By Sean Cunningham, DO
Mercy Health Physician Partners West Olive
Adult patients benefit from having a primary care provider (PCP) for a variety of reasons. In my practice, the top four conditions I treat are:
1) high blood pressure
3) high cholesterol
4) chronic pain
Sources of Ongoing, Chronic Pain
The sources of chronic pain vary from person to person. In general, patients under the age of 50 who experience chronic pain often do so because of undiagnosed musculoskeletal conditions such as acute or chronic sports-related injuries, trauma resulting from an auto or work accident, or undiagnosed scoliosis.
People over the age of 50 with chronic pain often suffer from single or diffuse joint pain due to arthritis. I frequently tell my patients, “If you live long enough, God will bless you with at least two things: one is high blood pressure and the other is arthritis.”
Some additional common sources of chronic pain in people over the age of 50 include:
- Obesity: This is often due to decreased muscle mass with increased body weight placing added burden on the skeletal system.
- Autoimmune disease: There are multiple types, but each cause inflammatory changes in multiple body systems.
- Abdominal pain: The sources of abdominal pain are abundant, but can be due to constipation, ulcerative colitis, Crohn’s disease, chronic pancreatitis, endometriosis, or many others.
- Cancer: Either the tumor itself, causing pain via compression of the surrounding tissues, or the medications and treatments utilized as therapy can lead to pain.
- Psychological conditions: Mental health conditions such as severe anxiety, depression, or PTSD can also be a source of pain. Psychological pain can manifest itself as physical pain.
Chronic Pain and Depression
I refer to patients with chronic pain as bearing an invisible cross — invisible, because other people cannot see another person’s pain. As soon as people with chronic pain awaken in the morning, they have to lug that cross with them…when they take a shower…when they do the dishes…when they go to work…when they play with their children or grandchildren….
Bearing that invisible cross weighs on people. They cannot live their lives in the ways that they want to because of their pain, which can lead to depression.
In my experience, chronic pain and depression are bedfellows; they almost always come hand-in-hand. It is often a challenge for patients with chronic pain to recognize that they are also suffering from depression. Addressing depression in these patients can lead to improvement in chronic pain symptoms and overall well-being.
Treatment Options for Chronic Pain
If the pain appears to be arthritic, the best thing a person can do is MOVE because motion and exercise make people feel better. I tell my patients, “Motion is lotion. The more your joints move, the more your body produces natural lubrication for your joints.”
Sometimes patients say they don’t have time to exercise. That is when I ask, “How many minutes each day do spend complaining or thinking about your chronic pain?” Most people say that it is hours each day. Then I say, “Then take just 30 minutes of your day to do something about it, so you don’t have to spend that time thinking about your pain.”
If the source of the pain is arthritis, there is nothing better for people over 50 than doing yoga. Being strong and flexible — and making joints go through the range of motion — is excellent for patients. The first couple of weeks they may be sore, but that will improve with consistency.
Physical therapy is widely used and a great option for treating pain; swimming is especially good for chronic pain as a low impact exercise option.
In my clinic, osteopathic manipulation (OMT) is a fundamental treatment modality for management of chronic pain. Osteopathic manipulation is a type of treatment that works with muscles and tissues of the body to help them heal themselves. I use gentle, hands-on techniques working through tight muscles and restricted joints, improving muscle integrity, circulation, and flexibility to reduce pain.
Certain antidepressant medications can also help improve mood and alleviate pain. Improving the mood of a patient with chronic pain often helps the person to feel better in general, curbing the mental block of thinking that there can be no relief for their pain.
In certain cases, a patient’s pain may be so severe that it requires referrals to local specialists as a collaborative effort for additional treatment options.
Reasons to Consult a PCP
In an age when information is readily available on the internet, there are compelling reasons to schedule an appointment with a PCP, especially when you have chronic pain.
- First, your PCP will listen to your concerns, ask questions and examine you.
- If tests are needed, your PCP can order them to identify the true cause of the pain.
- Working with you, your PCP will come up with a treatment plan.
- If referrals to a specialist are necessary, your PCP can make them for you.
- Finally, your PCP will hold you accountable by setting up follow-up visits to check your progress. If necessary, together you can fine-tune the treatment plan to reach your goals.
Taking over-the-counter (OTC) pain relievers for chronic pain is not recommended if you are already taking other medications. Tell your PCP all medications that you are taking, including supplements and OTC medications. Your PCP will be able to help you avoid drug interactions or experience negative consequences of taking multiple medications.
You don’t have to suffer. To find a Mercy Health PCP near you, please visit www.mercyhealth.com/findadoctor.