Thursday, May 27, 2010

Chronic Pain Management with Neuropathy

Neuropathic pain is a complex chronic pain state that is usually accompanied by tissue injury. With this type of pain, the nerve fibers themselves may be damaged, dysfunctional or injured. These damaged nerve fibers send erroneous signals to other pain centers in your brain. The impact of nerve fiber injury includes a change in nerve function both at the site of injury and areas around the injury.

According to the Neuropathic Pain Network, somewhere between five to twenty-three million people (that’s between 2 to 8 percent of our population) are living with neuropathic pain in the United States. Unfortunately, it is a syndrome that is often under-diagnosed and under-treated.

Some of the symptoms of neuropathic pain including shooting pain, burning pain, tingling, and numbness. An example of neuropathic allodynia—a non-harmful stimulus perceived as painful—is rough clothing rubbing on your skin which you feel as if it were sandpaper; another example would be someone shaking your hand in what is really a gentle grasp but you feel it as crushing or excruciating.

Another striking example of neuropathic pain is called phantom limb syndrome. This occurs when a limb like an arm or a leg has been removed because of illness or injury. The brain still receives (or perceives) pain messages from the nerves that originally carried impulses from the missing limb. These nerves now misfire and cause pain.

As anyone living with neuropathic pain knows the treatment can be frustrating and often ineffective. While acute short-term pain is usually easy to manage and most chronic pain management conditions can be treated effectively, neuropathic pain can be a major treatment challenge for both patients and their healthcare providers. Unfortunately, neuropathic pain often responds poorly to standard pain treatments and occasionally may get worse instead of better over time. For some people, it can lead to serious disability.

The capsaicin patch could be a much needed tool for many people experiencing neuropathic pain symptoms and find that other pain management medications (e.g., opiates or SSRI’s and SNRI’s) are not helping or have too many side effects. Of course medication management is only one component of an effective pain management treatment plan.

I believe that people also need to be developing nonpharmacological interventions as well as learning to better manage the psychological/emotional components of their pain. For those symptoms cognitive behavioral and rational emotive therapeutic interventions give the best outcomes.

To learn more about effective chronic pain management check out my article The Need for Multidisciplinary Chronic Pain Management that you can download for free on our Article page.

If you'd like to receive training for helping people with chronic pain and coexisting disorders, including addiction, I'm very excited to announce we are presenting my Addiction-Free Pain Management® Certification Training in Sacramento on August 5-7, 2010. To learn more about this 3 day 20 hour training and my other upcoming trainings you can check out our Calendar page.


You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you or a loved one is undergoing chronic pain management, especially if you're in recovery or believe you may have a medication or other mental health problem and you want to learn more effective chronic pain management tools, please go to our Publications page and check out my books; especially the Addiction-Free Pain Management® Recovery Guide: Managing Pain and Medication in Recovery. To purchase this book please Click Here.

To read the latest issue of Chronic Pain Solutions Newsletter please Click here. If you want to sign up for the newsletter, please Click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.

Wednesday, May 19, 2010

Positive Chronic Pain Management Outcomes Require Coping with Denial

Two Antidotes for Denial:

1. Peaceful Acceptance and

2. Problem Solving with Authentic Action

Acceptance is a peaceful acknowledgement of the truth. If you can calmly face the problem, acknowledge the truth about what is going on, and accept that it is happening to you, you can then develop a way for handling the situation. The person who has accepted the truth of a serious problem has the ability to honestly affirm to themselves: "I have a serious problem! I am responsible for dealing with it! I'm willing to learn how!"

Problem Solving is a system for finding solutions to your problems. Effective problem solving systems involve identification and clarification of your problems, identifying and projecting the logical consequences of alternatives, deciding which alternative to use, taking action, and evaluating the outcome. By recognizing and accepting the problem and developing an effective problem solving plan, your need to use denial will go down because your ability to manage your problems will go up.

This was the reason I teamed up with Terry Gorski and Jennifer Messier to write the Denial Management Counseling (DMC) for Effective Pain Management Workbook that could be a helpful resource for some of you reading this Blog. I believe that learning to identify and manage denial is a necessary first step for people living with chronic pain who want to learn how to develop and implement an effective pain management plan.

The DMC/Pain Workbook is designed for people who have experienced significant problems related to living with chronic pain, but who honestly don’t believe—or don’t want to believe—that their decisions and behaviors are undermining what could be an effective pain management plan. It can be one important tool to help someone identify and learn to manage their inner saboteur.

To learn more about chronic pain management and denial please check out my article From Denial to Effective Chronic Pain Management that you can download for free on our Article page.

If you'd like to receive training for helping people with chronic pain and coexisting disorders, including addiction, I'm very excited to announce we are presenting my Addiction-Free Pain Management® Certification Training in Sacramento on August 5-7, 2010. To learn more about this and my other upcoming trainings you can check out our Calendar page.


