DIAGNOSTICS: The Key to Success
CHRONIC HEAD PAIN: The Ultimate
"Pain: The Psychological Effect On The
Patient"- by Dr. Loren Pilling M.D.
Albert Schweizer said: "We must
all die. But that I can save [a person] from days of pain, that is what I feel
is my new or even great privilege. Pain is a greater lord over mankind than even
The following was written by Dr. Terrence
O'Shaughnessy a Board Certified Orthodontist and an expert in pain
management. He is considered one of the leading authorities in the field of
Objective Documentation and Expert Analysis of Unresolved Trauma Induced Injury
to Craniomandibular/ Temporomandibular/ Cervical Complex. He personally is a
chronic paining patient and understands that pain is no laughing matter. He
describes beautifully what happens emotionally when patients suffer chronic
THE CHRONIC PAIN PATIENT
by Dr. Terrence O'Shaughnessy
There is more than ample evidence to find that a
person has been suffering, and now continues to suffer, from the debilitating
effects of "Chronic Pain Patient Syndrome".
Today Chronic Pain is recognized as an entity unto itself.
Interfacing with the Chronic Pain Patient visage is not a pleasant experience.
Victims suffering from chronic pain are not likable people; not only relatives,
friends, acquaintances and strangers, but even clinicians are "turned
off" by the whining complaint. Clinicians with limited time schedules are
very much inclined to quickly write a prescription to avoid having to listen to
their woes again and again and again.
As a result, this disease entity was relegated to the same disposal heap as some
forms of mental illness (also not pleasant to encounter) and other entities
which did not conveniently fit into the schedules of doctors, attorneys and
friends or relatives. Little resource was assigned to the study of this disease
entity, and these victims were shoved under the rug of society.
Today, with gratitude to a handful of people who have devoted their careers to
the study of this disease, we are now privy to the ravages and ramifications it
has upon these victims. Furthermore, when given its proper priority in treatment
planning, these victims can often be reclaimed so as to resume their role in
society which had been so unfairly taken from them.
A victim suffering from pain as a result of unresolved soft tissue injury is a
chronic pain patient. If this pain is not resolved quickly (i.e., days or
weeks), but drags on for six months or more, this patient becomes a chronic pain
patient in distress with the following problems as recognized and documented in
both medical and dental literature:
the longer the injuries are left unresolved, the
more difficult diagnosis and treatment become; the patient experiences a
deduction in pain tolerance; the patient experiences a vicious self-feeding
cycle of frustration, despondency and anxiety, often leading to clinical
depression requiring supportive therapy; symptoms and patient complaints will
increase exponentially and "hop-scotch" around on good days and bad
days; the patient will gradually withdraw from friends and acquaintances,
family and spouse, hobbies, and even from the workplace, concentrating solely
on tolerating their multi-tiered levels of pain; consortium with a spouse or
companion is always affected, as even routine tasks such as eating and
sleeping are made more awkward and difficult to pursue.
The face is the mirror of our very existence; it
reflects all inner feelings, whether they be restful or in turmoil, as we
interface with others in every daily endeavor. Smiling, talking, laughing,
frowning, worrying, whatever our inner feelings happen to be is ultimately
displayed for all to share for good or bad.
Our mouths are used to speak, eat, love, and to communicate with the nuances of
expression every feeling imaginable.
Both the face and the mouth are at the mercy of the function or dysfunction of
the TMJoint; the TMJoint is the primary joint used to sustain life, and when
functioning properly, it provides for the enjoyment of life more than any other
joint. When dysfunction of this TMJoint is accompanied by constant pain or
discomfort, everything is affected. There are no time-outs; our very existence
becomes totally focused on this terrible template over-riding all else in our
the work place is affected;
Acute pain that diminishes in the course of the
natural healing process is generally manageable psychologically. However,
recurrent or persistent pain, which evolves into chronic pain the patient
believes is untreatable, and hence threatening to future function and
well-being, leads to progressive disability.
The caliber of our work deteriorates as does our relationships with
constant preoccupation with this problem precludes normal interfacing with
co-workers, family and friends;
even during leisure time there is no relief from this intrusion;
there are no pleasurable or restful interludes with friends or family;
the natural sequelae is seclusion and withdrawal unto ourselves, and yet that
very withdrawal serves to compound the depression and frustration of this
vicious, self-feeding cycle of despair.
Of particular note is the fact that muscles, tendons, ligaments and fascia when
so compromised results in pain symptoms (sometimes for decades) whenever tension
or stress is a factor during their function.
Also please read a paper written by Dr. Loren Pilling M.D., who founded
the first pain clinic at the Mayo Clinic who shares the emotional and behavioral
aspects of a paining sufferer in distress. "Pain:
The Psychological Effect On The Patient"