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CNN Saturday Morning News
"Weekend House Call"
Aired September 27, 2003 - 08:29 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
SEAN CALLEBS, CNN ANCHOR: And Weekend House Call begins right now with Elizabeth Cohen.
ELIZABETH COHEN, CNN CORRESPONDENT: Good morning and welcome to Weekend House Call.
Today we're going to talk about chronic pain. It's a major problem. Fifty-seven percent of American adults suffered from chronic pain last year and for many, finding relief can be a lifelong project.
(BEGIN VIDEOTAPE)
COHEN (voice-over): Seven years ago, Mary Vargas was injured in a car accident.
MARY VARGAS, CHRONIC PAIN SUFFERER: I felt burning up my back side of my neck into the side of my face. And that quickly turned into pain.
COHEN: That pain has been a constant companion ever since.
VARGAS: It is your whole every day life when you're in pain like that. You can't -- that's at the forefront of your mind. You can't focus on anything else.
COHEN: In fact, the U.S. surgeon general estimates that businesses lose $100 billion every year due to reduced productivity and increased medical costs due to pain. Vargas spent years going from doctor to doctor, 14 in all, and had nearly 30 procedures before receiving a diagnosis and treatment that worked.
VARGAS: The doctors didn't really know what was wrong so they kept, they kept starting over and doing the same tests over and over again.
COHEN: Vargas is not alone. New statistics from the American Pain Foundation show that 50 to 100 million Americans suffer from chronic pain and many go untreated or under treated.
LENNIE DUENSING, AMERICAN PAIN FOUNDATION: Most health care professionals haven't had any training in pain whatsoever. So when people go in and say that, tell them they're in pain, they really don't know what to do about it.
COHEN: Dr. Nelson Hendler has been treating pain patients for 30 years. He says early diagnosis is essential, yet he claims nearly 60 percent of patients get misdiagnosed.
DR. NELSON HENDLER, MENSANA CLINIC: Chronic pain is highly specialized, evaluating and treating patients with chronic pain is highly specialized. And you have to go to a physician who's experienced in that area of medicine.
COHEN: However, the Foundation estimates that only three percent of medical schools require a course in pain management. That's prompted former surgeon general Dr. David Satcher and other doctors to initiate online pain education for physicians. Those courses get under way later this month.
For Mary Vargas, the diagnosis was nerve damage and relief has come from a spinal cord stimulator implant that helps to dull her pain. She now only has to take one pain medication. But she still hopes that the next few years will bring new and better treatments.
(END VIDEOTAPE)
COHEN: Pain is a warning sign that something is wrong with your body. Chronic pain means that it's unrelenting, it doesn't go away, it lasts for at least six months or longer. The three most common types of pain are headaches, back aches and arthritis or joint pain. We'll talk about treatments, pain management and finding a doctor or a specialist who can help and we'll answer your questions.
Call us at 1-800-807-2620 or e-mail us your questions to housecall@cnn.com.
Dr. James Campbell joins us from Washington.
He's the founder and president of the American Pain Foundation.
Thanks for being with us, doctor.
DR. JAMES CAMPBELL, AMERICAN PAIN FOUNDATION: Thank you.
COHEN: We have a question for you just to begin. We all know people with pain, especially back aches or headaches. How do they know when it's time to see a specialist, when it's time to stop going to the regular doctor and go to a pain specialist?
CAMPBELL: When pain interferes with daily activities, when pain is intrusive so that productivity at work is being interfered with, when sleep is being interfered with, these are the times when pain is a problem that warrants more serious investigation.
COHEN: Well, we've gotten a lot of e-mail on this topic. Let's look at our first one. It's from Randy in Massachusetts who wants to know, "Does chronic pain have to be severe pain to qualify, or can long-term lower level pain be equally debilitating?"
In other words, I guess do you have to be in agony for it to be chronic pain or can it really be a problem even when it's just a low level of pain that doesn't go away? CAMPBELL: Well, that's an interesting question. We all have had situations where we've had severe acute pain, for example, we stub our toe, and that pain is excruciating. The pain that we have in that instance, if it were continued, would obviously drive us all batty.
