I know a little something about managing chronic and sometimes severe pain and I’d like to share a few tips with you.  

First, I’m not a doctor and this article is not intended to be medical advice.  And I'm not selling anything.  No magic potions, no cure-alls.  Nothing.  But these are things that have worked for me, helping to keep me (somewhat) sane.

In the last 10 years, I’ve had L4-L5 spinal fusion, surgical repair of both shoulders with impingements and torn rotator cuffs, one hip arthroscopy, one hip resurfaced (Birmingham Procedure) and the other hip replaced with a direct anterior total hip procedure.  And with Osgood Schaltter’s disease, my knees have been in constant pain for almost 50 years.  Not to mention having a few lumps removed and some rather unpleasant lower GI surgery.

With all this going on, I've managed to travel to far away places, lugging heavy camera gear as I hike the arctic tundra in search of wildlife to photograph.  I'm still in the game and going strong.

So here are my Top Eleven Tips for managing chronic (and sometimes severe) pain.

Tip 1.  Good medical care.  There’s just no substitute for good medical care - but be prepared to be your own advocate.  Don’t be afraid to question your doctor’s diagnosis or ask for a second opinion.  While most doctors are very good at what they do, mistakes are not unheard of.

Tip 2. Get a medical translator.  If you can, find a family member or friend who is a doctor or nurse and have them translate the medical jargon for you.  It seems to me that lots of medical language is intentionally designed to make you feel inferior - if not outright dumb.

Here's what I mean...

The world calls it a collar bone.  Medicine calls it a clavicle. 

The world calls it a heart attack.  Medicine calls it a myocardial infarction.

The world calls it “the crook of your elbow”.  Medicine calls it an antecubital fossa. 

The world calls it your leg.  Medicine calls it the “lower extremity”.

Having a medical translator will go a long way to keeping you properly informed by dispersing the fog of medical jargon.

Tip 3. Know what the agenda of your doctor is.  When I had severe, constant back pain (degenerative disc disease, compounded by getting rear-ended by a flatbed tow truck), my primary care doctor sent me to see a Physiatrist at the “Pain Clinic”.  (Which really should be called the Anti-Pain Clinic).  A physiatrist’s job is ostensibly physical rehabilitation through things like exercise and physical therapy. 

But what nobody told me at the time was that this physiatrist's objective was to keep me out of surgery.

That’s a noble goal - unless surgery is exactly what is needed.  In which case, other treatments only prolong pain unnecessarily.

After 9 years of mind-blowing and often crippling pain, I told the physiatrist that I was actually thinking about suicide - at which point he said, “Well, maybe it’s time for surgery.  We really wanted to wait until this effected your quality of life.”  Quality of life?  I've had quality of life those last 9 years - and it was horrible.

I was an awful mixture of stunned and enraged.  I'm still sputtering about it 10 years later, because I never understood his agenda.

That surgery (anterior lumbar inter-body fusion) definitely has it’s risks, but I was willing to accept them.  Fortunately, the results were spectacular and the pain has been gone for 10 years. 

Tip 4.  The stiff upper lip has its limits.  It’s all well and good to keep a brave face on.  Nobody likes a complainer.  In fact, I distinctly remember telling my wife that I was sick of hearing myself complain about back pain.  But that pain means that your body is trying to tell you something.  So instead of complaining to your family, friends and co-workers, tell your doctor and tell them that you need help managing the pain.

Tip 5. Beware the Narcotics.  Oxycodone, oxycontin, fentanyl, hydrocodone - I’ve had them all.  And while they can moderate your pain, they are really playing with fire.

The very last thing in the world you need is to replace physical pain with a drug addiction.

When I was waiting for that spinal fusion and the pain was so severe, the physiatrist put me on a fentanyl patch.  This gives a constant delivery of a synthetic narcotic that is 5 times the strength of morphine.

Due to an error on my part, I ran out of replacement patches on a Thursday evening.  The physiatrist couldn’t get me a prescription until the following Tuesday.  

I withdrew - cold turkey - and it was absolutely miserable.  Cold sweats, shaking, chills, skin crawling, jitters.  It gave me a whole new respect for those who successfully kick a heroin habit.

One example is the famous radio talk show host, Rush Limbaugh, who became addicted to narcotics as he was treated for severe, chronic back pain.  The over-use and subsequent alleged doctor-shopping saw him arrested and prosecuted and ended up destroying his hearing.  He was forced to undergo a cochlear implant to regain it.

