Pain medication is the Answer (bear with me).
Take yourself back to high school when you get home too late or when you get home the next morning and the dreaded questions start flowing:
“Where were you?” “What did you do last night?”
You can go a couple different directions with your answer. For the sake of this blog, let’s go with the answer that achieves a solution in the short term, the “lie.”
You tell them you were at Johns house. John is that friend who wouldn’t harm a fly. Your dad would let him take your sister to prom. John could do nothing wrong in your parents eyes.
This answer was a lie but it achieved a few things. You avoided a fight or argument, you avoided being grounded, you kept their trust, and you kept your freedom.
Little did you know at the time, they probably knew you were lying and eventually you will get caught (which will not be pretty). You don’t want to hear about how telling the truth now will be better in the long term. For that moment, in order to keep short term peace and based on what was important to you, lying was the answer.
Fast forward 20 years, now you are heading to your primary care with complaints of lower back pain. You can’t sleep, you can’t pick up your 3 year old daughter, you can’t play catch with your 10 year old son. You can’t even take your dog for a walk. The doctor prescribes you medication and [as he is leaving the room] says, “you can also give PT a try.”
You choose to start taking the pain medication. Immediately you can sleep again. Your daughter comes up to you in the morning and says, “daddy pick me up” and you can with no pain. Your son begs you to play catch and you go outside with absolutely no pain. You can now take your dog for a walk. You have your life back.
Little did you know at the time, your back pain will return with a vengeance. The pain medication will no longer be effective so you will need to take more, it will catch up to you (which will not be pretty). However, for that moment, in order to get your life back and do what you want to do, pain medication is the answer. You know deep down that it is not right, but it is okay until you have more time to address the problem.
Fast forward 5 years. You finally go in for physical therapy and tell the physical therapist the laundry list of medication you have been on. The physical therapist “educates” you with the following: “Pain medication is not the answer, it is not a solution to a problem.”
Game Over. Wall is built between you and them. It will be very hard to gain trust at this point.
As a PT myself, I’m here to say for the person sitting in front of us, pain medication is the answer. Just not a long term one.
This is an important realization. This is an important shift in our thinking that in my opinion needs to happen. This realization shows that we are able to truly put aside our knowledge on the topic and put ourselves in their shoes. This thought process allows us to have consideration for their feelings. This is a position of understanding. Not a position of the strict parent coming down on their teenage kid who came home too late.
This allows us to come alongside the person and have a sense of understanding for where they are coming from and where they want to be. Blanket comments like, “well you know pain medication is not the answer” and “you should stop taking medication, you know they are bad for you” should be dropped. When the patient in front of us senses that we are coming from a position of understanding, open dialogue will be achieved. Barriers and walls will be torn down.
Trust will be built.
The likelihood of healing will improve.
It is then that you will form a relationship of trust and will be able to influence them and work with them on a gradual strategy to achieve the long term answer (which does not involve pain medication).
I’m a huge believer that in the long term, better movement beats pain medication every time.
But I wonder how many times have we been robbed of the opportunity to journey with our patients down this path of finding their long term solution due to our lack of understanding on the front end.
Always keep this at the foundation of which your communication with each patient is built on:
“No one cares how much you know until they know how much you care.”