(My thinking on this was really challenged by the useful book What’s Wrong With Me by Lynn M. Dannheisser and Dr. Jerry M. Rosenbaum, an excellent book now available in Kindle format).
Another way to find a team (or a part of your team) is to find one that already exists – in what we might call a multidisciplinary pain clinic.
Today I would like to ask Dr. Michael Zitney to share his thoughts on these types of clinics from the inside. Dr. Zitney is the director of the Headache & Pain Relief Centre in Toronto, Canada. Let’s here what he has to say:
Many doctors can treat pain; an orthopaedic surgeon treats broken bones, neurologists treat migraines, anaesthesiologists block painful nerves, cardiologists treat chest pain caused by angina and family doctors treat all sources of pain every day. However, when an ongoing painful condition negatively impacts the way you function on a daily basis, there are tremendous advantages to attending a Multidisciplinary Chronic Pain clinic.
There is no specific definition of the words "pain clinic". The clinician in charge can be a physician, chiropractor, osteopath, physiotherapist or dentist. There may be only one clinician or they may have a team working with them.
The term "multidisciplinary" describes a team composed of various clinicians. This usually suggests doctors (medical, chiropractic or osteopathic), nurses, physical therapists and often, psychologists. If the clinic is located in a hospital there may be diagnostic services, research facilities, social workers and occupational therapists associated. Clinics may have all the clinicians on-site or may be associated with other practices in the area. Physicians may be neurologists, anaesthesiologists, family physicians or certified pain specialists. There may be inpatient and outpatient facilities; there may be a training program for medical students or others.
Chronic pain (especially if it includes chronic headaches and migraines) is a complex problem. There are many changes that occur in the brain and body. These changes progress over time. Numerous systems are involved; typically the changes are neurological, musculoskeletal, myofascial, vascular, immunological, psychological, emotional, nutritional, pharmacological and more. Entire families are affected and coping strategies are taxed. No one person, doctor or therapist can be an expert in all the changes that occur. It helps to have a well functioning team working together.
The human brain is an amazingly adaptable organ. Once these chronic pain changes occur, the brain resets to maintain the status quo, even in the face of pain and impairment. Trying one treatment or medication is often useless. The brain needs to be "rewired". This usually involves some combination of removing the pain/headache triggers, boosting the natural pain fighting and trigger blocking ability of the brain, improving the nutrition and sleep patterns and (temporarily) breaking the "pain cycle". These must be done all at the same time for a chance of success. It takes a well-crafted treatment plan utilizing various specialties to rewire the brain.
If you are having success at your currant clinic, continue with treatment. If you are not making progress after a reasonable effort, ask for a referral to a Multidisciplinary pain clinic.