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Pain Treatment
Methods
Note: Much of the following information was taken from pages on our
"sister' website: Pain101.com.
Summary
Until recently, the medical community has neglected
the treatment of pain. Certain chronic pains such as migraines and
gastrointestinal disorders have been shown in many patients to be related to
psychological problems such as stress. Pain clinic doctors will look for
lifestyle factors as well, such as alcoholism, a bad career or marriage, or
childhood traumas. There is said to be a "huge gap between what is known about
pain management, and what actually gets applied in practice."
With cancer pain, experts say that they have the
tools to control the pain, but many times these are not used, due to patient and
practitioner fears of addiction, lack of special training in pain among
physicians, and the need for a multidisciplinary approach which cuts across
medical boundaries.
Multidisciplinary or “interdisciplinary” pain centers often see patients with
chronic pain only after they have endured several years of pain, failed surgery
and left work—in many cases on compensation. Patients whose low-back pain
persists for more than eight weeks are at high risk of developing a chronic
condition.
P rocedures
used to treat chronic pain patients:
Traditional Methods
Alternative
Methods
Typical Goals of A Pain Treatment
Program…
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Reduce patient's level of pain, achieve effective
use of pain control techniques, when possible.
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Resolve/lessen psychosocial and family problems
resulting from chronic pain.
-
Eliminate/reduce usage of medication and substance
abuse associated with chronic pain.
-
Involve patient in a physical reconditioning
program, providing instruction in postural control, appropriate body
mechanics, work simplification and stress management.
-
Obtain surgery when appropriate.
-
Help patient set realistic lifestyle and
job-related goals.
-
Reduce patient's feelings of being alone and being
depressed.
-
Develop and follow a discharge plan for the
patient.
Inpatient
vs. Outpatient Programs…
Inpatient programs are longer in duration, and much
more expensive. Marketdata's (the owner of MyPersonalGrowth.com) proprietary
November-December 1994 survey of pain clinic directors found an average cost of
$12,416 for an inpatient treatment program, compared to $8,100 for an
outpatient program. (Data not collected for 1997,1999, 2001, or 2003).
Pain clinic directors interviewed by Marketdata
estimate that the inpatient/outpatient mix can vary substantially from clinic
to clinic, but a typical ratio today is about 85% outpatient and 15% inpatient.
Some estimated that inpatients only represent 5-10%. The trend should be toward
less inpatients because detoxification that used to be used is not needed as
much as in the past.
A number of hospitals have opened outpatient
facilities that focus exclusively on treating pain. The treatment of pain has
changed dramatically in recent years as new technology, drugs, and treatment
protocols have been introduced. C. David Tollison, director of the Pain Therapy
Center of Greenville (South Carolina), says that, using the new approaches,
medical personnel try to eliminate pain, not reduce it. Today’s pain
clinics range from those in which an anesthesiologist offers a limited range of
medical interventions to large centers with a full-time staff of therapists and
specialists.
According to the Pain Control and Rehabilitation
Institute of Georgia, most chronic pain patients can be treated on an
outpatient basis. There, the typical outpatient visits the clinic 2-3 times per
week. A complete pain rehab program requires about 15 days of treatment. At this
institute, inpatient treatment is recommended for patients who.. 1) have a
serious illness other than the pain problem which requires close medical
supervision,
2) are dependent on drugs and need detoxification, or
3) have serious physical and emotional problems requiring around-the-clock
supervision.
The Most Common Treatment
Techniques…
Based on
Marketdata Enterprises' proprietary
August-October 2003 survey of pain
program directors, 77% of pain
programs use a multidisciplinary
approach, and 55% utilize
psychotherapy. A total of 71% of all
programs surveyed use physical
therapy, 82% use nerve blocks, 84%
use trigger point injections, and
73% of programs utilize long-term
narcotic painkilling medications.
These are currently the most popular
treatment methods.
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