Chronic vs. Acute Pain
DEAR DR. ROACH: What is the difference between chronic pain and acute pain? How can I best describe my chronic pain when it is variable in intensity but negatively impacts so much of my life and my activities? Are there things my doctor should consider or suggest in my treatment or in communicating with me? — P.P.C.
ANSWER: Acute pain is usually due to an injury or infection, and we expect healing to occur relatively quickly. Chronic pain is expected to go on for at least six months. In some people, acute pain is not treated adequately at the time of injury, and the brain and body learn to be in pain chronically.
The reason for pain is perfectly obvious in some cases, but in others, it is not possible to identify the exact cause of pain. Most times, pain is due to damaged nerves (neuropathic pain); injury or degeneration in the musculoskeletal system (osteoarthritis and many kinds of back pain); inflammatory pain (due to infection or inflammatory diseases like rheumatoid arthritis); and compressive pain (such as kidney stones or cancer).
Chronic pain affects many parts of your life, as you correctly note, and an experienced doctor will ask about the effect of pain on your social life, mood (depression is very common), relationships, sleep, exercise and occupation. People with more severe problems will have limitations in their activities of daily living.
Many people with chronic pain have almost given up communicating the scope of the problems they have, as they don’t like “complaining” all the time, or they feel their loved ones are tired of hearing about it. However, getting a thorough history of the effect of all these dimensions of pain is important for your doctor. Questionnaires like the Brief Pain Inventory address more areas of function than a typical 1-10 pain scale, and may be useful to monitor response to treatment. Experts in pain management are more likely to have the knowledge and experience to communicate about pain effectively, and truly effective treatment for chronic pain requires understanding it.
There can be pain without suffering. Suffering is the emotional component brought on by fear: “How bad am I going to hurt today? Will I ever be able to work again? All of my relationships are suffering.” Learning to live a function-centered life is key in the treatment of chronic pain. It isn’t easy and requires a multidisciplinary approach.
The time of prescribing pain medications, especially opiates, without a comprehensive plan for long-term pain management, should be over.
Dr. Roach regrets that he is unable to answer
individual questions, but will incorporate them
in the column whenever possible.
Readers may email questions to ToYourGoodHealth@med.cornell.edu.
© 2021 North America Synd., Inc.
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Protect Your Medical Identity
Medical identity theft is a serious business. According to one study, about 1.5 million adults are victims of medical identity theft each year. FDIC Money Smart offers the following information and consumer tips.
Medical ID theft occurs when someone steals personal information and uses the information to get medical treatment, prescription drugs, surgery and/or other services and then bills Medicare for it. If the thief’s health information is mixed with yours, your treatment, insurance and payment records, and credit report may be affected. Sometimes people are denied Medicare coverage for a service or medical equipment because their records falsely show they already received it.
All types of people, including doctors and medical equipment companies, have been caught stealing people’s medical identities. About one-third of medical identity thieves are family members. Warning signs of a stolen identity include a bill for medical services not received, contacts by a debt collection company for money not owed, insurance company notification of the limit reached on medical benefits, or denial of insurance for a medical condition you do not have.
To avoid medical identity theft:
• Protect your Medicare and other health insurance cards.
• Review your Medicare Summary Notices (MSN), Explanations of Benefits (EOB) statements and medical bills for suspicious charges. If you find incorrect information in your records, insist it be corrected or removed.
• Only give personal information to Medicare approved doctors, other providers and suppliers, your State Health Insurance Assistance Program or Senior Medicare Patrol (SMP) program, or the Social Security Administration. Call 1-800-MEDICARE (1-800-633-4227) if you unsure if a provider is approved by Medicare.
• Beware of offers of free medical equipment, services, or goods in exchange for your Medicare number.
• Shred papers with your medical identity before putting them in the trash.
• Remove or destroy labels on prescription bottles and packages before you put them in the trash.
If you suspect medical identity theft, ask your health care provider for a copy of your current medical file. If anything seems wrong, write to your health plan or provider and ask for a correction. Your local Senior Medicare Patrol is ready to provide you with the information you need to protect yourself from Medicare errors, fraud and abuse, detect potential errors, and report your concerns. For more information, visit https://shiip.iowa.gov/medicare-fraud
Forget conventionalisms; forget what the world thinks of you stepping out of your place; think your best thoughts,
speak your best words, work your best works,
looking to your own conscience for approval.
