As a medical specialty, pain medicine tends to be more open minded than more traditional approaches to handling chronic pain. But even within the specialty we can be close-minded at times. We can get set in our ways. We can fail to consider that even pain medicine evolves over time. The solution is for the specialty to adopt a more open mind toward everything from diagnoses to treatments.
KindlyMD believes that a more open mind leads to discussions about alternatives, including applying for a Medical Card. Here in Utah, a state-issued Medical Card gives chronic pain patients access to a particular form of treatment they may have never tried before. It is a treatment that works very well for thousands of our patients.
Of course, a Medical Card isn't the only avenue for alternative treatments. There are many others. The point is to not be locked into a single way of thinking. Chronic pain is very personal. It requires an equally personal approach from pain clinics, pain medicine practitioners, and patients.
As a Utah pain clinic, KindlyMD serves patients from all walks of life. We work with professionals and blue-collar workers. We work with men and women. Virtually anyone struggling with chronic pain is a good candidate to visit KindlyMD. At the heart of what we do is plant-based medicine.
Plant-based treatments are actually not new. Eastern medicine has taken tremendous advantage of plants throughout human history. Western medicine has historically avoided them. We feel it is time to change that. We could use more plant-based medicines in Western healthcare.
For the record, this is what the Utah Medical Card is all about. Receiving a card means opening the door to plant-based treatments as an alternative to the more traditional approach to pain management. A treatment rooted in plant-based medicines just works better for some people.
One of the things we have been learning in pain medicine over the last two decades is just how much healthcare relies on static diagnoses and treatment options. But we have also learned that good health isn't static. What do we mean by that? We mean that there is no uniform standard for everyone.
Pain management is the perfect example. Not all patients experience pain in the same way. Not all patients exhibit the same pain threshold. Not all doctors interpret responses to the pain scale the same way. There is so much variation that it is impossible to come up with a static diagnosis and treatment applicable to every patient.
We can establish general guidelines. We can establish basic recommendations based on established facts. But when push comes to shove, healthcare needs to be flexible enough to accommodate the many differences between patients and their experiences. That's something Western medicine hasn't done very well throughout history.
A more open-minded approach to Western medicine recognizes that it is possible to pursue whatever works for patients, within reason. From our point of view, Medical Cards and plant-based medicines are well within reason. Plant-based medicine has thousands of years of history behind it. Medical Cards give patients access to it.
Throughout human history, we have treated injuries and illnesses through a variety of means flexible enough to accommodate individual needs. Somewhere along the way, Western medicine lost much of its flexibility. It's time to change that. Specifically, where pain medicine is concerned, we need more pain clinics adopting a more open-minded approach. The more we open our minds to new treatment possibilities, the better we will be at offering genuine pain relief.
Do you feel like your doctor doesn't listen to you? If so, you're not alone. There is growing sentiment among patients that our healthcare system isn't responsive to their needs. When patients feel that way, obtaining healthcare services can seem frustrating. It can make patients feel both helpless and hopeless.
For the record, none of this is a knock against doctors, nurse practitioners, physician assistants, etc. Unfortunately, most of them are locked into a system that doesn't allow them to pay as much attention to patients as they would like. They must walk that fine line between providing adequate care and keeping things moving. We can empathize with them.
Nonetheless, it is never good when a patient feels as though their doctor doesn't listen. That's why we take a different approach at KindlyMD. Our approach is a holistic one designed to treat the whole patient in body, mind, and spirit. We avoid focusing exclusively on symptoms alone.
The holistic approach to medicine isn't necessarily a new approach, per se. Rather, we like to describe it as a different way of thinking. It is different in the sense that the goal is the same as traditional medicine – to help patients feel better – but the journey to reaching that goal tends to be anything but traditional.
The typical Western approach to medicine seeks to make the patient feel better by addressing symptoms. If something hurts due to inflammation, we prescribe a medication designed to reduce that inflammation. But what about the root cause of the problem?
