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Pain Management Strategies

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By Author: Steven Johnson
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Fifty years ago, we were wheeled into surgery, knocked out with gas, and then repaired using the best skills available. Coming round in bed a few hours later, we had to remain as still as possible for days. Doctors believed healing was faster when we allowed the wounds to knit together first. If we pranced around the wards as if there was nothing wrong, there was a real risk we might reopen the surgical wounds and cause even more damage. Now, we are kicked out of bed and sent home as soon as possible. This is a dramatic reversal of thought. Now doctors believe muscles lose their tone and strength if we do not resume moving as soon as possible. In part, this is a result of the improvement in surgical techniques with many operations performed without cutting large holes. But it also reflects a more general view of the body. It's a lot stronger than we like to think.

One of the results of this revolution has been the general view that we have become too dependent on drugs. With the right mental attitude, doctors now recognize we can resume a normal life after injury or disease. Indeed, there's no reason why anyone should ...
... suffer any loss in the quality of life unless the injuries are catastrophic. In a way, this is a return to a Victorian view of the world. In those distant years, the Christian Science movement believed we could manage pain through the power of prayer and a judicious slug of a fortified wine or whisky should the distress grow.

Now you might ask, with some justification, why we should reject the use of modern painkillers. So, here's the question. Should we always use something just because we have it? Obviously it's an extreme example, but we do not drop atoms bombs on our enemies. We just use the threat to encourage them to negotiate. So there are a raft of heavy duty painkillers, many of them highly addictive. The best idea is not to jump on the raft and float out into the future. It's possible you will feel less pain in the short term but, as tolerance builds, you will end up taking ever larger doses. Then you are going to find you cannot stop. This is not a good recipe for a healthy life as your need for the drug becomes a problem in its own right and a drain on your finances.

The modern view is you should be able to manage the pain with the lowest possible reliance on painkillers. This all starts with a recognition you must have the best possible treatment for the underlying cause of the pain. Often a review of the treatment so far can find options to explore for further treatment. Only when these options are exhausted should you then move on to the next steps which are based on physical and cognitive behavioral therapies. None of this denies the role for Ultram. As one of the least addictive of the painkillers, it's a necessary part of keeping you moving. But you should arrive at the point where you only take Ultram when the pain flares. The rest of the time, you should adjust your lifestyle to live within your limitations.

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