If your doctor prescribes "Cipro" or other FQ's as a first line, ask them if there are any other options.

There are many many conditions where even with a proper diagnosis there is little help.

One of the easiest things to do with chronic pain patients is to minimize or handwave their pain as transient. There is no surgery for many of these people. No drugs that aren't heavily addictive. Little to no hope of anything but a lifetime of pain.

No _legal_ drugs that aren't heavily addictive. And the predictable result is that you can't even get legal medicine that works any more, because no one dares to touch the addictive stuff.

And I sort of get it, I went through hell getting off OxyNorm/Contin after the accident. But it's really shitty to leave people hanging with no legal alternatives.

Edit: What kind of person down votes this? I would seriously consider seeking help.

How do you deal with pain? Have you tried medical pot?

* Get you high * Make you drowsy * Addict you (yes, you'll have a tolerance, but no it won't be a problem) * Give you cravings * Stop your breathing

Each patch lasts a week and if they stick to my oily skin (I once dumped a 10 day heart monitor in 8 hours), it will stick to anyone. And you know what? It's not that much less effective than morphine. And it's even refillable.

Have you tried all the non opioid options? Lyrica, Gabapentin, Trifexis, Cymbalta, Nortriptyline (and other TCAs), etc? Lyrica is for nerve pain but Gabapentin and the others are used for all kinds of pain. CBD has limited evidence for helping nerve pain, but be aware that it has a long (>24 hour) half-life and can make you slightly high if you take enough daily (yes, in high enough doses it is psychoactive). There is good evidence for glucosamine/chondroitin for arthritis. There is limited evidence for tuermeric/curcumin (and its cheap!) for helping pain. There is limited evidence for SAM-E (but not if you've ever been manic) for pain. Are you on an NSAID? What about Tramadol? And for me, prednisone is a lifesaver for flights and conferences - I can't do either without it, but obviously you don't want to take it a lot. Great for flareups.

Have you tried compounded topicals? I have 9% Lidocain (store is 4%, pharmacy 5%), 9% Diclofenac (insurance covers 1$), 8% Tramadol (no mental effects), 2% cyclobenzaprine and 0.2% clonidine. You can pack in 30% of medicine, though I take 31.2% cause they still fill it. Topicals never helped me much - in particular lidocaine did shit. Until I tried 10%, that was magic. Most pain is felt on the skin - even organ pain, so you should definitely try this if you haven't. You can get a custom formulation fit exactly to your pain.

What about the various interventions offered via injection/rhizotomy? Do you see a physiatrist? Have you been to see an interventional anaesthesiologist? If you're really suffering have you asked about a spinal stimulator?

If you try most everything on the list, they will write you opioids even today, if buprenorphine doesn't cut it. Maybe you've tried all this stuff but most people I encounter on Quora aren't even anywhere near the end of the road and have given up.

Many people are unwilling to take drugs that affect the brain, and I always conclude they must not hurt very much because I'd take a pill with a 90% chance of curing me and a 10% chance of killing me.

Yeah, my dad has very bad diabetic neuropathy and there isn't really anything they can do about that condition from what I understand. I'm sure there are plenty of other conditions like Fibromyalgia and more.

Correct diagnosis combined with proper and effective treatment. Sadly, medicine doesn't offer effective treatment for the underlying cause of pain in far too many cases.

If you have FQAD, you might try looking up "nutrient depletions" for any and all drugs you were on. Also, look up any nutrients that need to be taken with those nutrients. So, for example, if they cause magnesium deficiency, you will probably need not only magnesium, but also calcium and vitamins D and K and maybe something else as well.

If you want to hire someone to do a job, you need to know how to do the job yourself. If you don't know, then you're prime target for stunt performances or casual incompetence.

This is simply not possible with the degree of specialization in the modern economy. There's no way you can be an electrician-plumber-mechanic-doctor-lawyer-IT specialist.

This is precisely why people care about reputations and gossip.

He's not wrong that the problem exists. It even has a name: the principal-agent problem.

You're not wrong that the knowledge you have can help you sniff out bad actors. Every little bit helps.

But it's not scalable. There will always be parts of life that you need to hire help with, but know very little about.

How do you choose which hospital to have a baby at? Which criminal defense attorney to hire? Which violin tutor to hire for your child?

Reputation is one the key ways people try to solve this problem when they're completely out of their depth.

