Chronic Pain 101

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   Posted 11/3/2009 11:19 PM (GMT -6)   
Chronic Pain 101

Chronic Pain 101 is a great ‘first place to look” when you have questions that you need answered quickly or you want links to research information. Below are topics that may be helpful to you as you try to deal with your Chronic Pain. If you know of other links to helpful information, please email a moderator and they will be added to the list as long as the sites are in accordance with our forum posting rules.

Please do not post on this thread because it would get very long. If you have questions, please start a new topic. This list was originally compiled by Moderators Chutz/Sherrine. Thank you both for putting this together!

What is Chronic Pain?

Chronic Pain and Acute Pain are very different and each needs different treatment. Acute pain is often a sharp, stabbing pain that only lasts for a short time or until the injury has been resolved or healed.

Chronic Pain is pain that lasts ‘a long time’. And what is ‘a long time’? If you do some research on the topic you will find answers anywhere from 3 months to 6 months (the most common answer) to “a long time”. Those who suffer from Chronic Pain need no description of what ‘a long time’ means. Pain is what it is to the person suffering and if you have Chronic Pain you know what it is. It either is with you constantly, around the clock, day after day without an end in sight or it comes and goes, waxing and waning but still with no reasonable hope of ending. Chronic pain often leads to additional problems like depression or other psychological disorders.

The National Institute of Health web site has good information on this topic. The link below will take you to their information on Chronic Pain and how it affects the entire body

NIH on Chronic Pain.

This is an excerpt from their site:

“While acute pain is a normal sensation triggered in the nervous system to alert you to possible injury and the need to take care of yourself, chronic pain is different. Chronic pain persists. Pain signals keep firing in the nervous system for weeks, months, even years. There may have been an initial mishap -- sprained back, serious infection, or there may be an ongoing cause of pain -- arthritis, cancer, ear infection, but some people suffer chronic pain in the absence of any past injury or evidence of body damage. Many chronic pain conditions affect older adults. Common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, neurogenic pain (pain resulting from damage to the peripheral nerves or to the central nervous system itself), psychogenic pain (pain not due to past disease or injury or any visible sign of damage inside or outside the nervous system).”

Pain Journal and Pain Chart

Having chronic pain is difficult to live with and it is difficult to describe to our doctors just how we really feel. They need to know how we feel, the intensity of our pain, how is changes during the day, and other aspects of our lives with Chronic Pain, in order to give us proper treatment. Below are some sites that describe levels of pain and how we can convey it to our doctors

I've also included a link to a pain journal. Print one copy of the journal page for each day of the week and fill it out by the end of each day. It’s convenient to either staple together a week’s worth of journal sheets or put them in a binder. Then when you visit any of your doctors, take your journal with you and ask that they review during your appointment. This way they get a detailed picture of your life with Chronic Pain…hour by hour, day by day, week by week and etc. This will be helpful not only in dispensing treatment for you but it helps the doctor see how medications they have prescribed are working. Tell your doctor you will bring the journal back each visit so they can review your progress, or lack of it. Using this tool can help you and your doctor(s) find the best treatment for your pain.

Also by keeping a pain journal you can see for yourself how daily activities affect your pain and will lead to better control by how you lead your daily life.

University/Teaching Hospitals

When people are looking for a great health care provider, we often suggest they go to a University/Teaching hospital. These medical facilities are on the leading edge of medical research and technology and are especially good at finding the reason and/or a cure for your condition. Below is a link that will take you to lists of University, or Teaching hospitals, across North America and around the world. Here is where you can find a doctor and maybe new hope for your medical needs.

Pain and Depression

When people suffer from chronic pain it can lead to depression, anxiety and related psychological disorders. It’s no surprise to those who are living with pain from day to day. These links have articles and information on the coexistence of these disorders.

Pain Medications

For the people who suffer from chronic pain, any relief is welcome. This may come from physical therapy, OTC medications, natural substances or specific pain medications. The following web site has a thorough list of the types and names of all pain medications.

Dependence vs. Addiction

Dependence, addiction and tolerance are often misunderstood. Here is a link that does a great job in explaining the different definitions.