But lesser pain that is ongoing, even if, for a given moment in time, it might be considered mild, if it's there all the time, day in, day out, it's like water torture. It's going to have a pervasive impact on that patient's life and it's going to really seriously compromise the quality of that person's life.
So, yes, it is a very serious problem, even if in a moment of time it would be considered mild.
COHEN: Do you often find, doctor, that patients just think oh, I can put up with this, I'll deal with this, I'll use my head and try to work my way around it and they don't seek help?
CAMPBELL: I'm sorry, say that again?
COHEN: Do you ever find that patients think oh, I can live with this pain, it's not too bad. And so they live with it year after year?
CAMPBELL: Oh, absolutely. There are patients in certain surveys that come up where they indicate in the surveys that they have severe pain and then you ask them what they're doing about it and it ends up that they're not doing anything about it. And that reflects a common attitude in America, and that is that nothing can really be done about a lot of very serious pain problems, and hence they simply give up and they don't seek treatments.
COHEN: Well, we have a question from Belinda in Kentucky.
Belinda, welcome to Weekend House Call.
You can go ahead with your question for Dr. Campbell. BELINDA: OK. My husband, he's been a construction worker for 23 years and he was hurt on an accident in his job and he has a chronic lower back injury. And he's had everything from heat therapy to massage therapy to physical therapy, epidural drips. He's been to the Lebanon Spine Center. Lower pain -- he's got minimum pain medication and everybody says, you know, there's nothing they would do in fear of making him worse.
What should we be looking to do next?
CAMPBELL: Well, this, as you might imagine, is not an uncommon problem. Back pain problems affect millions of Americans. And whereas we're able to help many people, some people have very serious problems that are very difficult to treat.
Obviously, you want to make sure that you've seen a highly qualified spine surgeon, someone who specializes in doing spine surgery almost exclusively, to make sure that there's nothing that's readily fixable surgically that can be addressed at this time. But if that fails and he continues to have his chronic back pain and other things are not working, then other interventions become worth considering. First line would be to consider more serious medications. And the first medication that I would bring up in that regard would be the use of morphine like drugs. These are under appreciated in terms of their ability to affect severe pain. If these trials were to fail...
COHEN: Doctor, I have a question for you about morphine drugs, which you just named.
CAMPBELL: Yes?
COHEN: And I want to hop on this now. If someone takes that, are they going to be on morphine drugs forever?
CAMPBELL: Well, if it works, then it is an option. An interesting thing about morphine is that in some ways it's a very scary drug, but in other ways it actually is quite safe. Morphine and its relatives, like oxycodone and other opioids, do not cause liver damage. They don't cause heart damage. They don't cause brain damage and they don't cause kidney damage, unlike with Tylenol or aspirin or other drugs that have that as a potential liability.
They have powerful effects, but those powerful effects usually go away once the drug is stopped.
COHEN: All right, well, thank you, doctor.
We've got to take a quick break right now and we'll be back with more of your questions.
When we come back, we'll be -- we're talking about describing pain to your doctor. The key is to be specific, and we'll give you some pointers and we'll talk about how to find a pain specialist.
Call us with your questions. Our number is 1-800-807-2620. Or you can e-mail us at housecall@cnn.com.
COMMERCIAL
COHEN: How many nights have you been up with a headache or backache? Pain is the biggest cause of insomnia. According to the National Sleep Foundation, 20 percent of Americans say pain or physical discomfort wakes them up at least a few nights a week. A lack of sleep can also cause your body to be more susceptible to pain.
This is Weekend House Call and we're talking about chronic pain. We'll look at treatments and finding a doctor in just a moment. But we want more of your questions. Call us at 1-800-807-2620. Or e-mail us at housecall@cnn.com.
While we get your calls lined up, let's check our Daily Dose health quiz. How do people process pain differently? We'll have that answer in 30 seconds, so stay with us.
COMMERCIAL
COHEN: Checking the Daily Dose health quiz, we asked, "How do people process pain differently?"
