shoulder aches as well, exacerbated by me stupidly injuring one shoulder a few years ago. While I did get a consultation, only now that I am post surgery/radiation for breast cancer, they can sneak in a PT referral on that pretext. Whatever it is I'll take it. Still wish therapeutic massage was covered by insurance.

Metalcat

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Re: Pain Management
« Reply #51 on: May 03, 2021, 10:17:21 AM »
That sounds nuts to me.

So is physio just not that common then? Where I live, there's a physio on almost every block, and you would never have to wait more than a few days for an appointment. I had an emergency recently and was even able to see a specialized neurogical physiotherapist the same day.
Physio (or PT in 'murican) is common, but the process of getting it can be complicated. The primary care doctor generally has to prescribe PT for it to be covered by insurance. In my case, my doctor wouldn't prescribe it until I had an Xray (cheap) and an MRI (almost $500). So it took me 4 appointments, 2 months and about $700 to get into PT for shoulder tendinitis.

Yeah, a lot of insurance companies here require a referral from an MD, but because medicine is publicly funded, they don't do x-rays or MRIs unless they absolutely have to. So they'll much sooner refer for physio than for an MRI.

Do MDs make money off of imaging there?

LifeHappens

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Re: Pain Management
« Reply #52 on: May 03, 2021, 10:28:21 AM »
Do MDs make money off of imaging there?
In my case, the MD didn't have their own imaging equipment, so I don't think there was a financial incentive. The main thing seems to be 1) managing risk of malpractice and 2) managing risk of my insurance denying coverage for PT.

Metalcat

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Re: Pain Management
« Reply #53 on: May 03, 2021, 10:45:43 AM »
Do MDs make money off of imaging there?
In my case, the MD didn't have their own imaging equipment, so I don't think there was a financial incentive. The main thing seems to be 1) managing risk of malpractice and 2) managing risk of my insurance denying coverage for PT.

Ahhh...makes sense.

Yeah, I've worked with some American surgeons who really struggled with the Canadian system because there's no much less ass-covering and they were kind of shit-their-pants scared because patients here can just as readily sue. They just don't.

jeninco

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Re: Pain Management
« Reply #54 on: May 03, 2021, 11:22:49 AM »
And that explanation above there is why I just pay out of pocket (out of an HSA, so pre-tax dollars, to complicate the situation) to see a PT (which I think is the same as "physio" in Canadian). It means I get to see people who practice modalities that are immediately effective for me (although, ouch, manual cross-friction massaging on connective tissue is painful, it gets'er'done so I can go back to my regularly scheduled activities) without arguing with doctors about "just take off 6 weeks" which is what I tend to get around here. (Yes, I live in a place full of professional athletes. Yes, "rest it for 6 weeks" is still advice I get. )

"Money well spent" -- make it better, so I can go back to living my life rather than chasing around doctor's appointments.

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Re: Pain Management
« Reply #55 on: May 03, 2021, 12:12:10 PM »
That sounds nuts to me.

So is physio just not that common then? Where I live, there's a physio on almost every block, and you would never have to wait more than a few days for an appointment. I had an emergency recently and was even able to see a specialized neurogical physiotherapist the same day.
Physio (or PT in 'murican) is common, but the process of getting it can be complicated. The primary care doctor generally has to prescribe PT for it to be covered by insurance. In my case, my doctor wouldn't prescribe it until I had an Xray (cheap) and an MRI (almost $500). So it took me 4 appointments, 2 months and about $700 to get into PT for shoulder tendinitis.

That sounds nuts. It also means you had to wait 2 months to actually start treating the injury.

I'm also Canadian and some extended health insurance plans here also require doctor referral. However, once you have the referral you can go to any licensed PT. Our family is covered by 2 different extended health plans, one requires referral and the other doesn't. My workaround is to have my GP write me (and anyone else in the family who I think may need it) a generic prescription for each service once a year (insurance requires each script to be no more than 1 year old). Works great because the insurance company either doesn't care or isn't allowed to ask what exactly was done at the PT appointment. Now that telehealth is so prevalent getting the referral is stupidly easy. I don't even have to go in person to collect my piece of paper. Although it still feels like a total waste of effort on everyone's part. Note that there's also a dollar limit on how much physio, massage, psychotherapy, etc insurance will pay for so their liability is pretty limited.

achvfi

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Re: Pain Management
« Reply #56 on: May 03, 2021, 01:53:11 PM »
First , Just to be clear unless someone is an actual Doctor anything suggested should be considered as just an opinion and nothing else. Any decision should be made on your own and probably even if from a Doctor.
While there is a lot of woo out there, there is also lot to gain to look for advice beyond doctors. Kudos.

