Pain Protest in Arkansas

(Summary of stories reported in the Times Record and The Associated Press State & Local Wire, December 4 and 5, 2002)

On December 5, the Arkansas Chapter of the American Pain Institute and the Arkansas Coalition for Patient Rights & Chronic Pain Management picketed the offices of their state's medical board. According to these groups, the board had gone too far in deciding to revoke some doctors' medical licenses and in proposing that Drug Enforcement Administration certification be required of physicians who treat chronic pain.

The Rev. Ronald V. Myers, Sr., an organizer of the event and family practitioner, said that Arkansas is in  "medical crisis" because patients who are battling chronic pain are unable to obtain appropriate medication. Many have to travel out of state because doctors in Arkansas fear repercussions from the medical board, he claimed.

State Senator-Elect, Denny Altes (R), pledged to introduce the Pain Treatment Act during the legislative session that begins next month. He said that after performing national research on pain management issues, he found that Arkansas is in "the dark ages" when it comes to the treatment of chronic pain. He stated that a lot of people could “...work and be productive if they had proper pain medication.”

Neuropathy Affects over 50% of Those with Diabetes

Diabetes Forecast, Dec 1, 2002

According to the American Diabetes Association (ADA), neuropathy occurs in over half of all people with diabetes. Commonly, diabetics suffer from peripheral neuropathy—a form affecting nerves not part of the brain or spinal cord. One form of peripheral neuropathy causes sensations of being pricked with “pins and needles,” numbness, or occasional stabbing pain in the body’s extremities. Peripheral neuropathy increases risk of injury and infection particularly in the feet. People with peripheral neuropathy often get infections in their feet because they do not feel pain when injured. Sometimes, this infection is unattended so long that amputation is required. Another form of peripheral neuropathy affects the nerves that control heart rate, blood pressure, bowels, sweat glands, the digestive system, and in men, erections.

To control peripheral neuropathy, the ADA recommends better blood sugar control. Tight control, studies have shown, can decrease the severity and amount of neuropathy patients experience (although it may these may increase initially for a short while due to a swelling of the nerves). To alleviate the pain of peripheral neuropathy, ADA suggests consulting a doctor to find out what kind of medications would work best.

 Treating Pain Can Help Patients Live Longer

Summary of a Column in the Spokesman-Review (Spokane, WA) November 26, 2002

According to Dr. Stacie Bering, physician and writer for the Spokane Review, pain treatment in hospitals, especially for post-operative pain, has improved over the past decade. In fact, some hospital nurses even include pain as a fifth vital sign along with blood pressure, pulse, temperature and respiratory rate.

Dr. Bering says that for patients not in hospitals, like those suffering from painful diseases such as cancer, pain treatment is not as good. The reason is that many doctors believe that pain never killed anyone and are hesitant to prescribe pain killers. But according to Dr. Bering, pain can kill. Pain produces chemicals that interfere with proper immune response. In fact, one study showed that individuals with pancreatic cancer who were treated for pain outlived those who weren’t by 3-6 months.

Still, Bering points out that prescribing effective pain medication is no easy matter. There are many kinds of pain—each of which may respond differently to different medications. A good doctor is one who knows exactly what kind of medication a particular type of pain requires.

Depression May Signal Onset of Chronic Pain

(Summary of a story reported in International Medical News Group, OB GYN News, Dec 1, 2002)

Investigators at the University of Iowa found that depression may be a risk factor for the onset of chronic pain. Chronic pain patients were given a questionnaire that showed that two-thirds had been diagnosed with depression. In 68% of those patients the pain followed the depression. The researchers concluded that because depression usually precedes chronic pain, there could be a causal relationship.

"The cross-sectional study included patients referred to a tertiary care pain center with chronic pain not associated with cancer that had lasted longer than 3 months. All patients were older than 18 years. The questionnaire included items on depression, duration of chronic pain and depression, demographics, and prior treatment."

The study found that depressed patients were more likely to be female, obese, those who had undergone surgery for their pain. They did not find a difference in these factors among patients whose depression preceded or followed the onset of chronic pain.