My chronic pain was a result of many years of athletic injuries. Mainly to my neck. Traditional doctors did nothing for me and were utterly useless. They didn't even have a recommendation. Just pills.

I'm almost completely cured after 5+ years of chiropractic adjustments and massage. Also, no matter how bad the pain was, I exercised at least 3x a week.

this article does not mention the arthritis which would probably account for half the pain relief being sought

We as patients need to be tenacious and keep asking our docs questions about alternative treatments and options. If costs concern you (and who doesn't worry about high costs?), than ask for lower cost options. I found this helping in shaping Qs:

http://whatstherealcost.org/video.php?post=five-questions

Acupuncture is usually very effective for pain relief -- both acute and chronic cases. Back, neck, shoulder, knee pain and headaches/migraines, in most cases, respond very well to acupuncture, with no side-effects.

There are about 200 community acupuncture clinics in the U.S. These charge affordable rates in the range of $15 - $40 for follow-up visits, with patients deciding what to pay within these ranges. To find the nearest community acupuncture clinic to you, check Locate-a-Clinic on communityacupuncture network.org

The IOM pain report fails to recommend energetic and needed changes to transform pain care for Americans. They emphasize self management of pain -despite the fact that self management is all too little for people suffering chronic pain. Conspicuously absent is talk of cures or empowering people in pain with a pain bill of rights. The IOm fails to put a dollar amount on how much more should be spent on pain research. The report lack a lot of detailed specific suggestions and it would seem to be mostly old wine in new bottles.

The IOm study doesnt call for lowering the prevalence of pain, it doesnt require any doctor to have any education in pain care, it doesnt improve the rights of people in pain. It largely is about underpowered suggestions that lack specificity to improve awareness of pain in the Country as well as improve pain self management programs- its the same old top down medicocentric pain care that has failed in the past- i guess as the saying goes-the more things change the more they remain the same

This was pretty much an empty article. I am 67 and have moderate to severe osteoarthritis. I have already had one knee replaced and have other joints not far behind. I have pain 24/7 and unfortunately I have a pseudo-allergy to all opiates. (That means that opiates attach to histamine receptors in the blood rather than to opiate receptors in the brain. Little pain relief, no risk of addiction, but itching, sleeplessness, and a puffy face instead. The pseudo just means that no initial exposure is necessary for the allergic reaction.)

But I am becoming an expert on how very poorly trained American physicians are. American medical schools use a system/structure/function approach to teaching. Unfortunately pain is not a system or a structure and is barely there as a function. This means that medical schools pretty much ignore pain management.

The biggest hope on the Horizon is a Phizer/Stoney Brook drug that interferes with the transmission of pain signals instead of interfering with the reception of the same signals in the brain. Early trials indicate that it means extremely good pain relief with no risk of addiction or fuzzy headedness. Trials were initially stopped in this country because of a tremendous increase in the number of hip and knee replacements among the trial participants. Turned out that in the absence of pain many people were overdoing it and ruining already compromised joints.

So there is some hope on the horizon.

I'm older and have arthritis, I am on pain maintenance medication. Oxy 3 times daily. I do not drink alcohol or use any recreational drugs. Now I find I have a herniated disk in my back. I have been just trying to deal with it but I'm losing that battle. My Dr. wants to inject cortisone treatments in my spine. I'm just not comfortable with that treatment. I have had cortisone 6-7 times before for other unrelated issues. It has never worked for me. My only other recouse is more pain meds for this problem. It's a catch 22. Now what?

The epidural injections I have received over the past 3 1/2 years have helped me tremendously.  The steroids have gradually helped my spinal injuries improve dramatically.  I was taking MS Contin and Oxycodone.  I gradually weaned myself off the MS Contin (it was pure hell) and now only take the Oxycodone.  I hope that my back continues to improve and that one day I can possibly even get off the Oxycodone.  I have been fortunate, and hope that you could possibly receive the same benefits.

A lot of chronic pain can be managed by what is considered "maintenance care" which is commonly excluded by many employer group health plans. I wish there would be more studies done on the cost of maintenance health care, such as massage therapy, vs. the cost of acute pain care that occurs when the patient does nothing until it's too late. I am sure that there would be a change in what they consider the more economical route.

