Poor Correspondence Between Pain Data and Actual Symptoms Hurts Patients
At PAINWeek 2016 in Las Vegas, Nevada, Roger B. Fillingim, PhD, professor and director at the Pain Research and Intervention Center of Excellence at the University of Florida, spoke about the conceptual models of pain and how following them word for word could cause problems.
If you look at the Biomedical Model of Pain, it’ll say that pain is a sensory experience which is a symptom of disease or tissue damage. And historically, that is what has been believed. Pain, whether acute or chronic, can certainly arise from injury, trauma, or surgery, but more and more doctors are viewing it as a condition all of its own.
The model also says that pain is proportional to the amount of tissue damage. This goes back to the earlier statement that in a perfect world, the two would match up. But what happens when a test doesn’t reflect the amount of pain that a patient “should” have? Doctors may go on to invalidate the patient because of the lacking data correlation. “This has probably been the most damaging to patients,” Fillingim said during the presentation. Due to this poorly correlating data, researchers are trying to develop more sophisticated ways to view pain.
“As you can tell, I’m not a fan of the Biomedical Model,” Fillingim said, pointing out that these highlight the inadequacies as opposed to the strengths of the model.
A 2008 study by Reva C. Lawrence, MPH, looked at radiographic vs. symptomatic osteoarthritis. The results found substantial differences between pain data and actual symptoms. Interestingly, the patients reported less pain than what the radiographic data indicated. Another study in 2006 by Eugene J. Carragee, MD, found that lumbar magnetic resonance imaging (MRI) reported pain when the patients didn’t actually have much at all. So tests could say that patients “should” be in pain because they have a disease, but that correlation may not even be there.
No model is perfect, and it’s fair to say that they all have their strengths, but that should be considered when treating patients with painful conditions.
Filed under: General Problems
If they were to listen to any chronic pain patients it would most likely only be those who despite chronic pain are rabidly anti- opioid. To listen might require that they give up the control they have over us and lord knows they aren’t going to do that!
I don’t think Steve allows our emails??I don’t know? [cmwmkw@,,the rest is gmail.com] /OF COURSE I’D EMAIL U BACK!!,,that is soo weird u mention your legs,,,mine too ached, along w/my feet,,In the a.m.,,,my legs look great,,by thee end of the day,,their swollen,,During this whole 20 years screw-up on my body,,my legs started to get huge varicose veins,,,huge sticken out of my legs,,This last surgery..I woke up to early and they surgery team had put this inflatable thingy’s on my legs,,Come to find out,,,because of sooo much swelling and water build up,ie edema, inside,,,,my descending arteries to my legs were being compressed,,
Getten back to the artiucles point,,they need to listen to thee actual patients,,,calll up from some sorta group meeting,,and pic a bunch of chroic physical pain people in,,to communicate to the powers to be what it is like to be a chronic physical pain person,,Cause they have no clue,,nor do they have any clue to the damage the have done to all of us,,,but they censor us,,they refuse to listen to us,,they do not want the truth/knowledge from people like u are me and sooo many other,,They refuse to document deaths due to untreated physical pain because again,,that would prove the genocide they have committed,,Until we get a honest,non-corrupt team in the White House…HHS,,THEE ALPHABET SOUP GOVERNMENT AGENCY,, nothing wil change,,because they want nothing to change,,They want to be able to willfully deny us axccess to our meds,,it about controlll NOT,, humane treatment for the medically ill w/painful chronic medical conditions,,jmo,mary
Anyone can put their emails in their posts… The consequences of doing so… is not my responsibility 🙂
As u already know,,the pancreas is on the left,,however,,as u know,,the duct for the liver is on that right side,,Also,,my surgeon saw all my scarring w/the camera they went in with,,,it never has shown up on a echo,,ever,,,,My doc has had 2 patients already,,whom have had their gallbladder taken out,,and still got stones AFTER,,their gallbladder was takern out,,soo,,it just suc’s,,u know,,we are not idiots,,we feel pain because something in our bodies is physically wrong,,U know out of the 50 doctors I have been force to see over 30 years,,only 1,,stated,,there are limitation to our medical testing and the field of medicine in general,,,instead of,like thee other 49 doctors,,blaming me,,,,,or in your case,, u,,If they can’t find it,,then we gotta be liers in their minds,,or were women,,so thats why it hurts,,,insane,,but true,,Like I said even Mayo Clinic,,told me,,nothing wrong,,,with your body,,all testing normal,,,in reality another stone was stuck in those ducts,,,U know,,I have been hearing this ”cbd” oil they get out of thee ,”hemp” plant works for some physical pain,,Its sold in every smoke shop here in Wisco,,Do not know about Alaska,,,expensive,,,but maybe worth a try??Also I have learned via a nurse friend of mine,,and I will try this next time I feel a bout of pancreatitis,,instead of going to some stupid e.r. again,,,WATER,, lots of lots of water,,,basically flushing your system on your own,,instead of in a hospital bed,,Just throwing things out there for u to maybe try,,,if u haven’t already?and I have hear marijuana also helps w/that physical pain,,hope this helps??MARY
I actually use CBD oil with tryptophan and while it helps somewhat with the burning pain in my legs it doesn’t seem to do anything for the “nonexistent” pain in my rib area. I reccomendations anyone try it. I have tried marijuana which is legal here but I have about 16 minutes of panic attack before the pain relief kicks in. I would like to try other strains to see if they’re better and don’t cause a panic attack. It’s weird how one thing can work so differently on both different pain as well as different people. I wish the powers that be could understand or at least accept that! Mary. If I post my email would you be willing to email with me?
