The Right (and Wrong) Way to Treat Pain

Chronic pain is a thief. It breaks into your body and robs you blind. With lightning fingers, it can take away your livelihood, your marriage, your friends, your favorite pastimes and big chunks of your personality. Left unapprehended, it will steal your days and your nights until the world has collapsed into a cramped cell of suffering.

Penny Rickhoff's world began to shrink suddenly in 1990, after a very tall and very heavy file cabinet toppled over onto her back. The freak accident damaged her spinal cord, leaving her with a constant, gnawing pressure in her lower back. "If I sit for very long, I'm in excruciating pain," she says. Once an avid tennis player, world traveler and amateur pilot, Rickhoff, who is in her 50s, was not only grounded, but she also became almost a prisoner in her home, unable to drive more than a short distance, unable to go anywhere without toting special "tush cush" pillows.

After seeing a dozen doctors, Rickhoff finally realized she wasn't going to be cured and started looking for ways to live with the pain. She took up Tai Chi and learned how to breathe deeply using her abdominal muscles. These pain- management skills enabled her to lower her dosage of morphine. But Rickhoff is the first to admit she can't make it through the day without her meds, and her powerhouse weapon was Vioxx. It helped destroy any pain, any time. Last September, when she learned that Vioxx was being pulled from the market by its manufacturer because of side effects, Rickhoff began to fret. "I knew from past experience that when I'd run out of a prescription, I would start to ache all over. I was so very distressed." She got a letter from her pharmacist urging her to return her supply of the drug, but she felt tempted--"very, very tempted"--to hang on to her hoard. "I'd taken it for five years with no problems at all," she says. In the end she figured it wasn't worth the risk. "So I returned it to the pharmacy and started suffering."

She has plenty of company in her misery. Approximately 1 in 6 Americans suffers from chronic or recurrent pain. For many, especially the millions who suffer from inflammatory diseases like arthritis or from chronic back pain, the withdrawal of Vioxx from the market last September and the serious questions raised about the safety of the entire class of COX-2 inhibitor drugs--at last week's Food and Drug Administration (FDA) hearings and in the latest issue of the New England Journal of Medicine--represent yet another setback in the long, frustrating search for relief. "I just loved Vioxx. It was magic," laments rheumatoid arthritis sufferer Lisa Dobbs, 50, of Bethesda, Md. "When they took it off the market, I was just destroyed."