December 4, 2025 • 30 mins
Hosted by Neil Scott and Dr. Tom Walsh
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Speaker 1 (00:00):
Welcome to Men's Health Matters with doctor Tom Walsh, director
of the University of Washington's Men's Health Center and Associate
Professor of Urology at UW, featuring important topics dealing with
men's health. Now here's your host, Neil Scott.
Speaker 2 (00:17):
Welcome to the March edition of Men's Health Matters, coming
to you from the iHeart Studios in Seattle. My co host,
doctor Tom Walsh, director of the University of Washington's Men's
Health Center. Doctor walks, it is finally spring.
Speaker 3 (00:31):
It finally is I'm waiting for the weather to catch up, Neil.
Speaker 2 (00:34):
Absolutely for the weather. This month, we're going to focus
on pain. There are different types of pain and various
treatments for managing pain. Unfortunately, we have one of the
top pain experts in the Pacific Northwest, doctor Brett Stacy,
will us. We're going to get into different types of
pain and pain management in just a couple of minutes.
But first, as we do always, we begin with the
(00:54):
questions from the Anonymous Inbox, and that's a chance for
listeners to submit questions and noonymously on any subject dealing
with men's health. And all you have to do is
send an email to men's healthmatters at iHeartMedia dot com.
We will not share or retain your email address. It
is one hundred percent anonymous. All right, doctor Walsh Tyree
(01:15):
from Tacoma. With all the talk about artificial intelligence, what's
on the horizon for healthcare using AI?
Speaker 3 (01:22):
Well, certainly, Tyree, it's a really good question. I think
probably a lot is on the horizon. You know, we
know that AI is already assisting healthcare in helping sort
of refine differential diagnoses. We are using AI to help
record better histories from our patients and my practice, I
(01:42):
have somebody who shadows me, called a scribe, who allows
me to just focus on my patients, and they take
notes so that I can just look my patients in
the eye and not have to remember everything they say.
Turns out this is a great application for artificial intelligence
to listen in and help me to still down what
my patients are telling me. Any AI, especially in something
(02:04):
so personal like healthcare, we're going to be really careful.
The applications in healthcare are going to be real. I
think they're going to enhance healthcare, but I think the
safety profile is really what's going to come first.
Speaker 2 (02:16):
Remember, you can send an anonymous email on any health
issue to Men's Health Matters at iHeartMedia dot com. Will
not retain or share your email. In twenty twenty three,
approximately twenty three percent of men in the United States
experienced chronic pain, generally considered to be pain lasting more
than three months. Our guest this month is doctor Brett Stacy.
(02:38):
He's a pain medicine physician at the University of Washington.
He has over thirty five years of experience in the
medical field. He graduated from University of Michigan and Arbor
back in nineteen eighty six. Presently Division Chief of Pain
Medicine and Professor of Anesthesiology and Pain Medicine at the
University of Washington. Welcome to Men's Health Matters, doctor Stacy.
(02:58):
So many questions, so little time, so let's get right
to it. No one is a big fan of pain,
but it seems to be an important communication tool to
let men know that something's not right in your body.
What are the different types of pain? That is an
excellent question. And there's a whole variety of pain complaints
and problems and issues. So first, most of the time,
(03:20):
when we have pain, it's a good thing. It's telling us, Hey,
pay attention. You just stepped on that nail, you put
your hand in the fire, something that requires your attention.
You pay attention to it, you take action. As you
recover from whatever that injury was, you feel better. So
pain often feels like a threatened injury, and there's always
(03:40):
a context to it, and that context is where it happens,
how it happens, and an emotional context too. Sometimes it's
horrible news and you're really upset, and other times you're
able to you're in the middle of do something else exciting,
you don't even notice it.
Speaker 1 (03:54):
So it's a.
Speaker 4 (03:55):
Cute pain, short term pain telling us something is wrong,
we take action better. Pain can arise from different parts
of the body, rise from the structures of the body,
like your foot, your ankle, your back. That pain we
often can point to the exact spot where it is.
Pain can also arise from internal organs, internal structures, and
that pain is called visceral pain. Visceral pain is much
(04:17):
harder to localize. It's somewhere in your body, like in
your chest. Like that's why heart attack and manifests. Chest
pain or shoulder pain or jaw pain or arm pain
sometimes can't tell so there can be pain from the body,
which we know no susceptive or somatic pain, pain from
the organs, visceral pain. There also can be pain from
(04:38):
the nerves, so the nerves can cause pain called neuropathic
pain or nerve pain, and that pain often is burning, tingling,
numb tingly. It's associated with nerve damage or threatned nerve
damage neuropathy. Neuropathy is an example. And then there's even
another type of pain, which is from the pain system itself,
kind of going haywiring and causing signals that feel like pain,
(04:59):
even though there's not a things structurally wrong, nothing wrong
with your nerves, nothing wrong with your with your body,
but the pain is in the nervous system itself. Would
that be phantom pain. It's got a really stupid name.
I will tell you. It's called no suplastic pain. And
then there's what you're starting to talk about, the acute pain,
which is short term pain, and chronic pain, which is
pain that goes on beyond the time we should have
(05:20):
had healing and things getting better. It's persistent, ongoing pain.
And that kind of chronic, ongoing pain tends to impact
large aspects of your life, your sleep, your emotions, your
ability to work, ability to interact with others. It makes
you less likely to want to participate in activities, but
you get less physically fit. Like a lot of things
can snowball. Can it morph into chronic pain? A cute
(05:42):
pain can morph into chronic pain if it's not treated
appropriately or for it kind of keeps on going. How
long does acute pain usually last. It's really quite variable,
so cute pain can take some time. But as long
as it's along the course of what we expect for
natural healing, we don't really think of it as a
chronic pain condition. Just it's in the subacut phases. It's
fading away, but it's when we expect the healing to
(06:03):
have occurred, and it keeps on going. That's when we
start labeling chronic pain, Doctor Walsh.
Speaker 3 (06:07):
How does somebody's constitution figure into this? I have patients
all the time say, oh, my pain threshold is high,
my pain threshold is low. Is there something to do
with understanding where your pain's coming from? That figures into this?
I know that if I can explain it, I often
feel a lot better about it.
Speaker 4 (06:24):
So many of those things impact our pain, So there's
really cool studies that show that if you tell people
something's going to be painful, it's more likely to be painful,
and they rated is more pain. If you give people
reassurance and even describe the sensation in a different way,
they often will have a higher threshold of having pain.
There are people who are born who are more or
less sensitive to pain. The extremes are problematic. Right if
(06:47):
you're someone who does not feel pain, that means you
injure yourself because pain is protective, and if you don't
have that protective natural reflex, you're going to hurt yourself.
The other end is people for whom normally non painful
stimuli like brushing the skin can be painful. Sometimes that's
in the area of an injury. Some folks have that
throughout their body or in a big region of their body.