Opioid Pain Medications

Over the past decade or so, the use of opioid pain medication has been hotly debated, which has left the patient often without pain control while the discussion rages on. Scientific research and studies of patients who are taking opioid pain medications show clearly that there is no need for often misguided controversy. Not only are they often the only medication that will relieve the patient’s pain, but the stigma from taking them has no basis in fact. Scientific research shows that people using these medications for pain relief rarely become addicted. The articles below explain the story…the story of how uneducated doctors refuse to prescribe them; how the media labels anyone using them a ‘druggie’; and the stigma that those who need to use them suffer, either in public or privately with emotional pain.

John Hopkins Medicine:


“Opioids, such as oxycodone, fentanyl, and morphine, may be prescribed for intractable pain. Because of concerns regarding addiction, ongoing opioid use for the treatment of chronic pain is controversial. Although the potential for abuse exists, it is actually very rare among chronic pain patients who don't have a previous history of addiction.”

John Hopkins Magazine:


“Several studies of cancer patients and other pain patients have shown that these patients rarely become addicted to their pain medication. As to why that is the case, Pappagallo notes that only a small minority of the general population has a predisposition toward addiction to begin with. Further, adds Campbell, most patients who take opioids do not experience euphoria from their medication, particularly from the timed-release preparations. Patients are not going to go to great lengths to seek a "high," as the heroin abuser would, because there is none. "You don't walk a mile to get a nicotine patch," says Campbell.”

Intrathecal Pumps and Spinal Cord Stimulators for Chronic Pain

For pain that can not be controlled by oral or other medications, often a pain pump or spinal cord stimulator (SCS) will be the answer to a somewhat normal life. The links below explain what they are and how they are used for those with Chronic Pain.

Post Edited By Moderator (Blessedx8) : 6/30/2013 1:07:35 AM (GMT-6)

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Date Joined Aug 2008
Total Posts : 3193
   Posted 6/30/2013 2:05 AM (GMT -6)   
(In order to fix the "hotlink" issue - I had to split up the CP 101 - thanks, Tina).

Prescription Medication ~ Financial Help

Having chronic illnesses puts such a drain on our finances and some of us just can't afford our medication. Chutz and Sherrine did research and came up with two sites that just might be able to help some of you! If you are unable to pay for your medications whether they are for pain or other disorders, try these sites.

General Information for Heat vs. Cold to relieve pain.

When we get a bruise, strain or sprain we often go for a warm pack, but maybe a cold pack would be better. How do we know when to use heat or cold? Below is an explanation of which to use and when.

Maintaining a Positive Attitude: Ten Strategies

This is so important in facing this illness...any illness for that matter! Your attitude plays a big part in how you cope with many things in you life. I hope you like this as much as I do.

Social Security Disability

Below are sites that some members have found useful. Use your own judgment.

Job search and retraining

For those in the agricultural industry, the AgrAbility Project will get you back to work. It’s purpose is to assist those with disabilities who work on farms or ranches. Often after an farmers are not able to return to independent work . But the AgrAbility Project gives technical assistance and retraining so you can get back to using the equipment you used before your accident.

Alternative choices for pain control

If you feel you just can’t go on, please call for help.

We care!

But we are not the ones who can help you if you have thoughts of self harm. Please call the number below or use one of the links to find help in your area.


For Teens

For those looking for a pain management doctor in your area I am listing below the names, telephone numbers & websites of organizations that have information on pain mgt drs across the country. I got this information from the American Pain Foundation.

American Academy of Pain Mgt.

American Academy of Pain Medicine

American Academy of Physical Medicine & Rehab.

American Board of Pain Medicine
Moderator - Chronic Pain Forum

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Date Joined Jan 2003
Total Posts : 9799
   Posted 9/15/2014 4:15 PM (GMT -6)

Useful Items for ACDF Post-op or neck pain: post by 'therabidweasel' 3/17/15

To be clear I am not advocating any particular product. I am telling what has been useful to me or the closest thing that I can find like it. FEEL FREE to add items that have helped you. I'd like to keep the thread like a reference, I did not see one in a quick search. Lets keep medications and such out, just useful items:

Aluminum articulating laptop tray

I recommend getting one with three legs, they are more complicated than an origami swan to get folded right, but once set up they are very valuable. Mine is similar to this one. It is a bit flimsy and my laptop is only 6lbs, so its on the small side. Mine said "made and designed in China" which seems about right. But it does get the job done.