Our Dr. Sanjay Gupta has the answer.
(BEGIN VIDEOTAPE)
DR. SANJAY GUPTA, CNN CORRESPONDENT (voice-over): That looks like it would hurt.
UNIDENTIFIED MALE: The puck is gone.
GUPTA: All dramatic injuries, yet some are able to shake it off and others are overcome with pain. So are some of us just wimps or could it be that our brains somehow respond differently to painful events? Well, now we have the images to give us the answer.
What these pictures tell us is that people who complain more about pain are not simply complainers, they're experiencing something different in their brains.
(on camera): So here's how it works. Pain signals travel up the spinal cord to the deep centers of the brain. That's here and that's the same for everybody. But in people who are particularly sensitive to pain, they see a dramatic increase in activity here, the sensory cortex. That's where pain is perceived. They also see an increase in activity here, the anterior singulagirus (ph). That's responsible for the unpleasant feelings associated with pain.
Remarkably, this can now all be measured.
(voice-over): These 3D models show what happened when 17 study volunteers had a 120 degree heat simulator placed on their legs. Those who reported minimal pain had only the deep areas of their brain light up. Those experiencing more profound pain had intense lighting up of other areas of the brain, as well, showing that people do, in fact, respond differently to pain.
Dr. Sanjay Gupta, CNN, reporting.
(END VIDEOTAPE)
COHEN: We're talking about chronic pain on today's edition of Weekend House Call.
Describing your pain in a specific way can be a challenge for many patients. Here are some tips from the American Pain Foundation.
Tell your doctor where it hurts and how much it hurts. Describe what makes the pain better or worse, and be descriptive. Use words like sharp or burning or throbbing. Explain how the pain affects your daily life and list the past pain treatments you've used.
We're joined today by Dr. James Campbell, head of the American Pain Foundation. Let's jump into a question from a viewer.
Tina, tell us what your question is for Dr. Campbell.
TINA: Good morning, Dr. Campbell.
My name is Tina and I'm from Clintwood, Virginia. I'm in a geographically isolated area. It took me 14 years to find Dr. Nelson Hendler to treat my pain. I had a C5-6 injury.
And my question is what is being done to educate doctors, especially in geographically isolated areas, about chronic pain and chronic pain management?
CAMPBELL: Well, Tina, you don't have to go into geographically isolated areas a to find problems with regard to access to care for pain treatment. The pain specialty is a growing area as a medical specialist. Fortunately, this is being addressed and more and more doctors are being trained in pain medicine. So this is an issue that hopefully with time will start disappearing.
COHEN: We have an e-mail now from Jim in Virginia, who asks a related question. "Why are doctors so reluctant to prescribe pain management? I've had severe back pain from auto accidents and other mishaps, but when I go to a doctor for relief I'm looked at as some kind of druggie."
Dr. Campbell, is that a common problem?
CAMPBELL: That's a very common problem. There is a pervasive fear of patients becoming addicts when they take strong medications for pain control. JACO, the accrediting institution for hospitals, however, has mandated that doctors and nurses assess pain in patients and treat it and offer treatment plans. And this is percolating through to the doctors' offices, as well. So this is something hopefully that, in time, will start disappearing.
COHEN: We have a phone call now from Pamela in New Jersey.
Pamela, you can go ahead with your question and welcome to Weekend House Call.
Pamela, are you there?
Let's go ahead then with a question from an e-mail from Kathi in Maryland. She wants to know, "As a person who suffers from chronic pain due to failed surgery, I can tell you it is not a myth. But I find it very hard to find care and find the right physician to care for me. Why does the medical community write you off as if it's all in your head?"
All in your head, those four words, Dr. Campbell, I bet you hear patients tell you that doctors have told them that many times.
CAMPBELL: That's perhaps one of the worst messages a health care provider can say to the patient, Kathi. And this is something that is a very detrimental way to approach patients on the part of the health care professional. It's incumbent on the health care professional to take the pain complaint seriously and to offer options to the patient. And if that provider isn't comfortable, him or herself, providing those treatments, then there should be a referral to someone who can.