(07:09):
Sometimes let's associated with things like neuropathy. Like you mentioned,
it's quite variable, So who we are matters, and also
so many other things. If you had a poor nights
of sleep three nights in a row, then you get
tested for your pain threshold. It's lower than if you've
slept all the night before. If you're stressed out, your
pain threshold is not going to be the same as
if you're calm, cool and collected and having a good day.
(07:30):
There's time of day variabilities, there's a whole bunch of things.
Speaker 2 (07:33):
The standard measure, at least in my experience with doctors
and pain scale of one to ten.
Speaker 4 (07:39):
They'll say, oh wait, I'm stopping. You're right there. My
scale goes to zero. You can have you can have
no pain, Neil, you don't have to pain. Zero, zero
to ten, not one to ten. It's one of my
pet peeves, but it's zero to ten. Yeah, yeah, so
zero you can have no pain. Right, But if I'm
in your office, I've got pain, You've got pain exactly,
(08:00):
wanted to day exactly. Well, you've got pain, but you
may have a pain free day. Oh, you may have
a pain free moment. So what do the numbers mean.
They don't mean a ton, but they do mean something.
So if someone says I have pain, that's always eight, nine, ten.
That's really high level pain, which we call high impact pain.
So people that have high levels of pain tend to
(08:21):
have more impact on everything. If you look at people
with nerve pain, for instance, you look at people who
have the exact same diagnosis and rate their pain at
eight nine ten versus those that say that their pain
is mild one two three. The people that have eight
nine ten pain consume twice as many dollars of healthcare
in a year, way more likely to visit a doctor,
(08:43):
way less likely to be working full time, way more
likely to say they have depression anxiety, and are impacted
by their pain negatively. So that high impact pain high
pain scores really tells you something. Sometimes that's brief. Sometimes,
you know, some as a migraine, they can have an
episode that is limited, a very severe pain, but in
(09:05):
between they have zero pain. Other times it's more persistent.
Speaker 3 (09:08):
This is really impactful. And as you're describing this, what
I'm hearing is is there is maybe not one solution.
There is not a magic pill here. You know, this
is multi modal. This is helping people to deal with pain.
And so that's what I want to get at is,
you know, I see men in the office all the time.
You know, they may have pelvic pain or pain chronic
(09:29):
pain in a testicle or their scrotum. Can we talk
a little bit about your approach to patients. You know,
I think we've kind of gained this understanding of the
acute pain. Pull your hand out of the fire. And
but I would like to talk about how you approach
these individuals that have this unexplained or chronic pain that's
really becoming debilitating.
Speaker 4 (09:48):
Typically the patients are referred to me for male genital pain,
whether it be testical, penile pain or pelvic pain, have
seen either a general surgeon or a urologist. I feel
best when that's the case, and the reason is sometimes
you guys find things to take care of absolutely, to
(10:09):
treat with antibiotics, or treat with surgery, or treat with
something else. And if that's the case, they shouldn't be
seeing me.
Speaker 3 (10:15):
One of the things that I like to tell my
patients when they see me is I like to just
look them in the eye and say, you know, one
of the most important things we're going to do today
is we're going to make sure nothing dangerous is happening.
And the truth is usually I can do that with
just some questions and a physical examination, and rarely, you know,
I may require some other pictures taken of their body
(10:37):
that doesn't seem to cure the pain.
Speaker 4 (10:39):
It's not enough. It's just a start enough, a starting point.
So I ask people to describe how their pain started,
how it's changed over time, exactly where it is, and
not vague terms. I want very specific terms and descriptions
of where it hurts, what makes it better, what makes
it worse, if they've noticed any pattern, like it's always
worse when I first wake up in the morning, it's worse,
(10:59):
when I get in our it's worse. Whatever makes it
worse and whatever makes it better. And then I also
want those descriptions like is it sensitive to the touch,
is it kind of a vague pain somewhere deep in here,
in here, or is it really very specific because it's
very I can touch the exact spot it hurts, How
it impacts them, how it impacts their sleep, their exercise,
ability to concentrate, their mood, their interaction with their spouse
(11:22):
or their partner, all those things. Pain is a brain thing.
Your penis doesn't feel pain. Your penis sends things to
your nervous system that gets to your head that we
interpret all kinds of different ways depending on the situation.
But pain is in the brain. All pains impact the brain,
So your other bodily experiences impact your pain. So I
(11:43):
want to know about everybody's all the pain they have
and kind of put them together because if you've had
a lot of pain issues, your pain system may be
a bit sensitive and more prone to this. And if
we don't take care of the bigger picture, it'll be
harder to take care of that specific spot too.
Speaker 2 (11:57):
Let's talk a little bit about drug treatment. Over the
countermedge to highly addictive pain medications, in particular opioih. With
acute pain, you take tylanol or advil or is that
a good thing to do.
Speaker 4 (12:11):
Yeah, if you've had an injury, ibuprofen or a scene
of menaphine or any other over counter medications. Those are
reasonable things and people often notice and typical I tell people,
if you really have an injury and you're hurting, take
kind of the maximum dose on the bottle. Often people
notice a difference an hour later, like I'm feeling little
bit better here, that this can be helpful. Those medications
(12:32):
tend to be the most helpful for acute pain, but
they don't really work very well for chronic pain. Now
we're getting into opioids. Well, there's a lot of other
things that can work. Tell me, so if the nervous
system gets sensitive, which it does with chronic pain, off
the nervous system now has this threshold that's lower, so
it doesn't take near as much for you to hurt
in that area. Then sometimes opioids really aren't the best choice,
(12:53):
and there's a lot of other medications that really can work.
It's like flipping a switch. I have very many memories
of when you give someone a medication that they don't
think is a pain medication because it wasn't necessarily designed
or developed as a pain medication, but it works for
their type of pain they have. They come and tell
you about the payment leef they have. I can tell
you a little story about that. When I was a
(13:14):
young doctor after finished training, I had a patient who
was an engineer. He had severe testicular pain. The testicular
pain would get worse if he ejaculated, which he thought
was a dilemma because he had an interest in doing
that and he had if he didn't, with the pain
and fair enough, yes, fair enough, right. And it turned
(13:37):
out because of this kind of dilemma he basically tried
to avoid it. His description is very much like nerve.
So I gave him a medication that we think of
for nerve pain, and I gave him an adjustment you
know how you start here, adjusted up and he called
with and talked with our nurses. We adjust a little
bit further, and he comes for his followup visit and
he's got his wife with him now. So I walk
into the office and into the room, exam room, and
(13:59):
how are you doing. I'm doing well, And his wife said,
I wanted to meet you and say thank you very much,
because we are both much happier now. But sometimes that's
not the first thing we would think of, because that's
not that medication at that time did not have any
FDA approval for pain. It is a medication that was
developed for something else that we realized, hey, this works
for nerve pain, and now we're using it this way.
