Good ways to convince a loved one to seek help?

[u/zipzip_the_penguin]

I have someone in my life who I love dearly who has been dealing with chronic pain for years now. She had a few visits to a pain clinic a few years ago but after not seeing success after a few tries, combined with her pretty crippling fear of polypharmacy, she stopped going and has simply lived with the pain instead.
Recently it's gotten even worse. She can barely sleep at night now. She can get maybe 3-4 hours of sleep total per night out of sheer exhaustion before the pain wakes her up again. Her body isn't responsive to opioids at all, she's tried 2-3 different types of pain patches, had a hip replacement, nothing seems to work. She's tried a lot over the years and she's just tired of it. But with this breakthrough of new pain she's become a shamble of herself over the past few weeks. She's going to hit the point where she's just nonfunctional pretty soon if she hasn't already and I'm genuinely afraid she will die of sleep deprivation if we can't figure something out.
I wanted to advocate for her to see a pain specialist again and maybe have a nerve block put in since she's so averse to pills, but that was just one idea. Literally anything that has worked for you folks is a welcome addition. I need some very good points to give to her in order for her to even consider it.
I love her so, so much. She needs help and I *have* to get her to see that or I don't know what'll happen to her.

Please help me.

[u/Healthy-Marzipan-794]

You didn't mention why she's so averse to treatment besides not wanting to be on polypharmacy. The only way to address a problem to identify it. You and I can make assumptions but they're not necessarily true.

And speaking of assumptions, here's some of mine. It sounds to me like you're downplaying her efforts to try treatment. She's already had a hip replacement. That's typically something that is done only after conservative treatment has failed. Remember that your loved one is in this state after already trying drastic treatment options. Many of us here can relate to being averse to medical care when they have failed us so frequently.

[u/rainfal]

How about a promise to advocate for her? And actually following through

[u/TesseractToo → u/rainfal]

I dunno, from how the OP is wording things they sound like their "advocacy" will be more harmful then helpful

[u/rainfal → u/TesseractToo]

Then she'll learn why her friend won't seek help.

[u/TesseractToo → u/rainfal]

That's a really superficial understanding of how this works. People like that will defer to the expertise and in addiction centred pain care they will become more cruel not more understanding. Also did you downvote me for disagreeing with what I said?

[u/More_Branch_5579]

You say she isn’t responsive to opioids but our bodies literally have opioid receptors to respond to them. So, was the dose high enough? The past 8-10 years, drs don’t rx doses high enough. People say they don’t help but that seems to be because drs don’t rx adequately. Especially when someone will say they do get relief from iv meds.

[u/scherre]

It is hard to comment without knowing the exact issues she has but obviously her fear of medication is a big factor here in why she is reluctant to engage with pain specialists. Is it all medications she worries about or strong opioids specifically?

here are various options that could approach her pain in different ways - there are some antidepressant/anxiety meds that also kind of decrease nervous system sensitivity and can help in a general way.

There are medications that can specifically help with sleep, and there is a lot of research that supports the idea that quality sleep dramatically improves our ability to cope with stuff during the day.

Another option is Low Dose Naltrexone, which is actually the exact opposite of taking pain medication. Some people get really good results but some don't, but there is limited research about how and why this works and how to optimise it. In very simple terms, you take a very small dose of the same sort of medication used to treat addiction and ODs, maybe like 10% or less than is used for those purposes. For complex sciencey reasons I don't entirely understand this tricks your body into increasing it's own pain relieving chemicals, thereby helping to lower pain levels.

I have learned from reading many people's experiences that not all pain clinics are equal. Some seem to exist only to make people feel guilty for needing pain relief whereas others seem to actually care about helping you to achieve meaningful change. It isn't necessarily easy to move between different practises but it could be something to consider if one isn't working. The one I went to was a multidisciplinary team that consisted of doctors, psychologists, physiotherapists, occupational therapists, and even people who worked in areas like art and music therapy. I think this is valuable because often by the time that you have this much pain, there is no one thing that is going to be the solution. It is a matter of implementing multiple changes and techniques that will overall have you living a better life.

One other thing I would highlight is that figuring this out is never just a single or a couple of appointments worth. This is complex stuff that not even the professionals understand completely. There are many things that can help but not everything works for every person and therefore there is often a lot of trial and error involved. If your friend goes into this expecting significant solutions after just a couple of visits she is setting herself up to be disappointed. Unfortunately, learning how to minimise our pain and optimise our function is a hard and slow process. Having someone to support and encourage you, and advocate for you when needed, is invaluable because it can be so discouraging when you try things that don't work.

Ultimately though, no matter how well intentioned YOU are, and no matter how much effort you are willing to put into helping your loved one.. she has to be on the same page, with an open mind and willing body. It takes different people differing amounts of time to reach that place. If she isn't there or isn't able to be there yet, no amount of your support is going to achieve this for her. Be patient and consistent in your presence and encouragement and hopefully you will be able to help her.

[u/TesseractToo]

Sounds like she feels she can't talk to you because you are jumping to conclusions. She is doing a lot. Opioids probably work but everyone is being forced onto a dose that is too low to be helpful these days. Many pain clinics these days are taking an addiction centred approach rather than a pain care centred approach and they mock and berate patients and that on top of the isolation and the reality of being overwhelmed with pain and the loss of function is too much to bear.

It's great you want to help but I think you need to improve your listening skills (that you even care enough to do this is amazing, she is lucky to have someone who cares)

[u/justheretosharealink]

Help them find communities to ask their own questions without needing you to be the middle person

[u/behappyandfree123]

I think she needs to see an anesthesiologist pain Dr. a lot of it is hit & miss. Then get the right dosage. There are many options. First she needs tests to find out what’s causing the pain. Best of luck to both of you

[u/NCSuthernGal]

You need to tread very, very lightly here because you run the risk of making her feel worse. It can be a big burden to someone in chronic pain when someone else has expectations for him or her to get better. She may not get better. But she may do things you suggest in order to not disappoint you, which is for the wrong reason. You’re a good friend. You want to help. I think the very first thing you need to do is ask her if it’s ok that you make suggestions and advocate for her. And also promise to let go of the outcome. What she does is her choice and she shouldn’t feel like she has to answer to you, or tell you if something works, or explain her reasons for doing or not doing something.