I dont have much advice for pain medication but two things worked for me are Nutrition and Physical therapy. Most doctors don't know about nutrition and its effect on body. They are not taught more than few sessions in school about nutrition. They usually focus on treating symptoms of what they can treat with medicine and ignore the root cause.

Just like MMM forum where people do of financial hacking there are communities for health hacking, I would recommend educating yourself on nutrition and ancestral way of eating (I do not recommend Vegan).

Nutrition: Try low carb diet. Give up on processed food. No grains, no flour, no sugar, no sweeteners, no alcohol, no vegetable oils. These are all highly inflammatory over time  result in degeneration of body at cellular level. They interfere with normal function of your body, your hormone balance and also deplete vital vitamins and minerals.

Eat lots of meat (beef is health food!), try bone broth and some greens and vegetables you like or tolerate. Basically eat food that doesn't come with list of ingredients. Focus on nutrient dense food. When you give your body the nutrition it requires it will heal itself what it can.

For me nutrition changes and combining it with physical therapy helped overcome my knee and ankle joint pain from years of sports and abuse. Beyond that I lost all my excess weight and now I am in best shape of my life. Every time I see myself in the mirror, I see me minus 10 years of aging and a toned body

Avoid regular high impact activities like running and replace wit low impact activities such as elliptical, swimming, biking/spinning.

I know this is a tall order but your body is worth it. Good luck.




Metalcat

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Re: Pain Management
« Reply #57 on: May 03, 2021, 03:21:57 PM »
^Although I don't necessarily agree with your diet advice, the advice of beef as a universal recommendation, I do totally agree that diet as a modulator of inflammation is important. This is well recognized in the medical world.

It's just tricky to develop into an evidence based treatment recommendation because it varies so much by person, which makes it difficult to study and difficult to implement. That, and doctors are not the professionals to oversee that kind of lifestyle stuff.

I will also TOTALLY agree with you that an aversion to woo should not equal a dependence on doctors alone. Doctors tend to be HORRIBLE at treating pain. They can be experts at treating issues that cause pain, but if, and only if the problem can be readily identified and is actually treatable.

I've had severe pain my entire life and I've seen dozens and dozens of doctors, and only the ones trained in pain management knew anything about managing pain properly.

The only doctors who have ever successfully resolved pain for me were the surgeons who took out my infected appendix, and the doctor who gave me a puffer when I had an asthma attack.

Otherwise I've been given a giant pile of prescriptions, which sometimes help in a pinch, but come with side effects, especially if taken long term.

Then there's all of the other shit. What works, what's woo? Who should you trust? Who's full of shit???

Well the key to navigating the world of non-doctor treatment is to give up on the need for explanations, and to generally ignore any explanations given.

Acupuncture works for some people for some reason. We have no idea why, we have theories, but no actual facts. Many chiros and naturopaths and whatever will give detailed explanations as to why they work...they don't know, but in the end, it doesn't matter.

If it works for you, then great. Don't question it, just do it.

It's the same with taping, cupping, and even massage therapy. The RMTs are taught detailed rationals for why what they do works and how it should be done. Meanwhile, it's all just a theory, but it works! Consistently! For almost everyone! Yay!

Truthfully medicine isn't any different. Doctors don't know why most of their drugs work. The difference is that they aren't usually taught bullshit reasons to explain it. They're doctors, they don't need PR to justify what they do.

These allied health folks, fitness folks, whoever, aren't at fault. This is what they're taught. They're taught theory as fact and they repeat it as if it's fact. That's where woo is a problem.

It's hard to sell people on alternative treatments if the sales pitch is "fucked if I know how it works, but you might as well spend a couple hundred bucks and see if it helps". So the industry doesn't promote that narrative. Plus what people in pain usually want even more than relief is answers.

I've "helped" countless pain patients just by being able to explain to them why they're in constant pain. Honestly this alone accounts for 99% of my patients satisfaction. Actually reducing their pain is usually just a bonus in terms of how much they value my service and its cost, even though it fails to help a lot of people. These industries know that, it's why they focus on giving clients answers.