Speaker 3 (14:21):
We've learned a lot about over using certain medications, where
I think we used to think that we really had
to treat everyone with opioids for prolonged periods of time
and in high doses, and I think now we're moving
into a spot where we know that that's not good
for the individual, it's not good for society, it's not
good for anybody.
Speaker 4 (14:39):
I'm going to say one thing about opioids, just real quickly,
which people didn't think about in the past, which is
chronic use of those medications. Opioids are narcotics, drugs like oxycodone, morphine,
those kind of things. They suppress testosterone. They lead to
a rectile dysfunction, and women, they lead to fertility issues
and irregular minstrel cycles. We didn't know this in the past,
(15:00):
but high doses prolonged can do that and impact your
sexual function.
Speaker 2 (15:04):
So just know that.
Speaker 3 (15:06):
So we're dabbling a lot in new things. And here
in Washington State, I think a lot about cannabinoid derivatives cannabis,
and I hear a lot of my patients talk about CBD.
Speaker 4 (15:17):
In terms of cannabinoids and CBD in particular. CBD has
lots of cachet and not much evidence to say it's
much of a pain medication. Together with THHC for some conditions,
it clearly is a pain leaving medication by itself. I'm
not so convinced, and most people really aren't.
Speaker 3 (15:35):
It's not very regularly not be the panacea. These are
the things that our audience wants to know.
Speaker 2 (15:40):
Yeah, what about other non drug forms of treatment? Meditation, ocupuncture, yoga,
exercise focused on the whole body can be helpful for
pain too. There's really good evidence for some of the
things you mentioned. Gentle yoga has evidence of working across
the spectrum for chronic pain conditions. Why is that, Who knows.
(16:01):
Maybe it's the meditative part of yoga. Maybe it's just
learning to use your body and get your focus somewhere
besides the part that's hurting. It needs to be a
kind of yoga that understands that you might have a
pain issue and it shows you how to modify to
make it appropriate for your condition. Things like acupuncture can
be helpful. Things like exercise in the pool can be helpful.
(16:21):
Just walking and doing other forms of exercise can definitely
be helpful. So exercise is one thing. Meditation is another thing.
That sphere of kind of mental health approaches. There could
be more structured approaches too. There's the most studied and
long standing approaches called cognitive behavioral therapy, but there's many
ways now of framing that that's a little bit different,
(16:44):
a little bit requires possibly some more acceptance and some
more active role from the person within. That's why we
have psychologists, we have social workers, we have physical therapists
as part of our team to kind of look at
those different aspects. Have an integrative health person who focuses
on things like acupuncture other approaches to wellness. I had
(17:07):
some knee problems a while back. I'm a runner, and
I went to the UDUB. One of the things they
told me is motion is lotion. You've got to keep
moving even if it hurts, and there's a difference between
hurt and harm.
Speaker 4 (17:23):
That's excellent advice. And the other one is exercises, medicine.
More exercise. More motion helps your overall health, can help
the specific pain. And there's a whole bunch of reasons
for that. When we're moving and using our bodies, a
whole bunch of nerves are stimulated and they send signals
up to your brain, and your brain has to process
all of that. That's why some people with pain ishes
(17:43):
will tell you I'm doing okay through the day and
I get in bed and I start to wind down,
and man, there's my pain. And that's because your brain says, okay,
what can I pay attention to now? Oh that thing
that's been there the whole time, Now it's number one
on the list. Exercise does a couple of things. One is,
while you're exercising, you got the other stimulation coming in
and then it changes your nervous system, it changes your physiology,
(18:06):
it changes those chemicals involved with mood and pain in
your brain and in your spinal cord. It's amazing, it's
great medicine.
Speaker 3 (18:13):
Well as urologist, I really want to emphasize that so
much of the pain really is muscular and skeletal in nature,
even in these pelvic organ places. We find that, especially
in our more sedentary population, we find that muscles that
are tight that shouldn't be tight, muscles are imbalanced that
(18:35):
should be symmetric, and it has really complex effects that
are not just pain, but can affect the way men urinate,
can affect their sexual function.
Speaker 4 (18:45):
First is, we live in our bodies. We use our
bodies all the time. We think we know our bodies
really well, but we sometimes wrongly assign where the pain's
coming from right, and we don't really understand all the
things that are involved with it. You'll see someone who
has their left shoulder always lower. They don't know they
have their left shoulder lower, and they pointed out to them,
(19:06):
and then you figure out why that is. You know,
So there's a lot of things in our body we
don't know until someone points it out to us. That's
what a physical therapist can do, or another type of
exercise specialist and strength matters, balance matters, and not over
using the ones that work well. That's what we sometimes
do right.
Speaker 2 (19:25):
Our guest is mother and ments health matter is doctor
Brett Stacy, one of the top pain management physicians at
the University of Washington. He's the Division Chief Pain Medicine
and Professor of Anesthesiology and Pain Management at the University
of Washington. We're going to continue our discussion with doctor
Stacy right after this short timeout.
Speaker 5 (19:42):
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Speaker 2 (20:37):
We're back in men's health matters. I'm n Neil Scott.
My co host is the director of the UDAB Men's
Health Center, Doctor Tom Walsh, and tonight, please to have
with us in the studio Doctor Brett Stacy, Division Chief
Pain Medicine at the University of Washington, Doctor Walsh.
Speaker 3 (20:50):
There's gonna be somebody who has chronic pain and they
just would like to imagine a better path. And then
there are going to be people who haven't started down
any path but like to learn more. I could certainly
imagine just outlining a paradigm where you tell people to
get connected to a healthcare provider.
Speaker 4 (21:07):
One of the things that doctor Walsh and any other
physician can tell you that the passive patients the hardest patients.
We want patients who want to be involved in their health.
We want patients who take responsibility for their health also
can do it in a realistic manner.
Speaker 3 (21:22):
You know, there's really something to be said for managing
your chronic pain and becoming more fit, for doing that
thing in your health that you've always wanted to do,
whether it is, you know, taking action on your cancer
screenings that you are afraid to do, you know, whatever
(21:43):
it is somebody who's empowered to just take charge.
Speaker 4 (21:47):
There probably isn't one thing. If you're coming to see
me a tertiary care specialist, you know, third level specialists.
You see your primary care provider, you see a specialist,
and then you come to see the pain doctors. I'm third,
third tier. You come to see me. The easy stuff
has been done. We all want the easy button, but
in reality, there isn't one. Sometimes a medication, sometimes a procedure,
(22:12):
sometimes a different way of thinking about your pain can
be that, but usually it's not. Usually it's a component
of it. If you just do one thing, you'll get
you know, five, ten, fifteen, twenty percent relief, it doesn't count,
it's not enough. If you do something else, should get
another three, five ten percent relief. They're in separate piles,
one at a time, does a mean thing. Put them together,
(22:34):
that starts to be a bit more and yet on
other layers, and now it starts to be a substantial
amount of change. So thinking about that multi dimensional cat,
thinking about you know what, I am going to try
to sleep better and try to go to bed at
a reasonable time rather than stay up late scroll through
my screens I shouldn't be doing. I am going to
make an effort to take that walk after dinner. Start
(22:56):
doing some of those things. None of them are the answer,
but they're part of the puzzle, you know, part of
the answer.
