The width and breadth of chronic pain seems immeasurable. There are countless ways in which it can manifest, countless ways in which it can be felt, and countless ways in which it impacts life. Because chronic pain is so complex, regardless of when it started or where it is located, treatment for chronic pain is often a very complicated affair.
Rather than help patients seek out a single cure or identify one treatment that works, doctors and physicians must work with different specialists to help each individual patient develop a treatment mix that is both medically-sound and cost-effective. This treatment mix, or multimodal approach, often needs more than one perspective and area of expertise.
You can’t hit several bullseyes with a single arrow – and because chronic pain has both short-term as well as long-term consequences, as well as physical and psychological concerns, treatment must encompass almost every facet of human existence, wherever the condition might surface. Finding the right treatment mix is no easy feat, and it starts with identifying the chronic pain itself.
Identifying and Recognizing Chronic Pain
The definition of “chronic pain” is pain that lasts at least twelve weeks, and it is quite prevalent in the American population. An estimated 20 percent of adults experience chronic pain in a given year, and 8 percent of adults struggle with high-impact chronic pain. Chronic pain is more common among older adults, as the body begins to show its age – joints begin to suffer under the wear-and-tear of several decades. Lower back, hip, and knee pain are the most common kinds of chronic pain, although there are limitless ways in which it can manifest.
For example, while a lot of pain may be age-related deterioration and inflammation, chronic pain can also be due to old injuries, repeated surgeries, nerve damage, neurological disorders, scar tissue, back problems, and much more. To help categorize the many ways in which the body can develop a chronic experience of lasting pain, there are a variety of ICD-10 medical diagnosis codes used to refer to different forms of chronic pain on the basis of their area and nature of origin: from trauma-related to post-surgical, cancer-related, unclassified, as well as a variety of catch-all terms to refer to different kinds of nerve damage or central nervous system problems – all forms of pain. Strokes, spinal trauma, MS, and Parkinson’s are also all linked to chronic pain, and there are many other psychological disorders that correlate to more severe experiences of pain.
Knowing when the pain started and where it is usually experienced helps medical professionals narrow down the potential causes for the pain. Sadly, there is not always a cure for chronic pain. The nature of pain is that it is meant to be temporary. When the brain makes the mistake of putting you through constant and consistent pain signals for weeks on end, you’re likely struggling with a “mistake.” It’s not always easy to identify where this mistake began or why it occurred, and whether it’s related to damage in the body or damage in the brain. Thus, many techniques and treatment methods focus on inducing relief and reducing the feeling of pain, alongside trying to find and address the pain’s origins.
The Importance of Multimodal Treatment
Chronic pain is a condition wherein the effects of several biopsychosocial factors are seen in a very pronounced way. As a condition, chronic pain can often improve or deteriorate on how the patient reacts to any combination of the following:
- Pharmacological treatment
- Psychological treatment
- Talk therapy (to help dispel depressive or anxious thoughts, and feelings of shame or burden)
- Physical therapy
- Massage therapy
- Music therapy
- Better doctor-patient relations
- An informed and engaged support system
Chronic pain management must take into account how a patient feels about their physical, mental, and social life and health. Chronic pain often robs individuals of their physical and cognitive capabilities, which can be devastating both to their finances as well as their emotions. While this is not always the case, therapy can help patients regain some of their faculties, and return to engaging in activities with others or even go back to work. But if left untreated, the emotional ramifications of chronic pain can further limit a patient’s mental and physical faculties.
It’s futile to treat one aspect of a condition and not the other, because of how they feed into each other. That is why a case of chronic pain needs the right treatment mix. But how is the right approach found?
Treating Chronic Pain as a Team
Chronic pain management should begin with a team. Not only is it less time-consuming for several people to work together to help one patient by combining their expertise and perspectives in different specializations, but it can be much more cost-effective as well, reducing the potential need for unnecessary tests and trial-and-error.
Treatment teams can consist of a long list of different professionals working together, including behavioral/mental health specialists, pain clinicians, nurses, general practitioners, orthopedic specialists, neurologists, oncologists, psychiatrists, pharmacists, physical therapists, and more. Research has confirmed that when working together, a multidisciplinary team can augment the effectiveness of treatment to a great extent.
Specific treatments depend entirely on the nature of the pain. There are cases where invasive interventions such as surgeries are the best way forward, and there are cases where these interventions are not necessary at all. At times, anything from temporary nerve blocks and the use of corticosteroids to physical and mental therapy can be enough to elicit long-term pain relief and help set a patient on the right path to manage their pain and adapt to their current conditions. One of the hardest aspects of chronic pain management is helping patients find the mindset with which to adapt to their situation and accept that, even though the pain may never go away, they can still live accomplished and fulfilling lives.
Pain management is never simple, and even under the lead of a primary care provider and with the use of good communication skills, it takes time for treatments to take effect, and it may take a considerable amount of time to find the right treatment mix for any given case. That’s where it’s important for friends and family to help maintain the hope that things will get better.