What pain outcomes do you aim for?

[indego83]

I’ve recently had two surgeries (one key hole, one that left a 6inch vertical incision), and each time the medical staff were incredibly well informed and supportive of Fibro. It was a pleasant surprise, I was really expecting to have a hard time explaining my needs, but there was no judgment, no disbelief, and I got the sneaking impression they were taking me saying “3 out of 10,” to mean 6. I defiantly was taken more seriously than other patients when I complained of pain/discomfort.

But what really got me was that the hospitals both had a policy to ensure their patient’s pain was kept under a 2 out of 10 at all times. And they really lived up to it.
My fibro pain can vary a lot, but I never get pain free days, and it’s quite rare for my pain to be below a 2. Needless to say I was quite a content patient during my stay, because even with a 6 inch hole from pubic bone to belly button, I was a lot comfier than I had been in years.
(Expect when I threw up. Oh dear god did that hurt.)

The nurses asked me how I managed my pain at home, were saying that even at home I should be aiming to keep my pain under a 2 out of 10. They were quite insistent that this should be my goal for the fibro pain as well.

For me, that’s just unobtainable. The endone tablets they sent me home with come close (some nights they achieved it, other nights they didn’t), which isn’t exactly a long term solution. My goal is never getting over a 4, and if I can’t achieve that then it’s just to keep things bearable.

So. In your personal experience and opinion, what should we be aiming for with our pain medication?
Should we be striving for a particular number out of ten? To keep it just low enough to keep active? Or just to keep the pain within what we can live with?

[indego83]

I guess it’s probably something we all have to answer for ourselves. How much relief is enough, how much can we handle?

But the questions really got me intrigued. Now I know that one of the major networks of hospitals in Australia has a "below 2" policy because research shows that patient outcomes are much better when the patient isn’t in pain. They also discovered that keeping pain low after surgery drastically lowers the risks of patients developing chronic pain.
It’s got me wondering how much the pain actually does impact us – even if we’re not massively bothered by it.

I had a chat with my GP today about what he thought was a reasonable pain level. He answered that it was up to me. I could medicate myself more heavily and lower my pain, or have less medication and more pain.
He agreed with the hospital that ideally under 2 is what everyone should aim for, but admitted that that’s not really possible with Fibro. He did point out that my pain tolerance seems to be absurdly high (I’ve been walking around on a swollen ACL for a week. I only mentioned a pressure in my knee in passing… Apparently an ACL as swollen as mine has been known to reduce grown men to tears) and I need to take that into account when medicating.
He pointed out that if I wait until the pain is at a 5 before medicating, I’m asking the medication to take care of more than it can handle.

His advice was to medicate early, or not at all.

I’d love to see some research into long term outcomes for Fibro patients comparing those who medicate their pain down to under a 2, and those who only medicate it down to a 5 or so.

[Bhupinder Kaur, MD]

Hello,
There is no particular treatment for fibromyalgia. For fibromyalgia get prescribed antidepressants and muscle relaxants apart from the pain killers. Antipsychotic medicines are also sometimes used to treat conditions that cause chronic (long-term) pain, such as fibromyalgia.
It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.