Speaker 3 (23:03):
I sit here, I'm thinking about I've been in practice
for twenty years. I consider myself an expert in my field,
and I deal with some pain. Can you talk a
little bit about just understanding pain, Because as I'm listening
to you, the amount of understanding that I'm gaining is profound,
and I could imagine that if I were suffering from
(23:24):
chronic pain, learning from an expert like you becomes really
profound and meaningful. I wonder, you know, as I'm listening
to you, I'm realizing that I'm not doing a sufficient
job of helping people understand their pain.
Speaker 4 (23:38):
And all the modality well, starting point is always going
to be your primary care practitioner and talk about your
pain with your primary care practitioner. And my suggestion is
if the pain is a big deal to you, set
up an appointment just for that. Don't have it be
your annual appointment. And they want they have a checklist
they need to get through, or they want to ask
(24:00):
you a bunch of things that don't seem related to
your pain, then you want to add this in. Make
an appointment to talk about this, and then they often
can get you in the right direction and get your
headed where you need to be. My background when I
was a medical student, I was going to be a urologist.
Of course you were, I really truly was. I matched
in urology and chose not to pursue it. I visited
(24:21):
two pain clinics and I thought I can do better
than this. So the first one I went to, all
they focused on was the mental health aspects of chronic pain,
and I saw people with clear physical issues that were
being completely ignored. I thought, this is messed up. My
(24:41):
head started thinking like this is not right. Then I
went to the next one. It was the exact opposite.
Everybody was getting an injection, everybody was getting medications, and
I saw tearful people talking about how their lives are
totally changed by their pain in a bad way. They
couldn't work, their spouses didn't like them. All this kind
of stuf, and it was not being addressed with a
(25:01):
needle or a pill. And I thought, somewhere between those
two is the right approach. When I decided not to
be a urologist, I had to scramble because I want
to be a pain specialist for an anesesia position. To
my great fortune, there was a spot at the University
of Pittsburgh, which is a top antiesesia program, and it
(25:22):
turns out they had just hired people to come and
start a new pain clinic. The reason they hired someone
to come start a new pain clinic is the person
in charge of all of health sciences across all of
the University of Pittsburgh had a family member with a
pain problem that wasn't being treated effectively. So he said,
we shall treat this better and he hired people to
do something different. So I had an amazing training and
(25:44):
amazing start to my academic career.
Speaker 2 (25:47):
Before we wrap up this edition of Mental Health Matters,
we need a call to action and some practical, in
vetted preventive resources dealing with pain and pain management.
Speaker 4 (25:56):
What do you suggest start with your primary care, so
cease someone to assess things to start with. That's step one.
And then for you looking for resources for yourself. I
really like the American Chronic Pain Association, which is an
organization that was founded by pain patients for pain patients.
It has many, many resources.
Speaker 3 (26:15):
What is that website, Neil, I'm looking at it right now,
and this is ACPA now dot com. That's ACPA now
dot com.
Speaker 4 (26:25):
Sounds like a great resource. It's a very good resource.
And then UW Medicine has several links for pain, including
to our clinic. Our clinic is referral only, so you
have to have seen someone else first to kind of
evaluate the pain problem initially, because often that's what you need.
You don't necessarily need to see me or one of
my colleagues.
Speaker 3 (26:44):
And I always like to say, Neil, for those those
individuals who are adrift, who are not connected to healthcare,
I think one of the major messages of this broadcast
is to get people connected. Call two six five two
zero five thousand. That's a great way to get connect
to UW Medicine primary Care, or you can simply go
to UW Medicine dot oorg. There's something that you started
(27:07):
talking about, which is sort of the origins of pain,
like why does pain exist? Actually, I think it was
Neil who introduced the idea that pain tells us something,
tells us not to do something. There's a word that
is included in there that we never quite said, which
is fear. And I think pain engenders a lot of fear,
and that fear can manifest different ways in different people.
(27:30):
For some people that will make them withdraw and not
seek out the right care for fear of what they
may learn. And yet others it could be very paralyzing
in their day to day lives or you know, just
dominate what they do. I've got to imagine that addressing
fear has to be part of pain management for some Oh,
it's a huge thing.
Speaker 4 (27:51):
People are fearful of that they're going to interest themselves,
break something, make the situation worse. And what Neil said
about you know, just because it's hurting doesn't mean you're
causing damage, right that That message is sometimes really hard
to get across and think about in your personal life.
We've all had something happen and we're worried about what
it means. So context is everything. Yeah, the way we
(28:14):
interpret sensations in our body really varies well dramatically. The
exact same sensation has a different meaning. The example I
often give is imagine you're at the movie theater sitting
next to someone and they put their hand on your
thigh and they go like this and try to smile
at you. And it's your personnel on a date with,
or are there with. It's your partner that feels nice.
(28:36):
If it's a total stranger, it's creepy as hell. Exact
same sensation, but the way we interpret it is completely different.
There's a lot of things about our bodies and our
sensations that really are variable. We don't understand all those things.
Speaker 2 (28:51):
And the whole psychology of pain, I mean, it's frustrating
when you're in pain. Pain cannot be seen, Nope. Other
people often are quick to shay, oh, you exaggerating.
Speaker 4 (29:01):
It's even worse sometimes if you go to see someone
who is very structurally focused. Specif physician who says there's
nothing surgical here, which sometimes people hear, oh there means
there's nothing wrong with me. Yeah, well there's got to
be something wrong because I hurt, right. I hear that
all the time. Right, But a normal MRI does not
(29:22):
mean no pain. An abnormal MRI doesn't mean pain either,
So that both these things are true, it's really frustrated
to not feel validated.
Speaker 2 (29:31):
That wraps up this edition of Men's Health Matter Special
Thanks to our dance doctor Brett Stacy, Division Chief Pain
Medicine and Professor of Anaesthesiology and Pain Medicine at the
University of Washington. By the way to reach the Men's
Health Center at the udube called two six five nine
eight six three five eight. I'm Neil Scott of behalf
of my co host, doctor Tom Walsh. Thanking you for
(29:52):
listening to Men's Health Matters and wishing you good health
and good sense and matters relating to men's health. Because
Men's Health Matters, stay healthy, live in gratitude, and be
kind to one another. Thanks for listening.
Speaker 1 (30:04):
You've been listening to Men's Health Matters with doctor Tom Walsh,
Associate Professor of Urology at the University of Washington and
your host Neil Scott on Sports Radio ninety three point
three KJR FM.
