Chronic pain resulting from serious injury or illness has both physical and psychological aspects, which makes it difficult to manage. It is a field that gets much attention, and therapies are constantly changing with the next study, the next new drug, and the next article in a medical journal. Here are some of the more current techniques that are being employed effectively.
Counselling is meant to be an adjunct to a course of pain medication, but its necessity is becoming increasingly clear. Counselling can help patients wean themselves off habit-forming pain medications when they have to switch or change their dosage, and it can give them tools to deal with their chronic pain and the problems that surround it. Often these patients are unemployed or underemployed, sometimes for long periods of time, due to the conditions that surround their chronic pain. They are concerned about money, they may have low self-esteem, and they are usually struggling with the effects of different medications.
Patients may be reluctant to undertake counselling because they are afraid the psychologist will tell them their chronic pain is imagined. The Stanford Pain Management Center website explicitly states, “Pain that is delusional cannot be alleviated through psychological treatments.” A patient rarely arrives at a diagnosis of chronic pain without a physiological basis for that pain. Several treatments under the umbrella of psychological counselling are used for chronic pain. Biofeedback/relaxation training coaches the patient in how to deal with their pain response. Self-monitoring through journalling and increasing activity levels gradually help to improve the quality of life for the patient through behavioural therapy. Visual imagery and self-hypnosis have also proven to be useful in helping patients to manage both their emotions and the chronic pain response.
Low-level laser therapy (LLLT), or “cold laser” technology, is a technique that many health professionals are embracing in the treatment of pain. Although talk about it is new, the treatment has been available in Canada for some time now. The Food and Drug Administration approved it for use in the U.S. in 2002.
Low-level laser therapy does not cut or burn the skin as high-intensity lasers do. Instead, low-level laser beams stimulate responses at the cellular level in affected tissue, speeding the healing process and allowing the cells to metabolize more quickly. Chiropractors, physicians and other professionals who have to deal with chronic pain are using the treatment to help wean patients off higher doses of pain medication and improve quality of life.
Increasingly, physicians are becoming afraid of prescribing opiates. Kathryn Hahn, an expert in pain management at the College of Pharmacy at Oregon State University, has stated in an article:“Surveys show that at least 30 percent of patients with moderate chronic pain and more than 50 percent of those with severe chronic pain fail to achieve adequate pain relief.”
In other articles, Hahn goes on to say that the economic impact of chronic pain exceeds $100 billion in the U.S. alone. Big statistics, and they also point to a huge problem: a societal stigma that surrounds painkillers and influences their prescription. While there can be no doubt that many painkillers are habit-forming, treatment through physiotherapy and psychological counselling can help to ensure that the negative effects of the medication are minimized. Hahn encourages insurance companies to pay for multidisciplinary pain management programs and advocates the need to train physicians further in painkiller medicine.
Participation in Online Programs
Access to electronic health records and other Internet-based sites allows immediate updates for physicians on best practices in pain management. Until a streamlined system is implemented, physicians have to rely on mailed abstracts from drug companies and medical journals to get news on what is considered up-to-date in the field and often waits of weeks or months are involved. If you currently subscribe to any medical journals, make sure you sign up for their email updates. These updates will position you as a professional ahead of the curve.
Standardized electronic health records are also recommended in order to establish best practices in chronic pain care. EHRs discourage contraindicated treatments and medications. They also quickly summarize a patient’s condition for another professional, minimizing phone calls between offices and increasing efficiency.
Summation: A Holistic Approach
As much as those in the field of chronic pain would like it to exist, there is still no single “magic bullet” prescription or treatment that will end chronic pain for the sufferer. As Hahn suggests, the starting point in the treatment of chronic pain is to recognize that it can have complex causation, and therefore that the best way to treat it is by taking a multidisciplinary approach.
- Pain Management Failing as Fears of Prescription Drug Abuse Rise. Science Daily, January 5, 2010
- Jesse C. Ploessl, DC, Laser Therapy Shines as an Alternative Complementary Treatment for Pain Management and Healing. Spine Universe, January 12, 2010
- Stanford Pain Management Center Website
- David Mitchell, New Report Sounds ‘Call to Revolutionize Chronic Pain Care.’ American Association of Family Physicians, November 11, 2009