Chronic pain is chronic pain to some extent, whatever the cause or whatever its 'seat'. Although people who suffer from back pain often share similar symptoms, back pain can include symptoms like sciatica which some experience but others do not. Patients can suffer from neurological disorders that are treated with the same medications as those used by patients with back pain... and so on.

I find that the best medications for chronic pain are those that do not make me sleepy. The duragesic patch is a good idea but it does not last 72 hours. Unfortunately, my HMO won't cover it if prescribed for use every 2 rather than 3 days, so I have to take other pain medications as well.

For patients who are in constant pain, the 'pain patch' is a good idea. I was trying to avoid constant narcotic use, not so much from fear of addiction as from fear that I would reach a point where nothing would work any longer. My doctor advised me to the effect that a constant supply of pain medication that allowed me to function at the best level was preferable to my system, which was to wait until the pain became absolutely unbearable before I took anything. I have to say that he was right.

I would like to make a comment about the misconception that heavy narcotics or opiates cause people to act like 'zombies'. That is not necessarily the case. Nor do they change a person's essential nature. If some one abdicates his/her duties as a human being, it is not the medication that is to blame, but the person! Opiates and narcotics have saved my life and allowed me to function and to maintain my duties and responsibilities both towards my own family and towards the world.

Obviously, medications affect people in different ways, and some people may find that they are 'knocked out' by a specific pain medication. Often this is an effect that passes as the person becomes accustomed to the medication. Life is filled with compromises. When the pain is unbearable, pain medication may be the only solution. It does not make one less of a human being, nor does it 'alter' one's spirit!

I would like to add that any person, whether a physician or not, who tells another that the pain is 'all in his/her head' is ignorant and his/her opinion really must be ignored. It is hard enough to live with chronic pain without being mocked, humiliated or given cause to doubt ones sanity or mental health. Many doctors, too insecure to be willing to simply admit that they haven't got a diagnosis, resort to the claim that the patient's pain is psychosomatic. In many cases, it takes years to uncover the true cause of the pain, but in the end, they find there usually is a physical cause for the patient's suffering.

The contemporary fad in favour of thrusting 'antidepressant' drugs at any one who suffers from pain that is not easily treated or diagnosed disgusts and amazes me. In my opinion, a drug that alters the actual composition of one's psyche or physical body is far more dangerous than any simple painkiller. Now, of course, they are finding that many so-called 'antidepressant' drugs actually promote suicidal moods in patients. Yet many doctors continue to order antidepressants for their patients in lieu of opiates or narcotics.

The idea of Pain Management Clinics is one of the more advanced medical achievements in contemporary society. To address Chronic Pain and work with patients to control it rather than pretending that all pain can be vanquished by a procedure is a step forward, and to recognise the fact that there are people who need pain medication (as well as physical therapy and other forms of treatment) on a regular, ongoing basis has been a breakthrough for the medical profession in the States.

It is the old Puritan philosophy that underlies the principle that pain medication is only for weak, spineless creatures, and that mind always should triumph over matter. Unfortunately, some of us cannot vanquish physical pain or the conditions that cause it with mind control. Some people are required to come to terms with the idea that their condition will last for years, even a lifetime and that the best they can do is control the pain with medication and other treatments.

As far as other treatment is concerned, the only thing that has worked for me to any extent, other than pain medication, is water therapy. Hot water does provide some relief, and bath salts can help as well. I only was able to perform simple exercises and recover a little mobility when I was allowed to use a therapy pool. Unfortunately, my HMO refuses to give authorisation for any more sessions and I haven't the means to buy one for myself. I do recommend it, however, especially for those who suffer from back pain, severe bursitis and/or arthritis of the hips. In water, one no longer is subjected to the pressure that gravity places on the body. It is a brief reprieve from the pain one suffers 'on land'.