COHEN: We have to take a quick break now.
When we come back, new treatments for pain. We'll tell you what's available now and what may be in the pipeline for the future.
This is Weekend House Call.
COMMERCIAL
COHEN: Welcome back to Weekend House Call, where we're talking about treating chronic pain with Dr. James Campbell of the American Pain Foundation.
Currently, the top five treatments are over the counter and prescription medications, physical therapy, chiropractic therapy and surgery. There are some new pain treatments available now, too.
Angela from Connecticut wants to know about botox. She asks, "For what types of chronic pain is botox now being used? Is research being done to expand the uses of botox beyond those already known?"
Dr. Campbell, how could something that gets rid of wrinkles also get rid of pain?
CAMPBELL: Well, botox is a medication that essentially paralyzes muscle for a short period of time. It appears that a lot of pain problems, however, are related to muscle contractures and injecting botox into these contracted muscles may relieve that pain. And so there is, in fact, a lot of work going on looking at and exploring how this treatment might help patients. And there are some suggestions that in some cases it works.
COHEN: We have another question about treatment from Susan in Oklahoma.
Susan, welcome to Weekend House Call.
And you can go ahead with your question.
SUSAN: Thank you.
Dr. Campbell, good morning.
My question is about alternative treatments for fibromyalgia and also is there a theory on the cause of fibromyalgia?
CAMPBELL: Susan, that's a very important problem. Fibromyalgia, just a few years ago, wasn't even on the map for most doctors as a diagnosis. Most doctors would say it really doesn't exist. I think increasingly now, though, doctors are appreciating that this is a real disease. We don't know what the cause is and there are things we can do to help fibromyalgia symptoms. But most of these don't necessarily go to the root cause because we simply don't know what that is.
But there are medical treatments. There are things like trigger point injections and other psychological therapies that may be helpful for treatment of this very difficult and very prevalent problem.
COHEN: Doctor, we've been talking a lot about different drugs that people can take to get rid of pain. But many people are worried about getting addicted to those drugs. Can you address that?
CAMPBELL: Well, addiction is a misunderstood problem and it's a very important problem. The liability for addiction in taking opiods depends on how those drugs are delivered. So if heroin is delivered in the vein, there is, in fact, a high liability for developing an addiction syndrome because the person has the chance of developing a craving for that drug. But the slow acting opiods do not have that liability.
So if the drug is introduced to the brain very gradually, as happens with the slow release opiods, it appears that the liability for developing addiction is, in fact, very, very small, and shouldn't be a barrier to using these powerful drugs to treat serious pain.
COHEN: We're going to take a quick break now. Grab a pen. When we come back, we'll give you a phone number and a Web site to help you find a pain specialist in your area.
Stay with us.
COMMERCIAL
COHEN: To locate a doctor in your area, go to the American Pain Foundation's Web site at www.painfoundation.org. If you click on finding support you'll see links to pain specialists and support groups, or you can call them at 1-888-615-PAIN. That's 1-888-615- PAIN.
Thanks so much for joining us this morning to talk about chronic pain. And we've been talking with Dr. Campbell, the head of the American Pain Foundation.
Dr. Campbell, any final thoughts about what chronic pain sufferers can do to get some help? liu www.painfoundation.org. i tns d on their legs. ml.ersonality tt
CAMPBELL: I think a simple message might be to be an advocate for yourself and don't let your problems be ignored. Go in there, indicate how this pain is impacting on your life and insist on getting answers. And often this will be rewarded by finding some solutions, because the fact is that the majority of pain problems can be addressed better than what they are currently.
COHEN: Well, that's all the time that we have for today.
I want to thank Dr. Campbell and I want to thank all the viewers who called and e-mailed us with their questions. Join us tomorrow when we talk about the latest advances in Lasix eye surgery. We'll talk about the costs, the risks and how to find the best eye surgeon. Plus, we'll help you figure out if you're a good candidate for Lasix. That's tomorrow at 8:30 a.m. Eastern, 5:30 Pacific.
Thanks for watching.