That's an interesting list. I agree with your general feeling on this. But in my case, out of necessity, I have had to become an expert in each of the fields you mention, and many more. By expert I'll say I know more than the average licensed person. The average. I also have cultivated professional relationships with people in each of the categories who are competent and know more than me. Which is a minority of each field.

I think that "If you want to hire someone to do a job, you need to know how to do the job yourself." is true in many ways because the average level of competence by specialists is low. I also agree that it's not easily possible to be competent as a very competent specialist in all of these fields. Where we perhaps disagree is that I would say it is possible for an amateur to become above average compared to professionals in all of these fields. In most of these fields I would much rather pay someone to do it. I don't particularly enjoy the work. But paying someone gets me substandard and incompetent work even in licensed fields most of the time, until I know more than the average practitioner.

Also when we are talking about a lot of trades, though smart people used to be well represented in them, it's less the case these days. So tradesmen often don't have a lot of sense for diagnosing or doing proper work. A smarter person is going to be able to do a better job, even though he doesn't want to have to do that. But he may have no choice if he wants work done properly.

As far as reputation and recommendations I've personally found that seldom works to find the best people. I recognize others experience may differ. The problem is the person doing the recommendation will recommend a relative, friend, or someone they know who does bad work but they don't realize it because they are unable to judge it properly. For a recommendation to be good the recommend-er also has to know enough about the field to identify skilled practitioners. Most people don't know this much unless they are skilled in the field themselves.

The best people I've found have been through brute force search techniques of hiring over and over until I find someone that is able to do things well.

This is an extremely harmful answer. Do not listen to this person. If you have chronic pain, see a pain management specialist - a physiatrist or an interventional anaesthesiologist, or both. There are many non-opioid options that work extremely well. They can coordinate other care.

For example here's a Quora answer listing just a few treatments for chronic arthritis pain: https://www.quora.com/What-do-I-do-as-a-chronic-pain-elderly...

Also, MRI’s are still very much blunt instruments. A high resolution 1 millimetre scan is still representing ~100,000+ cells per voxel.

But that's not what GP is saying. GP is saying that associating diagnosis with resolution is a recipe for disappointment and wasted effort. Given our current abilities and the state of the art, finding a cause is not possible for many people, period. It is great that some people find a cause. It is also great that some people turn hard work into millions of dollars. That does not mean that it is a reasonable expectation for others--in fact, it is a harmful one, that obviates or distracts from more constructive alternatives, which GP suggested.

> corrected by aggressive bodywork, including trigger point myofascial release and dry needling.

It was corrected, but that doesn't mean those techniques are what corrected it.

You’re espousing hippiedom and it’s top comment because of left wing ignorance.

Please don't be that guy.

They just want to help, and for all anyone knows, they are helping. Saying it's an extremely harmful answer is not only untrue, it's harmful to discourage conversation that can lead to progress.

However, it is helpful to let people know what options they have and who and what they can go to for help. GPs should be doing this, but you'd be surprised how little they know about chronic pain. I've yet to bump into a GP who forwards people with chronic pain in the right direction.

>If you have chronic pain, see a pain management specialist

This is so important. Few know there are chronic pain centers people can go to that literally specialize in just chronic pain. They can help. They usually consist of three doctors and a physical therapist. For people with years of chronic pain a combination of things needs to be done at once to help them get out of it.

Also, optimism is helpful because it can prevent learned helplessness. Imagine living a life in chronic pain that could be cured, but instead every hypothetical was shot down, so not enough attempts towards a solution was made.

The discussion surrounding my comment is quite interesting, too, and worth reading.

[1]https://news.ycombinator.com/item?id=13275535

But correct diagnosis does not imply there is a cure or treatment available for the condition?

As long as the medical industry, especially the psychological industry, continues to name diagnoses off of their symptoms instead of naming them what they actually are, it becomes difficult to create procedures and medicine that work for all people.

And are you hypothesizing that your injury may be related to prior fluoroquinolone use?

Proper diagnosis is hard, and most doctors are generalists rather than specialists. A common medical aphorism is "When you hear hooves, think of horses not zebras".

People with chronic pain have different levels of certain gut bacteria. One study claims to have cured fibro through FMT. That study has 1 subject... lol.

I am almost certain the cure for some chronic pain is in bacteria. It's cool hearing what you say about Mitochondria though.