Do bee stings help with chronic conditions? I don't know, maybe. But if they do, I guarantee no one else knows why either, especially not the chiropractor with pages and pages of explanation as to how it interacts with the body.

There's no question that a certain diet, a certain exercise, and a certain combo of treatments will probably help anyone who experiences pain. It's just very very hard to figure out which combo, because there's no reliable scientific way to determine which body will uniquely respond to what. And each type of provider only has evaluation techniques that allow them to say if their treatment MIGHT help, and the answer is almost always 100% "yes it might".

So that's really the best way to approach any ongoing bodily issue. Get the doctors to check if there is an objectively solvable problem, or if there's a problem that could get worse without intervention.

Beyond that, sure, read about options and the various theories as to why certain approaches might work, but take any and all explanations with a grain of salt. That doesn't mean these treatments or diets aren't powerfully effective for some people, just learn to have a healthy respect for how mysterious the human body is.

Respect that no one has answers, but a lot of people have options to offer, and the vast majority of options that can help you with chronic pain will not come from an MD.

It's trial and error. And if it works great, but don't kid yourself that you have much of an idea why something works. Just keep doing it as long as it works. And just because your woo-y alt medicine provider is probably entirely full of shit as to why they're recommending certain treatments, doesn't mean that full-of-shit woo huckster can't help you. Statistically, they can probably help you with pain more than the MD who is less full of shit but also has no good options for you.
« Last Edit: May 03, 2021, 03:32:10 PM by Malcat »

achvfi

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Re: Pain Management
« Reply #58 on: May 04, 2021, 09:09:46 AM »
^Although I don't necessarily agree with your diet advice, the advice of beef as a universal recommendation, I do totally agree that diet as a modulator of inflammation is important. This is well recognized in the medical world.

I mentioned beef on purpose because there is widely accepted myth among Nutritional, Medical community and general public that red meat and saturated fat will clog your arteries, cause cancer and kill you. But in fact that belief is based on poorly conducted epidemiological observational studies in 60s and 70s. In fact all this is outdated information that still persists in the mainstream.

These beliefs continue to be promoted by people with agendas beyond nutrition. Food, Pharma, animal welfare and religious so on, that control medical advice, nutritional guidelines and academic research. There is lots of confusion and misrepresentation of data that mainstream media picks up.

In fact beef if one of the most nutritious foods you can eat for both macro and micro nutrition perspective. Also nutrition it provides is bio available that the body can actually absorb and use compared to so much of plant based foods.

There are communities that are benefiting from meat based diets to resolve various conditions including pains that people used to accept as incurable or have to live with for their life.

I know this is all hard to accept after decades of marketing-brainwashing we have all been through.

Check out following YouTube channel where many people eating just meat that are thriving compared to their previous lifestyles. I am not recommending to eat just meat BTW.

https://www.youtube.com/channel/UC99hyfVlVP17XOic3K1_IvQ

Metalcat

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Re: Pain Management
« Reply #59 on: May 04, 2021, 09:29:49 AM »
^Although I don't necessarily agree with your diet advice, the advice of beef as a universal recommendation, I do totally agree that diet as a modulator of inflammation is important. This is well recognized in the medical world.

I mentioned beef on purpose because there is widely accepted myth among Nutritional, Medical community and general public that red meat and saturated fat will clog your arteries, cause cancer and kill you. But in fact that belief is based on poorly conducted epidemiological observational studies in 60s and 70s. In fact all this is outdated information that still persists in the mainstream.

These beliefs continue to be promoted by people with agendas beyond nutrition. Food, Pharma, animal welfare and religious so on, that control medical advice, nutritional guidelines and academic research. There is lots of confusion and misrepresentation of data that mainstream media picks up.

In fact beef if one of the most nutritious foods you can eat for both macro and micro nutrition perspective. Also nutrition it provides is bio available that the body can actually absorb and use compared to so much of plant based foods.

There are communities that are benefiting from meat based diets to resolve various conditions including pains that people used to accept as incurable or have to live with for their life.

I know this is all hard to accept after decades of marketing-brainwashing we have all been through.

Check out following YouTube channel where many people eating just meat that are thriving compared to their previous lifestyles. I am not recommending to eat just meat BTW.

https://www.youtube.com/channel/UC99hyfVlVP17XOic3K1_IvQ

All I said was that I don't agree with beef as a universal recommendation for everyone. I don't react well to beef for example, so I'm not about to have a beef heavy diet. I'm absolutely fine with dairy though, which my sister reacts to (we're not genetically related).

