PAIN MANAGEMENT MEANS MORE THAN TAKING 2 ASPIRIN

For anyone suffering pain, the idiom, "Take two aspirin and call me in the morning," is not a welcome prognosis.

It's only been in the past decade or so that the medical community has considered acute short-term and chronic pain a branch of medicine that requires multi-faceted treatment.

In Cape Girardeau, the Pain Management Center at St. Francis Medical Center is where pain sufferers can seek relief.

Donald Hinnant, director of the Pain Management Center, said there are many misconceptions to overcome when it comes to treating pain.

"There's a perception out there that people come to us to learn how to deal with their pain," said Hinnant. "People come in and they think, `It's all in my head, and you're supposed to teach me how to cope with it.'

"But the last thing we want to be known as is the last place to go to deal with chronic pain. I think that's a perception that's changing."

But not easily. Hinnant said it's taken about a year to get the Pain Management Center to the point where it encompasses the inter-disciplinary approach that's needed in pain treatment.

"A combined approach to treatment is necessary to do an adequate job," he said. "We're merging with anesthesiology to treat acute pain, to try to keep it from becoming a chronic pain problem.

"For chronic pain, the problem is more complicated and no one specialist is equipped to handle this area."

The staff at the Pain Management Center is comprised of Hinnant, a consulting anesthesiologist, a pain management counselor, a physical therapist, an exercise therapist, physicians and consultants as needed.

"There are quite a few people involved in the treatment program," said the director. "The treatment has to be individually tailored."

Patients are treated for everything from chronic headaches to painful limb and joint disorders. Something as minor as a sprained ankle can lead to a chronic pain problem, Hinnant said.

"Our most common patient is someone with low back pain," he said, "possibly from a work-related injury, arthritis or a muscle strain.

"We treat a lot of people with soft muscle tissue, which can be very frustrating for physicians. Often the patient is frustrated with the physician's inability to identify the problem.

"But it's extremely difficult to predict what kind of person can suffer a terrible back injury and successfully recover and have a normal life," Hinnant added, "and another person with the same injury who will have chronic pain."

The director said a lot of time at the pain center is devoted to education. Once a patient understands his symptoms, then he's more apt to accept treatment -- typically a prescription for hard work.

"If they accept that they're adequately diagnosed, then we give them the bitter medicine," Hinnant said. "Our successful patients work very hard, long before they see any results."

A typical patient might start a program that is comprised of four hours of treatment, five days a week. That might include 2 1/2 hours of intense physical exercise and 1 1/2 hours of "education-oriented" treatment, Hinnant said.

"They're in class everyday learning everything from nutrition to anatomy and how to cope with the medical system," he said. "In treatment, we investigate all the resources available here in Cape Girardeau. If we do not have the necessary resources here, we will know how to get the help that's needed."

There are benefits to pain management that go beyond the individual patient. Effective pain control after surgery, for example, can mean a shorter stay in the hospital, which reduces medical costs for everyone, Hinnant said.

He said he hopes the Pain Management Center can begin to do more consulting work in the area of industrial medicine -- helping businesses prevent work related injuries through job-site analyses.

"Injured workers are a real problem," he said. "Often following an injury, there will be a lot of tension between a good worker and an employer.

"The worker often is looked at as if he's faking the injury, or some obscure insurance adjuster is manipulating the worker. It can end up in a quagmire of persistent symptoms, numerous medical exams and failed treatment attempts."

Hinnant said his goal is to develop the Pain Management Center at St. Francis into a "model program" offering a full range of services -- from counseling to neuro-surgical procedures.

"I think the potential is really good for us to have a really comprehensive pain management program," he said. "For a town this size, I do believe we have a lot to offer."