According to the Institute of Medicine of The National Academies, 100 million Americans suffer from chronic pain. Pain is a critical public health issue in the United States costing the society US$560-635 billion, equivalent to $2,000 per individual, every year. However, it is not just an American epidemic; chronic pain affects the lives of 1.5 billion across the world.
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According to the Institute of Medicine of The National Academies, 100 million Americans suffer from chronic pain. Pain is a critical public health issue in the United States costing the society US$560-635 billion, equivalent to $2,000 per individual, every year. However, it is not just an American epidemic; chronic pain affects the lives of 1.5 billion across the world.
During the early 90s, it was increasingly recognised that patients living through their last days were in agonising pain. Soon after this, the American Pain Society (APS) began a campaign named “Pain, The Fifth Vital Sign,” to increase awareness among health professionals of pain assessment and management. The campaign led to increased pain research, awareness and most importantly focus on pain relief. The campaign was seemingly successful with regulatory bodies such as the Joint Commission declaring pain as the fifth vital sign and it was mandatory for healthcare organisations to assess, monitor and document patient’s pain. On the other side, there has been an unnoticed and unwarranted overreliance on opioids to treat chronic non-malignant pain. This over dependence only resulted in rampant and uncontrolled use of opioids. While opioid prescription and usage became prevalent, there was no clear evidence that opioid treatment was effective for chronic pain relief or improving function.
Acute or chronic pain has been so affecting billions across geographies but pain management as a practice and pain research are relatively new fields in comparison with the rest of medicine. Opioid-based approach has deterred organisations from contributing to or investing in research and clinical attention to the effectiveness of non-opioid pain management strategies. This has only resulted in a dilemma for healthcare providers who are expected to relieve suffering in today’s “Fifth Vital Sign” era. Healthcare providers will be continually challenged as chronic pain assessment and treatment becomes an integral part of their approach.
The key objective of chronic pain management is to discover the cause, lessen suffering, and restore function. There are numerous factors such as Biologic, psychological, and social that play a crucial role in achieving this. Some of the common pain management strategies that have proven to be effective include a multidisciplinary pain treatment, prescription of non-opioid medications (anti-depressants and anti-epileptic drugs), physical therapy, psychological and behavioural therapies, and complementary and alternative medicine such as Acupuncture etc.
Assessing and treating pain has become an ethical and legal obligation for clinicians. This calls for research to widen the scope of evidence based treatment, which results in effective pain management outcomes and functionality for patients. It is time for the healthcare organisations to shift gears and start focusing on non-opioid chronic pain management strategies on a consistent basis.