—Susan B. Anthony
• Dill planted near tomatoes will draw caterpillars away from the fruits. And it’s delicious.
• Potato salad will have more flavor if you whisk together all the dressing ingredients and add it to the potatoes when they are warm. The potatoes will absorb the ingredients better, and the flavor will develop even more during refrigeration.
• “I love to grill, and when it’s nice out, we grill every weekend. I always put on extra and use the leftovers through the week. Chicken in salad, a nice flank steak for fajitas, etc. And it means less cooking for me!” — Y.L. in Maryland
• Here’s a great recipe for an icy treat: Freeze orange juice or apple juice in ice trays. Throw a handful in the blender for a fruit slush that can’t be beat on a hot day.
• “A lot of smoke was coming off our grill, and our patio doors were wide open. Long story short: It swamped the living room with smoke. The smell was a little overwhelming. After we closed the door, my neighbor doused a kitchen towel with white vinegar, wrung it out and waved it around the room. It cleared out the smoke smell right away, and the vinegar smell went away just as quickly. What a miracle!” — F.F. in South Carolina
• Get cobwebs off a window screen with a lint roller.
• Use this trick to freshen your stuffed animals. Dust with baking soda and put several together in a large paper grocery bag until it’s half full. Fold the top of the bag down and shake vigorously. Remove the stuffed friends and shake off any excess baking soda. For good measure, put the dusted-off toys in a low- or no-heat dryer cycle for
• Honey has amazing properties, and one of them is its antiseptic powers. You can even use it on pimples. Just a tiny dab will help keep bacteria responsible for breakouts from taking over.
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Grilled Lobster Tails With Nectarine Sauce
A simply prepared dish that’s sure to impress, perfectly grilled lobster with a sweet, spicy, citrusy sauce makes a complexly flavored and delicious main dish.
Juice of 3 limes
2 tablespoon extra-virgin olive oil
1/2 teaspoon sea salt
1/4 teaspoon finely minced seeded habanero pepper
4 lobster tails
1. In a food processor, puree nectarines, scallion, 2 tablespoons lime juice, 1 tablespoon olive oil, 1/4 teaspoon salt and habanero pepper. Transfer to a medium bowl and set aside.
2. Heat grill to medium-high. In a small bowl, whisk together remaining lime juice, olive oil and salt. Split lobster tails lengthwise, remove membrane if desired and brush meat with the lime-oil glaze. Place lobsters on grill, meat side down, and roast for 4 minutes; turn over to shell side and grill until meat is opaque and cooked through, 4 to 5 minutes more.
3. Transfer to a platter, garnish with lime wedges, and serve with reserved nectarine sauce. Serves 4.
For thousands of triple-tested recipes, visit our website at www.goodhousekeeping.com/food-recipes/.
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Heavenly Hash Cream Pie
If you’re like most folks, dessert is the exclamation point to the meal! Well, this delicious pie is quite a way to punctuate any menu.
2 (4-serving) packages sugar-free instant white chocolate pudding mix
1 1/3 cups nonfat dry milk powder
2 cups water
3/4 cup reduced-calorie whipped topping
1 1/2 teaspoons coconut extract
6 (2 1/2-inch) chocolate graham crackers
1 (6-ounce) purchased chocolate piecrust
2 tablespoons flaked coconut
1. In a large bowl, combine dry pudding mixes, dry milk powder and water. Mix well using a wire whisk. Blend in whipped topping and coconut extract. Coarsely crush 5 graham crackers. Fold in cracker crumbs.
2. Spread mixture evenly into piecrust. Crush remaining 2 graham crackers into fine crumbs. Evenly sprinkle coconut and fine cracker crumbs over top. Refrigerate for at least 2 hours. Serves 8.
• Each serving equals: 206 calories, 6g fat, 6g protein, 32g carb., 516mg sodium, 1g fiber; Diabetic Exchanges: 1 1/2 Starch, 1/2 Fat-Free Milk.
© 2021 King Features Syndicate, Inc.