The article doesn't say anything about all the people who have had MEDICAL MISTAKES performed on them,then the patient's are tossed by surgeon's back to primary care who can't handle your debilitating pain not of your own making,who then if your lucky they send you to one of only 7,000 pain management dr's. in the country who when all nerve blocks,phys.therapy,and all other things have been tried have no choice but to put you on strong painkillers because have been taking weaker one's for so long,no choice left.I have been going through this for 38 yrs. and just turned 50.Had 2 back surgeries at 22,told I would be as good as new worked until 38 then had to be put on perm. disability.Now people treat me like crap because of the meds i take.Other dr's. dont want to help you with any other health issues because they don't want to get near you because of fear the DEA,even though another branch of our gov't published this report.SOMEONE please help those of us truly in pain,not all of us live on the OXYCONTIN express,but HAVE TO TAKE THIS JUST TO HAVE SOME SEMBLENCE OF LIFE !Even now I still suffer sleep deprivation from pain,have to sleep in multiple chairs,bed's,couches just for a few hours.Sorry to gripe so long but 38 yrs. of pain is a LONG TIME.

The article doesn't say anything about all the people who have had MEDICAL MISTAKES performed on them,then the patient's are tossed by surgeon's back to primary care who can't handle your debilitating pain not of your own making,who then if your lucky they send you to one of only 7,000 pain management dr's. in the country who when all nerve blocks,phys.therapy,and all other things have been tried have no choice but to put you on strong painkillers because have been taking weaker one's for so long,no choice left.I have been going through this for 38 yrs. and just turned 50.Had 2 back surgeries at 22,told I would be as good as new worked until 38 then had to be put on perm. disability.Now people treat me like crap because of the meds i take.Other dr's. dont want to help you with any other health issues because they don't want to get near you because of fear the DEA,even though another branch of our gov't published this report.SOMEONE please help those of us truly in pain,not all of us live on the OXYCONTIN express,but HAVE TO TAKE THIS JUST TO HAVE SOME SEMBLENCE OF LIFE !Even now I still suffer sleep deprivation from pain,have to sleep in multiple chairs,bed's,couches just for a few hours.Sorry to gripe so long but 38 yrs. of pain is a LONG TIME.

Why is it that Dr"s don"t understand the amount of pain a person is in especially when you have fibromygila,arthritis,IBS,building disc in back the lower this is very hard to try and get them to understand that a person is not addicted to pain meds because they have to take two to three pain medications a day.Hydrocodien or Oxycontin they only do what help to function on days when the pain is so bad you would not be able to function without it.God gave every one five senses and gave Dr,s knowledge to be able to help people with chronic pain.There is a remedy for every ailment in the bible .but it is so complex that is where Dr's come in those that have been trained to help the suffering and illness of people.

I have had chronic foot pain since 1949, the year that chiropedists changed their name to Podietrists. Recently (late last year) my Kaiser Primary Care physician referre me to the Pain Management Program at Kaiser's French (Hospital) Campus for their Pain Mangement Courses that over-all took 11 weeks to complete. I was one of the most skeptical members of that group. I was going along because my doctor recommended it but I knew it would prove useless; was I ever worng. I have reduced my need for precription pain relievers by at lest 80% and over-the-counter pain medication to almost 0%. The program has gone from five or so people to a staff of over 30 specialists in Chronic Pain Management; psychologists, physiotherapists, pharmacists; alternative medicine (accupuncture, accupressure, tai-chi, herbalists and other alternative medical practitioneers) All trained to help people with chronic pain. The results over-all are positive and many people are living nearly normal lives after the course. It isn't a way of curing pain but learning how to live with and avoid worsening or triggering more pain. The Pain Management Project would never have lasted the twenty years plus and grown to its' current size, if there had been no measurable success. I am a converted, skeptical participant and have much improved my whole life; I was nearly suicidal. I'm glad I gave it a good try. I highly recommend such a course to Chronic Pain Suffers and the people around them because Chronic Pain affects every aspect of life and it can be addressed with success.

 Pain management could easily be reduced to several million dollars per year.  Look to the Veterans Administration pain management clinics.  Also, realize that living a pain free life is not going to happen.  Learning to live with and manage some pain is as good as it can get.

It makes good sense to have more doc's go through this training. America is so behind in pain management, probably as much due to malpractice suits as lack of proper training.