Many of my clients with very severe injuries must learn to accept that they will live with pain the rest of their lives. After they exhaust all that doctors have to offer and realize that there is no "fix", these clients either adapt and live reasonably happy and productive lives, or they stay miserable. How individuals adapt and move forward while they feel pain every day is fascinating to me. My job as a lawyer is not to provide medical treatment or medical advice, but I like to share what I learn on this subject.
I was watching the TV program Rock Center with Bryan Williams two weeks ago when a piece came on about a virtual reality video game that was created to distract patients' brains from sensing pain during painful medical treatments. The show featured a disfigured service man who was severely burned and who had to endure excruciating procedures to treat his burns. The usual opiate medications used to treat pain simply weren't enough.
The virtual reality video game, called Snow World, had the burn patient wear headphones and a headset to immerse him in a peaceful, snowy landscape where he was required to lob snow balls at penguins and other animals. An MRI of the patient's brain gave objective proof that the patient was truthful when he said that he felt significantly less pain when he was playing the video game. The show also featured researchers applying a mildly painful heating device to the reporter's foot before and during her playing the video game. She also was convincing in her statements that her pain was almost eliminated when she was focused on playing the game.
If you would like to learn more about this, here is one link: http://www.hitl.washington.edu/projects/.
I intend to research this further and ask local pain management physicians whether they have any information about using this device to treat chronic pain, and who locally is using it. The University of Washington link above also has research papers on using the game to treat post-traumatic stress disorder, and fear of spiders. Interesting.
How to treat chronic pain was a topic addressed by several of the featured speakers at the WILG convention in Las Vegas this weekend. (WILG is a non-profit organization that assists attorneys in advocating the rights of injured workers.) Dr. Steven Simon, M.D. of the Kansas University Medical Group spoke about CRPS complex regional pain syndrome. He defined CRPS as an inciting event (usually trauma, but sometimes immobilization) to a a nerve that then moves into the spinal cord where it becomes a systemic chronic pain problem.
Dr. Simon stressed that the earlier the problem is diagnosed, the better the patent's chances were for a successful treatment orientation. He acknowledged that many treating orthopedic physicians were not knowledgeable enough about treating chronic pain systems consisting of depression, anger, sleep deprivation, hormonal deprivation, and pain. When the patient doesn't get better and the cause of the problem is not readily identified using traditional diagnostic methods, the adjuster likewise becomes frustrated and schedules an independent medical exam. That results in more delays in getting the injured worker to an appropriate physician to treat the CRPS. Many CRPS sufferers find that an attorney advocate is necessary to ensure proper treatment and a fair impairment evaluation.
--Written by Virginia Hunt, Hunt Law Office
See attached video for a great explanation of how someone with CRPS (complex regional pain syndrome) experiences pain.
Last week, I had lunch with Dr. Mel Pohl, M.D., the Medical Director of Las Vegas Recovery Center, and his Admissions Coordinator, Jackie Pippin. The Las Vegas Recovery Center is a small, private facility that offers a chronic pain recovery program. While most chronic pain management treatment for injured workers involves ongoing prescription pain medication, injections and surgeries, this program focuses on medically detoxifying the individual from all opioids and then treating the physical and emotional pain with an intensive inpatient treatment program. That is followed by outpatient care modeled on twelve-step recovery programs. The program uses an individual, multidisciplinary approach that includes physical therapy, biofeedback, chiropractic, Pilate's, acupuncture, and yoga. Dr. Pohl writes about alternative treatments in his book A Day Without Pain.
Dr. Pohl told me that this isn't a program for every injured worker with chronic pain. He acknowledged that some injured workers are able to use opioid medications without developing dependence and compulsive use behaviors. He also knew that it was very difficult to obtain authorization from industrial insurers for an expensive inpatient treatment for drug dependency caused by a work injury. He and Jackie impressed me as compassionate people who were sincerely committed to finding solutions to how to treat chronic pain, particularly when it also involves addiction to opioid medications.
For more information on the Chronic Pain Recovery Program at the Las Vegas Recovery Center, contact Jackie Pippin at firstname.lastname@example.org or (702) 290-6928.
I came across another website that offers information on treating chronic pain, as well as a comprehensive list of other websites with additional help for people dealing with injuries or illnesses that cause chronic and long-lasting pain. There may be something useful for you here, particularly the kit offered for tracking and measuring your pain. http://www.partnersagainstpain.com/pain-management-resources/tips.aspx You might also want to read the articles on how to better communicate what you are experiencing and feeling with regard to your pain when meeting with your doctor. As you know, so much of treating chronic pain involves trial and error, both with prescription medications and lifestyle changes until the person does not feel overwhelmed and controlled by pain. I am always looking for useful tips or information to share with injured workers, so please feel free to send me your comments.