Mary, I have literally begged to have my pancreas and the ducts checked (gallbladder removed years ago) only to be told that my pancreas is on the other side! Where do these “doctors” get their license? I am thinking from a yard sale put on by someone who bought theirs at k- Mart!
Until u find a doctor who is willing to acknowledge there are limitation to medicine and medical testing,,,YOUR SDREWED,,,,X-RAYS did not show how swollen my internal organs were,,A c.t,,,,showed absolutely nothing wrong inside,,,when in reality,,,my internal organs were swollen 3 x there size,,,my gallbladder was packed w/stones,,my ducts were clogged,,,X-ray,,echo’s,c.t.,,,showed NONE OF THIS,,, the echo,,,showed swollen pancreas,,but not the scarring,,,thee echo,,showed some stones,,like 5,,,but in reality there was over 30,,but thee echo was not done till I was admitted,,because blood work finally showed something,,lipase level at 1800,,by then the damage was permanent,,,NEVER GIVE UP HUN,,, tell the truth,,,always,,u know your body,,,but I have told my current doctor,,no more x-rays,,no more echo’s,,no more c.t.,,,EVER!! they lie,,they do not show the truth inside my body,,,thee only test I will have done is w/a camera,,inside my body,,,then maybe I will agree to a m.r.i.,,,which did show the tumor in my cord,,,,but not the swollen pancreas or gallbladder issues,,and a camera that see’s the outside of my organs,,,,not the inside,,,Those ,”normal” test results cause more damage to me ,,medically in the long run,,,soo no more ,”normal” testing for me,,Hell,,I do not have kids,,because of this complete screw-up,,,We would of liked to have 1 kid,,but because ,they” claimed everything was ,”normal” after that tumor was removed,,but I srtill had severe physical pain,,we knew we could not take care of a child like that,,,,,The whole situation is very pissing to me and my hubby!!!!!!!! BUT NEVER STOP TELLING THE TRUTH,, hell your autopsy will show it then,,,that is what I use to say..”fine when I crook,,i want a autopsy done specifically where my physical pain is!!!,,,mary
Speaking of bad data,,and knowing our own bodies,,which is 1000% true,,,,recently I got another episode of pancreatitis,sooo,,,I called the Doc who did my 1 st surgery,,,I asked him if there was any scarring on my pancreas from what he saw in the recent surgery,,What he told me pissst me off soooooo bad,,,He went in w/ a camera bout 6 month ago,,He told me my pancreas,my stomach outside wall,,my ,”internal organs,” were soooo swollen,,3 X,,normal and my gallbladder was sooo calcified,,it must of took over a decade to make it look sooo badly mangled,in there..His exact words,,”they are badly beaten up,” unquote,,,,Now u women can understand this,,,,My very very 1st incident of physical pain was under my left breast,,,,spiderring across my entire left chest,,,They found a lower lung collapsed,,arythemia’s[sp],17 cardiac ablations,and a spinal cord tumor T-2 thru T-9,,pressing on my spinal cord,,They;s told me ,,,this was the problem,,,NEVER EVER LOOKED AT MY PANCREAS/GALLBLADDER,, in 20 years,,They took out that tumor..brought my left lung up,,cardiac ablations,,,I WAS STILL IN TERRIBLE CHEST PAIN UNDER LEFT BREAST,,, I was called a lier,,,a women,,a panic attack,,accused of all kinds of terrible things,,touching leads,,,discharged un- able to even get off the hospital gurnee,,again,,No-one ever even looked at my pancreas/gallbladder or duct work,,,ever!!! in 20 years,,the physical pain was my fault,,had to be,,they could not find the cause,,soo,,it had to me as a person,,,so 20 YEARS WORTH OF PANCREATITIS,GALLSTONES BLOCKING DUCT WORK,, organs swelling,,3 x there normal size,,,and a gallbladder the doc said looked like a gravel pit,,,point being,,all along I knew there was something wrong,,I knew i was not being a wimp,,,Mayo clinic,,rochestar,,St.Lukes Milwaukee,,,,St.Joes,,St.Katherines,,,freaking 5 hospitals all said nothing wrong,,Geez even when this all went down,,my local e.r. literally said i was full of shit,,,did a c.t. 2nd er visit,,said not 1 gall;stone seen via c.t.,,when in reality it was packed w/gallstone…Test lie,,x-rays lie,,people lie,,now a days I would of been accused of Doctor shopping because I simply wanted my physical pain stopped,,,that how freaking stupid this government is,,Now,,my pancreas is permanatly scarred,,my spinal cord is scarred,,my internal organs ,”r badly beaten up,” because of terrible LIEFUL documentation,,medical limitation of x-rays,c.t.s and doctors who read a nurses comments,,,everything is fine,,patient possible faking it,”” unquote,,,How the hell do u miss a gallbladder soo packed w/stones the surgeon calls it a gravel pit,?,Even the admitting nurse,,bitch,,instead of putting pain medicine in my initial i.v.,,simply flushed it ,,seeing if I was lieing about my physical PAIN FROM PANCREATITIS,,After my surgeries,,I literally dropped 50 pounds in 3 weeks of nothing but water,,,my adominal decenting artery was being compressed by all this,,When they open up my duct work,,I was loosing water out of orifice