GPs can do very positive things for some patients with aches and pains as many such patients are Vitamin D deficient. Vitamin D deficiency commonly presents with widespread aches, weakness, and tiredness, and can also present with focal symptoms. If a patient has several musculoskeletal diagnoses over time (for example plantar fasciitis, hip pain, back pain, and knee pain) then Vitamin D deficiency should be suspected. Deficiency can be confirmed biochemically by checking Vitamin D levels. Expert consensus suggests that optimal Vitamin D status requires serum levels of 25 OH Vitamin D of 75 nmol/l (that is, 30 mg/l) or more (repeat levels 3 months after initial treatment to ensure patients are replete). Recent work shows ‘no credible evidence’ for hypercalcaemia at treatment doses of Vitamin D.1 Treatment must be with adequate doses (for example, 400 000 iu in the first 2 weeks and then 20 000 weekly) as low dose supplements containing calcium will not restore Vitamin D levels, nor give symptom relief. This condition is common in all ethnic groups, especially in the north and west of the country, and is often forgotten or missed.
I received this comment recently, after treatment (of a white middle-aged man). ‘I feel 10 years younger with fewer aches and pains. Mood and energy levels are much improved. I can get about to go fishing much more easily’. Many patients have similar positive experiences.
Moreover, treatment may improve general health as it is now well recognised that Vitamin D deficiency is a risk factor for many other conditions including cardiovascular disease, diabetes, cancer, and infections.2
Finally, patients may approach exercise with more equanimity if the hopeful phrase ‘wear and repair’ is used instead of the sinister ‘wear and tear’.
Most times when your physician won't prescribe you opioid pain medications, it's because they are don't want you to form an addiction. Opioid painkillers are incredibly effective, but also incredibly addictive and habit-forming.
Simple Ways to Better Communicate with a Patient in Pain
I follow the Golden Rule in how I treat my patients, and I teach medical students do so the same: do unto others as you would want them to do unto you. It is simple but often forgotten amid the daily complexities of being a physician.
One often overlooked aspect of pain management is the role of relaxation techniques. By incorporating these techniques into their daily routines, individuals can significantly reduce the intensity of their pain and improve their quality of life.
Under international human rights law, governments must take steps to ensure that people have adequate access to treatment for their pain. At a minimum, states must ensure the availability of morphine, the mainstay medication for the treatment of moderate to severe pain.
Conclusion: What We Owe to Patients with Chronic Pain
This means the ability to pursue their passions in work or play. It means the ability to form and sustain relationships. It means the ability to carve one's own environmental niche in the complex natural and social environment that is human society.
In a Numerical Rating Scale (NRS), patients are asked to circle the number between 0 and 10, 0 and 20 or 0 and 100 that fits best to their pain intensity [1].
Primary pain disorders (such as irritable bowel syndrome, fibromyalgia, and chronic headaches) are pain problems that are not usually caused by an underlying disease or injury. In pain conditions where there is an underlying disease, pain acts as a warning sign.
Blood tests.Electromyography to test muscle activity.Imaging tests, such as X-rays and MRI.Nerve conduction studies to see if your nerves are reacting properly.
If you feel your primary care doctor doesn't take your symptoms seriously, ask for a referral to a specialist or go to a different practice for a second opinion. A fresh set of eyes can be extremely helpful. Review how to present your symptoms factually, clearly, quickly, and without unnecessary minutiae.
Introduction: My name is Aracelis Kilback, I am a nice, gentle, agreeable, joyous, attractive, combative, gifted person who loves writing and wants to share my knowledge and understanding with you.
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