Understanding Pain: When Relief Fails, Education Matters

Do You Suffer From Pain?

If you’ve been following my blog or know me personally, you know that beyond running my own practice, I also provide in-home visits for patients throughout the Bronx, New York. Whether I’m seeing patients in the office or in their homes, one issue I encounter time and time again is pain, both acute and chronic, affecting daily life in profound ways.

Just this past week, I saw a patient whose pain was so severe that it directly affected her blood pressure. Her reading was 179/103, and she openly acknowledged that her elevated blood pressure was related to her pain level. Upon reviewing her medications, I noted that she had been prescribed three different pain medications. There was enough to provide meaningful relief if taken correctly.

I asked her a simple question:
“Did you take any pain medication this morning?”
She answered, no.

I followed with another:
“Do you take your pain medication consistently throughout the day?”
Again, no.

Despite this, she was adamant that her medications “did not work” and expressed frustration and distrust toward her primary care provider. After we discussed how her medications were meant to be taken, she acknowledged (for the first time) that she may not have been using them appropriately.

Before sharing the specific instructions I gave her, I want to pause and share a personal experience that permanently shaped how I approach pain management.

My First Encounter with Severe Pain

I do not currently live with chronic pain, and if I’m being honest, I don’t know how people endure it. After giving birth to my son, I developed a deep vein thrombosis (DVT - a blood clot) in my left leg. The pain was so excruciating that I welcomed death over continuing to endure it.

The vascular specialist prescribed the pain medication hydrocodone every 4–6 hours as needed for a few days. Before I left his office, he emphasized—sternly—that it was a narcotic, highly addictive, and that misuse could lead to addiction. At the time, I was not yet in the medical field. I understood nothing about pain management. This statement invoked pure fear.

So, I went home and took the medication only when the pain became unbearable. My pain stayed at a constant 10/10.

When I returned to him and explained that the medication was not working, I asked for a dosage adjustment or an alternative. The look he gave me is one I will never forget. He accused me—implicitly—of being a drug seeker and refused to adjust anything.

I found myself in tears, uncertain whether the emotion stemmed from the false accusation or the realization that I might be left without pain relief. Most likely, it was the weight of both.

After he left the room, a nurse came in, sat beside me, and gently asked:
“Tell me how you’re taking the medication.”

I told her the truth. I was terrified of addiction, so I waited until the pain was unbearable before taking a dose.

Her face softened immediately.

She said, “If you take it like that, you will never get ahead of the pain. If you wait until your pain is above a 7, you could take the whole bottle and still not get relief.”

She explained that during the acute phase of pain, medication needs to be taken consistently—every 4–6 hours—regardless of pain level, to bring pain under control. Addiction, she reassured me, was not a concern in this short-term, medically supervised setting.

I followed her advice.
And I became pain-free.

That encounter never left me.

What Pain Taught Me as a Clinician

Now, as an advanced clinician, I often reflect on that moment. It fundamentally shaped how I practice. I do not dismiss patients’ pain. I do not assume exaggeration. And I take the time to teach patients how pain medication actually works.

One of the most important principles of pain management is this:
Pain is best controlled when treated early—at a level of 2–3, not 8–10.
Once pain escalates, it becomes significantly harder to manage.

Returning to My Patient in the Bronx

Based on her prescriptions, here were the instructions I provided—for temporary use during the acute phase of her pain:

• Apply the prescribed pain patch every 24 hours, preferably at night

• Take Ibuprofen every 8 hours, always with food

• If she wakes during the night, she may take Tylenol, as prescribed (every 8 hours, spacing doses appropriately)

• Alternate Ibuprofen and Tylenol during the day, ensuring proper timing and spacing

• Continue this schedule consistently—not reactively—to stay ahead of the pain

This approach was not meant to be permanent, but rather to stabilize her during a period of severe distress. A follow up revealed she had significant relief.

Why Do People Experience Pain?

Pain has many causes, including:

• Inflammatory pain (arthritis, autoimmune conditions)

• Neuropathic pain (pinched nerves, sciatica)

• Mechanical pain (degenerative disc disease, bone-on-bone joints)

• Phantom pain

• Post-surgical or injury-related pain

Because pain is complex, this blog will focus specifically on inflammation-related arthritis pain.

Treating the Root Cause, Not Just the Symptom

If you live with chronic arthritic pain, it is critical to address the root cause, or you may find yourself relying on pain medication indefinitely.

• Bone-on-bone knee pain often requires joint replacement

• Pinched nerves may require procedural or surgical intervention

• My next blog will highlight a natural approach.

• Degenerative conditions must be addressed structurally—not masked pharmacologically

Pain medication can dull symptoms, but pain is the body’s alarm system. It exists to tell you that something is wrong.

I practice naturopathic and integrative medicine and strongly believe that the body, when given the right environment, nutrients, and support, has an incredible ability to heal itself. That said, there are times when conventional medicine and surgery are necessary—and lifesaving. The two approaches do not have to compete; they can coexist.

Reducing Inflammation Naturally

For individuals with inflammatory arthritis affecting multiple joints, reducing systemic inflammation can significantly improve pain. Some foundational strategies include:

• Eating a balanced, anti-inflammatory diet

• Eliminating foods known to trigger inflammation (processed foods, excess sugar)

• Reducing or eliminating certain meats

• Supplementation such as:

  • Turmeric/Curcumin

  • Vitamin C

  • Omega-3 fatty acids

  • Magnesium

• Adequate hydration

• Gentle movement and weight management

Pain should never be ignored—but it also should never be misunderstood.

Education matters. Compassion matters. And sometimes, relief begins not with a stronger medication—but with better guidance.

In Part II, I will explore what pain truly is, how it develops in the body, why it becomes chronic, and how naturopathic and integrative approaches can help manage pain at its root—not just mask it.

Disclaimer:
This blog reflects clinical experience and integrative medical principles and is not intended as individual medical advice.

Reference:
– National Institutes of Health (NIH). Pain: Mechanisms and Management.

This blog is part of an ongoing series focused on understanding pain, healing, and integrative care. If you would like to receive future posts, clinical insights, and educational content, please subscribe to my email list. You are also encouraged to share this blog with others who may find it informative or helpful.