This is not to say that you shouldn’t take properly prescribed narcotics.  But be aware that they can be very addictive and if you abuse them, you will eventually have to withdraw.  Hopefully, it won’t be in a drug rehab center - or a jail cell.

Tip 6. Stay ahead of the pain.  I have found that it is much easier to treat the pain before it gets too bad.  Treatment in my case has always been more effective at that point than waiting too long and trying to knock the pain down later.

Of course, this is one of the ways that you risk addiction to narcotics, so you’ll have to balance those two factors.  Ask your doctor for advice on minimizing that risk.

Tip 7.  Distractions work.  One of the worst places to be when you’re in severe and/or chronic pain is alone inside your own head.  I’ve always found that by keeping myself busy with anything - TV, reading, writing, walking outside, a video game - anything at all, helps me to focus my attention on something beside my pain.

Tip 8.  Consider a support group.  There are plenty of support groups out there - just search for “Chronic Pain Support Group” and you’ll come up with something - hopefully, one that’s close to you.

Not that you want to sit around in a circle to have a “complain about pain” session, but it’s helpful to know that you’re not alone in your struggle.  You might even make some new friends.

Tip 9.  Refuse to be intimidated.  This is more possible for some than others, but I urge you in the strongest possible terms not to let yourself be a victim.  In many and perhaps even most cases of chronic pain, there is still something meaningful you can do with your life.

I strongly urge you to take charge and do it.  Whether it’s as mundane as just showing up for work every day or as lofty as reaching out to help others with whatever time and abilities you have left, just do it.

Doing that means that you’re still in charge.  Your pain hasn’t taken you over. 

It is not in control - you are.  

Unless life is slipping away from you this very moment, you can still come up with a way to do something meaningful.  Something with purpose.  You are still in control, so take charge - now.

Tip 10.  Prayer.  I have found prayer to be an enormous help.  If you don’t belong to a church, this is a good time to find one.  Talk with a pastor.  If you don’t already, get to know God and open a conversation with Him.  You won’t regret it.

Tip 11.  Beware the Quacks.  There is no shortage of "alternative" medicine out there.  Much of it is simply a way for the unethical to prey on the fear, pain and diseases of others. 

In my opinion, those that sell this kind of false hope are the lowest of the low.  They are the absolute scum of the earth (with apologies to actual scum).

Treatments that actually work are embraced by real medical doctors - after proper testing and clinical proof through double-blind, randomized, peer-reviewed clinical trials that are conducted with the highest of clinical and ethical standards and multi-stage FDA review.

The quacks will tell you that doctors and drug companies are involved in a conspiracy to keep you sick so that they can keep making money from your illnesses.

But one thing investigators will tell you about conspiracies - especially large ones - is that they always fall apart over time.  Somebody's conscience makes them come forward and tell the truth.  Somebody in the conspiracy gets greedy.  Somebody decides to take a plea deal to save himself from prison.  Somebody blows the whistle.

So which is more believable?  That there is a perfect, never-broken conspiracy among doctors and drug companies to keep you (and their own loved ones) sick?  Or that someone who has spent years studying and working to heal people is actually 100% committed to doing just that?  And that drug companies who make their living by selling medicines that cure people are actually developing them as fast as they can?

There's a reason (an FDA requirement) that quack products are always tagged with this phrase: "Not intended to diagnose, treat, cure or prevent any disease".  They'll say it as fast as they can or put it in the smallest print possible - because they hope that the false promise of a cure will speak louder than their federally required disclaimer.  And that you'll whip out that credit card.

The problem with the quacks is not only that they separate you from your money.  The problem is that they raise false hopes of miracle cures.  Not only does that do real emotional damage to people who are suffering, it is a direct attack on Tip 7 - distraction. 

When you are tricked into thinking that there's hope for a way to end your suffering in a miracle cure you see on TV or hear on late night radio, it makes it that much harder to focus on anything other than your pain.

My solution?  Hit the mute button as fast as possible.  Don't give them the privilege of getting inside your head.

So those are my Top Eleven Tips for dealing with chronic and sometimes severe pain. 

I hope that you’ll find some good ideas in there.  Something to help you cope.  Something to help you see past the pain and stay in this game we call life!