Welcome to Men's Health Matters with doctor Tom Walsh, director
of the University of Washington's Men's Health Center and Associate
Professor of Urology at UW, featuring important topics dealing with
men's health. Now here's your host, Neil Scott.
Speaker 2 (00:17):
Welcome to the March edition of Men's Health Matters, coming
to you from the iHeart Studios in Seattle. My co host,
doctor Tom Walsh, director of the University of Washington's Men's
Health Center. Doctor walks, it is finally spring.
Speaker 3 (00:31):
It finally is I'm waiting for the weather to catch up, Neil.
Speaker 2 (00:34):
Absolutely for the weather. This month, we're going to focus
on pain. There are different types of pain and various
treatments for managing pain. Unfortunately, we have one of the
top pain experts in the Pacific Northwest, doctor Brett Stacy,
will us. We're going to get into different types of
pain and pain management in just a couple of minutes.
But first, as we do always, we begin with the
(00:54):
questions from the Anonymous Inbox, and that's a chance for
listeners to submit questions and noonymously on any subject dealing
with men's health. And all you have to do is
send an email to men's healthmatters at iHeartMedia dot com.
We will not share or retain your email address. It
is one hundred percent anonymous. All right, doctor Walsh Tyree
(01:15):
from Tacoma. With all the talk about artificial intelligence, what's
on the horizon for healthcare using AI?
Speaker 3 (01:22):
Well, certainly, Tyree, it's a really good question. I think
probably a lot is on the horizon. You know, we
know that AI is already assisting healthcare in helping sort
of refine differential diagnoses. We are using AI to help
record better histories from our patients and my practice, I
(01:42):
have somebody who shadows me, called a scribe, who allows
me to just focus on my patients, and they take
notes so that I can just look my patients in
the eye and not have to remember everything they say.
Turns out this is a great application for artificial intelligence
to listen in and help me to still down what
my patients are telling me. Any AI, especially in something
(02:04):
so personal like healthcare, we're going to be really careful.
The applications in healthcare are going to be real. I
think they're going to enhance healthcare, but I think the
safety profile is really what's going to come first.
Speaker 2 (02:16):
Remember, you can send an anonymous email on any health
issue to Men's Health Matters at iHeartMedia dot com. Will
not retain or share your email. In twenty twenty three,
approximately twenty three percent of men in the United States
experienced chronic pain, generally considered to be pain lasting more
than three months. Our guest this month is doctor Brett Stacy.
(02:38):
He's a pain medicine physician at the University of Washington.
He has over thirty five years of experience in the
medical field. He graduated from University of Michigan and Arbor
back in nineteen eighty six. Presently Division Chief of Pain
Medicine and Professor of Anesthesiology and Pain Medicine at the
University of Washington. Welcome to Men's Health Matters, doctor Stacy.
(02:58):
So many questions, so little time, so let's get right
to it. No one is a big fan of pain,
but it seems to be an important communication tool to
let men know that something's not right in your body.
What are the different types of pain? That is an
excellent question. And there's a whole variety of pain complaints
and problems and issues. So first, most of the time,
(03:20):
when we have pain, it's a good thing. It's telling us, Hey,
pay attention. You just stepped on that nail, you put
your hand in the fire, something that requires your attention.
You pay attention to it, you take action. As you
recover from whatever that injury was, you feel better. So
pain often feels like a threatened injury, and there's always
(03:40):
a context to it, and that context is where it happens,
how it happens, and an emotional context too. Sometimes it's
horrible news and you're really upset, and other times you're
able to you're in the middle of do something else exciting,
you don't even notice it.
Speaker 1 (03:54):
So it's a.
Speaker 4 (03:55):
Cute pain, short term pain telling us something is wrong,
we take action better. Pain can arise from different parts
of the body, rise from the structures of the body,
like your foot, your ankle, your back. That pain we
often can point to the exact spot where it is.
Pain can also arise from internal organs, internal structures, and
that pain is called visceral pain. Visceral pain is much
(04:17):
harder to localize. It's somewhere in your body, like in
your chest. Like that's why heart attack and manifests. Chest
pain or shoulder pain or jaw pain or arm pain
sometimes can't tell so there can be pain from the body,
which we know no susceptive or somatic pain, pain from
the organs, visceral pain. There also can be pain from
(04:38):
the nerves, so the nerves can cause pain called neuropathic
pain or nerve pain, and that pain often is burning, tingling,
numb tingly. It's associated with nerve damage or threatned nerve
damage neuropathy. Neuropathy is an example. And then there's even
another type of pain, which is from the pain system itself,
kind of going haywiring and causing signals that feel like pain,
(04:59):
even though there's not a things structurally wrong, nothing wrong
with your nerves, nothing wrong with your with your body,
but the pain is in the nervous system itself. Would
that be phantom pain. It's got a really stupid name.
I will tell you. It's called no suplastic pain. And
then there's what you're starting to talk about, the acute pain,
which is short term pain, and chronic pain, which is
pain that goes on beyond the time we should have
(05:20):
had healing and things getting better. It's persistent, ongoing pain.
And that kind of chronic, ongoing pain tends to impact
large aspects of your life, your sleep, your emotions, your
ability to work, ability to interact with others. It makes
you less likely to want to participate in activities, but
you get less physically fit. Like a lot of things
can snowball. Can it morph into chronic pain? A cute
(05:42):
pain can morph into chronic pain if it's not treated
appropriately or for it kind of keeps on going. How
long does acute pain usually last. It's really quite variable,
so cute pain can take some time. But as long
as it's along the course of what we expect for
natural healing, we don't really think of it as a
chronic pain condition. Just it's in the subacut phases. It's
fading away, but it's when we expect the healing to
(06:03):
have occurred, and it keeps on going. That's when we
start labeling chronic pain, Doctor Walsh.
Speaker 3 (06:07):
How does somebody's constitution figure into this? I have patients
all the time say, oh, my pain threshold is high,
my pain threshold is low. Is there something to do
with understanding where your pain's coming from? That figures into this?
I know that if I can explain it, I often
feel a lot better about it.
Speaker 4 (06:24):
So many of those things impact our pain, So there's
really cool studies that show that if you tell people
something's going to be painful, it's more likely to be painful,
and they rated is more pain. If you give people
reassurance and even describe the sensation in a different way,
they often will have a higher threshold of having pain.
There are people who are born who are more or
less sensitive to pain. The extremes are problematic. Right if
(06:47):
you're someone who does not feel pain, that means you
injure yourself because pain is protective, and if you don't
have that protective natural reflex, you're going to hurt yourself.
The other end is people for whom normally non painful
stimuli like brushing the skin can be painful. Sometimes that's
in the area of an injury. Some folks have that
throughout their body or in a big region of their body.
