Pain management is one of the largest problems of today and is to be included in every form of illness, including the psycological side of the house. There are thousands and thousands of ways to deal with pain, but no 100% positive cure. There seems to be limitless ways that pain get's initiated as well. With all of this and more, it would seem almost impossible to do anything about it. Nothing could be further from the truth.

I would like to discuss some of that truth here.

You see, with all pain, there are somethings that they have in common. Understanding those commonalities helps to reduce the amount of pain being felt. For instance: Everyone knows that pain is the way your body has to tell you that something is wrong. The more pain, the worse the problem is. Also, the more pain, the less your body wants you to move or touch the area. So we can almost say that it is a defensive measure that body takes as well as an informational one. We also know, especially in the case of MS, that what ever "they" give you to deal with the pain will not stop it totally, and eventually your body will overcome it making it useless. (At least for me.) I'm going to jump round here due to MS getting in the way. Sorry. Okay, let's take it slow and in this manner:

Your legs are sending some world class pain signals to your brain and nothing you have is even slowing it up. You can't sleep, can't lay in bed, and sitting in your chair doing compression releases aren't having any effect either. In short you are an emotional wreck, and the pain seems to be getting worse. BEFORE you call and scream at your doc to do something, (which they won't without seeing you first) I want you to try this. Just give it an honest try one time. First, realize what pain is. It is a chemical stimulis to your nerves that transmit a signal to your brain. The pain, is not causing any actual damage to you, it is merely sending a signal. That signal is following a specific path from the exact place that is in trauma and leads to your brain. Some of it will branch off to your spine which controls your reflexsystem. This is to try to get you to move away from the source causing the trauma, as in the case of getting burnt. Ignore that as it happens to fast. Try instead, to 'feel' the route the nerve going to your brain is taking. This will help you locate exactly at what point the pain is comming from. If possible, look at the site. Try to determine what movement, (slowly!) makes the pain less or greater. The same holds true for pressure. Try elevation, tensing and relaxing the area. It has been noted with RA patients that a session of physical workout of the surrounding area, at the time of pain, does actually reduce the pain levels considerably. So with MS related pain, you might try this.

A bit ago, we said that there is no 100% cure to pain. Knowing this and actually forcing that into your head when you are in pain, should, (when allowed to) remove part of the stress of pain. That is, "how much more of this do I have to take?" Make no mistake, one way or another, you will have to take it, just like all the other times. So on that issue, try to let it go; there is nothing you can do about it anyway, and it is taking energy away from managing the pain. If that fact helpped, then you saw/see a relationship of what we are saying, and an actual reduction in pain, however slight. Since this is true, then there is no real reson to cry, whine, or do any other theatrics usually associated with pain. Instead, get logical on it. Again, discover as much as you can about your pain; what actually brought it on, was there things going on hours days or weeks before the onset, that you did that set it in motion? Keep asking and digging into the pain with the intent to learn as much about the causes of it as possible. The idea is, when you DO talk with your doc, you can speak from an informed stance, and not an angry, frustraited, blame tossing one. The former attitude is far more likely to be met with a spirit of coperation; the latter being met with, "take some Ibuprophen and call me never." I'm going to stop here, and see what you have to say up to this point, then I will continue. By the way, I have done extensive research on this in order to deal with my own chronic pain, so I'm not simply spouting mindless drivel, though it might just be that. You never can tell what a plaque head is going to say next.

MSDave

Well Dave, first let me say, Welcome to NeuroTalk

Now to disagree with you

Some pain associated with MS CAN be treated long term with meds, some pain cannot, and some pain leaves as mysteriously as it came. Depending on the location of the pain there is absolutely NO way to "work" with the pain - movement, tensing, elevation, ect.

Exercise/physical activity are known to be beneficial for pain and in general beneficial to MS. However, you can do everything that has been suggested and it won't make a difference for some types of pain.

With MS pain can happen anywhere in the body and unfortunately, sometimes there IS NOTHING you can do about it. There can be times you have to adapt to the pain, LIVE with it to the best of your ability AND not let it interfere with your life - hard to do but possible.

There is another option for some types of pain - heat.

"Some pain associated with MS CAN be treated long term with meds,"
Go back and re-read the original post. Treated? Yes, but there is no 100% treatment, of any type, that will totally stop pain.

"some pain cannot, and some pain leaves as mysteriously as it came."
You are correct here, and this is one of the features of MS that frustraits research. First, they couldn't find the cause of a particular pain in an individual. Then, when they ALMOST have a therapy to actually ease the patients pain, it's gone. This also causes problems between doctor and patient, where the doctor is behind in their studies. To these people, it almost looks like the person is a hypochondriac.