You can learn more about the Addiction-Free Pain Management® System at our website http://www.addiction-free.com/ If you are working with people in chronic pain or are undergoing chronic pain management and have any resistance or denial and want to learn how to develop a plan for helping to identify and manage denial please go to our Publications page and check out my book the Denial Management Counseling for Effective Pain Management Workbook. To purchase this book please Click Here.

To read the latest issue of Chronic Pain Solutions Newsletter please click here. If you want to sign up for the newsletter, please click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.

Tuesday, May 11, 2010

Chronic Pain Management May Lead to Long-Term Opiate Problems

According to researched published in Pain Physician Journal (2006), 90 percent of people in the US receiving treatment for pain management are prescribed opiate medication. Of that number 9 percent to 41 percent had opiate abuse/addiction problems. Unfotunately, this is not the only problem with prolonged use of opiates.

Neuroplasticity (variously referred to as brain plasticity or cortical plasticity or cortical re-mapping) refers to the changes that occur in the organization of the brain as a result of experience. A surprising consequence of neuroplasticity is that the brain activity associated with a given function can move to a different location as a consequence of normal experience or brain damage/recovery.

According to research published in Annals of the New York Academy of Sciences 933:175-184 (2001) titled “Spinal Cord Neuroplasticity following Repeated Opioid Exposure and Its Relation to Pathological Pain;” convincing evidence has accumulated that indicates there are neuroplastic changes within the spinal cord in response to repeated exposure to opioids. Such neuroplastic changes occur at both cellular and intracellular levels. Since so many people living with chronic pain are using opiates these neuroplastic changes need to be better understood.

Learn more about the down side of long-term opiate use in chronic pain management by reading my 2009 News and Research Post titled Long-Term Opioid Use May Increase Sensitivity to Chronic Pain that you can read by going to this link and scrolling down the page to that title.

To learn more about effective chronic pain management please check out my article The Need for Multidisciplinary Chronic Pain Management that you can download for free on our Article page.

If you'd like to receive training for helping people with chronic pain and coexisting disorders, including addiction, I'm very excited to announce we are presenting my Addiction-Free Pain Management® Certification Training in Sacramento on August 5-7, 2010. To learn more about this and my other upcoming trainings you can check out our Calendar page.


You can learn about the Addiction-Free Pain Management® System at our website http://www.addiction-free.com/ If you are working with people undergoing chronic pain management and want to learn how to develop a plan for managing their chronic pain and coexisting psychological disorders; including depression, addiction and other coexisting psychological disorders effectively; please consider my book Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. To purchase this book please Click Here.

To read the latest issue of Chronic Pain Solutions Newsletter please click here. If you want to sign up for the newsletter, please click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.

To see an online overview of a Web-Based Delivery of Addiction-Free Pain Management® please go to this Link for a free demo.

Saturday, May 8, 2010

The Suboxone Controversy

Last month I posted a new article on our website on Suboxone. I'm including a few paragraphs below.
There is a difference of opinions on whether patients should be maintained on Suboxone (buprenorphine) or go through a total detoxification for opiate addiction. A similar debate has been going on for decades about another medication used for opiate addiction treatment—methadone. I would like to propose a third option: using the medication as a transitional treatment intervention with eventual discontinuation.

Unlike methadone physicians are more likely to prescribe Suboxone in their offices for people who are dependent or addicted to opiates such as opiate pain medication, heroin, or methadone. Buprenorphine (the active treatment medication in Suboxone) is a more convenient maintenance medication for opiate addiction because it does not require daily or weekly visits to a clinic. Buprenorphine blocks the effects of other opiates; it reduces or eliminates cravings and prevents withdrawal symptoms such as pain and nausea.

Subutex and Suboxone are the brand names that buprenorphine is being marketed as for the treatment of opiate dependence. Both medications contain the active ingredient buprenorphine hydrochloride, which works to reduce the symptoms of opiate dependence. Subutex contains only buprenorphine hydrochloride which was developed as the initial product.

Please check out this entire article titled Revisiting Suboxone: Maintenance versus Total Detoxification that you can download for free on our Article page.


You can learn about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you are working with people undergoing chronic pain management and want to learn how to develop a plan for managing their chronic pain and coexisting psychological disorders; including depression, addiction and other coexisting psychological disorders effectively; please consider my book Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. To purchase this book please Click Here.

To read the latest issue of Chronic Pain Solutions Newsletter please click here. If you want to sign up for the newsletter, please click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.

To see an online overview of Cognit delivering Addiction-Free Pain Management® please go to this Link for a free demo.

To learn about my upcoming trainings you can check out our Calendar page.