(07:09):
Sometimes let's associated with things like neuropathy. Like you mentioned,
it's quite variable, So who we are matters, and also
so many other things. If you had a poor nights
of sleep three nights in a row, then you get
tested for your pain threshold. It's lower than if you've
slept all the night before. If you're stressed out, your
pain threshold is not going to be the same as
if you're calm, cool and collected and having a good day.
(07:30):
There's time of day variabilities, there's a whole bunch of things.
Speaker 2 (07:33):
The standard measure, at least in my experience with doctors
and pain scale of one to ten.
Speaker 4 (07:39):
They'll say, oh wait, I'm stopping. You're right there. My
scale goes to zero. You can have you can have
no pain, Neil, you don't have to pain. Zero, zero
to ten, not one to ten. It's one of my
pet peeves, but it's zero to ten. Yeah, yeah, so
zero you can have no pain. Right, But if I'm
in your office, I've got pain, You've got pain exactly,
(08:00):
wanted to day exactly. Well, you've got pain, but you
may have a pain free day. Oh, you may have
a pain free moment. So what do the numbers mean.
They don't mean a ton, but they do mean something.
So if someone says I have pain, that's always eight, nine, ten.
That's really high level pain, which we call high impact pain.
So people that have high levels of pain tend to
(08:21):
have more impact on everything. If you look at people
with nerve pain, for instance, you look at people who
have the exact same diagnosis and rate their pain at
eight nine ten versus those that say that their pain
is mild one two three. The people that have eight
nine ten pain consume twice as many dollars of healthcare
in a year, way more likely to visit a doctor,
(08:43):
way less likely to be working full time, way more
likely to say they have depression anxiety, and are impacted
by their pain negatively. So that high impact pain high
pain scores really tells you something. Sometimes that's brief. Sometimes,
you know, some as a migraine, they can have an
episode that is limited, a very severe pain, but in
(09:05):
between they have zero pain. Other times it's more persistent.
Speaker 3 (09:08):
This is really impactful. And as you're describing this, what
I'm hearing is is there is maybe not one solution.
There is not a magic pill here. You know, this
is multi modal. This is helping people to deal with pain.
And so that's what I want to get at is,
you know, I see men in the office all the time.
You know, they may have pelvic pain or pain chronic
(09:29):
pain in a testicle or their scrotum. Can we talk
a little bit about your approach to patients. You know,
I think we've kind of gained this understanding of the
acute pain. Pull your hand out of the fire. And
but I would like to talk about how you approach
these individuals that have this unexplained or chronic pain that's
really becoming debilitating.
Speaker 4 (09:48):
Typically the patients are referred to me for male genital pain,
whether it be testical, penile pain or pelvic pain, have
seen either a general surgeon or a urologist. I feel
best when that's the case, and the reason is sometimes
you guys find things to take care of absolutely, to
(10:09):
treat with antibiotics, or treat with surgery, or treat with
something else. And if that's the case, they shouldn't be
seeing me.
Speaker 3 (10:15):
One of the things that I like to tell my
patients when they see me is I like to just
look them in the eye and say, you know, one
of the most important things we're going to do today
is we're going to make sure nothing dangerous is happening.
And the truth is usually I can do that with
just some questions and a physical examination, and rarely, you know,
I may require some other pictures taken of their body
(10:37):
that doesn't seem to cure the pain.
Speaker 4 (10:39):
It's not enough. It's just a start enough, a starting point.
So I ask people to describe how their pain started,
how it's changed over time, exactly where it is, and
not vague terms. I want very specific terms and descriptions
of where it hurts, what makes it better, what makes
it worse, if they've noticed any pattern, like it's always
worse when I first wake up in the morning, it's worse,
(10:59):
when I get in our it's worse. Whatever makes it
worse and whatever makes it better. And then I also
want those descriptions like is it sensitive to the touch,
is it kind of a vague pain somewhere deep in here,
in here, or is it really very specific because it's
very I can touch the exact spot it hurts, How
it impacts them, how it impacts their sleep, their exercise,
ability to concentrate, their mood, their interaction with their spouse
(11:22):
or their partner, all those things. Pain is a brain thing.
Your penis doesn't feel pain. Your penis sends things to
your nervous system that gets to your head that we
interpret all kinds of different ways depending on the situation.
But pain is in the brain. All pains impact the brain,
So your other bodily experiences impact your pain. So I
(11:43):
want to know about everybody's all the pain they have
and kind of put them together because if you've had
a lot of pain issues, your pain system may be
a bit sensitive and more prone to this. And if
we don't take care of the bigger picture, it'll be
harder to take care of that specific spot too.
Speaker 2 (11:57):
Let's talk a little bit about drug treatment. Over the
countermedge to highly addictive pain medications, in particular opioih. With
acute pain, you take tylanol or advil or is that
a good thing to do.
Speaker 4 (12:11):
Yeah, if you've had an injury, ibuprofen or a scene
of menaphine or any other over counter medications. Those are
reasonable things and people often notice and typical I tell people,
if you really have an injury and you're hurting, take
kind of the maximum dose on the bottle. Often people
notice a difference an hour later, like I'm feeling little
bit better here, that this can be helpful. Those medications
(12:32):
tend to be the most helpful for acute pain, but
they don't really work very well for chronic pain. Now
we're getting into opioids. Well, there's a lot of other
things that can work. Tell me, so if the nervous
system gets sensitive, which it does with chronic pain, off
the nervous system now has this threshold that's lower, so
it doesn't take near as much for you to hurt
in that area. Then sometimes opioids really aren't the best choice,
(12:53):
and there's a lot of other medications that really can work.
It's like flipping a switch. I have very many memories
of when you give someone a medication that they don't
think is a pain medication because it wasn't necessarily designed
or developed as a pain medication, but it works for
their type of pain they have. They come and tell
you about the payment leef they have. I can tell
you a little story about that. When I was a
(13:14):
young doctor after finished training, I had a patient who
was an engineer. He had severe testicular pain. The testicular
pain would get worse if he ejaculated, which he thought
was a dilemma because he had an interest in doing
that and he had if he didn't, with the pain
and fair enough, yes, fair enough, right. And it turned
(13:37):
out because of this kind of dilemma he basically tried
to avoid it. His description is very much like nerve.
So I gave him a medication that we think of
for nerve pain, and I gave him an adjustment you
know how you start here, adjusted up and he called
with and talked with our nurses. We adjust a little
bit further, and he comes for his followup visit and
he's got his wife with him now. So I walk
into the office and into the room, exam room, and
(13:59):
how are you doing. I'm doing well, And his wife said,
I wanted to meet you and say thank you very much,
because we are both much happier now. But sometimes that's
not the first thing we would think of, because that's
not that medication at that time did not have any
FDA approval for pain. It is a medication that was
developed for something else that we realized, hey, this works
for nerve pain, and now we're using it this way.