My point was that different bodies are different. Each person needs to figure out what their body responds best to. I've done multiple elimination diets, and I respond best to vegetarian with dairy and eggs.

I'm all for discounting historical diet bullshit, but I don't agree with pushing any one diet on everyone. Every person responds to everything differently. To say otherwise is 100% bullshit.

The science around nutrition is all over the place, so anyone claiming to know "the truth" when it comes to nutrition is guaranteed to be stretching the applicability of research.

The only absolute truth that we can conclude about most diets is that what works for the individual is highly dependent on the individual and for the most part, we have no solid idea as to why.

achvfi

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Re: Pain Management
« Reply #60 on: May 04, 2021, 11:49:36 AM »
All I said was that I don't agree with beef as a universal recommendation for everyone. I don't react well to beef for example, so I'm not about to have a beef heavy diet. I'm absolutely fine with dairy though, which my sister reacts to (we're not genetically related).
I am not sure why you keep writing about universal recommendation. I am giving an option that people can try, they may not be aware of or not usually ready to accept generally that worked very well for me. I am not pushing universal truths here.

You can almost recommend nothing universally, its meaningless. That doesn't mean you cant recommend something. Yes, it is individual and also what an individual is capable of mentally and physically overtime.

My point was that different bodies are different. Each person needs to figure out what their body responds best to. I've done multiple elimination diets, and I respond best to vegetarian with dairy and eggs.
That is awesome that you figured out what works for you after trying different ideas.

Metalcat

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Re: Pain Management
« Reply #61 on: May 04, 2021, 12:00:43 PM »
All I said was that I don't agree with beef as a universal recommendation for everyone. I don't react well to beef for example, so I'm not about to have a beef heavy diet. I'm absolutely fine with dairy though, which my sister reacts to (we're not genetically related).
I am not sure why you keep writing about universal recommendation. I am giving an option that people can try, they may not be aware of or not usually ready to accept generally that worked very well for me. I am not pushing universal truths here.

You can almost recommend nothing universally, its meaningless. That doesn't mean you cant recommend something. Yes, it is individual and also what an individual is capable of mentally and physically overtime.

My point was that different bodies are different. Each person needs to figure out what their body responds best to. I've done multiple elimination diets, and I respond best to vegetarian with dairy and eggs.
That is awesome that you figured out what works for you after trying different ideas.

Sorry if I misinterpreted. The way I read your post seems to be saying that everyone should be eating beef.

lexde

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Re: Pain Management
« Reply #62 on: May 05, 2021, 08:13:14 AM »
I’m 31, so I’m not sure how well this will hold up, but cutting way back on alcohol and coffee, drinking tons of water/tea, consuming lots of anti-inflammatory food (turmeric for one), and stretching/yoga helps me. I have a bad back, and this keeps everything manageable without other meds.

Metalcat

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Re: Pain Management
« Reply #63 on: May 05, 2021, 08:54:56 AM »
I’m 31, so I’m not sure how well this will hold up, but cutting way back on alcohol and coffee, drinking tons of water/tea, consuming lots of anti-inflammatory food (turmeric for one), and stretching/yoga helps me. I have a bad back, and this keeps everything manageable without other meds.

Yeah alcohol is a big one, a lot of people self medicate pain with alcohol because it is reasonably effective for pain in the short term, but it's horrible for making pain worse overall on multiple fronts, both directly and indirectly by seriously damaging reparative sleep, although no one knows how sleep works or what it even goes, but we do know that disrupting sleep cycles is horrible.

shelivesthedream

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Re: Pain Management
« Reply #64 on: May 24, 2021, 01:31:39 PM »
I know this thread is a bit old now, but I've just read it and wanted to chip in on "alternative therapies". My mother is really into whatever is the latest health fad in the mainstream news - blueberries cure dementia, goji berries make you live forever, whatever. So I always think, "Uh huh, and how does THAT work? Who massaged THOSE statistics and sent them to the scientifically illiterate editor?"

But I've also come round to the "can't hurt, might help" school of thinking when it comes to chronic conditions. There are lots of unproven therapies that no one can explain how they're supposed to work, but people say they work for them. If there is no downside to trying them out and they might help, why not give them a go? Like, I don't see a downside other than being out a few quid of trying acupuncture. Sounds like a crock of shite to me, but if it works for me then that's the important thing. If it doesn't, oh well, move on.