I'm Elizabeth Cohen.
TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com
Aired September 27, 2003 - 08:29 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
SEAN CALLEBS, CNN ANCHOR: And Weekend House Call begins right now with Elizabeth Cohen.
ELIZABETH COHEN, CNN CORRESPONDENT: Good morning and welcome to Weekend House Call.
Today we're going to talk about chronic pain. It's a major problem. Fifty-seven percent of American adults suffered from chronic pain last year and for many, finding relief can be a lifelong project.
(BEGIN VIDEOTAPE)
COHEN (voice-over): Seven years ago, Mary Vargas was injured in a car accident.
MARY VARGAS, CHRONIC PAIN SUFFERER: I felt burning up my back side of my neck into the side of my face. And that quickly turned into pain.
COHEN: That pain has been a constant companion ever since.
VARGAS: It is your whole every day life when you're in pain like that. You can't -- that's at the forefront of your mind. You can't focus on anything else.
COHEN: In fact, the U.S. surgeon general estimates that businesses lose $100 billion every year due to reduced productivity and increased medical costs due to pain. Vargas spent years going from doctor to doctor, 14 in all, and had nearly 30 procedures before receiving a diagnosis and treatment that worked.
VARGAS: The doctors didn't really know what was wrong so they kept, they kept starting over and doing the same tests over and over again.
COHEN: Vargas is not alone. New statistics from the American Pain Foundation show that 50 to 100 million Americans suffer from chronic pain and many go untreated or under treated.
LENNIE DUENSING, AMERICAN PAIN FOUNDATION: Most health care professionals haven't had any training in pain whatsoever. So when people go in and say that, tell them they're in pain, they really don't know what to do about it.
COHEN: Dr. Nelson Hendler has been treating pain patients for 30 years. He says early diagnosis is essential, yet he claims nearly 60 percent of patients get misdiagnosed.
DR. NELSON HENDLER, MENSANA CLINIC: Chronic pain is highly specialized, evaluating and treating patients with chronic pain is highly specialized. And you have to go to a physician who's experienced in that area of medicine.
COHEN: However, the Foundation estimates that only three percent of medical schools require a course in pain management. That's prompted former surgeon general Dr. David Satcher and other doctors to initiate online pain education for physicians. Those courses get under way later this month.
For Mary Vargas, the diagnosis was nerve damage and relief has come from a spinal cord stimulator implant that helps to dull her pain. She now only has to take one pain medication. But she still hopes that the next few years will bring new and better treatments.
(END VIDEOTAPE)
COHEN: Pain is a warning sign that something is wrong with your body. Chronic pain means that it's unrelenting, it doesn't go away, it lasts for at least six months or longer. The three most common types of pain are headaches, back aches and arthritis or joint pain. We'll talk about treatments, pain management and finding a doctor or a specialist who can help and we'll answer your questions.
Call us at 1-800-807-2620 or e-mail us your questions to housecall@cnn.com.
Dr. James Campbell joins us from Washington.
He's the founder and president of the American Pain Foundation.
Thanks for being with us, doctor.
DR. JAMES CAMPBELL, AMERICAN PAIN FOUNDATION: Thank you.
COHEN: We have a question for you just to begin. We all know people with pain, especially back aches or headaches. How do they know when it's time to see a specialist, when it's time to stop going to the regular doctor and go to a pain specialist?
CAMPBELL: When pain interferes with daily activities, when pain is intrusive so that productivity at work is being interfered with, when sleep is being interfered with, these are the times when pain is a problem that warrants more serious investigation.
COHEN: Well, we've gotten a lot of e-mail on this topic. Let's look at our first one. It's from Randy in Massachusetts who wants to know, "Does chronic pain have to be severe pain to qualify, or can long-term lower level pain be equally debilitating?"
In other words, I guess do you have to be in agony for it to be chronic pain or can it really be a problem even when it's just a low level of pain that doesn't go away? CAMPBELL: Well, that's an interesting question. We all have had situations where we've had severe acute pain, for example, we stub our toe, and that pain is excruciating. The pain that we have in that instance, if it were continued, would obviously drive us all batty.
