Last updated: Jun 15, 2008
The old way of dealing with pain was to ‘wait until it hurts enough to treat it,” says Carol A. Foster, MD, director of Valley Neurological Headache and Research Center in Phoenix and author of Migraine: Your Questions Answered. “But in the last few years, there has been a complete turnaround. Now we know that prevention and early intervention are absolutely critical.”


The new thinking has made all the difference for Carolyn Robbins of Petaluma, California, who suffers from chronic back and neck pain, the result of a spinal-disk injury combined with nerve damage from Guillain-Barre syndrome. “If youve ever had an exposed nerve in your tooth, you know what it feels like,” says Robbins, who describes her pain as “electrical shocks” in her upper and lower back.

The 45-year-old mother of two doesnt wait until pain hits her full force before treating it. She now relies on a daily prevention regimen, starting with a hot shower and a double dose of ibuprofen. She swims two to three times a week for strength and mobility, and gets weekly massage and chiropractic treatments. And during those times when things get really bad, she pulls out the stronger painkillers prescribed by her doctor. “Ive found that its not a good idea to try to power through the pain, because other things start to go wrong,” Robbins says. “Pain depletes your system as much as exposure to germs.”

Just five years ago, a “kitchen sink” approach like Robbins might have been pooh-poohed by pain-management types, who would have been quick to prescribe hard-core, addictive drugs like oxycontin for such a serious condition. But now the focus has switched. “It used to be, people treated the pain and didnt always treat the underlying disease,” Foster says.

The problem with such an approach, though, is that it sets up a vicious cycle of dependence. “Giving narcotic pain pills to headache patients is like giving cookies to diabetics,” she adds.

So how do you break the habit of heading straight for the medicine cabinet? No matter what your source of pain, the first step is to get an accurate diagnosis and then set up an early intervention strategy with your doctor, says Neil Kirschen, MD, president of the American Association of Orthopedic Medicine and chief of pain management at South Nassau Community Hospital in New York. “The whole goal of pain management today is to keep pain from becoming chronic,” he says.

The reason? Pain actually causes the brain to fire off a stress response that, over time, makes nerves more and more sensitive—and thus better able to telegraph intense pain to you. In other words, pain actually begets pain.

Nan Weiner, executive editor at San Francisco magazine, is a case in point. When she broke her ankle eight years ago, it never completely healed, and the pain became chronic. What should have been a relatively simple injury became an odyssey that had Weiner visiting specialists all over San Francisco. She finally found a podiatrist who “took a detective-like approach to the problem,” Weiner says, by exploring and treating each joint and tendon in a methodical search for the pains source. Thanks to this care, which includes regular pain-preventing cortisone shots, the 55-year-old mother of one has been able to resume her hobby of salsa dancing.