The big example for me personally has been the FODMAPS elimination diet. It changed my life. I am not exaggerating. Fuck knows what goes on in people's guts that means eating onion and garlic gives me joint pain, but it does. (Along with crippling fatigue and occasionally gastro symptoms.) But I figured it can't hurt to do the full elimination and reintroduction protocol, and it might help. Changed my life. I have to hold myself back from enthusing about it at every opportunity because it's been so great for me.

I've also been converted to physiotherapy through a similar process. I had pelvic girdle pain in my last pregnancy. It can get so bad, women end up in wheelchairs. I was sent to a physiotherapy class and internally rolled my eyes that they were palming me off with stupid "exercises" because I was pregnant so they couldn't do anything real and helpful. But I grudgingly figured I might as well give it a try because it couldn't hurt and might help. YES IT HELPED. I regained and retained a significant amount of pain-free and lowered-pain mobility for the last portion of my pregnancy. I am a total convert to the benefits of physiotherapy and would choose it above surgery as a first line treatment for future issues.

(In fact, I think physio has been shown to be more effective on treating knee pain than surgery. Have a poke around the interwebs and consider pushing for physio first with an option on surgery if it doesn't help.)

The thing I try to keep in mind is what kind of results I was hoping for and whether I've achieved them. I think people get conned by"alternative therapies" when there's nothing much wrong with them and they're looking for unproven "wellness" benefits which won't manifest for decades. But as a treatment for a problem, I have no problem trying out most crazy ass stuff if the worst case scenario is "it does nothing".

As a side note, I've never liked icing things for pain. I've always preferred a hot water bottle. I know it's not what you're supposed to do for e.g. a twisted ankle, but it subjectively feels better to me. Also, strong preference for hot Epsom salt baths for muscle pain, not showers, as I can relax all my muscles as I don't need any to keep me upright. I don't know if the Epsom salts work (as in, contribute extra beyond the hot bath" but I bought 10kg on eBay when I was last pregnant and I'm willing to throw away 10p worth per bath on the offchance it's helping. Certainly FEELS like it helps, and that's the main thing.

As a final note, interesting to read what Malcat was saying about how opiates change your subjective perception of pain, not take it away. That's my experience of gas and air while in labour, which worked fantastically for me. It still hurt, but a good huff of g&a as a contraction got going sort of gathered my brain back up again and helped me focus on everything else that was in the room, rather than a disparate feeling of "OWWWWW!" where I couldn't concentrate on anything else. I'm told that patient-controlled pain relief works better in labour, whether it's g&a or those push-button epidurals where you dose yourself. Given how personal pain is, I can believe it. I would class myself as having a low pain threshold and generally making a fuss about being ill, but I managed labour pain really well because it felt qualitatively different to a stubbed toe, even though it was wayyy higher on the 1-10 scale.

Hula Hoop

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Re: Pain Management
« Reply #65 on: May 24, 2021, 01:49:06 PM »
A lot of this discussion reminds me of the research I did while pregnant on childbirth pain.  I remember seeing mention of the TENS machine (not available here unfortunately) and also something very similar to "mindfulness therapy" mentioned above.  Ina Mae Gaskin is really good on this subject.  Rather than fearing childbirth pain and seeing it as abnormal - she tries to reframe childbirth pain as "manageable" and completely normal.

Also - it is indeed difficult to remember pain.  I remember having this though while giving birth to my second child.  I'd forgotten how incredibly intense the pain is when I decided to have a second kid.  I remembered that it was extreme but not the actual feeling of being in pain.

Metalcat

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Re: Pain Management
« Reply #66 on: May 24, 2021, 02:22:49 PM »
I know this thread is a bit old now, but I've just read it and wanted to chip in on "alternative therapies". My mother is really into whatever is the latest health fad in the mainstream news - blueberries cure dementia, goji berries make you live forever, whatever. So I always think, "Uh huh, and how does THAT work? Who massaged THOSE statistics and sent them to the scientifically illiterate editor?"

But I've also come round to the "can't hurt, might help" school of thinking when it comes to chronic conditions. There are lots of unproven therapies that no one can explain how they're supposed to work, but people say they work for them. If there is no downside to trying them out and they might help, why not give them a go? Like, I don't see a downside other than being out a few quid of trying acupuncture. Sounds like a crock of shite to me, but if it works for me then that's the important thing. If it doesn't, oh well, move on.