But lesser pain that is ongoing, even if, for a given moment in time, it might be considered mild, if it's there all the time, day in, day out, it's like water torture. It's going to have a pervasive impact on that patient's life and it's going to really seriously compromise the quality of that person's life.
So, yes, it is a very serious problem, even if in a moment of time it would be considered mild.
COHEN: Do you often find, doctor, that patients just think oh, I can put up with this, I'll deal with this, I'll use my head and try to work my way around it and they don't seek help?
CAMPBELL: I'm sorry, say that again?
COHEN: Do you ever find that patients think oh, I can live with this pain, it's not too bad. And so they live with it year after year?
CAMPBELL: Oh, absolutely. There are patients in certain surveys that come up where they indicate in the surveys that they have severe pain and then you ask them what they're doing about it and it ends up that they're not doing anything about it. And that reflects a common attitude in America, and that is that nothing can really be done about a lot of very serious pain problems, and hence they simply give up and they don't seek treatments.
COHEN: Well, we have a question from Belinda in Kentucky.
Belinda, welcome to Weekend House Call.
You can go ahead with your question for Dr. Campbell. BELINDA: OK. My husband, he's been a construction worker for 23 years and he was hurt on an accident in his job and he has a chronic lower back injury. And he's had everything from heat therapy to massage therapy to physical therapy, epidural drips. He's been to the Lebanon Spine Center. Lower pain -- he's got minimum pain medication and everybody says, you know, there's nothing they would do in fear of making him worse.
What should we be looking to do next?
CAMPBELL: Well, this, as you might imagine, is not an uncommon problem. Back pain problems affect millions of Americans. And whereas we're able to help many people, some people have very serious problems that are very difficult to treat.
Obviously, you want to make sure that you've seen a highly qualified spine surgeon, someone who specializes in doing spine surgery almost exclusively, to make sure that there's nothing that's readily fixable surgically that can be addressed at this time. But if that fails and he continues to have his chronic back pain and other things are not working, then other interventions become worth considering. First line would be to consider more serious medications. And the first medication that I would bring up in that regard would be the use of morphine like drugs. These are under appreciated in terms of their ability to affect severe pain. If these trials were to fail...
COHEN: Doctor, I have a question for you about morphine drugs, which you just named.
CAMPBELL: Yes?
COHEN: And I want to hop on this now. If someone takes that, are they going to be on morphine drugs forever?
CAMPBELL: Well, if it works, then it is an option. An interesting thing about morphine is that in some ways it's a very scary drug, but in other ways it actually is quite safe. Morphine and its relatives, like oxycodone and other opioids, do not cause liver damage. They don't cause heart damage. They don't cause brain damage and they don't cause kidney damage, unlike with Tylenol or aspirin or other drugs that have that as a potential liability.
They have powerful effects, but those powerful effects usually go away once the drug is stopped.
COHEN: All right, well, thank you, doctor.
We've got to take a quick break right now and we'll be back with more of your questions.
When we come back, we'll be -- we're talking about describing pain to your doctor. The key is to be specific, and we'll give you some pointers and we'll talk about how to find a pain specialist.
Call us with your questions. Our number is 1-800-807-2620. Or you can e-mail us at housecall@cnn.com.
COMMERCIAL
COHEN: How many nights have you been up with a headache or backache? Pain is the biggest cause of insomnia. According to the National Sleep Foundation, 20 percent of Americans say pain or physical discomfort wakes them up at least a few nights a week. A lack of sleep can also cause your body to be more susceptible to pain.
This is Weekend House Call and we're talking about chronic pain. We'll look at treatments and finding a doctor in just a moment. But we want more of your questions. Call us at 1-800-807-2620. Or e-mail us at housecall@cnn.com.
While we get your calls lined up, let's check our Daily Dose health quiz. How do people process pain differently? We'll have that answer in 30 seconds, so stay with us.
COMMERCIAL
COHEN: Checking the Daily Dose health quiz, we asked, "How do people process pain differently?"