Wireless Trackball for your Laptop

I am doing some solid modelling (CAD) on my laptop these days and after about one long day my wrist was killing me from using the touchpad. But my little aluminum tray is too small to accommodate a mouse, so I got the exact trackball that I linked to from Walmart, $33. In this case I really recommend the Logitech stuff because the little part that plugs into your USB port is very tiny, much smaller than those from other companies, and you can leave it in all the time, even when traveling or in the bag. Now I just kick back all the way in my recliner, the keyboard is comfortable with they tray, I turned the touchpad off so I dont keep hitting it accidentally, and the trackball hangs out motionless on my armrest. It has helped my neck immensely. The trackball takes a little getting used to, but I really like this variety that is actuated only by your thumb.

Useful Pillows I tend to alternate between about 5 different pillows. For the first 2 weeks I had them all stacked in a pile to form a decent wedge on which I slept Here are some.

Tempurpedic cloud

This is far and away my favorite pillow. It conforms so nicely to your neck and shoulders. I use it most nights, but it is just a bit on the firm side. It is nice enough that my wife will steal it any time I dont use it.

Tempurpedic King Size Rhapsody

This thing is HEAVY. It weighs like 8lbs and can be difficult to lift in the dead of night. It is also a tall pillow and I cant do much but use it like a rather firm but very adjustable body pillow. This pillow can be used as a weapon. Seriously, it is heavy.

Tempurpedic side pillow

I received this on accident, but decided to buy it. I was in a pillow shopping mood. I used it upside down for a long time, like 2 years. Apparently you are supposed to have is flat side up. It really works well like if you sleep on your side, the divot in it is where your shoulder fits. If you do flip it over, if offers decent neck support too. . .but my neck has very little lordosis, so as with all of this YMMV.

Walmart Down Pillow

As far as down pillows go these are cheap and extremely soft. They offer very little support, but are good if you like a low soft pillow. I sometimes stack mine on top of my cloud with very comfy results.

Walmart Memory Foam Pillow

This is the kind I have but they are legion in the market place. It is much softer than any tempurpedic pillow I have used and offers less support. It is just a little like sleeping on a balloon. I rarely use this pillow now that I have the cloud, but it formed the lumbar portion of my crazy pillow wedge that I used during my first 2 weeks.

Kelty Down Camp/Travel Pillow

So this thing is cheap, but it is really nice. It is better than most full sized down pillows. I use it in the car along with the hard neck collar to make the seat more comfortable. It is also a really nice pillow to take camping, Seriously, it is better than the pillows in most hotels and B&Bs. . .which is not saying much, but I do really like it.

Water Bottles

I like this bottle because it has a "bite valve" and you really cannot spill it. It also works like a built in straw so that you can drink without tilting your head. I have carried the 1L version with me everywhere I go for years. I have multiples and clean them in a rotation. I love it, cant say enough good about it. The only bad is that if you fill it and then it warms up, the back pressure from the expanding water pushes through the bitevalve. IE, if you leave it in your car in the summer you need to rotate the bite valve down to prevent the back flow. . .but I always forget and come back to a cup holder filled to the brim with water.

Bluetooth Headsets

I like this headset because the noise cancellation is phenomenal and the battery life has a 4+ hour talk time. The downside is that it does not get very loud and so while the noise cancellation helps in a noisy environment for your listener, it is difficult to hear. These are also legion, but it is way better than holding the phone to your head.


These are legion, but I like it because I can use it in bed until my meds kick back in. If you dont have one I really recommend taking the plunge. It's expensive for the phone and the service, but its like when the internet first became available. Once you have it you dont see how you got by without it. I do recommend the largest possible screen. I carry a Galaxy Note 2 in my pocket. It is bigger than my GPS and I only noticed it for about the first 4 hours. I used to be a small phone guy, but not now.