The big example for me personally has been the FODMAPS elimination diet. It changed my life. I am not exaggerating. Fuck knows what goes on in people's guts that means eating onion and garlic gives me joint pain, but it does. (Along with crippling fatigue and occasionally gastro symptoms.) But I figured it can't hurt to do the full elimination and reintroduction protocol, and it might help. Changed my life. I have to hold myself back from enthusing about it at every opportunity because it's been so great for me.

I've also been converted to physiotherapy through a similar process. I had pelvic girdle pain in my last pregnancy. It can get so bad, women end up in wheelchairs. I was sent to a physiotherapy class and internally rolled my eyes that they were palming me off with stupid "exercises" because I was pregnant so they couldn't do anything real and helpful. But I grudgingly figured I might as well give it a try because it couldn't hurt and might help. YES IT HELPED. I regained and retained a significant amount of pain-free and lowered-pain mobility for the last portion of my pregnancy. I am a total convert to the benefits of physiotherapy and would choose it above surgery as a first line treatment for future issues.

(In fact, I think physio has been shown to be more effective on treating knee pain than surgery. Have a poke around the interwebs and consider pushing for physio first with an option on surgery if it doesn't help.)

The thing I try to keep in mind is what kind of results I was hoping for and whether I've achieved them. I think people get conned by"alternative therapies" when there's nothing much wrong with them and they're looking for unproven "wellness" benefits which won't manifest for decades. But as a treatment for a problem, I have no problem trying out most crazy ass stuff if the worst case scenario is "it does nothing".

As a side note, I've never liked icing things for pain. I've always preferred a hot water bottle. I know it's not what you're supposed to do for e.g. a twisted ankle, but it subjectively feels better to me. Also, strong preference for hot Epsom salt baths for muscle pain, not showers, as I can relax all my muscles as I don't need any to keep me upright. I don't know if the Epsom salts work (as in, contribute extra beyond the hot bath" but I bought 10kg on eBay when I was last pregnant and I'm willing to throw away 10p worth per bath on the offchance it's helping. Certainly FEELS like it helps, and that's the main thing.

As a final note, interesting to read what Malcat was saying about how opiates change your subjective perception of pain, not take it away. That's my experience of gas and air while in labour, which worked fantastically for me. It still hurt, but a good huff of g&a as a contraction got going sort of gathered my brain back up again and helped me focus on everything else that was in the room, rather than a disparate feeling of "OWWWWW!" where I couldn't concentrate on anything else. I'm told that patient-controlled pain relief works better in labour, whether it's g&a or those push-button epidurals where you dose yourself. Given how personal pain is, I can believe it. I would class myself as having a low pain threshold and generally making a fuss about being ill, but I managed labour pain really well because it felt qualitatively different to a stubbed toe, even though it was wayyy higher on the 1-10 scale.

I chuckled a bit reading this because FODMAPS and physio are really not alternative or woo at all where I live, they're pretty commonly recommended by MDs here. So I'm not at all surprised that you got good results with them.

PDXTabs

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Re: Pain Management
« Reply #67 on: May 24, 2021, 10:56:38 PM »
Are you asking if there are any pain pills that are safe to take long term?

Well yes and no. Some people's bodies can handle taking pain medications every single day, and some can't.

I'm in the unenviable position where I can't take any NSAIDs due to an Aspirin allergy. However, in the past when I was worried about my liver function my doctor was happy to draw up blood work for how my body was handling my medication (unrelated to pain, a very strong black box warning medication I was on). If for some reason I had to take a ton of Tylenol I would do that again.

Also, as a slight aside, my friends and I with too much inflammation have had good results with AIP.

shelivesthedream

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Re: Pain Management
« Reply #68 on: May 25, 2021, 02:04:55 AM »
Quote
I chuckled a bit reading this because FODMAPS and physio are really not alternative or woo at all where I live, they're pretty commonly recommended by MDs here. So I'm not at all surprised that you got good results with them.

Hah, no, not "woo" at all! But I definitely perceived them as "not real effective medicine".

I did FODMAPS when it was really new, as part of a trial of it at my local hospital, at what turned out to be the end of a two year diagnostic process. So at that time it sounded like "Yeah, we dunno, try this random thing". And physio for a hormonal issue that loosened all my ligaments also sounded like "Yeah, we can't give you any actual medicine because you're pregnant" but was super effective.

