Pain management looks different today

FINDLAY — Many people may associate pain management with opioids, but there are a variety of treatments available, and treatment today looks very different than it did in the early 2000s. Dr. Thomas Kindl, a physician with Blanchard Valley Pain Management, said some chronic pain patients do still take opioids today, but not all. When opioids are used, they are just one piece of the treatment puzzle, and are used alongside other medications and treatments. Research has shown that people who take opioids build a tolerance to them over time, meaning they will eventually need higher and higher doses to get the same effect. This poses other health risks, separate from the possibility of addiction. Kindl said large doses of opioids would harm a person's health, causing gastrointestinal issues and disorientation, among other symptoms. Education is a big part of the process, he said. Pain management today may involve multiple disciplines. In some cases the recommendation may be a hip replacement, and the patient would be referred to a surgeon. Kindl said other medications used in pain treatment can include muscle relaxants, anti-inflammatory drugs and medications such as gabapentin and Cymbalta, among others. Other times, the patient may receive injections of a pain medication. And sometimes patients are referred for treatment that doesn't involve medications at all, such as physical therapy or chiropractic care. Kindl said people are sometimes reluctant to come in for pain treatment, and fear of addiction may be part of why. "Education is paramount," he said. "And part of that process is just to let us be your advocate." He said he and the other members of the pain management team each strive to be an "empathetic listener". But older patients, in particular, are sometimes reluctant to talk about their pain, he said. They may instead bring it up by talking about how they are not functioning as well, such as not being able to walk to the mailbox anymore. Kindl said concerns about cost can also be a barrier to people coming in seeking treatment. Insurance companies vary in what they are willing to approve and when. Kindl said sometimes these concerns lead people to come in less frequently than would be recommended. Kindl, who has been a pain management physician since 2007, said the work is rewarding because he sees how his patients do find relief. Patients are frequently referred through word of mouth, reaching out because a friend or family member had found that relief, he said. He has seen, too, how people living in chronic physical pain may also end up experiencing poor mental health. After all, being in pain for a day is bearable, but if you remain in pain for a month, you may find you are stuck at home, isolated. "It becomes completely demoralizing," Kindl said. He finds the work rewarding because he can see people improve their ability to physically function, and then improve their overall quality of life because of this. For example, a grandmother in her 80s might not be able to go to her granddaughter's sporting events, as she is in too much pain to get out of her bed or chair. This hypothetical patient might not be the best candidate for back surgery, but doctors can provide a few injections throughout the year that will allow her to get out and about. Less pain means a greater ability to function, which in turn means less isolation. Treating patients like these means they can go out and socialize and go to family events. Over time, they can regain more of their lives. "That's where the magic happens," Kindl said.