An MD Perspective on Chronic Pain
An MD-authored article in The New England Journal of Medicine provides food for thought when it comes to the treatment of chronic pain and provides evidence that even for medical doctors, opioid abuse is a major concern.
"For many patients, especially those who have become dependent on opioids, maintaining low pain scores requires continuous or escalating doses of opioids at the expense of worsening function and quality of life. And for many other people, especially adolescents and young adults, increased access to opioids has led to abuse, addiction, and death.
"Pain-intensity ratings aren't necessarily a reflection of tissue damage or sensation intensity in patients with chronic pain. The intensity of chronic pain can't be reliably predicted from the extent or severity of tissue damage, since chronic pain is not determined primarily by nociception."
Drs. Ballantyne and Sullivan also suggest patient-centered care may be the most effective way to manage patients with chronic pain – a refreshing perspective from medical doctors, to be sure, but also relevant advice for all health care practitioners:
"Multiple measures of the complex causes and consequences of pain are needed to elucidate a person's pain and inform multimodal treatment. But no quantitative summary of these measures will adequately capture the burden or the meaning of chronic pain for a particular patient. For this purpose, nothing is more revealing or therapeutic than a conversation between a patient and a clinician, which allows the patient to be heard and the clinician to appreciate the patient's experiences and offer empathy, encouragement, mentorship, and hope."
The article by Drs. Ballantyne and Sullivan is available for free download by clicking here.
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