So especially the first thing but also the second made me reassess what counts as "effective medicine" and have another look at "woo". For example, I am trying out some "woo" as well as some "real medicine" for my current issues. And while I would previously have rolled my eyes at some of the stuff mentioned in this thread, I now shrug and think anything's worth a go if it's not hormful.

I've also come to embrace the placebo effect when it comes to subjective, QOL issues. It's not "just" the placebo effect (dismissive wave), it's having the actual gold star outcome of making me feel better. Take Epsom salts. If the issue is not an actual injury but just muscle aches from a longer than usual walk carrying heavier than usual shopping, the potential placebo effect making me feel better is the same as actually making me better. It doesn't matter if it works on the muscles or the brain, I'm getting thr desired result.
« Last Edit: May 25, 2021, 03:25:12 AM by shelivesthedream »

Metalcat

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Re: Pain Management
« Reply #69 on: May 25, 2021, 04:32:20 AM »
Quote
I chuckled a bit reading this because FODMAPS and physio are really not alternative or woo at all where I live, they're pretty commonly recommended by MDs here. So I'm not at all surprised that you got good results with them.

Hah, no, not "woo" at all! But I definitely perceived them as "not real effective medicine".

I did FODMAPS when it was really new, as part of a trial of it at my local hospital, at what turned out to be the end of a two year diagnostic process. So at that time it sounded like "Yeah, we dunno, try this random thing". And physio for a hormonal issue that loosened all my ligaments also sounded like "Yeah, we can't give you any actual medicine because you're pregnant" but was super effective.

So especially the first thing but also the second made me reassess what counts as "effective medicine" and have another look at "woo". For example, I am trying out some "woo" as well as some "real medicine" for my current issues. And while I would previously have rolled my eyes at some of the stuff mentioned in this thread, I now shrug and think anything's worth a go if it's not hormful.

I've also come to embrace the placebo effect when it comes to subjective, QOL issues. It's not "just" the placebo effect (dismissive wave), it's having the actual gold star outcome of making me feel better. Take Epsom salts. If the issue is not an actual injury but just muscle aches from a longer than usual walk carrying heavier than usual shopping, the potential placebo effect making me feel better is the same as actually making me better. It doesn't matter if it works on the muscles or the brain, I'm getting thr desired result.

It's funny, because in the serious illness/chronic pain world, we mostly kind of see MDs as often pretty useless on the management front, and the various allied health professionals, like PTs as the real medicine that actually helps and heals.

I have a very serious and complex condition, and I really try to minimize what doctors get to do to me. They tend to be reactive and prescribe stupid shit just because they don't know what to do.

I can't tell you how many times I've been offered "real medicine" treatments, like steroid injections, that are totally contraindicated for my condition, just because they don't know what else to do. Oh, and so many surgeries. If I wasn't an expert medical professional myself, I would have had so many surgeries by now. I shake my head constantly at my peers with the same illness who report having had 20-30 surgeries by their mid 40s. It's unbelievable.

What's absolutely ridiculous is that when I say no to steroid injections and surgeries, the doctors always agree with me! They're always like "yeah, ultimately it would probably make things worse". Like, they know that, but they can't help themselves.

So yeah, I take "real medicine" worth a grain of salt, and instead focus on food, exercise, physiotherapy, massage therapy, psychotherapy, meditation, getting out in nature, and yeah, whatever placebo makes me feel good.

I also say this as someone whose practice was dedicated to treating chronic pain patients, and my main resource was orthotics and sending people to physiotherapy. Injections, medications and surgery, aka "real medicine" were a very last resort.

BlueHouse

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Re: Pain Management
« Reply #70 on: June 08, 2021, 07:00:20 AM »
I'm not a doctor. I'm near 50. What's been most helpful for me includes going gluten free and low carb, working with a PT to identify exercises and stretches to help restore mobility, staying active via walking and lifting, seeing a bodyworker like a ROLFer, using a percussion massager, taking fish oil and a beef organ supplement, and doing mental health work to maintain a positive mental outlook. I introduced each of the above at different times, among trying other things that didn't work, and the introduction/subtraction of each of the above helped me slow the symptoms that prove the fact that getting old is a b*tch. When I'm really bad, topical magnesium lotion is also helpful.

