The Quality of Mercy
Effective pain treatments already exist. Why aren't doctors using them?
MIGRAINE HEADACHES Severe headaches caused by expansion of blood vessels. PAIN TREATMENT Prescription drugs, including Imitrex and Depakote; also acupuncture and massage. RESOURCES The National Headache Foundation (800-843-2256) and Web site [http://www.headaches.org]. Migraine by Oliver Sacks (University of California Press, $15.95).
TMJ Temporomandibular joint disorder. A jaw condition caused by muscle spasms and teeth-grinding. PAIN TREATMENT Muscle relaxers, anti-inflammatory drugs, narcotics and, mouth splints. RESOURCES The American Academy of Head, Neck and Facial Pain (800-322-8651). TMJ and Facial Pain Center Web site [http://www.netset.com/docws/]. TMJ: Its Many Faces by Wesley Shankland (Anadem Publishing, $19.95).
SHINGLES A disease of the skin and nerves caused by the chicken pox virus. PAIN TREATMENT Antiviral drugs can minimize outbreaks. Narcotics and antiseizure drugs may be prescribed. A new anesthetic cream, EMLA, seems effective in dulling skin tenderness. RESOURCES The VZV Research Foundation (800-472-8478). Shingles and PHN (Cross River Press, $10.95) by Thomas Carl Thomsen.
TERMINAL ILLNESS Cancer and AIDS can inflict severe pain, especially near the end. PAIN TREATMENT May consist of drug "cocktails" containing a narcotic (to dull pain) and a stimulant (to ward off drowsiness). Many patients also find relief from therapies such as acupuncture and massage. People with terminal illnesses often need help managing depression, anger, and grief, as well. RESOURCES The National Hospice Organization (800-658-8898). The National Cancer Institute, Cancer Information Service (800-422-6237). The Cancer Pain Page Web site [http://www.mdacc.tmc.edu/acc]. Online book Pain in HIV/AIDS [http://www.roxane.com/Roxane/RPI/AIDSPain/PainBook/index.html]. Centers for Disease Control and Prevention Web site [http://www.cdc.gov] and AIDS Hotline (800-342-2437).
BACK PAIN Bone, muscle, ligament, tendon, nerve, and joint disorders can lead to chronic back pain. PAIN TREATMENT Over-the-counter painkillers, prescription anti-inflammatories, exercise, ultrasound, and traction. Surgery and narcotics may also be advised. RESOURCES Chronic Back Pain: Moving On (Biddle Publishing Co., $9.95). WellnessWeb [http://wellweb.com/index/QBACKPAI.html].
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