Pain Management in Pittsfield and Berkshire County

What is Chronic Pain

The International Association for the Study of Pain defines pain as “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” The IASP goes on to say that “Pain is always subjective. Each individual learns the application of the word through experiences related to injury in early life...It is unquestionably a sensation in a part or parts of the body, but it is also always unpleasant and therefore also an emotional experience.” Acute pain is pain that lasts for a short period of time typically under 6 weeks depending upon how long the cause of the episode is expected to heal. Chronic pain is defined as pain that persists or recurs over a period of time beyond 6 weeks after the expected healing time for an acute episode. Pain that goes on longer then the 6 week period should be carefully assessed by your physician.

It is important to understand that not all pain disorders have a clear cause or can be objectively identified such as a herniated disc. Fibromylagia is an example of this, though there is beginning to be found evidence of objective findings with this condition. We know that a history of trauma such as childhood sexual or physical abuse is often found in those that develop chronic pain. This by no means that this history means the pain is made up or just "in your head." Again research is investigating the biological changes in the brain that may be involved in the development of chronic pain in those with a trauma history. In short pain is a very complex process involving numerous biological factors. And this research although greatly advanced over the last 20 years has much still to accomplish.

.

The Wakefield Self-Report Questionnaire is scored by adding up the numbers selected for each of the 12 items. Most depressed people score 15 or above on the Wakefield, whereas most non-depressed people score between 0 and 14. It is important to realize that a rating scale such as the Wakefield does not diagnose clinical depression. The Wakefield measures the frequency and intensity of symptoms often associated with depression. Some high scores may be attained by individuals with other emotional problems or physical illnesses. Therefore, use the test as a guide, and consider consulting a doctor for an evaluation if your score is 15 or more.

Scores lower than 15 may still warrant consultation with a doctor if your distress or dysfunction is substantial. Repeating the Wakefield approximately two weeks after its first use may be helpful, and if your score is still below 15 but rising, you should strongly consider consulting a doctor.

THE WAKEFIELD QUESTIONNAIRE FOR DEPRESSION

Read these statements carefully, one at a time, and write down the number next to your answer that best describes how you feel. Scoring directions are below.

          SCORE

A.   I feel miserable and sad.

0) No, not at all

1) No, not much

2) Yes, sometimes

3) Yes, definitely

     B.   I find it easy to do the things I used to do.

0) Yes, definitely

1) Yes, sometimes

2) No, not much

3) No, not at all

     C.   I get very frightened or panicky feeling for apparently no reason at all.

0) No, not at all

1) No, not much

2) Yes, sometimes

3) Yes, definitely



     D.   I have weeping spells, or feel like it

0) No, not at all

1) No, not much

2) Yes, sometimes

3) Yes, definitely



     E.   I still enjoy the things I used to.

0) Yes, definitely

1) Yes, sometimes

2) No, not much

3) No, not at all

      F.   I am restless and can’t keep still.

0) No, not at all

1) No, not much

2) Yes, sometimes

3) Yes, definitely


     G.   I get off to sleep easily without sleeping tablets.

0) Yes, definitely

1) Yes, sometimes

2) No, not much

3) No, not at all



     H.   I feel anxious when I go out of the house on my own.

0) No, not at all

1) No, not much

2) Yes, sometimes

3) Yes, definitely



     I.   I have lost interest in things.

0) No, not at all

1) No, not much

2) Yes, sometimes

3) Yes, definitely

     J.   I get tired for no reason.

0) No, not at all

1) No, not much

2) Yes, sometimes

3) Yes, definitely

     K. I am more irritable than usual.

0) No, not at all

1) No, not much

2) Yes, sometimes

3) Yes, definitely

     L.   I wake early and then sleep badly for the rest of the night.

0) No, not at all

1) No, not much

2) Yes, sometimes

3) Yes, definitely

Joint Pain Relief: An Overview
by: Eddie Tobey

Your knees, shoulders, and elbows are all large joints. Your hands and feet contain many tiny joints. Our joints are used for almost every movement we make. Half of adults over age 65 - or more than 20 million Americans, endure recurrent or chronic joint pain, stiffness, and sometimes swelling. Joint pain can be so severe that ordinary daily activities of sufferers, such as eating a bowl of cereal or washing one's hair, become difficult or even impossible.

For many years, treatment options for joint pain relief were limited to two types of medications: acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs). Both are effective treatments for mild joint pain, and the latter reduces joint inflammation too.

Recent medical studies show that sufferers themselves can greatly improve their condition through exercise. Exercise builds strength and flexibility, and toning the muscles that surround the joint helps to stabilize it. Exercise can reduce stiffness, increase blood flow, and aid in weight loss, which takes the stress off of joints. Patients should determine a safe level of exercise with their doctor, and together develop a routine individually tailored to provide the optimum benefit to the sufferer.

Heating pads, ice packs and topical creams, rubs, and sprays provide short-term joint pain relief. For persistent, chronic joint pain, injections of the steroid glucocorticoid can provide relief for about three weeks, and injections of hyaluronic acid, a substance naturally present in joints, can last up to a year.

Surgery may be necessary for patients with debilitating joint pain. Surgeons may elect to realign the joint or completely replace the damaged joint with an artificial one. Total joint replacement can bring dramatic joint pain relief for many patients.

Natural supplements such as glucosamine (derived from crustaceans shells) and chodroitin (a part of connective tissue from cow tracheas) may help alleviate joint pain as well. Alternative treatments like supplements and acupuncture have become increasingly popular in recent years, so much so that the National Institute of Health is currently conducting research on both to determine the effect they have on joint pain relief. Results of this research may validate supporters' claims or even alter the prescribed course of treatment.