"Ask Dr. Cook" is a series of questions and answers regarding endometriosis. The current subject and answer can be found on Current Ask Dr. Cook web page. The questions may represent a summary of questions I have been asked by several different patients. I hope you find this information helpful. If you have a question you would like answered, please Submit A Question.

Adequate Pain Relief; Part 1

Question:
My pain is so bad I can't stand it. I had a laparoscope for endometriosis and did feel better for a while, but the pain just keeps getting worse over time. I feel like I am begging my doctor for pain killers. It is humiliating, but I just don't want to hurt so much. I am also afraid of becoming addicted to the pain medicine. Until I can find a doctor that can get rid of the pain, is there any way of controlling this pain?

Answer:
Yes there usually are methods to control the pain. While it would be ideal to eliminate the pain, a more realistic goal is to reduce the pain to a tolerable level. A level at which the pain is not controlling your life. The concept is to have you in control of the pain and your life rather than the debilitating level of pain that all too many of you experience.

Unfortunately, much of the medical community as well as the general population do not understand chronic pain and appropriate pain management. A lot of the medical literature regarding chronic pain is based upon cancer patients. People, many of whom are dying, with horrible pain. One would think that the medical community would have the compassion and knowledge to provide adequate pain relief to these people. People that are looking to their doctors to help ease the pain and suffering from their remaining days of life. If a significant number of people with cancer can not obtain adequate relief, how can an endometriosis patient, who looks well and does not have a terminal disease, hope to find appropriate pain relief?

It is possible to find appropriate pain management, but quite frankly, you may have to be persistent. Pain management is not a routine aspect of most OB/GYN training programs. Most OB/GYN doctors do not understand chronic pain management and it is really not reasonable to expect that they should. The days of the family doctor doing everything are gone. A Pain Management doctor is a specialist (usually a doctor with a background in anesthesia) in the field of pain management. A good pain management doctor is invaluable. Unfortunately, there is a range in quality of pain management doctors (some do not even want to treat female pelvic pain) and many insurance companies will make it difficult or impossible to see a good pain management doctor (if you want them to pay for the visit).

Over the next couple of weeks we will discuss the general approach to the use of pain medications in the treatment of chronic pain and the various types of pain medications.

Updatede October 29, 2005