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By Donna Sumner

Pain is a part of CFIDS/ME. If a patient has pain, it is important to let your physician know about it and to describe what makes it worse or better by giving examples of how it effects your daily life. Pain management is an essential part of treatment. Untreated, pain can produce depression.

There are two types of pain: acute and chronic. Acute pain is severe and relatively lasts a shorter time. It is a signal that your body has been injured and, when the injury heals, the pain subsides. Chronic pain lasts months and years. Breakthrough pain is a term used when a person experiences a brief flare. It can occur when medication is wearing off before the next dose or can be the result of an activity or event.

No physician can test for pain. You must tell them the role your pain is playing. Asking for pain medication is not a weakness on your part. Taking pain medication on a regular basis does not mean you will become addicted. Your doctor must know the type of pain you're having and where it is happening. Describe your pain to the physician. Is it aching, crushing, prickling, crampy, pressing, tender, sharp, pins and needles, pounding, knot-like, stretching, electric, dull, sore, throbbing, deep, tight, pulsing, burning, stabbing, shootinG, pinching or gnawing? Tell your doctor if you've found ways to help alleviate the pain to some degree such as heat or lying in a certain position. Keeping a record of your pain for a period of time is also helpful.

The American Pain Foundation's Pain Care Bill of Rights says that those with pain have a right to have their pain taken seriously and be treated with dignity and respect by doctors, nurses, pharmacists and all health care workers. You have the right to have your pain assessed and promptly treated. You have the right to be informed what may be causing your pain and the benefits and risks of possible treatments. You have the right to be have your pain reassessed regularly and to the right to be referred to a pain specialist if your pain persists. You have the right to get clear and prompt answers to your questions and you can refuse any particular type of treatment if you choose. These aren't rights that are required by the law but they are rights every patient should expect and demand for pain care.

A few states have guidelines for chronic non-cancer pain. The state of Washington was the latest to have a draft guideline. These guidelines are to address the practitioners questions of what is safe and effective and what they should look for to raise awareness and reduce risks. North Carolina, Texas and Utah are also working with new guideline developments to help prevent any overdose problems.

CFIDS/ME patients assume that fibromyalgia (FMS) is part of their pain problems but this is an assumption that has not been proven. FMS is common in people who have autoimmune diseases. The Israel Medical Association Journal (2008/10, Buskia. Sarzi-Puttini) recently published a review of the co-morbidity of FMS with autoimmune diseases. The pain in these illnesses may well be proven to have other causes as well such as a slow onset of a cancerous condition or other pain syndromes such as polymyalgia which is associated with ciguatera. While some causes may be speculative, the pain never is and should be treated aggressively.

The National CFIDS Foundation * 103 Aletha Rd, Needham Ma 02492 * (781) 449-3535 Fax (781) 449-8606