"Depending on the location of the pain there is absolutely NO way to "work" with the pain - movement, tensing, elevation, ect."
Please do not be ofended, nor take this as an attack. We do not know each other yet, however I suspect we both are trying to work the problem from different perspectives. This statement actually sounds like the collection of complaints I have seen in the hospital, as well as all over the net. I think it comes from those who have been trying to fight the good (?) fight, but time has worn them out to the point that they simply give up and stop looking. I am not saying "quitter," I am saying wore out. Especially when there is no data to back this claim up. For everyone in the medical community that has tossed in the towel in trying to end the pain, I can come up with dozens of others who are still looking.

"Exercise/physical activity are known to be beneficial for pain and in general beneficial to MS. However, you can do everything that has been suggested and it won't make a difference for some types of pain."
Again, this is based on personal opinion, and not any fact or data. Exercise and eating right, range of motion exercises, as well as massage, all will improve any type of pain, if only for a little while. Improved health and mobility have both been shown to reduce pain levels greatly. Improved muscle tone, (to the extent one can achieve it) actually helps increase circulation which help the body send needed blood into an area inflamed and thus speeds the medicine into this area.

Some of this sounds like I am contradicting myself I think, but bear with me as we discuss this area for a little while. Sometimes I have to 'work out' what my point is or what I'm actually trying to say. In this case, I am (In part) providing a basis. In a few days I will make the point clear....... I hope.

MSDave

So far I have only one serious pain (aside from chronic migraine) that can't be helped by meds. I have trigeminal neuralgia on my right side, and now its starting on the left. At times it is quite severe-I'd say a 10+.

Maybe because of my long experience with migraine (30+ years) where I have developed a tolerance of pain. (None of the migraine meds work for me.) I am (most of the time) able to basically ignore it until its at a 10 for 3 days at a stretch. That's when I can't take it anymore and have to resort to actively meditating. It takes practice, but it helps.

I think that's a bit what Dave is saying here. Since the pain comes from the nerves and even meds can't always fool the nerves into believing there is no pain, you have to go beyond them, deeper into your brain.

You might consider meditation sort of like self-hypnotism or praying. You accept the pain on the one hand, and in accepting it, it becomes easier to manage. Of if you think of it as praying, you give up your pain to a higher power or take assistance from that higher power to give you the ability to withstand the pain, therefore diminishing it. Just as believing in the meds, though, you do have to believe in meditation/prayer. And just as meds sometimes take time to work, meditation takes some practice, and you will need a few quiet moments to concentrate in order to gain relief.

I can only tell you it works for me. And if you're desperate, couldn't you at least try?

Dave, You seem to be speaking about leg pain but, maybe that is just an example.

No, we don't know each other....at all. I know about MS and I know about pain. What you think are answers for pain just isn't always the case.

I have been dx'd for 22 years with symptoms going back to childhood. For the first time I understand having pain that cannot be treated. Not due to lack of trying or effort but because of where the pain is, being med sensitive to the point I have now had two meds cause suicidal ideation and other options just not practical due to the pain location.

I have been dealing with my pain now for over a year. I have tried numerous meds and combination of meds as well as MJ. I have also had numerous tests done by different doctors to make sure the pain does not have another cause, it does not. I'm done. This pain can either decide it's here to stay or leave when it's ready to. I am not in control of the pain but I am in control in how I live my life with it.

I'm not sure if I am misunderstanding but, you seem to feel pain can be treated sucessfully or at least controlled using different methods and if that is true I'm here to tell you it's not always possible.

That was alot for my mush brain to hold onto, so maybe I am way out there with this but what you say Dave sounds like Mind over Matter.

I have lots of pains, Some I can tell are no thanks to MS, but my leg, butt, and lower back pain isn't.

If I didn't tell my doctor (s) I would never have found out that I have severe Osteoarthritis, Facet Joint disease amongst other problems. I finally gave up and just received steriod injections in 4 of my facet joints....So far so good, but I know they may not last long especially with mine being severe.

I have done the mind over matter thing with a therapist, but in the end the pain laughed at me in so many ways my mind gave up on the matter.

What works for some doesn't always work for the rest!

Good Luck and I really hope you get relief soon from your pain.

I don't feel "normal" (not neurological) pain the way that others do, so I was in for a rude awakening when I first experienced neurological pain. My first indication of pain (pre MS) has always been confusion/cognitive problems. After that goes on for a while, I start searching my body for what must be hurting me. I still go through this with neurological pain (cognitive problems), but where the pain "seems" to be coming from is usually apparent before I get a chance to go looking for it.

I have had TERRIBLE MS pain and meds have, at MOST, only taken the edge off (from a 9 to a 8 1/2). The worst part for me is the length of time it usually lasts (months!), and the scariest part is no knowing how much longer it will. I agree with Dave that that stress is usually my unraveling.

