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Will there ever be a cure for chronic pain?

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Re: Will there ever be a cure for chronic pain?

#51

Post by rjurney »

sdegutis wrote: post #20

Although there is value in trying to removing pain when doing so would be ethical, this thread mentions many situations where there is pain but no possibility yet of removing or reducing it. In these cases, a long-term general solution is to continue research on these situations. But the short-term solution per person is to learn the meaning and value of suffering. It is frowned upon in intellectual forums to discuss…

You and Jesus are assholes. May you suffer as I do and learn the value of suffering first hand.

Re: Will there ever be a cure for chronic pain?

#52

Post by rjurney »

Retric wrote: post #48
rjurney wrote: post #39

Earlier quoted context omitted.

There is usually no cure for chronic pain. This is medical fact. Your case is not descriptive. It is usually not caused by scar tissue, or an infection. For example MRI reports are only slightly correlated with actual spinal pain. It generally involves an up modulation of pain sensation in the peripheral and central nervous system. It is worthwhile to investigate the cause but most people don't find a cure like you d…

That’s exactly the kind of diagnosis you get when the real answer is “I don’t know.” Peripheral nervous system issues may be the root cause for some chronic pain, but it’s very difficult to rule out all other causes. Also, MRI’s are still very much blunt instruments. A high resolution 1 millimetre scan is still representing ~100,000+ cells per voxel.

I'm not saying don't investigate. Its been ten years for me, and I'm still investigating. But the numbers are clear: usually there is no clear cause except a poorly understood change in the nervous system. The answer for most people is, "I don't know," with the current sophistication of medicine. You can't try harder and find the answer because there is no answer at this time for most people.

Re: Will there ever be a cure for chronic pain?

#53

Post by jraph »

sdegutis wrote: post #20

Although there is value in trying to removing pain when doing so would be ethical, this thread mentions many situations where there is pain but no possibility yet of removing or reducing it. In these cases, a long-term general solution is to continue research on these situations. But the short-term solution per person is to learn the meaning and value of suffering. It is frowned upon in intellectual forums to discuss…

I don’t think speaking about religion is a problem. Here's what I think, for what is worth:

First, your message may give the impression that you are giving an unfounded lesson to some people here. “You will not […]”

Second, you may be speaking a language to which not everyone is receptive. For instance, you are stating things about our duties, but people who don’t see a meaning or a goal in life (does it sound sad?), or don’t feel they have a specific duty may not fully understand your message.

Some people here may also be seeking evidences for some statements you make because they are not obvious to them. For instance: how can you know that nobody will ever suffer as much as Jesus or more? Is there a study out there finding this result?

Though I may also be doing the mistake you may be doing, that is, not speaking the right language to be understood (I may also have offended you by doing so and I'm sorry for that if that is the case). Quite like in the following copy-pasted joke:

---

A religious women upon waking up each morning would open her front door stand on the porch and scream,

“Praise the Lord.”

This infuriated her atheist neighbor who would always make sure to counter back,

“There is no Lord.”

One morning the atheist neighbor overheard his neighbor praying for food, thinking it would be funny, he went and bought her all sorts of groceries and left them on her porch. The next morning the lady screamed,

“Praise the Lord, who gave me this food.”

The neighbor laughing so hard he could barely get the words out screamed

“It wasn’t the Lord, it was me.”

The lady without missing a beat screamed:

“Praise the Lord for not only giving me food but making the atheist pay for it!!”

---

Re: Will there ever be a cure for chronic pain?

#54

Post by rjurney »

codr7 wrote: post #23
searine wrote: post #12

Earlier quoted context omitted.

>there already is a cure to chronic pain and it is called correct diagnosis. There are many many conditions where even with a proper diagnosis there is little help. One of the easiest things to do with chronic pain patients is to minimize or handwave their pain as transient. There is no surgery for many of these people. No drugs that aren't heavily addictive. Little to no hope of anything but a lifetime of pain.