Smartphone dash mount

I love this mount so much, you just shove your phone in and it grabs on. Squeeze the buttone and it pops out. It sticks to your dash so well you can use it as a handle to get into the car. I even have one in my hotrod and use it to bluetooth my phone OBDII port. . .I use it as extra gauges etc in that car. . .it rotates and sticks very well. It is handy to hold your phone while you use your headset or car phone and/or use it as a GPS.

If you have trouble swallowing thin fluids, or need thicker food

This stuff is available pretty much everywhere and really does thicken any food without adding flavor, even water. It is a little weird, but if you need it, it is a lifesaver.


You will need a prescription from your doctor for this. OK, so the link above is just an example that you can buy your own TENS unit for like $30 with pads. If you have not used one I recommend you try it first as some people do not like it. If you go to PT, they will certainly have one that costs thousands and is not better than what is sold above, but asking them to try it on you if they dont volunteer it is a way to try one out. Put simply it electronically stimulates your muscles and the end result is similar to a massage. . .the process itself is dislike anything other than being electrocuted. I recommend at least two channels and one with a fair bit of adjustability in pulsewidth and stimulation type. . .certain things feel better on certain days. I use all the adjustability on mine and wish it had more.

READ THIS about TENS I'm just giving my personal experience and reckoning as a civilian, OK, you do what you want. I only use the TENS to relieve the muscles that are in spasm in my shoulders etc from wearing the brace. I DO NOT RECOMMEND USING THIS ON YOUR NECK. Like I said, it flexes your muscles and it does it very specifically and often harder than you could voluntarily flex that muscle. Muscles pull, bones push. . .your bones were just ground to dust and stacked on top of each other. It's not advisable to use this on your neck spasms in my opinion. Also, little pads "hit" harder than bigger pads. Something to think about if you aren't getting enough juice or are getting blown out of your seat

Compound Pain Relieving/Muscle Relaxing Cream

OK, I said no medicines and here I am. I was prescribed different compounds for many years by the various PM doctors that I saw over the years in different states. The most potent that I have personally used comes from here and I use it on the spasms in my neck and it helps a bit. Your doctor can write these guys a script, I am fairly certain that they call the formulation "5391". I'm not recommending them per se, maybe your doctor has a local compounding pharmacy that he likes. Just think of this like Ben-Gay on steroids. Get your prescription before you have surgery. The spasms begin on Day 0 and the valium stops long before they do.

For reference the above drug contains Katamine, Gabapentin, Ketoprofen, Lidocain, Carbox(I think), Bax(something), Ami(something), IB(something). . .in case 5391 is wrong. A "30 day supply" is 60 grams.

Non-prescription Cream

This was recommended by someone in another thread. I cannot personally vouch for it, which should mean very little to you, but the claim was that nothing else helped the person than this brand of creams. It comes in three different varieties and this warming version was the one that was preferred.

Cervical Traction Device

TO BE CLEAR I DO NOT RECOMMEND USING THIS POST-FUSION UNTIL FULLY HEALED AND CLEARED BY YOUR DOCTOR AND I also do not recommend this unit be used without very heavy modifications This thing costs about $900 and I got mine via prescription through my PM Doc. Notice that it tilts your head forward and that is just the plain wrong way to pull a neck for traction. For this thing TO NOT BE A COMPLETE PILE OF GARBAGE MONEY WASTER you must remove the thing that tiltw your head forward, cut the entire bottom flap off, and then grind it as flat as possible where your neck hits. I'm a handy guy and can post a picture of mine modified. The thing that I do like about this traction device is that it grips your head well. But even my my heavy modifications to this very expensive thing, manual traction by a good PT or trained partner is better, way better.

A Good Office Chair with Neck Support

I have had the opportunity to try an RFM Verte chair, linked above, for about 3 weeks now. Before this I had a $200 chair from staples that had neck support. . .but the staples neck pad was just too loose and could not be made stiff enough to give you more than the appearance of support. . .although it was slightly better than nothing.

