War On Pain
In October 2017, the President declared the opioid crisis a public health emergency. Although there is a growing number of deaths related to opioid misuse, the idea of regulations on pain medication sent terror through the chronically ill patient community. Once again, the needs of patients are overlooked. Lumped into a crisis that, for the most part, has nothing to do with the patient community. A patient community that massively relies on these types of medications to help improve their quality of life.
The changing landscape
According to the rheumatology advisor online magazine, opioid use is high in the ankylosing spondylitis community. What they are finding is that the use of anti-TNF therapies is reducing and opioid and corticoid steroid use is rising. “Even though these anti-TNF therapies should be the first line of pharmacotherapy, prescription opioids may offer an 'inexpensive and rapid means of achieving symptomatic relief'” according to rheumatologyadvisor.com.
It sounds like we are creating an environment where we merely finding temporary solutions for long-lasting problems. Creating multiple issues for the patient and the healthcare system overall. This type of treatment plan is fueling the cries of an opioid epidemic while placing the chronic patient in the firing range. How can we turn this around?
Acheiving pain relief
Pain relief is a must to achieve proper healing. When you’re in constant pain, your body is not able to heal. Stress, insomnia, tense muscles can all prevent you from properly healing. Pain relief medicine often gives your body the time to relax so that the medication you take to heal can have a chance to do so.
Living without proper pain management is not possible for patients living with a condition like AS. However, an appropriate plan of treatment should include adequate pain management. For patients living with a physically disabling disease, there are ways to help ease yourself off of opioid dependency and increase your physical capabilities. Here are a few ideas to help you get through your health journey in a fashion that will lead toward actually healing, as opposed to patching up the problem.
Over the years, my workout agenda has been dictated by my inflammatory bowel disease, and it’s extraintestinal manifestations. High impact workouts just are physically impossible for me all of the time. However, physical therapy has been helping my body heal. Your therapy sessions should be customized to fit your needs. For example, my physical therapists incorporate pilates movements and lots of heat to help stretch my muscles without too much stress. He also includes a back massage before every session, to get me warmed up.
I’m obsessed with ThermaCare patches and wraps. They come with lower and upper back sizes. The heat isn’t very intense and goes off and on to give you a break. Topricin is a great topical pain reliever that doesn’t leave a residue or an overbearing scent. Heated blankets are also an excellent remedy to a cooler night. During a family movie or game night, I’ll fold the blanket in fourths and create a heated cushion for me to sit up against. Also, invest in better tennis shoes, desk chairs, and mattresses. Ones that will accommodate your back pain and stiffness.
Create your medical team
There is a way to medically take control of your treatment plan. The best way is to create a team of healthcare providers all working together toward your remission. They should be talking to each other and in agreement on your therapy plan.
For example, if a biologic is in your treatment plan, you should be discussing something that will cover as many of your ailments as possible. This can reduce stress and put you on the path toward better health. A pain management specialist should include on this team. Having someone document your levels of pain may help with determining a proper pain management plan that may or may not include pain medication.
Communication is critical when it comes to your health. You should be talking to your doctors about what your fears and concerns, treatment pathways, and your quality of life. There should be a plan you are collectively working on with your healthcare provider. And the mission of the program should be to increase your quality of life. You need to work with your practitioner on what that looks like for you. Everyone’s quality of life is different. There is no right or wrong way. If you find that communication isn’t working between you and your doctor, do not be afraid to begin interviewing others. You do not have to stay in an uncomfortable situation when it comes to your health.
Sometimes with all that surrounds our condition, we feel trapped. Trapped in our bodies, our health, and our lives. One thing I have learned is that when you take a step back for a moment and look at the situation with another view, you can find a solution. The point is to not panic, but re-engage with your healthcare team and yourself to find the best quality of life solution.
Other than back pain and fatigue, what is the most common symptom that AS patients experience?