I've lived 12 years with chronic pain caused by a smashed vertibrae from a climbing accident. No _legal_ drugs that aren't heavily addictive. And the predictable result is that you can't even get legal medicine that works any more, because no one dares to touch the addictive stuff. And I sort of get it, I went through hell getting off OxyNorm/Contin after the accident. But it's really shitty to leave people hanging w…

Have you tried the Butrans patch? It is buprenorhpine and as of February, 2018 there is no legal restriction on it under CDC/FDA policy: unlimited prescriptions. No special license required to prescribe it (it is against regulation to use the patch for addiction). It is now generic ($160/month with a coupon, usually requires a prior authorization), and doesn't:

* Get you high * Make you drowsy * Addict you (yes, you'll have a tolerance, but no it won't be a problem) * Give you cravings * Stop your breathing

Each patch lasts a week and if they stick to my oily skin (I once dumped a 10 day heart monitor in 8 hours), it will stick to anyone. And you know what? It's not that much less effective than morphine. And it's even refillable.

Have you tried all the non opioid options? Lyrica, Gabapentin, Trifexis, Cymbalta, Nortriptyline (and other TCAs), etc? Lyrica is for nerve pain but Gabapentin and the others are used for all kinds of pain. CBD has limited evidence for helping nerve pain, but be aware that it has a long (>24 hour) half-life and can make you slightly high if you take enough daily (yes, in high enough doses it is psychoactive). There is good evidence for glucosamine/chondroitin for arthritis. There is limited evidence for tuermeric/curcumin (and its cheap!) for helping pain. There is limited evidence for SAM-E (but not if you've ever been manic) for pain. Are you on an NSAID? What about Tramadol? And for me, prednisone is a lifesaver for flights and conferences - I can't do either without it, but obviously you don't want to take it a lot. Great for flareups.

Have you tried compounded topicals? I have 9% Lidocain (store is 4%, pharmacy 5%), 9% Diclofenac (insurance covers 1$), 8% Tramadol (no mental effects), 2% cyclobenzaprine and 0.2% clonidine. You can pack in 30% of medicine, though I take 31.2% cause they still fill it. Topicals never helped me much - in particular lidocaine did shit. Until I tried 10%, that was magic. Most pain is felt on the skin - even organ pain, so you should definitely try this if you haven't. You can get a custom formulation fit exactly to your pain.

What about the various interventions offered via injection/rhizotomy? Do you see a physiatrist? Have you been to see an interventional anaesthesiologist? If you're really suffering have you asked about a spinal stimulator?

If you try most everything on the list, they will write you opioids even today, if buprenorphine doesn't cut it. Maybe you've tried all this stuff but most people I encounter on Quora aren't even anywhere near the end of the road and have given up.

Many people are unwilling to take drugs that affect the brain, and I always conclude they must not hurt very much because I'd take a pill with a 90% chance of curing me and a 10% chance of killing me.

Re: Will there ever be a cure for chronic pain?

#55

Post by sdegutis »

jraph wrote: post #53
sdegutis wrote: post #20

Although there is value in trying to removing pain when doing so would be ethical, this thread mentions many situations where there is pain but no possibility yet of removing or reducing it. In these cases, a long-term general solution is to continue research on these situations. But the short-term solution per person is to learn the meaning and value of suffering. It is frowned upon in intellectual forums to discuss…

I don’t think speaking about religion is a problem. Here's what I think, for what is worth: First, your message may give the impression that you are giving an unfounded lesson to some people here. “You will not […]” Second, you may be speaking a language to which not everyone is receptive. For instance, you are stating things about our duties, but people who don’t see a meaning or a goal in life (does it sound sad?),…

Thank you for that wonderful joke! Your advice reminds me of what Ven. Fulton Sheen talks about here[1], and your great joke reminds me of his other videos[2]. Bless you friend and thanks again :)

[1] https://www.youtube.com/watch?v=Zz0a3TSkHVU&t=8

[2] https://sdegutis.github.io

Re: Will there ever be a cure for chronic pain?