I couldn't equate pain with diet until I moved into a 4 story house.  When I go overboard with carbs and sugars, I can barely walk down the stairs.  I think it's inflammatory pain and I've been trying to get myself to try an inflammation-avoidance diet for years, but I always mess it up.  still trying. 

RetiredAt63

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Re: Pain Management
« Reply #71 on: June 08, 2021, 07:21:50 AM »
My physio treated my bad knees (medial ligament damage and torn meniscus, both knees) with deep pulse ultrasound.  It is not fun (it only hurts where the tissue is damaged, that is how she knew where to use it) but it works.  She said that acupuncture in the knee works much the same, they both somehow get the damaged tissue to start healing itself instead of just sitting there hurting.  I was walking unbalanced because of the knee pain (one was worse than the other and I favoured it) and she also did a very gentle spinal pressure to straighten out my very slightly no-longer-straight lower spine.

Best thing my doctor did was send me for an MRI so we could see what was wrong with my knee, and then write the referral to PT.  I was damaging my stomach lining with all the NSAIDs I was taking for the pain.

wenchsenior

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Re: Pain Management
« Reply #72 on: June 08, 2021, 08:38:25 AM »
I'm not a doctor. I'm near 50. What's been most helpful for me includes going gluten free and low carb, working with a PT to identify exercises and stretches to help restore mobility, staying active via walking and lifting, seeing a bodyworker like a ROLFer, using a percussion massager, taking fish oil and a beef organ supplement, and doing mental health work to maintain a positive mental outlook. I introduced each of the above at different times, among trying other things that didn't work, and the introduction/subtraction of each of the above helped me slow the symptoms that prove the fact that getting old is a b*tch. When I'm really bad, topical magnesium lotion is also helpful.

I couldn't equate pain with diet until I moved into a 4 story house.  When I go overboard with carbs and sugars, I can barely walk down the stairs.  I think it's inflammatory pain and I've been trying to get myself to try an inflammation-avoidance diet for years, but I always mess it up.  still trying.

Yes, I experience more pain with a high-glycemic diet as well. In my case, it seems to be a secondary effect of poor diet fucking up my hormone levels, which predisposes me to chronic pain.  I also do less well if I eat more dairy, so I limit that to a couple servings per week.  Supplemental magnesium does appear to help me with pain (and sleep) as well.

wenchsenior

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Re: Pain Management
« Reply #73 on: June 08, 2021, 08:43:42 AM »
My physio treated my bad knees (medial ligament damage and torn meniscus, both knees) with deep pulse ultrasound.  It is not fun (it only hurts where the tissue is damaged, that is how she knew where to use it) but it works.  She said that acupuncture in the knee works much the same, they both somehow get the damaged tissue to start healing itself instead of just sitting there hurting.  I was walking unbalanced because of the knee pain (one was worse than the other and I favoured it) and she also did a very gentle spinal pressure to straighten out my very slightly no-longer-straight lower spine.

Best thing my doctor did was send me for an MRI so we could see what was wrong with my knee, and then write the referral to PT.  I was damaging my stomach lining with all the NSAIDs I was taking for the pain.

I just went through a variant of this as well, only instead of ultrasound I got plasma injections and manual tendon-stripping (which stimulates the body to heal the injury with fresh more flexible tissue).  Plasma injections aren't covered by insurance, and are RIDICULOUSLY expensive given how simple they are (honestly, if I had access to a centrifuge I could almost have given them to myself...even the physio guy who did them said it was ludicrous how much they cost and kept apologizing).

It was totally worth it though...my fucked up hamstring is back to almost fully functional after more than a year of misery and impairment.  And I bought my own tendon stripping kit, which I use when I feel it starting to stiffen up, and also on my Achilles, which has chronic tendonitis. Very helpful, if 'low rent'.

(Btw, random fact... my sister is a vet tech and said they use plasma injections when all else fails for severe soft tissue injuries (eye injuries etc) and have had great success with them.)
« Last Edit: June 08, 2021, 08:47:04 AM by wenchsenior »

ixtap

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Re: Pain Management
« Reply #74 on: June 08, 2021, 08:49:04 AM »
We can see a specialist without a referral, but still need one for physio.

For DH, it helped to go through an elimination diet. His obvious triggers were dairy and potatoes. This process is going to work better for most people than just eliminating the Boogeyman of the day.