There was one day where Rita-Marie Geary was in so much pain from several health conditions that she just wanted to laugh it away.
Unfortunately, it hurt her to laugh.
So Geary, a parishioner of St. John of Rochester in Perinton and a resident of Greece, called Msgr. Gerard Krieg, a family friend, so she could hear his hearty, infectious laugh.
Releasing feel-good endorphins through laughter is one of the ways Geary has managed a lifetime of chronic pain. The head of the local support group of the American Chronic Pain Association, Geary notes that pain has a purpose: It protects a person from getting hurt.
"For people with chronic pain, it’s like the pain signal is stuck on," Geary said. "We’re safe, but our body is still screaming out in pain."
The International Association for the Study of Pain defines pain as an unpleasant sensory or emotional experience associated with actual or potential tissue damage, said Dr. Armando Villarreal, an assistant professor at the University of Rochester’s Department of Neurosurgery who is board certified in anesthesiology and pain medicine.
"That definition involves the fact that a person does not have to have a physical injury to have pain," he said, noting that instead of an injury, pain could be caused by a dysfunction of the nervous system or an illness, such as in the case of diabetic neuropathy or the pain after shingles called postherpetic neuralgia.
Villarreal said when a person feels pain, that pain registers in the brain both as a physical sensation and as an emotion, such as fear. Pain treatment must address both the physical symptoms and the emotions connected with the pain, he said. For instance, workers injured on the job may avoid returning to work because of fear.
"It’s hard to treat those patients because they may be telling you they are still in pain, but it’s not pain coming from injury, it’s the pain of the fear of repeating that same injury," Villarreal said.
Treatments may include a wide range of options: medications, pain patches, physical therapy, psychological counseling or surgery, he said. Doctors plan pain treatment or management using a patient’s medical history, physical exam and contributing factors, including low economic resources, disruptions in family life, loss of employment and stress, he added.
"Pain is a complex problem that doesn’t have one single solution, and so we cannot determine just because a person has a diagnosis what is the best treatment for that diagnosis," Villarreal said.
Doctors may recommend such over-the-counter medicines as ibuprofen, acetaminophen or naproxen, though some of the medicines may cause organ damage in high doses, especially in older patients, Villarreal said. Doctors also may prescribe anti-seizure medicines, anti-depressants, anticoagulants, creams or skin patches that numb pain.
Opioids, including hydrocodone, oxycodone, morphine and codeine, also may be helpful, Villarreal said. He said certain patients may be more prone to addictions to opioids, so doctors avoid prescribing them to patients with a history of depression, abuse, family history of addictions or weak family or community supports.
However, many people confuse addiction with tolerance, Villarreal said. Just as those who drink coffee regularly get headaches if they miss their daily cup, those who have developed a tolerance to opioids may experience withdrawal symptoms of stomachache, excessive sweating and nausea if they do not take the medicine.
"Someone who cannot control the impulse of taking the medication, despite the possibility of harm of the medicine, is addicted," Villarreal explained.
Doctors also avoid prescribing opioids in large doses to geriatric patients, he said.
"There were a lot of cases where patients were getting massive doses of opioids, began getting dizzy, fell and broke their hips, or had head traumas," Villarreal said. "There has to be a balance between how much benefit the medication can provide vs. the risk."
Villarreal said alternative and complementary therapies also may be part of a pain management plan. Physical therapy, psychological counseling, acupuncture, massage therapy or yoga may be helpful.
"We have to rely on all our colleagues to find out the best treatment options for the patients," Villarreal said.
Geary said she has found self-hypnosis, stress reduction and relaxation techniques to be helpful. She uses biofeedback — a measure of the body’s physiological signs — to help guide her relaxation and the gentle movements of the Feldenkrais Method as well as warm water therapy to expand her range of motion.
"It allows your body to move and do things that your body wouldn’t normally do," Geary said.
She said she also attempts to divert her attention through such creative hobbies as photography and scrapbooking.
"That’s one of the things that you can do: something that brings joy in your life, something that distracts, something that gets you out of yourself," Geary said.
She said she also relies on her faith to help her manage her pain. Although Catholics place importance on suffering, that does not mean their faith obligates them to suffer through life with pain, she said. It is a point echoed by her friend, Msgr. Krieg.
"When our Lord begins his public life, there are two things he does: he heals, and he teaches," Msgr. Krieg said. "Putting pain in focus is an essential part of his public life, and if we are expected to follow him, healing should be very much a part of our faith."
For those whose pain is not easily treated, Msgr. Krieg noted that suffering helps mold them in the image of the incarnate Jesus.
"Pain shouldn’t be taken out of context: It is part of our human nature, but our human nature rests in the creation act of God, and is expressed so beautifully in the human presence of Jesus," he said.
– – –
Editor’s Note: The local chapter of the American Chronic Pain Association will host speakers on chronic pain from 6:45 to 8:30 p.m. Sept. 16 at The Baptist Temple, 1101 Clover St., Rochester; at 7 p.m. Sept. 22 at St. John of Rochester Church, 8 Wickford Way, Perinton; and at 7 p.m. Sept. 29 at Pieters Family Life Center, 1025 Commons Way, Henrietta. For details, e-mail rmgeary@gmail.com or call 585-458-4954.