Our Dr. Sanjay Gupta has the answer.
(BEGIN VIDEOTAPE)
DR. SANJAY GUPTA, CNN CORRESPONDENT (voice-over): That looks like it would hurt.
UNIDENTIFIED MALE: The puck is gone.
GUPTA: All dramatic injuries, yet some are able to shake it off and others are overcome with pain. So are some of us just wimps or could it be that our brains somehow respond differently to painful events? Well, now we have the images to give us the answer.
What these pictures tell us is that people who complain more about pain are not simply complainers, they're experiencing something different in their brains.
(on camera): So here's how it works. Pain signals travel up the spinal cord to the deep centers of the brain. That's here and that's the same for everybody. But in people who are particularly sensitive to pain, they see a dramatic increase in activity here, the sensory cortex. That's where pain is perceived. They also see an increase in activity here, the anterior singulagirus (ph). That's responsible for the unpleasant feelings associated with pain.
Remarkably, this can now all be measured.
(voice-over): These 3D models show what happened when 17 study volunteers had a 120 degree heat simulator placed on their legs. Those who reported minimal pain had only the deep areas of their brain light up. Those experiencing more profound pain had intense lighting up of other areas of the brain, as well, showing that people do, in fact, respond differently to pain.
Dr. Sanjay Gupta, CNN, reporting.
(END VIDEOTAPE)
COHEN: We're talking about chronic pain on today's edition of Weekend House Call.
Describing your pain in a specific way can be a challenge for many patients. Here are some tips from the American Pain Foundation.
Tell your doctor where it hurts and how much it hurts. Describe what makes the pain better or worse, and be descriptive. Use words like sharp or burning or throbbing. Explain how the pain affects your daily life and list the past pain treatments you've used.
We're joined today by Dr. James Campbell, head of the American Pain Foundation. Let's jump into a question from a viewer.
Tina, tell us what your question is for Dr. Campbell.
TINA: Good morning, Dr. Campbell.
My name is Tina and I'm from Clintwood, Virginia. I'm in a geographically isolated area. It took me 14 years to find Dr. Nelson Hendler to treat my pain. I had a C5-6 injury.
And my question is what is being done to educate doctors, especially in geographically isolated areas, about chronic pain and chronic pain management?
CAMPBELL: Well, Tina, you don't have to go into geographically isolated areas a to find problems with regard to access to care for pain treatment. The pain specialty is a growing area as a medical specialist. Fortunately, this is being addressed and more and more doctors are being trained in pain medicine. So this is an issue that hopefully with time will start disappearing.
COHEN: We have an e-mail now from Jim in Virginia, who asks a related question. "Why are doctors so reluctant to prescribe pain management? I've had severe back pain from auto accidents and other mishaps, but when I go to a doctor for relief I'm looked at as some kind of druggie."
Dr. Campbell, is that a common problem?
CAMPBELL: That's a very common problem. There is a pervasive fear of patients becoming addicts when they take strong medications for pain control. JACO, the accrediting institution for hospitals, however, has mandated that doctors and nurses assess pain in patients and treat it and offer treatment plans. And this is percolating through to the doctors' offices, as well. So this is something hopefully that, in time, will start disappearing.
COHEN: We have a phone call now from Pamela in New Jersey.
Pamela, you can go ahead with your question and welcome to Weekend House Call.
Pamela, are you there?
Let's go ahead then with a question from an e-mail from Kathi in Maryland. She wants to know, "As a person who suffers from chronic pain due to failed surgery, I can tell you it is not a myth. But I find it very hard to find care and find the right physician to care for me. Why does the medical community write you off as if it's all in your head?"
All in your head, those four words, Dr. Campbell, I bet you hear patients tell you that doctors have told them that many times.
CAMPBELL: That's perhaps one of the worst messages a health care provider can say to the patient, Kathi. And this is something that is a very detrimental way to approach patients on the part of the health care professional. It's incumbent on the health care professional to take the pain complaint seriously and to offer options to the patient. And if that provider isn't comfortable, him or herself, providing those treatments, then there should be a referral to someone who can.
