I’ve written quite a bit recently about how healthcare providers should collaborate with patients to help them choose the best way to care for their health issues.
Our clinic treats pain, and I get questions all the time from friends and family who say things like “David, this weekend I suddenly got a sharp pain in my knee, do you think it’s serious? What should I do?”
In this post I’m going to tell you what I tell them, based on how they describe their pain:
You woke up with a crick in your neck – and it’s still there mid-afternoon. Or perhaps you felt a sudden pop or stabbing pain when you stood up, or moved some furniture, or rolled over in bed.
Care model: If you think you know what caused your pain, and you’re pretty confident it isn’t severe, then the best next step is simply to check in with a healthcare provider who can verify your self-diagnosis and suggest the best quick relief and self-care strategies. Unless your pain suddenly gets worse or doesn’t improve, you generally don’t need x-rays, MRIs, prescription medications or a referral to a specialist or a visit to an emergency room.
And unlike a consultation with “Dr. Google,” you get an expert’s confirmation of what’s actually wrong, plus the right treatment to start feeling better, right away. For example, many people think the best treatment for sudden low back pain is lying as still as possible – but that often makes your pain worse.
You had a minor car accident on your way home last week. You were sore for a couple of days but thought you’d be back to normal by the weekend. Now it’s a week later, you’re in more pain – and you’re starting to wonder if you’re more seriously injured than you initially thought you were.
Care model: Definitely have a healthcare provider who specializes in musculoskeletal issues assess more intense pain, especially if it keeps you from doing things you could easily do before. You want to make sure you’ve got the right diagnosis – otherwise, you may not get the best treatment. In this situation, while you won’t generally need an emergency room visit, an MRI or other imaging is often well worth the time and money to speed both diagnosis and treatment.
Most moderately painful musculoskeletal conditions are highly treatable, so you can expect to eventually be completely pain-free again. However, to get there, you’ll probably need a care plan designed around the underlying cause of your pain. That plan usually includes some combination of self-care treatments, physical therapy, medical massage and/or chiropractic treatment. Early in your treatment and healing process, it may also include a short course of over-the-counter or prescription medication.
Occasional mild recurring pain usually falls into the “simple pain” category we discussed above. More intense and persistent chronic pain usually results from major traumatic injury that involves multiple parts of your body, or serious medical conditions, like fibromyalgia, rheumatoid arthritis or diabetic neuropathy. Sometimes excruciating pain even continues after the initial trauma has healed.
Care model: If you have chronic and severe pain, look for a pain clinic that’s comfortable working closely with your entire healthcare team to tailor a plan that treats your pain in different ways at different times, depending on its severity.
For example, people with the most common form of multiple sclerosis may alternate between times of extreme pain and times when they’re more comfortable. You need a team that understands those nuances, and a plan that addresses both situations.
A blended approach that combines the expertise of several types of healthcare providers is usually the best treatment choice for chronic severe pain. For example, chronic pain from multiple sclerosis may be treated with medication plus ongoing physical therapy and chiropractic sessions to protect compromised musculoskeletal systems, plus cognitive-behavioral therapy and mindfulness training to help you manage the chronic stress that accompanies and worsens chronic pain.
Sudden Severe Pain
Sudden unexplained and excruciating pain is a major red flag. Examples include severe pain in your organs, like in your stomach or abdomen, “the worst headache of my life”, or crushing chest or shoulder pain.
See a doctor right away, because you could have a life-threatening condition that needs immediate treatment. If you don’t have a regular doctor or can’t get an appointment right away, go to an urgent care clinic or the emergency room.
The Bottom Line
Whether you’re experiencing mild, moderate or severe pain, the right treatments at the right time can nearly always reduce your pain. In most mild and moderate cases, you can expect to be pain-free again. Even in severe cases, you can generally expect real improvement on a day-to-day basis so you can still feel good about yourself and your life.
The key to pain relief is to understand the kind of pain you have, and choose the right care model for your specific situation. This strategy provides the fastest possible relief and saves time and money: you get the right help faster, at a cost that makes sense for your budget.