area of medicine and, for this reason, often difficult to accurately diagnose. My personal definition is pain for a significant period of time that is lim- iting your function.” Often, adds Cowan, chronic pain is simply a result of growing older. “We’re talking about issues such as osteoporosis and knee and hip replacements — the joints have com- pletely worn out, whether it’s due to old injuries or perhaps just being overweight,” she explains. “It’s a gen- eral thing related to being human.” However, chronic pain is not some- thing that afflicts only adults, Cowan notes. That’s why the American Chronic Pain Association established a website called Growing Pains (www
.growingpains.org) that teaches young people effective coping skills to better live with pain. “Pain shouldn’t define who they are,” Cowan says. “It’s just a small piece. That’s the message we give to everyone.” For military personnel, pain is often part of the job. “Being a soldier — or anyone who wears the uniform — is difficult work,” Buckenmaier says. “We compare our soldiers to athletes, and there are corollaries to the wear and tear on the body that football players un- dergo. Soldiers wear 40 pounds of body armor, and the difficult jobs we ask these young men and women to perform are hard on the body.” The effects of chronic pain on the life and well-being of an indi- vidual — civilian or servicemember — can be devastating. If unresolved, pain can make people irritable and difficult to be around and can adversely affect daily activities. Cowan, for example, reports that before she sought treatment, her pain was so severe she barely could hold a coffee cup. In addition, flare- ups might interfere with a person’s ability to hold a job, and the use of opioids to alleviate pain can leave patients sedated and unable
Opioid Risks
Opioid drugs such as morphine have been a staple of pain man- agement for more than 150 years, but these drugs carry significant risks, including sedation, addiction, and, if abused, even death. Because of such risks, many physicians are reluctant to prescribe
opioids to their pain patients despite the obvious need, says Col. Chester “Trip” Buckenmaier III, USA (Ret), M.D., director at large for the American Academy of Pain Medicine and current program director for the Defense and Veterans Center for Integrative Pain Management. However, a growing number of pain-management programs success- fully are using opioids in conjunction with other treatments as part of a multidisciplinary, multimodal approach. The key to effectively using opioids is understanding how these
drugs work and how they can be incorporated safely into a comprehen- sive pain-management program, Buckenmaier explains. “This means becoming an informed medical consumer,” he says. “As complex as medicine has become, it has to be a partnership in which the patient and the physician are working together, and that requires a certain level of responsibility from the patient to educate himself [or herself] and become aware of the different treatment options.” According to Buckenmaier, people tend to spend more time re-
searching their next car than they do their medical issues. “That has to change,” he says. “At the same time, physicians and the health care profession have to become better educated regarding interdisciplin- ary and multimodal approaches for pain management so we can get a handle on this national health care crisis.”
to interact with loved ones. Most dramatically, those who fail to find relief might contemplate suicide. Chronic pain also comes with some amount of stigma. Experts report disbelief among family and friends can be the most devastating side effect for chronic pain sufferers. “More than anything, people with
chronic pain want their pain validat- ed because you can’t see it,” Cowan says. “You can’t tell simply by looking at someone if they have a headache or a backache, so being validated that their pain is real is very important.” The good news for individuals with
chronic pain is help is available. In the past, mor-
[CONTINUES ON PAGE 80] JUNE 2015 MILITARY OFFICER 69
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