As a Dartmouth trained Board Certified Rheumatologist, I have successfully treated thousands of patients with fibromyalgia and other chronic painful conditions since 1990.
Patients with fibromyalgia and other chronic painful conditions represents a large segment of the population which is poorly understood, and more importantly, underserved. Unfortunately, many of these patients continue to suffer needlessly. I believe that it is fair to say that most general doctors (although well intended) are not very good at treating fibromyalgia and other chronic painful conditions. Many physicians do not even believe that the condition of fibromyalgia exists! If they don’t believe that it exists, they certainly don’t know how to treat it! Many of these patients have been labeled as hypochondriacs and malingerers--ironically, fibromyalgia is quite prevalent, yet the majority of these patients are not able to obtain appropriate treatment.
Patients with fibromyalgia and other chronic painful conditions feel disenfranchised from the medical community. Most are at their wit’s end. These patients suffer on a daily basis-- many have become depressed because of their pain. Chronic painful conditions of any etiology is usually associated with some degree of depression, this would make simple sense; how could one be a happy camper if they are in constant pain?
With regards to patients who are seeking appropriate care, one of the biggest barriers for the patient is the knowledge and comfort level of the prescribing physician when it comes to managing patients with chronic pain. Many doctors prescribe medications according to “their” comfort level as opposed to the comfort level of the “patient“.
There is certainly an art to managing patients with chronic painful conditions. There are some classes of medications in which certain doctors will not even prescribe. I know of many doctors’ offices which will not prescribe narcotics. I’m not saying that all painful conditions need narcotics for relief--but many of them do. If you happen to have a condition where the use of a narcotic on a daily basis would be appropriate and necessary, you will certainly be out of luck if your doctor will not prescribe you a narcotic. The doctor will move onto the next patient and you will be no better off than before your visit! They are not the ones that are suffering.
My philosophy is that nobody should have to suffer needlessly. Chronic painful conditions are not going to spontaneously get better--that’s why they are chronic. However, chronic pain can be successfully “managed” whereby a patient can return to a comfort level which is compatible with a peaceful and productive existence. I know this is possible because I have been treating patients with fibromyalgia and other chronic painful conditions for over twenty years, and the vast majority of these patients have responded quite well to the medication regimens that I have prescribed.
The good news is that there are plenty of cost effective medications (generics) that are available for the management of fibromyalgia and other chronic painful conditions. Chances are that your doctor has prescribed many of these medications to other patients for the management of non-painful conditions. The secret to my success with treating these types of conditions has been with prescribing medications to patients with fibromyalgia and other chronic conditions in an “off-labeled” fashion. What this means is that I am prescribing either one or a combination of medications to a patient for reasons other than the FDA indication for that drug. For example, certain anti-seizure medications can be very effective for the management of some painful conditions. Prescribing one of these medications in this instance would represent a doctor writing a prescription in an “off-labeled” fashion. This can be a very safe, effective, economical, and non-narcotic way to treat certain painful conditions. The problem is that most doctors are either not familiar with or do not feel comfortable with prescribing a medication in an “off-labeled” manner. This is where the art of chronic pain management comes into play. There are plenty of doctors out there who know how to effectively use these and other medications for the management of fibromyalgia and other chronic painful conditions. It’s all about using the right combinations of medications when it comes to managing these disorders. I have found that a good majority of chronic painful conditions can be managed without narcotics. On the other hand, there is the proper place for narcotics in the management of certain painful conditions. When necessary, nothing short of a narcotic will suffice to adequately address certain painful conditions.
I have recently completed a book--”Fibromyalgia And Other Chronic Painful Conditions: The Patient’s Guide And Survival Manual For Obtaining Proper And Effective Medical Care”. I wrote the book with the intention of reaching out to the masses of people who suffer with these conditions. Of course, this is not a how-to-do book. The reader will need to share the information in this book with their doctor (in a tactful way). The information in this book will enable and empower not only the patient, but their physician with regards to the validation of fibromyalgia as a real medical condition, but will also give step by step guidance as to the rational for building a medication regimen that will be unique for each individual patient.
There is a lot of valuable information in this book which only comes with treating these types of patients for over twenty years. If you, a friend, a family member, or other loved one has been suffering from fibromyalgia or one of many chronic painful conditions, I would encourage reading this book. My approach to these conditions is unique; the book is written in plain English--no need to look up medical terms in a dictionary. The last chapter has several case presentations which has been presented in a way which is designed to connect with reader--it puts the content of the book into practical use. If you have read this far into this webpage, you must be a person who has been dealing with either fibromyalgia or another chronic painful condition which has not been adequately addressed in the past. This book has been designed to help those who have previously fallen through the cracks and feel that there is no further hope for ever attaining significant improvement of their chronic painful condition.