The RFM chair is extremely expensive. If you suffer from sub-cervical spinal issues I'd bet money it is the best chair you'll ever sit in. My lumbar feels like it's a new spine when I get it adjusted correctly. The cervical support is stiff enough to offer actual support, but for my neck at least, even with the weird sliding vertebrae thing and point the pad surface straight up I could not get it far enough back. The Verte will lock in several reclined positions, which is a nice feature, but it also doesnt quite go back far enough to allow me to rest my neck fully. All of that said, I am still buying it because it gives me just the thinnest margin of neck rest to allow me to work all day.

If you are buying any chair, you simply must sit in it first. The RFM Verte in particular cannot be returned, so that is very important unless you are nonchalant about $1400. The Verte, being so adjustable, is also hard to get just right because so much of the adjustment (the spine) occurs simultaneously. If you want to add lumbar support, push the cervical back, etc it has to be done simultaneously. I find myself needing to adjust it several times a day to accomodate the different reclining positions that I need to relax and I just cant get everything exactly as I want it without help. It would be helpful if you could see through the vertebrae a little and have reference marks so you could dial in that perfect position.

Self-Massage Tool

This tool costs about $40 and is worth a lot more than that to me. It lets you release a knot much better than any massage therapist because you can get right on the bad spot, dig into it just right and move both the muscle you are massaging and the tool at the same time. 2 minutes with this tool is better than 10 minutes of massage of the same area by someone else. For my neck (which is healed now) I sometimes have my wife use the tool to dig into the muscle as she can do it harder than I can, but it is great for all purposes.

Just some general information on memory foam that I ran across when using it for my job:

Memory foam is highly temperature sensitive. It is almost CRAZY temperature sensitive. If you find a pillow or bed too firm, and you keep your house cold like I do (60 degrees), it may help just to warm it up.

I realized when I laid down on my pillow last night it was rock hard. . .and then I remembered. So maybe this information is useful if you are testing a pillow out for the first time. If youre in a hot store or house and your pillow is too soft, 5 degrees cooler may firm it up for you and vice versa.

BTW, memory foam is so temperature sensitive you can put it in the freezer and it becomes as hard as wood, you can cut it with a table saw.

A comfortable recliner that also SWIVELS has been a wonderful asset to me. So now I can move around without moving my neck. And of course that recliner needs to be comfortable enough for sleeping in too. It may be the most comfortable place for quite some time.

Bendable straws are good too when I don't have my better cup with built in straw.

At a restaurant a booth with a tall back is more comfortable than chairs.

Bib-I hardly ever eat a meal without dropping food. I'm almost 6 months post-op and this is still an issue. Be prepared to cover the collar in some way when eating.

As an FYI, Temperpedic memory foam will get that hard in a freezer, but Comforpedic won't. They demonstrated it to us at the furniture store when we bought our Comforpedic bed.

Also, we bought the Comforpedic pillow and were told it has three functions: If you're a back sleeper, you use the highest part of the pillow under your neck. If you're a side sleeper, you use the lowest part of the pillow to cushion your neck and shoulder. And if you are a stomach sleeper, you flip the pillow over and use the flat side of the pillow.

RE: NSAID's and Bone Fusion
IAmGrammie provided this quote
(from the University of Virginia School of Medicine):

A large body of information suggests NSAIDS have a negative impact on the healing of bone. Although each clinical healing scenario presents a slightly different level of challenge, the healing of a posterolateral spinal fusion is one of the most difficult challenges in bony healing. Clinically, this results in a relatively high rate of nonunions using traditional fusion techniques. Spinal fusion models have confirmed NSAIDS have a definite inhibitory effect on healing of the fusion. Although data are limited, it appears this effect is most severe when NSAIDS are administered in the early postoperative period. Moreover, the effect may be worse with certain types initial inflammatory, subsequent reparative, and final remodeling phases. Because of the anti-inflammatory activity of NSAIDS, one might assume their effects would be worse when administered in the inflammatory phase. Indeed, the study by Riew et al suggests the inhibitory effects are more significant when NSAIDS are administered earlier following fusion. Other studies conducted with non-spinal models also suggest early administration of NSAIDS results in greater inhibition of bone formation (Goodman et al). Unfortunately, the length of the inflammatory phase in humans is not well known. This leaves the clinician unsure about the safe time to allow resumption of NSAID usage clinically. It appears likely NSAID use following a spinal fusion procedure will increase the rate of pseudarthrosis. The literature suggests that avoidance of NSAIDS in the postoperative period may avoid nonunion. Additionally, we propose that chronic NSAID usage should be addressed in a similar manner to cigarette smoking. While neither are absolute contraindications to elective spinal fusion, patients should be counseled to discontinue the use of NSAIDS in the peri- and postoperative period to maximize their chance for a successful fusion.

