Battling Chronic Pain and Dealing with Doctors, Insurance, and Therapy

Will Rowe Health Guide
  • I don't like to appeal to war analogies to describe the experience and situation of people in pain in this country but sometimes they seem completely accurate.  Think of a person in pain...maybe a condition that resulted from an injury, in addition to some degenerative condition, in addition to something like diabetic neuropathy----three very prevalent conditions.  This person will probably encounter self doubt and recrimination for appearing to be a complainer or a wimp.  He will probably have severely diminished ability to perform at work, to engage in many social activities and to hold up the bargain to share household tasks.  Then he goes to the doctor.....probably 10 doctors before he gets a decent diagnosis or diagnoses. 

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    Treatment plans get recommended which include medicines, physical therapy, lifestyle changes----all which might make good sense.....but the insurance won't cover 3 out of 6.    Or they are covered but only after he tries and fails other "steps" defined by the insurance company.  He ends up battling himself, probably his boss, his family, the doctors, and the insurance company.  And most likely, at the end of all of that, 2 years later, he still is in pain.  At times, it seems like that everywhere you turn, there is a battle to be fought.


    Here's another battleground.  If you live in New York State and have low back pain which is the result of a work injury or claim be aware that the New York State Legislature will be considering a draft Low Back Pain guideline for Workers' Compensation.  The guideline that they are considering was published by the American College of Occupational and Environmental Medicine. 


    This guideline lists approximately 50% of tests, treatments and therapies as "not recommended."  Insurance companies will very likely use these recommendations as a basis for denying coverage for procedures not recommended in this guideline.  The guideline lists some very well established treatment methods as not recommended or limits their recommendation.  The guideline lists spinal cord stimulation as not recommended which will eliminate this as an option for patients with neuropathic pain.  Certain injections and nerve blocks would be significantly limited.  We know that states and insurers have a critical obligation to control medical costs.  But we have heard, for example, numerous personal stories from individuals who have tried absolutely everything to find relief who finally found that relief in a therapy such as spinal cord stimulation.  Don't take pain relief options away from people who need them.


Published On: May 13, 2009