It's a bit scary how eager doctors are to prescribe them. "Hey doc, I'm in pain" – "Here's a bottle of painkillers, NEXT" Bitch, I don't want painkillers, I want you to figure out why my body is hurting when it's not supposed to. It's surprisingly frustrating to talk doctors into looking for the cause instead of treating the symptom.
Thankfully, the metamizole they kept filling me up with is not nearly as addictive as opioids and we have free health care, so I didn't have to pay a dime for the repeated blood analyses and CT it took find the cause. Otherwise I'd probably have bigger problems right now.
To be fair, this is related to the symptom you're asking them about. Pain often occurs with no apparent cause.
As an extreme example, it is normal for amputees to experience the sensation of a "phantom hand" where their hand would be if it hadn't been amputated. The phantom hand can feel pain. I'm fairly confident that there is nothing physically wrong with the hand someone doesn't have, even if it is in pain.
His latest work has been investigating body integrity identity disorder which is sort of the opposite of phantom limb: where you feel like a part of you doesn't belong.
I believe this gist of the work is that there is a mapping between our body and our brain (this is what enables one to 'know' where your body is in relation to itself when your eyes are closed) that sometimes is overloaded or malformed and can result in these issues.
http://www.webmd.com/pain-management/tricyclic-antidepressan...
In middle ages, millions dies of plague 'with no apparent cause'. I guess humankind just said 'ah, these things happen, let's not investigate further'. </irony>
If you have pain and you know why, you'll generally volunteer that information to your doctor. If you have pain and you don't know why, they will look at the area that hurts. If there's nothing obvious there, they'll give you painkillers, because all the safe money is on the idea that no matter what they try, they'll never be able to eliminate or even identify the cause of the pain. This is what you want them to do.
Looking at it from the doctor's viewpoint: Does this patient complain a lot? Is this complaint important? Hard to answer, expensive to find out with current technology and discoverability of relevant knowledge, techniques and advances is an everyday battle that hasn't been addressed consistently.
Some patients, like my grandmother, avoided complaining to not seem "fussing" when she dismissed heart disease as indigestion, ultimately had to have a quintuple bypass and coded three times in the OR. Slowly, she came back but it gave her back more energy than the previous decade and she's still alive.
well, we're not, and unless you are billionaire/us president, we won't get there in our lifetimes, nor our children's. fiancee is an internal doctor in one of biggest hospitals in Switzerland (read - you don't get much better public healthcare anywhere in the world), and they are
a) overwhelmed by amount of people, especially old whose bodies are just a massive clusterfuck of issues - welcome to being old. all they try is to keep them somehow alive when today this was failing, tomorrow that etc. there are simply no resources in medicare to treat your non-fatal condition which doesn't stem from something obvious.
b) 50% of people are sometimes in pain. each body is unique. what makes one thrive brings other to its knees.
c) as said here before, doctor's role is not detective investigation, that's research. doctors these days are overwhelmed with patients and must prioritize their incoming queue, even if it's with somebody's pain. Every patient also means hours of bureaucratic hell, same for incoming as for outgoing ones. that's why rich people have private health care - it's not about having best doctor available (same as you don't find brightest IT people in say SAP consulting), it's mainly about having someone dedicating as much time as needed to you.
I wish it would be so too, but that's simply not reality now
So while there might not be much to do if the brain is just crossing signals incorrectly for a couple of days, I would still suggest significant pain be checked out and a doctor you are paying should help look into it.
Chronic pain lasts for years, or forever. An incredible amount of effort has gone into understanding it. We can't blame practitioners for knowing that they don't understand pain and aren't likely to in the future, and therefore deciding to treat it with painkillers.
New Metal Gear game?
The issue is that many opioids and non opioids gap between the therapeutic dose range and LD50% is often dangerously narrow.
Complication #0: serum bioavailable molecule assay is rarely monitored. People metabolize and clear drugs at vastly differently rates.
Complication #1: Hospital mistakes still happen quite frequently, despite many measures to prevent them, especially with inexperienced and overworked nurses/assistants.
Complication #2: cummulative dosing error or interactions, especially multiple, independent prescriptions for similar opioids with different administration routes (patches, sprays, pills, injections)
Complication #3: overprescription of opioids because they're cheap, especially to veterans, which also leads to prescription and hard drug addictions.
Solution: opiods need to be singularly controlled at home or in the hospital by an integrated, blood/interstitial fluid measuring/dispensing unit to avoid OD and push back on abuse.
Plus, anyone taking opioids should also have narcan or equivalent antidote readily available, and wear a medalert QR code bracelet which lists relevant conditions and medications should they be found unresponsive.
Finally, avoid painkillers as much as possible and take the least dose which reduces stress level.