I’m confused and need a definitive answer. I live with chronic neck, shoulder and back pain that started five years ago after an automobile accident. My orthopedist originally told me to medicate the symptoms, so I have taken medication only when the pain gets worse. Recently, I’ve been referred to a pain specialist who is saying that I should not wait until the pain becomes severe to take the newly prescribed medication. Should I take the drug when I can’t tolerate the pain or take it regularly as prescribed?
According to Jason Sobel, MD, an internist board-certifed in hospital and palliative medicine who works with Capital Care in northern Virginia, the orthopedist most likely anticipated that your pain would last a week or two at most. That’s why the pain medications were recommended on an “as-needed” basis. In hindsight, your injury was worse than originally appreciated, and it likely has changed over time. Sobel said, “To make matters worse, the protracted nature of your pain has reprogrammed your nervous system so that your pain has become an altogether different beast. This is more challenging to treat.” Pain medicines are prescribed on a schedule to minimize your discomfort, which you may or may not need indefinitely. Sobel added, “It is critical that you and your physicians explore what culprits are contributing to the chronicity of your pain. There may be some spinal stenosis or other problems causing referred pains to other areas of your body. There are additional interventions to oral medication, such as injections and physical therapy, that can further help to alleviate the pain. As you move through multistep decisions to evaluate the therapeutic process, you will need to take your pain meds on a scheduled basis, at least until the structural problems can be resolved.”
Want to learn more about pain medications? Read “Opioids and Your Gut,” “Over-the-Counter & Natural Relievers for Joint Pain,” and “Pain Killers: Avoiding Addiction.”