Another important aspect of holistic care is the fact that it addresses both the mental and physical. At KindlyMD, we combine mental health services with alternative medicines for a more thorough and comprehensive treatment. We want patients to feel better physically and experience better mental health at the same time.
Getting back to the main premise of this post, know that you can change doctors. Your health is important to you. It is too important to continue working with a medical provider in whom you don't have confidence. So if you don't feel like your doctor listens and you have unsuccessfully tried to resolve the issue, perhaps it's time to start looking for a new provider.
We actually see this quite a bit in pain medicine. It is very common for pain management doctors to take on new patients who feel as though their GPs are unable to help them. Again, we are not knocking GPs. They have their hands full dealing with everything from allergies to colicky babies and the common cold.
Chronic pain is something that GPs and family doctors do not always address well. Switching to a pain medicine doctor is a better option for many patients. And that's okay, by the way. Seeking out a new doctor capable of helping you doesn't make you unappreciative or disloyal. It makes you smart.
If you feel like your doctor does not listen to you, we understand. We get you. We also want you to know that we are here to listen. KindlyMD practices a holistic form of medicine that seeks to treat the whole patient rather than just symptoms. Our specialty is chronic pain management.
We have multiple clinics ready to serve you here in Utah. Check out our Clinics page to find the one nearest to you. Whether you need help with medication management, mental health, or obtaining a Utah Medical Card, we are ready to work with you to help you feel better.
Chronic pain is a curious thing. It can be completely debilitating to one person while only mildly inconvenient to another. Yet chronic pain always has the potential to diminish a person's quality of life. How would a person know? By applying what pain medicine physicians refer to as the Quality of Life Scale for pain.
If you've never dealt with chronic pain for an extended amount of time, you might be wondering how a person could not know that their pain was diminishing quality of life. That is understandable. But here's the deal: a person living with chronic pain for long enough can actually get used to it. You can get used to a “new normal” to the point of forgetting what life used to be like.
Getting used to that new normal could make it more difficult for a chronic pain patient to decide whether the pain was diminishing quality of life. It is almost as though the patient doesn't know any better. In this case, the patient’s reference point for quality of life is skewed.
The Quality of Life Scale was originally developed by the American Chronic Pain Association (ACPA). It was designed as a number-based scale that could be used as a reference point by pain management doctors and their patients. From the doctor's perspective, the scale provides a baseline for measuring future pain.
To fully understand how pain affects your quality of life, a doctor would want to know how your pain influences:
If a pain management doctor wanted to apply the Quality of Life Scale to your situation, you could expect to be asked certain questions. You could expect to be asked to rate your pain in relation to the things listed above. Your rating would be on a scale of 0-10, with 0 being non-functional and 10 being normal.
It is generally a good idea to work with a pain management doctor to track your pain and how it impacts your daily life. A pain management doctor is a qualified medical provider who specializes in pain. All of that said, you can utilize the scale at home, by yourself.
Just rate the five things listed above on a scale of 0-10. The numbers you choose when first using the scale make up your baseline. They are your starting point. Future ratings are compared to this baseline to see how you're doing.
Now, there are two things to pay attention to:
One of the unfortunate things about treating chronic pain is that we have no diagnostic test to measure it. Pain management physicians need to rely on the Quality of Life Scale to understand where patients are. The good news is that you can use the scale to see for yourself how you're doing. If you are concerned that pain is diminishing your quality of life, we invite you to visit us at KindlyMD.
Pain clinics specialize in treating patients unable to find significant pain relief by working with their family doctors or GPs. From the patient's perspective, finding a good pain clinic can be easier said than done. It can be disappointing to visit a clinic for the first time only to discover that its doctors have the same mentality: treating only with prescription meds.
The WebMD website offers a pretty detailed article on pain clinics and what patients should know about them. Near the end of the article is a recommendation to "stay away from pain clinics that offer mostly narcotics to treat pain." The article then goes on to briefly discuss the highly addictive nature of such medications.
Given the recommendation, the question becomes one of whether you should avoid pain clinics with a prescription med mentality. The choice is ultimately up to you, but we can give you some information that might help you make a decision.