#56

Post by rjurney »

threehams wrote: post #13
juancn wrote: post #2

Should there be one? Pain is a symptom of something else, treat the root cause. Managing pain should only be a temporary measure.

Pain is sometimes a symptom of something else. The overwhelming belief that pain is always a symptom of something else has held back research for decades. "At least initially, a clinician probably will assume pain is a symptom of some underlying condition and prescribe analgesics, while focusing on discovering what the underlying problem might be. But if a cause cannot be found, if early treatments fail to bring impr…

Thank you so much! So much terrible information at the top of this page, really shows the weaknesses of the upvote model here.

Re: Will there ever be a cure for chronic pain?

#57

Post by sdegutis »

rjurney wrote: post #51
sdegutis wrote: post #20

Although there is value in trying to removing pain when doing so would be ethical, this thread mentions many situations where there is pain but no possibility yet of removing or reducing it. In these cases, a long-term general solution is to continue research on these situations. But the short-term solution per person is to learn the meaning and value of suffering. It is frowned upon in intellectual forums to discuss…

You and Jesus are assholes. May you suffer as I do and learn the value of suffering first hand.

Jesus did not take away my suffering. I asked him three times, and three times he said no. He said his grace is sufficient for me, because his power is made perfect in my weakness. I now understand why Jesus said no. Because he did not come to take away suffering, but to teach us how to endure it without failing ourselves or others.

Re: Will there ever be a cure for chronic pain?

#58

Post by rjurney »

Wistar wrote: post #40

Perhaps naive but from NPR this morning: "For people who live with chronic pain, getting up, out and moving can seem daunting. Some fear that physical activity will make their pain worse. But in fact, researchers find the opposite is true: The right kind of exercise can help reduce pain." https://www.npr.org/sections/health-shots/2019/09/23/7548691...

This is true to some extent - use it or lose it. They also teach you to know your limits so your pain doesn't flareup and put you in bed for a week. You learn this delicate balance this over time, to push yourself just enough but not too much. At first you hurt yourself constantly because your body can do whatever you want - right? But no. Not now.

That fact doesn't really make it easier to get out of bed. Your brain tells you not to move, that you're injured. Rest. Its an animal thing. You have to overcome it each morning, and all day long. And unfortunately that takes energy. It drains you. You have much less capacity as a result. Everything in life is harder. You do the best you can. This is the reality of disability.

It fucking sucks.

Re: Will there ever be a cure for chronic pain?

#59

Post by nordsieck »

avgDev wrote: post #41
nordsieck wrote: post #34

Earlier quoted context omitted.

> If you want to hire someone to do a job, you need to know how to do the job yourself. This is simply not possible with the degree of specialization in the modern economy. There's no way you can be an electrician-plumber-mechanic-doctor-lawyer-IT specialist. This is precisely why people care about reputations and gossip.

He is not wrong. I know quite a bit about plumbing, electrical work, car repair......Large amount of people who are licensed or considered experts are pretty terrible or generally lazy and cut corners. Finding someone good is really difficult.

> He is not wrong.

He's not wrong that the problem exists. It even has a name: the principal-agent problem.

You're not wrong that the knowledge you have can help you sniff out bad actors. Every little bit helps.

But it's not scalable. There will always be parts of life that you need to hire help with, but know very little about.

How do you choose which hospital to have a baby at? Which criminal defense attorney to hire? Which violin tutor to hire for your child?

Reputation is one the key ways people try to solve this problem when they're completely out of their depth.

Re: Will there ever be a cure for chronic pain?

#60

Post by rjurney »

nate wrote: post #44

Tangent from the article, but when I read the headline I thought I'd at least share in case it helps anyone who might have chronic pain like I've dealt with lately. For years now I've been suffering from tons of weird shit. I've had this persistent painful skin rash that pops up all over my body. Steroids would kill it for awhile but it would always come back. Folks would ask me if I had burned myself when they'd see…

Diet doesn't cure chronic pain. You obviously had some condition that wasn't chronic pain, where pain was a symptom of that disease.
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