Pain Management

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Information provided by the VA War Related Illness & Injury Study Center
warrelatedillness.va.gov

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Dealing with Chronic Pain

A Resource for Veterans, Service Members, and Their Families

Many Veterans live with chronic pain. Pain is called “chronic” when its lasts over a long period of time. This includes pain that you feel regularly, even if it comes and goes. Chronic pain can affect a particular part of the body, such as the back, shoulders, or knee, or be experienced as general all-over body pain. Living with pain can interfere with your life because of the negative impact it has on how you are feeling and functioning day to day. However, by managing pain effectively (often referred to as pain management) you can feel better and live better. Effective pain management includes a number of things:

Work with an understanding and knowledgeable doctor to evaluate treatment options

While primary care providers (PCPs) can often help you deal effectively with painful symptoms, depending on the severity and duration of those symptoms it may be important to talk to your PCP about a referral to a doctor who specializes in pain medicine. Most Department of Veterans Affairs (VA) Medical Centers have a pain management clinic, where Veterans can be referred. Developing an open and trusting relationship with this doctor is important in treating your pain. Communicate with your doctor about where the pain is, how bad it is, and how often it occurs. Also talk about what makes the pain better or worse.

Since pain symptoms vary from person to person, pain management treatment strategies and treatments also need to be individualized. Medication alone is often not sufficient to treat pain and sometimes too many medications or taking them for prolonged periods of time can cause other problems. Additional treatments for you might include interventions for your specific type of pain or non-traditional treatments. As time passes, it is important for you and your doctor to reevaluate what’s working for you and what can be done differently to accommodate any changes in your symptoms. Finding the right combination is the key.

Take care of the things you can control

Getting enough sleep, eating healthy, and exercising is essential to maintaining function and health and even more so when you are dealing with chronic pain. The good news is these are things you can control and do for yourself. It may seem that trying to exercise does not make sense- you have pain so you do not want to move, or are afraid to cause more pain. Studies show that low-impact graded aerobic exercise (such as walking, swimming, or biking) can actually help reduce the pain. Ask your doctor which exercises are safe for you. He or she may even recommend you work with a physical therapist that will tailor an exercise program to best meet your needs.

Other things you can do yourself are: therapies for the mind and body such as meditation and yoga (non-traditional treatments often referred to as Complementary and Integrative medicine practices).
These may help reduce stress, improve mood, and make you less aware of pain which will help you feel better. Again, your doctor can help you decide which techniques may be beneficial for you.

Care for Your Emotional Health

Chronic pain is often accompanied by undesired changes in your personal routine. These changes might include: loss of function, inability to work, and deterioration of personal relationships. Because of negative life changes, people in chronic pain have an increased risk for emotional health issues such as depression and anxiety. Your emotions may range from: fear, anger, and denial to hope and optimism. Every person feels different emotions at different times, and sometimes emotions can make controlling pain more difficult. Taking care of the emotional aspects of chronic pain is a necessary part of treating your overall pain. Your doctor may want to prescribe medication for depression, anxiety, and sleep disturbances and, may also suggest cognitive behavioral therapy (CBT). CBT is based on the idea that emotions and behavior are influenced by our thoughts about a situation (e.g., “this is awful” vs. “this is uncomfortable”). By learning to modify the way we think about difficult situations, we can cope better and avoid acting in ways that make the situation worse. This is part of your doctor’s approach to treating pain as a “whole” not just the part that physically hurts. Some things you can do to help yourself deal with the emotional aspects of pain are to: keep a journal of your emotions, talk to loved ones about how you feel, or join a local support group.
If you are a Veteran with chronic pain consider how the above information relates to you and what the next steps are in gaining more control of your pain. Although it may not be possible for you to be completely free of pain, through pain management you can minimize pain and live the happier life you deserve.

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Resources for Pain Management

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San Diego VA Healthcare System
Please contact your Primary Care Provider Team for a referral for pain management services available at the San Diego VA.
Primary Care Line: (858) 552-7475
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American Chronic Pain Association
(800) 533-3231
theacpa.org

Facilitates peer support and education for individuals with chronic pain and their families so that they may live more fully in spite of their pain.
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Healthier Living Managing Chronic Conditions
Contact: Charlotte Tenney
(858) 495-5500
sdcounty.ca.gov/hhsa

Provides workshops to support developing strategies to intervene in the symptom cycle to relieve the pain, reduce fatigue, calm anxiety, relieve shortness of breath and soothe muscle tension.
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Chronic Pain Rehabilitation Program – Scripps Health

Scripps Mercy Hospital, San Diego
4077 Fifth Avenue
San Diego, CA 92103
(619) 294-8111

Scripps Mercy Hospital, Chula Vista
435 H Street
Chula Vista, CA 91910
(619) 691-7000

scripps.org/services/pain-management

Program addresses a number of health issues, including: anxiety, depression, fatigue, memory difficulties, sleep problems, and stress. Offers a combination of comprehensive based treatments, research, education and advocacy. The program is offered at both the San Diego and Chula Vista Scripps Mercy campuses.
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Chronic Pain Support Group
6645 Alvarado Road
San Diego, CA 92120
(619) 229-7216

Support group meets the 1st and 3rd Saturday of each month from 1:00 to 3:00 pm in the 3rd floor conference room at the San Diego Rehabilitation Institute.
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Feldenkrais Center
341 Neptune Avenue
Encinitas, CA 92024
(760) 436-2403
thefeldenkraiscenter.com

Outpatient facility focuses on alleviating the pain of recent injuries or accidents, chronic pain management and treating disabilities.
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Partners Against Pain
(888) 726-7535
partnersagainstpain.com

Offers information on understanding, managing, and tracking pain for those afflicted and their caregivers. Provides resources for finding pain care locally.
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VA Yoga for Back Pain Class
Location: Medical Center La Jolla, 1st floor, Patient Education Classroom (Room 1493)
Information/Registration: Ask your primary care provider to send a consult to “Yoga Clinic” for approval to attend the class by Dr. Baxi.
11:30 am – 1:00 pm, every Tuesday
sandiego.va.gov/patients/patientedclasses.asp

This is an 8-week program designed for veterans with chronic back pain, who have met inclusion/exclusion criteria as determined by their primary care provider.
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VA Tai Chi Exercise Class
Location: Medical Center La Jolla, 1st floor, Patient Education Classroom (Room 1493)
Information/Registration: Ask your primary care provider to enroll you in the class by sending a consult to “Physical Therapy” (PT) and note evaluate for participation in Tai Chi Class.
Call (858) 552-7487 (Mention Tai Chi) or Toll-Free: 1-800-331-VETS [8387] x7487
1:00 – 2:00 pm, every Monday
sandiego.va.gov/patients/patientedclasses.asp

This Tai Chi class is offered for patients with chronic pain. All patients with chronic painful conditions who are motivated for self-management of pain through exercise are invited to attend. Tai Chi Chuan combines a series of gentle, meditative postures flowing from one to the other in a continuous rhythmic movement. The benefits of practicing Tai Chi Chuan are improvement in balance, strength, flexibility, posture, coordination, endurance, breath control, digestion and mental clarity. Tai Chi Chuan reduces stress, pain, anxiety, depression and the risk or fear of falling.