A good starting point is discussing the different types of pain medications doctors recommend. Some, like prescription narcotics, provide relief by masking the pain. They make patients feel better by making it more difficult for their brains to both recognize and interpret pain signals. These medications, in particular, are the ones that give so many people pause.
There are other medications that offer pain relief by reducing inflammation. Still others relieve pain through the analgesic effect. Both anti-inflammatory and analgesic medications can be offered as over the counter (OTC) or prescription drugs.
A third type of medication is a plant-based medication. It is the option KindlyMD medical providers are most likely to recommend under normal circumstances. Plant-based medications are considered alternatives to Western prescription meds. But their “alternative” status does not make them any less effective.
While the addictive nature of prescription narcotics is the primary issue discussed in the WebMD article, it is also worth noting how a medical provider actually approaches pain management. This is important since most people who visit pain clinics suffer from chronic pain. So, they are engaging in long-term relationships with their pain management doctors.
Though there are exceptions to the rule, a medical provider with a prescription med mentality approaches pain management from the perspective of taking a given number of pills per day. It is a pharmacological approach that doesn't necessarily yield the best results. A clinic that offers alternative therapies, with or without prescription meds, tends to take a more holistic approach to pain management. We think offering both traditional and alternative pain management options will give our patients the greatest chances of success.
A holistic approach does not zero-in on the symptom of pain exclusively. It doesn't seek to merely relieve pain and nothing else. The holistic approach helps us treat the whole person—not just their symptoms—so pain is no longer a life-dominating factor.
A major benefit of the holistic approach is that it offers the opportunity to create individualized treatment plans for each patient. On the other hand, individualized treatments are the rare exception when a pain management physician relies exclusively on prescription meds. The pharmacological approach is very static. There is little room for individuality or flexibility.
Pain clinics adopt a variety of approaches to help patients manage pain. Should you avoid clinics with a prescription med mentality? That's up to you. We have given you some insights based on our experiences and philosophy as pain management specialists. Now you must decide what type of approach you want to take toward managing your pain.
What is integrated behavioral healthcare and how does it apply to pain management? To understand the answers, we must first recognize that pain isn’t just a physical condition, it’s also an emotional one.
Suffering from chronic pain and other chronic health issues can leave a person feeling hopeless, demoralized, and disempowered. This, in turn, can lead to anxiety, depression, suicidal thoughts, and even anger.
People suffering from chronic pain may not realize that treating physical pain symptoms goes hand-in-hand with treating emotional distress. Treating one or the other can certainly make a big difference in one’s pain experience. Research shows treating both physical pain and comorbid emotional issues has an even greater positive effect.
That’s why pain management programs like the one offered at KindlyMD go above and beyond treating only the physical symptoms of pain. When a patient visits us for pain treatment, we include a behavioral health clinician (BHC) in the discussion.
The BHC can help you develop a number of strategies to meet your healthcare goals. The pain clinician can prescribe pharmaceuticals or recommend plant-based alternative medicine, if appropriate. Together, this coordinated care team can help you address your pain through multiple avenues.
We want to note that the behavioral health portion of a KindlyMD clinic visit is not a replacement for traditional therapy. Patients suffering from PTSD, depression, or other mental health problems would likely benefit from full-length therapy sessions, which we can also arrange.
The experience of pain differs from person to person, and it can have a wide variety of negative effects on each person’s life. We mentioned some of the negative emotional effects above, but consider that pain can also:
Good pain management programs focus on pain relief and improving the patient’s quality of life and ability to function. This means we’re attacking the pain problem from multiple angles and achieving multiple positive results. By integrating pain management and behavioral healthcare, our clinicians help patients relieve pain as efficiently as possible.
We think it’s important to listen to our patient’s healthcare goals and present them with a personalized “menu” of treatment options. We want our patients to be actively involved in the process of setting achievable health goals. Some of the best quality of life improvements come from choosing an outcome you desire, followed by setting reasonable goals to help you get there.