Speaker 3 (14:21):
We've learned a lot about over using certain medications, where
I think we used to think that we really had
to treat everyone with opioids for prolonged periods of time
and in high doses, and I think now we're moving
into a spot where we know that that's not good
for the individual, it's not good for society, it's not
good for anybody.
Speaker 4 (14:39):
I'm going to say one thing about opioids, just real quickly,
which people didn't think about in the past, which is
chronic use of those medications. Opioids are narcotics, drugs like oxycodone, morphine,
those kind of things. They suppress testosterone. They lead to
a rectile dysfunction, and women, they lead to fertility issues
and irregular minstrel cycles. We didn't know this in the past,
(15:00):
but high doses prolonged can do that and impact your
sexual function.
Speaker 2 (15:04):
So just know that.
Speaker 3 (15:06):
So we're dabbling a lot in new things. And here
in Washington State, I think a lot about cannabinoid derivatives cannabis,
and I hear a lot of my patients talk about CBD.
Speaker 4 (15:17):
In terms of cannabinoids and CBD in particular. CBD has
lots of cachet and not much evidence to say it's
much of a pain medication. Together with THHC for some conditions,
it clearly is a pain leaving medication by itself. I'm
not so convinced, and most people really aren't.
Speaker 3 (15:35):
It's not very regularly not be the panacea. These are
the things that our audience wants to know.
Speaker 2 (15:40):
Yeah, what about other non drug forms of treatment? Meditation, ocupuncture, yoga,
exercise focused on the whole body can be helpful for
pain too. There's really good evidence for some of the
things you mentioned. Gentle yoga has evidence of working across
the spectrum for chronic pain conditions. Why is that, Who knows.
(16:01):
Maybe it's the meditative part of yoga. Maybe it's just
learning to use your body and get your focus somewhere
besides the part that's hurting. It needs to be a
kind of yoga that understands that you might have a
pain issue and it shows you how to modify to
make it appropriate for your condition. Things like acupuncture can
be helpful. Things like exercise in the pool can be helpful.
(16:21):
Just walking and doing other forms of exercise can definitely
be helpful. So exercise is one thing. Meditation is another thing.
That sphere of kind of mental health approaches. There could
be more structured approaches too. There's the most studied and
long standing approaches called cognitive behavioral therapy, but there's many
ways now of framing that that's a little bit different,
(16:44):
a little bit requires possibly some more acceptance and some
more active role from the person within. That's why we
have psychologists, we have social workers, we have physical therapists
as part of our team to kind of look at
those different aspects. Have an integrative health person who focuses
on things like acupuncture other approaches to wellness. I had
(17:07):
some knee problems a while back. I'm a runner, and
I went to the UDUB. One of the things they
told me is motion is lotion. You've got to keep
moving even if it hurts, and there's a difference between
hurt and harm.
Speaker 4 (17:23):
That's excellent advice. And the other one is exercises, medicine.
More exercise. More motion helps your overall health, can help
the specific pain. And there's a whole bunch of reasons
for that. When we're moving and using our bodies, a
whole bunch of nerves are stimulated and they send signals
up to your brain, and your brain has to process
all of that. That's why some people with pain ishes
(17:43):
will tell you I'm doing okay through the day and
I get in bed and I start to wind down,
and man, there's my pain. And that's because your brain says, okay,
what can I pay attention to now? Oh that thing
that's been there the whole time, Now it's number one
on the list. Exercise does a couple of things. One is,
while you're exercising, you got the other stimulation coming in
and then it changes your nervous system, it changes your physiology,
(18:06):
it changes those chemicals involved with mood and pain in
your brain and in your spinal cord. It's amazing, it's
great medicine.
Speaker 3 (18:13):
Well as urologist, I really want to emphasize that so
much of the pain really is muscular and skeletal in nature,
even in these pelvic organ places. We find that, especially
in our more sedentary population, we find that muscles that
are tight that shouldn't be tight, muscles are imbalanced that
(18:35):
should be symmetric, and it has really complex effects that
are not just pain, but can affect the way men urinate,
can affect their sexual function.
Speaker 4 (18:45):
First is, we live in our bodies. We use our
bodies all the time. We think we know our bodies
really well, but we sometimes wrongly assign where the pain's
coming from right, and we don't really understand all the
things that are involved with it. You'll see someone who
has their left shoulder always lower. They don't know they
have their left shoulder lower, and they pointed out to them,
(19:06):
and then you figure out why that is. You know,
So there's a lot of things in our body we
don't know until someone points it out to us. That's
what a physical therapist can do, or another type of
exercise specialist and strength matters, balance matters, and not over
using the ones that work well. That's what we sometimes
do right.
Speaker 2 (19:25):
Our guest is mother and ments health matter is doctor
Brett Stacy, one of the top pain management physicians at
the University of Washington. He's the Division Chief Pain Medicine
and Professor of Anesthesiology and Pain Management at the University
of Washington. We're going to continue our discussion with doctor
Stacy right after this short timeout.
Speaker 5 (19:42):
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Speaker 2 (20:37):
We're back in men's health matters. I'm n Neil Scott.
My co host is the director of the UDAB Men's
Health Center, Doctor Tom Walsh, and tonight, please to have
with us in the studio Doctor Brett Stacy, Division Chief
Pain Medicine at the University of Washington, Doctor Walsh.
Speaker 3 (20:50):
There's gonna be somebody who has chronic pain and they
just would like to imagine a better path. And then
there are going to be people who haven't started down
any path but like to learn more. I could certainly
imagine just outlining a paradigm where you tell people to
get connected to a healthcare provider.
Speaker 4 (21:07):
One of the things that doctor Walsh and any other
physician can tell you that the passive patients the hardest patients.
We want patients who want to be involved in their health.
We want patients who take responsibility for their health also
can do it in a realistic manner.
Speaker 3 (21:22):
You know, there's really something to be said for managing
your chronic pain and becoming more fit, for doing that
thing in your health that you've always wanted to do,
whether it is, you know, taking action on your cancer
screenings that you are afraid to do, you know, whatever
(21:43):
it is somebody who's empowered to just take charge.
Speaker 4 (21:47):
There probably isn't one thing. If you're coming to see
me a tertiary care specialist, you know, third level specialists.
You see your primary care provider, you see a specialist,
and then you come to see the pain doctors. I'm third,
third tier. You come to see me. The easy stuff
has been done. We all want the easy button, but
in reality, there isn't one. Sometimes a medication, sometimes a procedure,
(22:12):
sometimes a different way of thinking about your pain can
be that, but usually it's not. Usually it's a component
of it. If you just do one thing, you'll get
you know, five, ten, fifteen, twenty percent relief, it doesn't count,
it's not enough. If you do something else, should get
another three, five ten percent relief. They're in separate piles,
one at a time, does a mean thing. Put them together,
(22:34):
that starts to be a bit more and yet on
other layers, and now it starts to be a substantial
amount of change. So thinking about that multi dimensional cat,
thinking about you know what, I am going to try
to sleep better and try to go to bed at
a reasonable time rather than stay up late scroll through
my screens I shouldn't be doing. I am going to
make an effort to take that walk after dinner. Start
(22:56):
doing some of those things. None of them are the answer,
but they're part of the puzzle, you know, part of
the answer.