The things I found most useful and some things I still need 6 weeks post op are:
Pill cutter (you cannot swallow pills whole)
Chewable supplements
I did not want to by a recliner (although a swiveling recliner is perfect chair) so I made do by using our zero gravity lawn chair, added a foam pad to it.
Pillows must go under your arms at all times to reduce the spasm in your traps (doing it now as I type on my iPad
iPads are good for lots of things (kindle, TV etc)
I also bought a hospital table which was good for the first weeks in bed, but still use it
This table linked below I am able to bunji cord my iPad upside down over my bed to read in bed while flat on back (I was told I can only sleep on my back with small pillow because of my hard cervical collar which I must wear 24/7) I also use it for my keyboard to get it up high enough to see.

Cup with straw, bendable straws for when you are in bed

Someone should at least stop by daily your first week
I bought a plastic chair to put in my shower and used hand held to shower for first few weeks, still use handheld shower on the days I don't wash my hair. Showering exhaust me even now and I get light headed on hair washing days.

Lots of soft food. Think of baby food - I am tired of protein drinks but can eat quinoa, couscous, mashed cauliflower and other things that are easy to swallow.

My husband bought me some super soft socks that I cut to fit the chin pad of my brace since it was chaffing.

Grabber since reaching will increase your pain (not at the time but later)

Magic bullet or similar light weight easy to use blender, not just good for those high nutrient shakes you need to have but also to make other food edible, eg. I purée strawberries into a sauce so I can eat them, otherwise no way!

No slip cushiony shoes (you will want to avoid all jarring to your body)

Ice packs - I find the small ones are easier to get in where I need them around my brace.

Bluetooth a must since holding phone will hurt your neck

SETTING A TIMER: When I knew that 15 minutes was my limit to be up working in the kitchen, etc. before pain overtook me, I wish I had simply set a timer for 13 minutes and avoided that extra pain.

CHECK RANGE OF MOTION PRE-OP TO COMPARE LATER: This is just something else I wish I had thought to do.


A friend who recently underwent PAO surgery recommend the book "Prepare for Surgery, Heal Faster: A Guide of Mind-Body Techniques" by Peggy Huddleston. I am more impressed the more I read it and listen to the CDs on Relaxation and Healing. I feel far more comfortable and at peace with my upcoming surgery, and am confident that everything will go extremely well.

The food dribbles,easy fix here. Old hand towels or dish towels and long ways cut a 5-6 inch cut right in the middle and use 2 pieces of stick on Velcro to make a clasping like device,fold at bottom two inches and you can use crazy glue or more sticking Velcro to make a pocket at the bottom to catch food if you don't sew.

I have seen larger men use a bathtowel and just cut a round hole to fit over the head but thats not very feasible if you have no help and are trying to put it over a cervical collar.

My rolling desk chair is Wal-Mart cheap, rolls around has adjustable back heights and complete chair hights and swivels,they come with or without arms and are my kitchen necessity as much as my pots and pans!!

I do dishes, laundry and if I am making something time consuming even cook from it.

I roll in the bathroom and clean tub and toilets from it with one of the long handled Mr Clean sponge things never having to squat or bend or get on my knees.

I have even rolled around with a wet towel under my feet to tidy up the kitchen floor. It's surely saved me from countless battles with pain from bending and stooping.

Once you get the smartphone you can get a app that can control many aspects of your life taking away a great deal of unnecessary work. Make sure you add a talk to text app and a voice response for hands free talking and dialing.

Post Edited By Moderator (straydog) : 10/18/2015 9:45:42 AM (GMT-6)

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