After all, you are the one in charge of your healthcare. Unless someone else acts as your healthcare proxy, it’s ultimately your decision to seek healthcare and carry out your treatment plan.
Once a person suffering from chronic pain makes an appointment with a pain clinic, he or she has already demonstrated a sense of empowerment. If the pain clinicians do their job well, that patient will leave the clinic feeling even more empowered. Patients visiting KindlyMD can expect that level of service.
Everyone suffering from chronic pain has a unique experience with the condition. Apart from the physical source(s) of pain, quite a few factors influence a person’s pain experience.
“For example, sex, age, and ethnic group differences in the prevalence of chronic pain conditions have been widely reported,” wrote Dr. Roger Fillingim in a study called “Individual Differences in Pain: Understanding the Mosaic that Makes Pain Personal.”
Fillingim is a clinical psychologist who researches pain and the different ways people experience it. His study also mentions genetic and psychosocial factors can shape a person’s pain experience.
Since pain can differ so greatly from one person to another, it makes sense that the most effective treatment plans are tailored to each individual.
One of the most common ways to create a customized pain treatment plan is through cognitive-behavioral therapy (CBT). As far as pain management goes, CBT is most helpful for patients who feel helpless about their pain situations. Such patients often believe their pain makes them unable to function.
Behavioral health clinicians help patients realize that they can, in fact, improve their lives by developing and practicing certain skills. For example, BHCs can teach patients about managing stress, solving problems, setting goals, and being assertive about reducing pain.
Once again, the advice a BHC gives is not generalized, but personalized for each patient’s unique situation and goals. With a little dedication and practice, the skills your BHC helps you develop will last a lifetime and maximize your pain relief.
If you or someone you know suffers from chronic pain, we want to help you find relief, starting right now. Click here or call us at 385-388-8220 to schedule a pain clinic appointment.
We all experience pain from time to time. Nearly all of us will even experience chronic pain at least once or twice. Patients and their general practitioners can usually work together to manage it just fine. So how do you know when this is not enough? How do you know it's time to visit a pain clinic?
Pain is a subjective thing. We cannot say you should visit a pain clinic if you've been experiencing pain for a certain amount of time. Yet despite not being able to provide a black-and-white answer, we can give you a few things to consider. Below are three signs it might be time to visit a pain clinic.
As you read, remember that KindlyMD is the largest QMP specialty group in Utah. Not only can our pain management physicians help you manage your pain, but we can also help you get a Medical Card if you qualify.
We genuinely appreciate the splendid work GPs do. GPs are internists, and internal medicine is one of the toughest specialties of all. GPs must be prepared to deal with just about anything. The downside is that they do not always have the resources and knowledge to effectively treat chronic pain. Therein lies the first sign that it might be time to visit a pain clinic.
Perhaps your GP has run out of options. The two of you have worked together on every pain relief strategy your doctor could think of. But despite all you've done, you haven't found sufficient relief. Your GP doesn't know what else to do for you. The good news is that a pain management physician probably does.
Another way to know that it might be time to visit a pain clinic is that your only options to date have been prescription medications. Unfortunately, traditional Western medicine relies far too heavily on a pharmacological approach to pain management. It is not always a bad approach, but it shouldn't be the only option. Some people just don't respond well to prescription medications.
If you have only been offered the pharmacological approach in the past, we want you to know that there are other options. One of them is plant-based medicine, which we promote here at KindlyMD. We understand that prescription medications are sometimes the best choice, and perhaps the only choice, for treating certain conditions. For example, some people with diabetes need daily injections of insulin to survive. Plant-based medicine, as diverse and effective as it is, cannot replace insulin.
But we also know that plant-based medicines can be remarkably effective for chronic pain patients. We believe pain clinics should give patients the choice.
The third sign it might be time to visit a pain clinic: you are concerned about the prescription medications you are currently taking. If this is the case, know that you are not alone. The more we learn about prescription painkillers, the more consumers are nervous about them.
