Feel No Pain

By Christine Gorman

Pain will propel most people to a doctor's office faster than just about any other complaint. It's usually a sign that something is wrong--though it's not always clear just what the problem is. Doctors can't measure pain objectively the way they can blood pressure or cholesterol levels. So when pain doesn't immediately respond to treatment, physicians and patients often--too often--accept it as just another symptom that has to be lived with.

The suffering and confusion should begin to lift this year, however, thanks to the efforts of the Joint Commission on Accreditation of Healthcare Organizations, the group responsible for certifying the quality and safety of the majority of hospitals, nursing homes and clinics in the U.S. Starting Jan. 1, these medical facilities will have to show that they meet certain standards for the assessment and treatment of pain in all their patients. Failure to meet the standards, which were jointly developed with the University of Wisconsin Medical School in Madison, could lead to a financially devastating loss of the right to treat Medicare and Medicaid patients.

Among the new requirements: all patients have the right to have their pain assessed and managed appropriately; medical facilities must ask their patients to rate their level of pain (children can, for example, point to pictures showing a range of faces from mildly frowning to contorted); and the results must be documented. The idea is to take pain out of the background and make it another "vital sign" that must be attended to.

That's what the doctors and hospitals have to do. What can you do to ensure that the new rules work for you? Plenty.

--DON'T SUFFER IN SILENCE Surveys have shown that many patients don't tell doctors or nurses about their pain for fear of being labeled cranky or difficult or because they assume that their discomfort will go away. And yet, says June Dahl, professor of pharmacology at the University of Wisconsin, that reluctance can backfire. Left uncontrolled, the pain you thought was temporary can trigger a long-term chronic condition. It can also interfere with the healing process and lengthen your recovery time.

--PLAN AHEAD Find out before you are wheeled into the operating room what the various treatment options for pain are--as well as their side effects--and choose the one that suits you best. Don't just assume that "someone will take care of it."

--GIVE FEEDBACK If your current treatment isn't controlling your pain, say so. It often helps to have a family member make the case for you.

--BONE UP Learn what pain killers can and can't do. Lots of folks fear they will get "hooked" on strong medications. In fact, though most patients build a tolerance to pain drugs, they don't become addicted. Others rely solely on pills and ignore lifestyle changes--like losing weight--that can alleviate pain in the joints and back.

Unfortunately, says Dr. Kathleen Foley, an attending neurologist at Memorial Sloan-Kettering Cancer Center in New York City, not all pain can be controlled. "But you know what?" she says. "We'll never do anything if we don't try." And no one can even begin to help you until you say where and how much it hurts.

For more, visit time.com/personal or www.painfoundation.org You can send e-mail to Christine at gorman@time.com