COHEN: We have to take a quick break now.
When we come back, new treatments for pain. We'll tell you what's available now and what may be in the pipeline for the future.
This is Weekend House Call.
COMMERCIAL
COHEN: Welcome back to Weekend House Call, where we're talking about treating chronic pain with Dr. James Campbell of the American Pain Foundation.
Currently, the top five treatments are over the counter and prescription medications, physical therapy, chiropractic therapy and surgery. There are some new pain treatments available now, too.
Angela from Connecticut wants to know about botox. She asks, "For what types of chronic pain is botox now being used? Is research being done to expand the uses of botox beyond those already known?"
Dr. Campbell, how could something that gets rid of wrinkles also get rid of pain?
CAMPBELL: Well, botox is a medication that essentially paralyzes muscle for a short period of time. It appears that a lot of pain problems, however, are related to muscle contractures and injecting botox into these contracted muscles may relieve that pain. And so there is, in fact, a lot of work going on looking at and exploring how this treatment might help patients. And there are some suggestions that in some cases it works.
COHEN: We have another question about treatment from Susan in Oklahoma.
Susan, welcome to Weekend House Call.
And you can go ahead with your question.
SUSAN: Thank you.
Dr. Campbell, good morning.
My question is about alternative treatments for fibromyalgia and also is there a theory on the cause of fibromyalgia?
CAMPBELL: Susan, that's a very important problem. Fibromyalgia, just a few years ago, wasn't even on the map for most doctors as a diagnosis. Most doctors would say it really doesn't exist. I think increasingly now, though, doctors are appreciating that this is a real disease. We don't know what the cause is and there are things we can do to help fibromyalgia symptoms. But most of these don't necessarily go to the root cause because we simply don't know what that is.
But there are medical treatments. There are things like trigger point injections and other psychological therapies that may be helpful for treatment of this very difficult and very prevalent problem.
COHEN: Doctor, we've been talking a lot about different drugs that people can take to get rid of pain. But many people are worried about getting addicted to those drugs. Can you address that?
CAMPBELL: Well, addiction is a misunderstood problem and it's a very important problem. The liability for addiction in taking opiods depends on how those drugs are delivered. So if heroin is delivered in the vein, there is, in fact, a high liability for developing an addiction syndrome because the person has the chance of developing a craving for that drug. But the slow acting opiods do not have that liability.
So if the drug is introduced to the brain very gradually, as happens with the slow release opiods, it appears that the liability for developing addiction is, in fact, very, very small, and shouldn't be a barrier to using these powerful drugs to treat serious pain.
COHEN: We're going to take a quick break now. Grab a pen. When we come back, we'll give you a phone number and a Web site to help you find a pain specialist in your area.
Stay with us.
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COHEN: To locate a doctor in your area, go to the American Pain Foundation's Web site at www.painfoundation.org. If you click on finding support you'll see links to pain specialists and support groups, or you can call them at 1-888-615-PAIN. That's 1-888-615- PAIN.
Thanks so much for joining us this morning to talk about chronic pain. And we've been talking with Dr. Campbell, the head of the American Pain Foundation.
Dr. Campbell, any final thoughts about what chronic pain sufferers can do to get some help? liu www.painfoundation.org. i tns d on their legs. ml.ersonality tt
CAMPBELL: I think a simple message might be to be an advocate for yourself and don't let your problems be ignored. Go in there, indicate how this pain is impacting on your life and insist on getting answers. And often this will be rewarded by finding some solutions, because the fact is that the majority of pain problems can be addressed better than what they are currently.
COHEN: Well, that's all the time that we have for today.
I want to thank Dr. Campbell and I want to thank all the viewers who called and e-mailed us with their questions. Join us tomorrow when we talk about the latest advances in Lasix eye surgery. We'll talk about the costs, the risks and how to find the best eye surgeon. Plus, we'll help you figure out if you're a good candidate for Lasix. That's tomorrow at 8:30 a.m. Eastern, 5:30 Pacific.
Thanks for watching.
I'm Elizabeth Cohen.
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