In Search of the Best Pain Clinic in LA: Mild Pain Syndromes

By | August 30, 2011

Capsaicin is a medicine extracted from red hot chili peppers. It is formulated in a number of creams and ointments. Capsaicin causes intense burning followed by numbness and pain relief when applied topically. It is useful in a number of neuropathic pain states.

Although very few people use this criterion as a discriminant in the search for the best pain clinic in Los Angeles, it is actually a very good one. Very few people actually seek medical evaluation of mild chronic pain syndromes, not because they are uncommon or not troubling, but because they are afraid that either they will not be taken seriously or because they fear that the cure will be worse than the disease.

Mild back pain or mild arthritis pain are two of the most common conditions that I see. In the case of mild chronic back pain, I think that keeping these people away from over-eager surgeons is at least as important as relieving their pain. I cannot tell you how many lives I have seen that have been ruined by the complications of unnecessary surgery. The same is true of degenerative hip and knee joint disease.

I have spent a lifetime in and around operating rooms. I am intimately aware of the potentials and the limitations of the most common procedures and one of the most important things that I do is to provide the patients with an independent appraisal of the potential risks and benefits of a wide variety of surgical procedures.

As far as taking patients seriously, I have seen many doctors become haughty and dismissive when patients complain of things that the physician feels are “beneath him”. The reality is that most of the time this is a poor psychological defense mechanism for feelings of inadequacy when the physician is unable to pontificate with the authority of God, as is his usual practice. The reality is that very little time is spent in medical schools and residency programs on the little complaints that vex most patients. As a result many physicians feel unsure of themselves when treating these minor conditions.

I have found a simple three-step method to deal with these situations. First I learn as much as I can about the problem. I have found it as interesting to learn about capsaicin as chemotherapy. Second, I share my knowledge with the patient. The pros and the cons of most of these simple therapies are usually well within the grasp of the patient. Finally I leave all decisions about therapy to the patient, which by the way is what I do for more serious problems as well. The patient is usually the one who is best equipped to decide how much cure he is willing to put up with in the treatment of his disease. We will often start with treatment #1 this week and then move on to treatment #2 next week, and when the patient tells me that I have annoyed him enough; I figure that we are done.


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