of my body..,,,There are soooo many idiots out there,government officials, nurses,doc’s etc out there,,False documentation literally should of killed me,,how/why I am still alive,,I don’t knowe,,still wondering if some of this physical pain is from another spinal cord tumor,,but Doc tooo chicken to look,,logically u would think,,with all this going on in thee upper abdominal ,thoracic,,there could be another one back there,,I guess their more worried about there careeers then my spinal cord,,hell,,its already damaged anyways!,,,,,,U KNOW YOUR BODY,, u know if something isn’t rite,,,keep on telling the truth,,insist of writing your own version of what happens and add it to your medical records,,For u know dang well,,,in this climate created by our government,,Doctors,nurses are going to cya it,,to prove there is nothing wrong,,when in reality,,there is something very very medically wrong w/your bodies,,,jmo,sorry soo long,,this issue is kinda personal and gets me fired up,,and my case is a perfect example of how incompetent,corrupt data,,is soo very harmful to the chronic physical pain from medical illness humanbeing,,it dam near killed me,,mary
Mary, I so know how you feel. I am currently fighting for my health business being a pain patient and will new issues causing more pain I might as well sh** and fall in it. I have a lump just under my right rib that anyone who looks can easily see and recently the entire area,front and back, of my right ribcage is swollen feeling and very painful. This is only one of the issues I can’t seem to get adequately addressed. They do repeats of blood work, exrays and cat scan that I am told show there is nothing there and they quit looking. I am in Alaska where medical care of any quality is hard to come by and if you are a pain patient FORGET IT cuz you won’t be listened to!
Anyone check YOUR gallbladder/pancreas or very important,,the 2 ducts leading to your guts,,the pancreatic and bile ducts,,,if theyare clogged,,,your liver/ie right side,,will swell,,,your diaphragm will give u a proble,m,,hell even breathing will hurt,..i COULD NOT BREATH OR LAY DOWN AT ALL,, with out physical pain,,,The ambulance driver ,’labeled” me as ,”NON-COOPERATIVE& COMBATTIVE,, because I refuse to lay down in the ambulance,I could barely sit,,so these 2 a-holes are literally grapping my upper arms pushing me into the gurnee,until I threaten to call the cops on them,,they finally stopped,,But the E.R,,treated me like shit,,that e.r. visit,,which was 3 days before my emergency surgery,,,,Those ducts are very very important,,,,my gallbladder was soo calcified,,soo full of stones,,soo swollen,,,as 1 nurse put it,,THAT DOESN’T HAPPEN OVER NIGHT,,,THAT HAPPENS OVER YEARS OF PHYSICAL PAIN,,, and she is rite,,,For 20 years all my blood work came back normal cause there is a diufferent kind of blood work NOW A DAYS,, they do to see how your pancreas/gallbladder/liver is functioning,,and it not going to be found in your ,”normal blood work,”’,,,keep on document your physical pain,,their is something wrong,,obviously!!!MARY
Connie there is no place they will listen to you. We can’t do much this time but the next time our votes go in we will force some changes. We have the numbers. Hang in there. I’m sorry for your pain.
If some politicians,and shrinks weren’t sooo arrogant,,and realize simple humanity,,that no-one can physically feel the physical pain of another,,thus as a evolving humane society,,we have the tools to lessen that physical pain,,,it is NOT their place to judge us,,,,to respect the fact,,,that their are certain things they have no rite to decide,,especially since it is literally impossible to physically feel the physical pain of another,,,,Simple humane treatment to all would end this torture and genocide,,,,getting rid of the true psychopaths like little hitler klondyne,,,,Honor the law,,like Dr.Cheek state,,,Doctors are exempt for being prosecuted for prescribing our medicine’s,,,This is truly prohibition all over again,,,and we best stand up against it,,,or more will die,in physical pain from medical illness!..,maryw
Yes you understand the real problem. To get everyone to stand up together. Maybe we need to ask for ideas on how to do this. We have the power to do it. We just have to join together to do it.
Sandra
Perhaps doctors should realize that we know our bodies and how we feel and could actually listen to us and believe what we are telling them! I know that won’t happen but in a perfect world it would.
I agree with you. They think they are so special and we should bow down to them.
One of my doctors stated that when he first went into practice that most doctors wanted to help people. He said the new doctors go into practice to make money. He said that is what we have for doctors now. They refer you to all doctors and have you come back and go over findings . Also the drug reps streaming in their door …new drugs ect…they take them to dinner bring in nice presents….oh yes most of this you can look up on line. I just wonder what you can’t see. Yes take some new drugs.