It has been our experience that some chronic pain patients eventually reach a point of being willing to try anything. At least in some cases, they experience genuine anxiety about taking prescription medications for long periods of time. They are looking for plant-based alternatives as a possible way to cut back on prescription meds. We support that whenever appropriate.
Hopefully, the information we have provided in this post gives you a framework for deciding whether you should visit a pain clinic. Always remember that pain clinics are staffed by medical professionals whose specialty is pain. They are the most qualified to help you.
Utah residents diagnosed with certain qualifying conditions are eligible to apply for Medical Cards that give them access to certain types of herbal medicines. Given that KindlyMD operates a number of pain clinics here in Utah, we can also help patients apply for their cards. One of the tools we rely on to get the process started is a short quiz designed to quickly determine Medical Card eligibility
While the quiz is only a preliminary determination, the patient completes the quiz and submits it electronically. We can determine, from the answers given, whether a patient is likely to qualify. If so, the patient can then make an appointment to see one of our qualified medical providers (QMPs).
For KindlyMD QMPs to make a Medical Card recommendation, we need to verify two things. Our preliminary quiz helps us here by giving us some basic information. A patient's answers can give us a sense of their overall health and any health problems.
Here is what we need to verify:
To verify these two things, our quiz asks some basic questions. One of the questions relates to the condition for which you are seeking treatment. Chronic pain is one of the options you can choose. But we also ask:
The answers you provide tell us a great deal. We can learn a lot more by sitting down and talking things over in-person, but the quiz is a very useful preliminary screening tool. It helps both KindlyMD and its patients get a better idea of whether a Medical Card is worth investigating further.
Patients interested in visiting our QMPs to obtain their Medical Cards can complete our quiz online. It only takes a minute or so. If you are concerned about submitting information online, know that KindlyMD is HIPAA compliant. You might even notice a small seal at the bottom of the quiz designating as much.
HIPAA stands for the Health Insurance Portability and Accountability Act. In a nutshell, HIPAA is a 1996 federal law that requires healthcare providers to protect their patients’ sensitive medical information.
We take every precaution possible to protect patient data. We comply with all state and federal mandates relating to collecting and storing information online. But even if the legal mandates weren't there, we would still do our best to protect our patients. Your safety and security are important to us.
We assume you have visited the KindlyMD website because you are looking to visit a pain management doctor. If that's the case, we encourage you to take our Utah Medical Card eligibility quiz today. It may be that getting a Medical Card isn't your best option. But perhaps it is. There's no way to know without first visiting with a QMP. Our quiz is the starting point.
Believe it or not, taking the brief quiz accomplishes a lot. It gives us vital information we need to determine whether we can help you get your card.
Are you a chronic pain patient who often feels frustrated by the arbitrary pain scale doctors use to measure your discomfort? If so, you are in good company. Doctors feel the same frustrations from time to time. The unfortunate truth is that there is no scientific way to accurately measure pain. Still, a pain scale that may seem arbitrary to patients does mean something to doctors.
If you have no idea what we are referring to, pain management doctors regularly ask their patients to rate their level of pain on a scale of 1 to 10. We even have a graphic image featuring six emoticons – complete with facial expressions – to help patients make sense of the pain scale.
In a recent post published by Psychology Today, chronic pain patient and contributor Jen Sarché, MPH discussed both the pain scale and its accompanying graphic in terms that weren't very favorable. The truth be told, it's hard to argue with her assessment.
Sarché laid bare a fundamental truth every chronic pain patient knows – pain is a very personal thing. No two people experience it the same way. This is what makes the pain scale so frustrating to patients. Trying to rate their pain on a numerical scale is exceedingly difficult in light of the fact that they have no baseline.
Not only that, but the pain experience can also change on a daily basis. Things are made even worse when patients have to deal with multiple conditions that contribute to different kinds of pain. It all becomes an overwhelming mishmash of pain and the emotions that come with it.
We pain management doctors have great empathy for our patients. Our greatest desire is to offer some measure of relief. In order to do that, we need to have some idea of how a patient feels – both physically and mentally/emotionally. That's why we rely so heavily on the pain scale and its numeric rating system.
