A Roster of Chronic Pain Personality Types

By PETER ROUSMANIERE, our Vermont-based workers' compensation columnist

Picture the waiting room of a Main Street pain clinic. The room's lined with patients young and old, some injured from accidents suffered at work, others the victims of stress and tension brought on by activities repeated over years or even decades.

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Patients' discomforts, once acute, have mellowed and settled into an endless ebb and flow of throbbing pain, a condition that has become chronic though not necessarily debilitating.

The mood in the waiting room is somber, even resigned. Yet patients, who come from all walks of life, are alert and some are even chatty. Their tales of the causes of their injuries spring from a multitude of causes.

Following certain characteristics, victims of chronic pain can be grouped into different categories. They are:

--The Walking Pharmacy.A 35-year-old inventory worker with a shoulder injury, she is taking several pain drugs, one for long-term control, one for breakthrough pain when needed and a drug for anxiety and one for the sleep disorder brought on by her pain killers. She has become an amateur pharmacist, adjusting prescribed medications and over-the-counter drugs to find for herself pain relief with the least side effects. She wants to get back to work.

--The Traveler Without Maps.A 42-year-old parcel delivery driver with diffuse pain arising from a wrist injury, he worries constantly about an unending future of pain, which he fears robs him of not only a decent-paying job but also access to his beloved recreation of lake fishing.

--The Implant Seeker. This 48-year-old's back problems have not been relieved by several back surgeries. The spinal fusion that she hoped would help did little other than put her at risk for the disk spaces above and below the fusion site. An inpatient care nurse, she has studied spinal cord stimulator implants and hopes to get one, at a cost to her workers' comp insurer of upward of $50,000.

--The Minimalist. No aggressive procedures and the least possible drugs for this yoga-practicing believer in acupuncture. She has returned to her call center job but takes frequent breaks during the day and sick time for neck pain. This struggle has been going on for five years.

--The Swinger. This 26-year-old dry wall worker has been taking recreational drugs since the 9th grade. He has convinced his doctor to increase the dosage of Oxycontin; he sells half of his prescription to his friends. Meanwhile he appears crippled from a knee injury.

October 15, 2008

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