Originally Posted by canklecat

Don't get me started on the current concept of "pain management." In my area it's become a way to milk insurance companies while neglecting patients.

In 2018, after I was hit by a car and, coincidentally had thyroid cancer, I switched from one of the larger public all-purpose medical organizations to the VA, over the "pain management" joke. Too much incompetence and indifference with the public hospital. The last straw was when they referred me to their in-house pain management clinic, which told me the soonest available appointment was in six months, at which time they would only do an evaluation, no actual treatment. When I asked why it takes so long, the guy on the other end said "Take it or leave it," and hung up on me.

I switched to the VA and got prompt, courteous, competent and compassionate care... until the pandemic hit in 2020. Then the VA system pretty much fell apart. Lots of employee burnout and turnover. They were overwhelmed with a combination of older veterans who got serious cases of COVID, and a sharp spike in homelessness as landlords raised rents, sometimes double, and evicted tenants who got behind.

I considered myself fortunate to have a standing prescription for cyclobenzaprine, a muscle relaxer. But I hate using the stuff. It makes me groggy for 24-48 hours after a single small 10mg dose. For two years my primary care doctor at the VA ignored my request for referral to pain management or some form of physical therapy to deal with the pain from multiple back, neck and shoulder injuries (as I've mentioned before, I've been hit by cars twice in 20 years). I just wanted a local injection of anti-inflammatories, maybe an evaluation for some newer non-surgical treatments. But after two years I got tired of waiting, and my annual checkup this week didn't show any signs things were getting better with the VA.

So my Medicare replacement provider referred me to a local medical group that initially seemed promising -- good initial consults with ortho and spine specialists. My cervical spine stenosis is beyond anything that can be helped with physical therapy, chiropractic, etc. I already do my own PT almost every day, and continue to bicycle and jog despite it all. They said I could get local injections of anti-inflammatories almost immediately, and a non-surgical procedure to deaden the pain nerves within two weeks.

Then the house of cards collapsed.

I got calls from "Acclaim," the same damned group that did almost nothing other than hinder any progress four years ago. The contractor doctors mean well - they're young, enthusiastic relatively new docs. But Acclaim's sole purpose seems to be to put up obstacles between patients and procedures recommended by doctors. An Acclaim rep called this morning to say the soonest initial appointment would be December 20 -- far longer than the two weeks suggested by the doctor -- and it would be only an initial treatment. And, oh, by the way, they'll notify me of the exact time only a day in advance, and I need to have a driver on standby to stay with me and drive me home afterward. No, they can't give me more notice than that. No, they don't have any appointments sooner than that. Turns out they're just a front for the same indifferent, incompetent public health system I was first assigned to in 2018. They just changed the name and moved some clinics off-campus to put a shiny veneer over the same old crap.

They weren't quite as rude and indifferent as four years ago, but not much more effective either.

I'll be looking for an entirely different medical provider -- again.

I can see now why so many folks opt for unproven treatments, promises of relief based on ... nothing, no scientific evidence ... voodoo, exotic sounding "Oriental" treatments, needles, cupping, bone-crackers, hand-wavers, bell-ringers and incense smokers. After awhile you get desperate enough to try anything.

Fortunately I've gotten reasonable relief from kratom, which I use sparingly, just enough to relieve the pain so I can stay active. It's far less detrimental than cyclobenzaprine, Tramadol or hydrocodone to my energy and alertness, so it doesn't hinder my workouts. I can't take NSAIDs for more than a couple of days at a time, especially ibuprofen -- they cause itchy and often painful skin rashes. Acetaminophen does almost nothing for me. CBD is okay, pretty mild, and expensive for what it is.

And I use percussion massagers, a TENS unit, several topical analgesics, soaks in a hot bath with Epsom salts. I've tried pretty much everything.

But if other folks have experiences like mine, it's no wonder abuse of prescription and non-prescription drugs continues to escalate. I can see why some folks get desperate enough to try anything to cope with pain.