[1171]

another study that links the presence of chronic pain to the onset of depression.
"This is similar to human depression, where sufferers have difficulty finding the energy or enthusiasm to do anything, including activities they value. This results in fewer pleasant events and encounters, which may enhance the depression."

http://arstechnica.com/science/2014/08/u...content%29

I've come to believe that the presence of chronic pain in a person's life requires professional outside help to minimize the growth and effects of depression. while pain medication can reduce the pain threshold it does not reduce or destroy the body's link to depression and depressive behaviors.
the article has a link to the study published in Science

[California_Help]

Great link 1171.

What are your thoughts about injured workers who have secondary psych claims after a chronic injury? There is a stigma with some that these are add on claims and just a way for applicant attorney's to bump up PD ratings. It is clear from the article you provided that there is a connection between chronic pain and depression.

There is also a link to depression that occurs after opioid medications are discontinued. The brain stops making some of the chemicals that provide "happiness feelings" as the opioids replace those chemicals. When the medications are discontinued, the brain will slowly recover, but can take months up to a year. I wish this issue would be addressed and injured workers were treated when their medications are discontinued to help with the withdrawals AND depression caused by chemical imbalance in the brain. In California, after medications are denied by UR and the IW then requests and IMR, months can go by before there is a determination, and many claims adjusters are denying medication refills without a physician monitored detox program.

[1171]

In my opinion the biggest problem is subjectivity.
until pain can be accurately identified and measured it's difficult not only to treat and rate but also link it to depression and other psychological/behaviorism consequences.
until the potential for abuse, exaggeration, and secondary gain can be reduced through some level of objectivity the comp system and the political and economic entities that drive it will not be willing to open that door to increased comp benefits.
studies like these are essential to moving forward in pain measurement and management.
maybe at some point in the future they will be able to test and establish valid chemical pain markers in the body.

[Manley2]

I have always said I wish they could plug into my brain and read it like a computer to understand the pain and maybe something like that could help them pin point the cause. Maybe one day they will figure something out

My pain doctor told me a while back to tell my lawyer he needed to understand he treats his patient by what he sees and they tell him not by what an x-ray says. He said he sees lawyer spend too much time talking about what is on an x-ray and that is only a small part in how he treats people

[bronco54501]

good material 1171,

What I find disturbing is when you go to a pain clinic for help they give you a sych evaluation before they decide to treat you. I'm not saying its wrong because obviously a lot of patients may need extra help dealing with the pain and emotions that come with it.. But what I do find disturbing is the after math, when all fails and wc decides to pull the plug, the injured people now have a lot more to deal with, withdrawls, depression, added pain, this is when they really need the sych eval. Been there, even wondered what it would be like to have no pain, wanted to end the agony.

My dr and I had talked a lot about this, he always asked me how my pain is going and if meds were working for my anxiety/depression. He had been my dr 15 years before my accident so he knew my signs.

Manley, my lawyer said the same thing and always said I will just show the judge your exrays. It does help pinpoint possible reasons, but in the end don't mean squat. Yea my hardware looks great on an exray but the real pain is coming from else where.

[1171]

doctors need tests to rule out some things, identify others, and establish a baseline as there maybe multiple things going on at the same time.
they use tests for broken limbs, heart problems and every other condition.
i would be surprised if they didn't do testing prior to developing a pain management program for someone.