by Sheba Hayward

Created on: June 14, 2009   Last Updated: June 23, 2009

As a physical therapist who treats some people who have intractable pain, there have been times when I have been grateful for other "pain specialists" and legitimate pain clinics. No person in my U.S. state can see a physical therapist without a physician's prescription and we are aware of drugs and their interactions but do not prescribe or suggest them. We do attempt to discern the physical source of the pain and formulate solutions such as activities, exercises, positions, manual therapy or modalities such as electrical stimulation or therapeutic ultrasound which can at least break the cycle of pain without drugs. Here in Indiana, this is all with the consent and recommendation of the physician who may be an orthopedist, physiatrist, general practitioner or other specialist. Unfortunately in some cases the combination of prescription or over the counter analgesics and our treatment is not successful.

This is where legitimate pain clinics can be the best option. The problem lies in that word legitimate, and what has been involved in treatment in those clinics. Clinics where licensed medical doctors, psychology, psychiatry and rehabilitation professionals utilizing a combination of physical therapy, medication, psychotherapy and education in self management, as well as unconventional methods including massage therapy and chiropractic have been successful in relieving pain and "breaking the cycle of pain" for people, which sometimes has been occurring for years. Because insurance companies limit their payments and sometimes patients have limited funds to pay for this kind of treatments. Particularly in this economy, these types of clinics have virtually disappeared. Most physicians that I have encountered here in Indiana are very hesitant to prescribe narcotics on a long term basis for chronic pain, since patients may not only become dependent, develop an "immunity" to the effects or experience dangerous side effects.

In 2008 I injured my left shoulder and had it surgically repaired four months later. Six months of disturbed sleep, varying levels of pain, immobility, a reduced salary on short term disability, lack of exercise left me with a new compassion and understanding of patients with pain due to an injury or trauma. I took no narcotics until after the surgery and for three weeks after. I thanked God every day that I had the best surgeon and physical therapist in the city and had other support around me. Frankly I did not feel really good and normal until this month, approximately one year later. The average person who is does not work in my field and has access to my knowledge and contacts would have suffered much longer than the nine total months that I did. That person also does not have the personal and professional resources and contacts that I do. My question is then, where do they turn for relief? Some infomercial claiming the next medical breakthrough "you can't get at the drugstore", alcohol, doctor-hopping, hoping someone believes them. Hopefully not someone who does not have the interest of the patient's health at heart.

I believe there IS a place for pain clinics and hate to see them disappear as they have in the past year here as they have the opportunity to treat the mind and body. As a medical professional who has direct experience with chronic pain I know both have to heal to have freedom of pain. Where legitimate clinics are not viable in this economy and in our system currently, my strategy with chronic pain patients is to work closely with other professionals and educate the patients on resources and being proactive in their own treatment.

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