We don't hold to any fantasies that the pain scale is a scientifically accurate measurement of physical pain. But it does help us interpret where a patient is at any given time. For example, if you were to rate your current level of pain at 10, that tells your doctor that you cannot imagine things getting any worse. They know that you have reached your limit and you are looking for literally anything that will help.
It doesn't so much matter if your pain isn't really that intense (provided there were a scientific way to actually measure it). All that matters is your perception. You feel it is at 10 so that's what it is. Now your doctor knows how to respond.
If it helps you feel better about the pain scale, think of it as a communication tool rather than a diagnostic tool. You already know that the pain scale isn't in the same league as an MRI or CT scan. No doctor can look at the results of your pain rating and figure out what's causing you to feel the way you do. Instead, the pain scale is a way for you to communicate your current level of discomfort in a comprehensible way.
Chronic pain patients often find themselves frustrated when asked to rate their pain on a 10-point scaled. That is understandable. We pain doctors get it. But the pain scale is designed to help us understand how you feel so we can respond accordingly. Despite your frustrations with the scale, humor us. It helps us help you.
It goes without saying that pain management is not an exact science. People have different pain experiences. They have different levels of tolerance for pain. Patients also react to pain treatments differently. For pain clinics, the goal is to find what works best for each patient. Unfortunately, a new study shows that antidepressants may not be a reliable option.
Antidepressants are sometimes prescribed in lieu of prescription painkillers, physical interventions (like physical therapy, for example), and invasive procedures. But it would now appear as though antidepressants do not help much, if at all.
A study recently published in the BMJ not only suggests antidepressants are not appropriate for pain management, but it also goes on to explain why that might be. It's a fascinating study that deserves attention from pain management physicians and the clinics that employ them.
As we have mentioned in other blog posts, pain is generally a response to some other condition. It has been described by some pain management doctors as an experience rather than a symptom. Pain signals are sent to the brain for interpretation. A person's perception of those signals constitutes their pain experience.
In many chronic pain cases, doctors are content to prescribe medications designed to either block pain signals or at least take the edge off. These prescription painkillers vary in their efficacy and potency. Some are considered pretty risky because of a high propensity for addiction.
When medications are preferred but painkillers are to be avoided, doctors may prescribe antidepressants instead. This is considered an off-label practice. In other words, doctors are prescribing medications for purposes other than originally intended.
Antidepressants were introduced as an alternative for managing chronic pain based on their effects on brain signals. Drugs like amitriptyline and sertraline alter some of the brain chemicals known to contribute to the pain experience. As the thinking goes, alter these chemicals in the right way and it is possible to either block pain signals or reduce their intensity.
Unfortunately, the previously mentioned study found otherwise. Researchers from Australia conducted systematic reviews of 26 previous studies involving 156 trials with a combined 25,000 patients. The study considered 8 different classes of antidepressants being used to treat nearly two-dozen pain conditions.
To make a long story short, so to speak, in nearly every instance in which antidepressants seemed to help alleviate pain, they did no better than placebo. Researchers were left to conclude that what chronic pain patients believe about their pain has a greater influence on the pain experience than antidepressant medications.
The one bright spot is the use of SNRIs to treat neuropathic pain, fibromyalgia, and a couple of other specific types of pain. The medications proved effective 26% of the time for those particular conditions. But other than that, the researchers didn't turn up very much evidence in support of prescribing antidepressants for chronic pian management.
On one hand, it is a relief to know that patients are not imagining things when they report antidepressants aren't helping their pain. On the other hand, it's disappointing to learn that a long trusted therapy probably isn't helping. Underscoring the whole discussion is the reality that patients still need options. They need as many options as possible.
It's back to the drawing board for pain management physicians who tend to rely on antidepressants rather than prescription painkillers. Hopefully, future research will give us access to more tools. The more choices we can offer our patients, the more effective we can be as pain management physicians trying to bring much needed relief.
