Team Up to Fight Pain

More than 50 million Americans suffer from chronic-pain conditions, but now groups of specialists from both Eastern and Western medicine, are offering new hope.

By Alice Lesch Kelly

Penny Rickhoff lives with pain that never ends. It began in 1985 when she ruptured a disk in her lower back, and it worsened several years later when a file cabinet fell on her. "Basically, on a scale of one to 10, my pain averages about a five, which is moderate," says Rickhoff, a substitute teacher in her early 50s who lives in Scottsdale, Arizona. "In the evening, it goes to a six. And periodically, I have flare-ups that send it up to an eight or nine."

The intense flare-ups in her lower back, which occur a few times a year when she lifts something heavy or suddenly moves the wrong way, are excruciating. "My muscles contract, and they become hard and immobile. Sometimes I can hardly even turn in bed. It's like a constant, heated, deep pain--and if I move, it becomes a stabbing pain," she says. "Then I feel faint, and if I try to get up and move too much, my blood pressure goes up and sometimes I feel nauseous." Even after the flare-up subsides, she still hurts nonstop. "It's a constant aching feeling that is always there and never goes away."

Rickhoff's suffering has made a huge impact on her life. After the file-cabinet injury, she was forced to give up her job as a corporate pilot. Her condition contributed to marital problems. (She and her husband eventually got divorced.) Even going out with friends has become difficult, because her back often hurts more late in the day.

Rickhoff is one of 50 million Americans who suffer from chronic pain, including pain from lower back problems, arthritis, cancer, repetitive stress injuries, headaches, fibromyalgia, and other ailments, as well as from botched surgeries and industrial accidents. "The individual with chronic pain is not comfortable while awake, and usually doesn't sleep well at night," says Steven D. Feinberg, M.D., clinical adjunct professor of anesthesiology at the Stanford University School of Medicine and director of the Bay Area Pain Program in Los Gatos, California. "Weight gain and sexual difficulties occur," he continues. "Anger, depression, despair, and irritability are common. Chronic pain is often accompanied by loss of hope and self-esteem. It saps the individual's energy and the ability to think straight."

Chronic pain, defined as continuous pain for more than six months, can trigger a cycle of disability. Those who suffer from it often retreat into themselves, becoming inactive and minimizing contact with other people; lack of social interaction contributes to feelings of depression and isolation. They may rely on medications to get through the day, and then to sleep, and those medications may cause side effects--dizziness, nausea, and drowsiness--that immobilize them further. Inactivity causes their muscles to weaken; deconditioned muscles make them feel even more infirm. Over time, despair may set in, and the pain may seem even worse; studies show that depressed people feel pain more acutely than nondepressed people. Feeling worse, they may ask their doctor for more medication, and when they take it, they may feel even groggier, debilitated, and depressed. And the cycle progresses downward.

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