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Is the Medical Community Not Providing Adequate Pain Management?

Thomas Northcut/Thinkstock(NEW YORK) -- A series of studies published in Lancet may provide proof that patients in pain may not be receive proper care for managing their aches and discomfort.

It is estimated that up to 75 percent of surgical patients in the U.S. may not receive adequate post-operative pain relief.  Research also shows that acute postoperative pain can become chronic in as many as 30-50 percent of patients who undergo procedures such as mastectomies, hernia repairs and coronary artery bypass procedures.  But improvements have been made over the past decade in providing pain relief, mostly through regional pain relief such as epidural analgesia or peripheral nerve catheters.  Study authors from Johns Hopkins University School of Medicine write that the use of multiple pain medications or techniques at once “may lead to substantial gains in the treatment of acute post-operative pain and potential reduction in the development of persistent pain states.”
The cost of chronic non-cancer pain, typically defined as pain lasting longer than three months or beyond the expected period of healing, is estimated to be over $210 billion per year here in the U.S.  The authors in a University of Washington study review some of the most commonly used interventions to treat chronic pain such as nerve blocks, surgeries, implantable drug-delivery systems, physical rehabilitation, psychological treatments, and even complementary and alternative treatments.  They find that “the best evidence for pain reduction averages roughly 30 percent in about half of treated patients.”  As with acute pain, these authors stress the need to research the effectiveness of combination treatments as “none of the most commonly prescribed treatment regimens are, by themselves, sufficient to eliminate pain and to have a major effect on physical and emotional function in most patients with chronic pain.”
Among patients with solid tumors, an estimated 15-75 percent experience significant chronic pain, but research suggests that an average of 43 percent of cancer patients receive inappropriate care for their pain.  The authors of a review from Beth Israel Medical Center in New York discuss the best ways of managing cancer-related pain, arguing that only addressing the physical symptoms is not sufficient.  Rather, a more individually tailored, holistic approach is necessary in order to reduce pain and improve the patients’ quality of life.  Although the term “palliative care” may be associated with end-of-life care, these researchers argue that such an approach to pain management should be initiated from the time of diagnosis and be applied “throughout the course of the illness…[including] interventions that are intended to maintain quality of life, mitigate suffering and improve coping and adaption by reducing the burden of illness and supporting communication, autonomy, and choice.”
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