Speaker 3 (23:03):
I sit here, I'm thinking about I've been in practice
for twenty years. I consider myself an expert in my field,
and I deal with some pain. Can you talk a
little bit about just understanding pain, Because as I'm listening
to you, the amount of understanding that I'm gaining is profound,
and I could imagine that if I were suffering from
(23:24):
chronic pain, learning from an expert like you becomes really
profound and meaningful. I wonder, you know, as I'm listening
to you, I'm realizing that I'm not doing a sufficient
job of helping people understand their pain.
Speaker 4 (23:38):
And all the modality well, starting point is always going
to be your primary care practitioner and talk about your
pain with your primary care practitioner. And my suggestion is
if the pain is a big deal to you, set
up an appointment just for that. Don't have it be
your annual appointment. And they want they have a checklist
they need to get through, or they want to ask
(24:00):
you a bunch of things that don't seem related to
your pain, then you want to add this in. Make
an appointment to talk about this, and then they often
can get you in the right direction and get your
headed where you need to be. My background when I
was a medical student, I was going to be a urologist.
Of course you were, I really truly was. I matched
in urology and chose not to pursue it. I visited
(24:21):
two pain clinics and I thought I can do better
than this. So the first one I went to, all
they focused on was the mental health aspects of chronic pain,
and I saw people with clear physical issues that were
being completely ignored. I thought, this is messed up. My
(24:41):
head started thinking like this is not right. Then I
went to the next one. It was the exact opposite.
Everybody was getting an injection, everybody was getting medications, and
I saw tearful people talking about how their lives are
totally changed by their pain in a bad way. They
couldn't work, their spouses didn't like them. All this kind
of stuf, and it was not being addressed with a
(25:01):
needle or a pill. And I thought, somewhere between those
two is the right approach. When I decided not to
be a urologist, I had to scramble because I want
to be a pain specialist for an anesesia position. To
my great fortune, there was a spot at the University
of Pittsburgh, which is a top antiesesia program, and it
(25:22):
turns out they had just hired people to come and
start a new pain clinic. The reason they hired someone
to come start a new pain clinic is the person
in charge of all of health sciences across all of
the University of Pittsburgh had a family member with a
pain problem that wasn't being treated effectively. So he said,
we shall treat this better and he hired people to
do something different. So I had an amazing training and
(25:44):
amazing start to my academic career.
Speaker 2 (25:47):
Before we wrap up this edition of Mental Health Matters,
we need a call to action and some practical, in
vetted preventive resources dealing with pain and pain management.
Speaker 4 (25:56):
What do you suggest start with your primary care, so
cease someone to assess things to start with. That's step one.
And then for you looking for resources for yourself. I
really like the American Chronic Pain Association, which is an
organization that was founded by pain patients for pain patients.
It has many, many resources.
Speaker 3 (26:15):
What is that website, Neil, I'm looking at it right now,
and this is ACPA now dot com. That's ACPA now
dot com.
Speaker 4 (26:25):
Sounds like a great resource. It's a very good resource.
And then UW Medicine has several links for pain, including
to our clinic. Our clinic is referral only, so you
have to have seen someone else first to kind of
evaluate the pain problem initially, because often that's what you need.
You don't necessarily need to see me or one of
my colleagues.
Speaker 3 (26:44):
And I always like to say, Neil, for those those
individuals who are adrift, who are not connected to healthcare,
I think one of the major messages of this broadcast
is to get people connected. Call two six five two
zero five thousand. That's a great way to get connect
to UW Medicine primary Care, or you can simply go
to UW Medicine dot oorg. There's something that you started
(27:07):
talking about, which is sort of the origins of pain,
like why does pain exist? Actually, I think it was
Neil who introduced the idea that pain tells us something,
tells us not to do something. There's a word that
is included in there that we never quite said, which
is fear. And I think pain engenders a lot of fear,
and that fear can manifest different ways in different people.
(27:30):
For some people that will make them withdraw and not
seek out the right care for fear of what they
may learn. And yet others it could be very paralyzing
in their day to day lives or you know, just
dominate what they do. I've got to imagine that addressing
fear has to be part of pain management for some Oh,
it's a huge thing.
Speaker 4 (27:51):
People are fearful of that they're going to interest themselves,
break something, make the situation worse. And what Neil said
about you know, just because it's hurting doesn't mean you're
causing damage, right that That message is sometimes really hard
to get across and think about in your personal life.
We've all had something happen and we're worried about what
it means. So context is everything. Yeah, the way we
(28:14):
interpret sensations in our body really varies well dramatically. The
exact same sensation has a different meaning. The example I
often give is imagine you're at the movie theater sitting
next to someone and they put their hand on your
thigh and they go like this and try to smile
at you. And it's your personnel on a date with,
or are there with. It's your partner that feels nice.
(28:36):
If it's a total stranger, it's creepy as hell. Exact
same sensation, but the way we interpret it is completely different.
There's a lot of things about our bodies and our
sensations that really are variable. We don't understand all those things.
Speaker 2 (28:51):
And the whole psychology of pain, I mean, it's frustrating
when you're in pain. Pain cannot be seen, Nope. Other
people often are quick to shay, oh, you exaggerating.
Speaker 4 (29:01):
It's even worse sometimes if you go to see someone
who is very structurally focused. Specif physician who says there's
nothing surgical here, which sometimes people hear, oh there means
there's nothing wrong with me. Yeah, well there's got to
be something wrong because I hurt, right. I hear that
all the time. Right, But a normal MRI does not
(29:22):
mean no pain. An abnormal MRI doesn't mean pain either,
So that both these things are true, it's really frustrated
to not feel validated.
Speaker 2 (29:31):
That wraps up this edition of Men's Health Matter Special
Thanks to our dance doctor Brett Stacy, Division Chief Pain
Medicine and Professor of Anaesthesiology and Pain Medicine at the
University of Washington. By the way to reach the Men's
Health Center at the udube called two six five nine
eight six three five eight. I'm Neil Scott of behalf
of my co host, doctor Tom Walsh. Thanking you for
(29:52):
listening to Men's Health Matters and wishing you good health
and good sense and matters relating to men's health. Because
Men's Health Matters, stay healthy, live in gratitude, and be
kind to one another. Thanks for listening.
Speaker 1 (30:04):
You've been listening to Men's Health Matters with doctor Tom Walsh,
Associate Professor of Urology at the University of Washington and
your host Neil Scott on Sports Radio ninety three point
three KJR FM.
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