Treatment of Pain requires more than just a pain medication prescription.

For most people, the solution for pain should not be to just take a pain medication. There’s a deeper and more thoughtful approach figuring out what’s wrong, and devising a plan to help improve the situation.

I saw an interesting patient recently that connects key musculoskeletal wellness issues. My patient is a 32-year-old woman, new patient to me, she has various aches and pains mainly in her shoulders and left wrist. So there are few things in her history that require some additional discussion.

The first is, it turns out she’s been using a medication called Arcoxia. I’ve never even heard of this medication so I had to google this, and it turns out it’s another name for the medication Vioxx. Vioxx has not been sold in the United States for a number of years. In large part because of significant rates of higher risks of heart disease. In addition this class of medication also has potential kidney and liver toxicity side effects as well.

Vioxx has been pulled from the United States market several years ago, but my patient received this medication through her parents who live in Israel. When you look up Vioxx, you realize that this medication while no longer sold in the United States is sold throughout the rest of the world. That’s really interesting that a medication that is thought to be unsafe for Americans is okay to be sold in other parts of the world. Is that appropriate? As a physician I have deep misgivings about this practice in a larger context.

Secondly, for this individual, because she’s seeing me, because she is requiring pain medication, that automatically triggers in my mind that we need to be thinking what are the next three to four steps to make her better. How do we treat this on a deeper level so that we can prevent this from getting worse, so that we can actually treat the cause of her pain, not just hand her a pain prescription.

It’s not good enough to have a one-step process in terms of treating her pain with medications only, we need to dig deeper, and go the three to four extra levels to really determine what’s going on, treat the source, and try to make this better long term. This requires a thoughtful diagnostic process and creation of a unique individual plan for her particular condition. The end result should be that she does not require daily pain medication usage long term.

Fortunately for this individual, we talked about the risks of taking this kind of medication long term, started the diagnostic process to accurately identify the cause of her pain, and will set her down a better path to improve her quality of life and reduce the use of pain medications long term.

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