Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

Pain Treatment vs. Pain Management

After all of these years of treating injured workers, I am convinced that the patients routinely tell their authorized treating physician_the nurse_the staff_and others that they are depressed. I also strongly believe that they ask what to do, if anyone can help and/or can they be referred to someone.

I believe that this arises quite early in care; not at the end.

I also believe that their requests are summarily ignored.

They are told _we do not treat that in this office, and I have no one to whom to refer you._ Or, even more likely, _you_ll need to ask your case manager or adjustor to refer you to somebody_that_s not something I can do._

Since often the injured worker cannot speak directly to the employer or insurer, the request stops there. But the problem does not.

The patient cannot sleep so asks for pain medication. The patient says that their pain is worse, and their narcotics are adjusted. They do not regularly show or fully participate in physical therapy. They are told that they are capable of light duty work but are pessimistic and do not pursue the option. They are late for appointments, state that no one is listening to their back (neck, shoulder, etc) complaints.

They are depressed.

If they cannot receive attention/treatment for the depression, then they will amplify their expression of physical complaints because someone will listen to that.

While months pass, the wrong complaints continue to be addressed, and they are passed around among various physicians.

This could_and still can_be short circuited merely by addressing the real problem rather than avoiding doing so.

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