I have found methods to distract myself, and the best one is deep breathing exercises. I also rely a lot on hypnosis during those periods. I have definitely reached my limit though, at times, and like Snoopy . . . nothing works. I am just worn out, and I can not think anything any more, let alone find ways to stay positive/work with the pain.

If I had to live like that on an ongoing basis, I would NEED to find something or I KNOW I would give up eventually.

Dave, I know that there are a lot of people who would really benefit from what you've said. Some people have a very low tolerance to pain (not that they can help it any more then I can help the way I am), and you offered some good advice. Anxiety, stress, uncertainty, anger, frustration ... all those things can make pain worse.

... then again, sometimes even doing everything imaginable, the pain is still unbearable & unmanageable.

Thanks for you thoughts on this subject though, and I do appreciate many of your thoughts on the subject.

Cherie

Thanks for replying Catch. Migraines are, I admit, the exception to the rule. With those, all you can do is lay there and take it. Nothing seems to help at all. I've had one so I know what you are talking about there. Meditation? I don't know why, but I get nervouse for real around that term. Be that as it may, you are correct. Sometimes, the best you will get out of meds is for them to 'knock the sharp edge off. Then it is up to you to deal with. That is where..... anything I label this is going to sound flipant but..... mind over matter comes in. In my case, I have an advantage most people do not, my 20 years in the Army. There are times you have to take any pain and keep focusing on the situation at hand. That or you're going to die. So you are forced to find a way to do that. Here, I am trying to find a way to show that there IS a way to go about that, without the fear of combat as a motivator. So yeah, finding and focusing on something else, excepting the pain, deminishing it by removing the stress, all come into play and when done with belief that it can be done, then you can affect your pain levels.

MSDave

MSDave...I think I get what you are saying, I have lived with pain from a very young age, before the age of sixteen actually. I fell down thirteen steps and broke the bone that holds the spine in place. I also have chronic migraines...they hit hard and without warning...longest I've had one three weeks. Meditation will not stop a severe migraine, the pain is like someone sticking a drill in your skull and pullin out your eye socket. I take Topamax daily and I still can get one without warning...MS caused.

I also have severe pain from MS...mind over matter will only go so far, today even with pain that felt like someone was beating on my whole body...I still managed to get things done. I think it is not always mind over matter but how severe does the pain progress or just how bad is it when it starts. I can take pain med on any given day, it might work, might not...depending on how severe that pain is or becomes.

When pain jerks me out of a sound sleep after four hours and two pain pills it has not stopped...I don't play around...I go to the ER. Severe body trauma, pain included can trigger relapses according to some neuros.

Lady...I hear ya loud and clear...but don't give up ya gotta stick around...I have a high pain tolerance, my friend's is very low. She dropped a book on her foot, I thought she broke it she was in tears. She does not have any chronic illness, fibro nothing...just can't take pain.

The main thing I do...keep faith, humor and diginity...I can't change it, I can live with it and I will not stop living just because I have MS. However, I am considered to have a warped sense of humor or just mostly warped by friends and family.

Did I get what you are saying that nothing will completely stop the pain so we need to focus on other things rather than whining? Hey, I've been saying that for several years, just not on this board. lol

I'm going to try to lump all the replies into this one post here. If we go back and read most of the posts, everyone is saying the same basic thing, AFTER telling me that it can't be done. That is, moving the pain out of the way so you can get on with your day. You all say that this is impossible, if I read it right, yet you say that you have no choice but to endure it. It's the same thing to me, I just prefer to say that I am moving it out of the way. As far as pain meds go? I'm lucky if I have one that will knock the edge off the making it a little easier to deal with.

I will also say that you can go too far with pain meds as well. For a time, I was given "Marinol" (synthetic pot) for spasticity. A side effect was pain management. When I got high enough, (by this time I was also buying and smoking it) the pain simply did not matter. It was still there, still an 8 or what have you, it was just that I did not care any longer. You would think this was great, but I also did not care about anything else, that is, the things I was aware of. My doc pointed out one day that I 'might' have a problem with addiction. I stopped smoking and taking the pills that day. Eventually the pain started to matter again and we eventually found another way to deal with spasticity. My point is this: with pain, you have a choice. Medicate yourself into oblivion, or find enough to take the sharp edge off and then just go through the pain. There is no need to throw a tantrum, or go into any type of fit over it, all this does is make it worse, and causes everyone round you to suffer as well. You do not want that, and you know it, under normal circumstances.

So here in this thread, I am trying to pick your brains, as much as I am sharing my experience. The real question here is, after the medical community has done about everything they can, (AT PRESENT) to deal with your pain and it's now up to you, how do you do what you do? Even if it is just having to endure it, how do you do that?

MSDave