Developing a Collaborative Pain Management Strategy

Pain is a fact of life and oftentimes a useful one. While it’s a partner we generally tend to loathe, pain is a partner that saves lives. It’s often through pain that people first become aware that something is wrong in their bodies, and it’s through following the pain that many physicians diagnose countless patients and often catch diseases that would otherwise end their lives. Pain gives us the natural apprehension and caution necessary for injuries to resolve themselves and heal. But pain can be misleading, superfluous, or unnecessary

By far, most patients who come into a doctor’s office worry about the pain they’re experiencing. More Americans are struggling and complaining about chronic pain and related injuries. Meanwhile, thousands of Americans struggle with pain due to genetics and various diseases, from disc degeneration to fibromyalgia and everything in between. To tackle these challenges head-on, the medical community needs to build an encompassing understanding of the nature of pain, its many shapes and forms, and the various collaborative pain management methods for effective diagnosis and treatment.

The Challenges of Addressing and Relieving Chronic Pain

Pain is a sense, much like our other senses, and it is typically triggered when nociceptors in the body react to physical stimuli. For example, if you fall over and break a bone, the damage done to the body will send a severe pain signal to the brain, letting you know that something has gone wrong and requires your immediate attention. This may be dulled at first by a sudden rush of endorphins and adrenaline, which numb the pain somewhat.

• Nociceptive pain can be somatic and visceral, with somatic pain being either superficial or deep.
• Superficial somatic pain is mainly in the outer “layers” of the body, mostly our skin and membranes (such as the inside of the mouth).
• Deep somatic pain is rooted in the muscle tissues, bones, tendons, etc.
• On the other hand, visceral pain is organ pain (such as a stabbing feeling in the heart, searing lungs, pain in the bowels, etc).
• Pain can also be neuropathic. Neuropathic pain is caused either by damage to the brain and central nervous system or by damaged nerves and nerve endings. While an underlying tissue injury often accompanies neuropathic pain at the root of it all or some other source, it can sometimes arise without painful stimuli or long after an injury has healed.

Pain is treated pharmacologically, psychologically, physically, and socially. Approaches have to consider that pain is a complex issue that changes very quickly, and determining the exact cause of the pain can be difficult in certain cases. Modern, collaborative pain management does not lean immediately towards the narcotic option because of the adverse risks associated with skipping straight to opioid medication. Over-the-counter medication can help with certain forms of pain, but most of the time, it takes more than an anti-inflammatory to help a patient feel better.

Interventions, both surgical and non-invasive interventions, are key. Active interventions call for patients to participate directly in treatment, including complementary and alternative medicine (CAM). In contrast, passive interventions require no input from the patient (injections, acupuncture, massage therapy, and surgery). Patient-centered care, as well as psychotherapy, play a part in reducing pain through the psychological aspect. The way a patient is treated can have an impact on their pain. A low mood and depressive symptoms can often arise from long-term and chronic pain and complicate a patient’s case as these moods are also linked to increased pain perception.

Pain Is Subjective, Complex, and Multidimensional

When patients experience pain, their personal perception of pain is unique. Some patients feel pain very differently from others, and pain tolerance is bound to a very long list of factors that may determine how a person perceives and manages their pain, including mood, culture, overall physical health, and more. Furthermore, the effects of pain, as well as the duration of the pain, can differ from case to case.

And finally, patients respond differently to different types of treatment for pain. While everyone responds positively to treatments that tackle and resolve the root cause of the pain, recovery time is individual, and not every pain has an immediate and obvious root cause that can be fixed within a short period of time. This ultimately highlights the most challenging problem when tackling pain as a medical issue: it’s very individual.

This is why collaborative pain management strategies are necessary, working with experts from different medical professions to develop a plan of action that considers a patient’s history and all biopsychosocial factors. Most importantly, pain management needs to incorporate the wishes and thoughts of the patient. Working with patients is just as important as other medical professionals, especially when the issue is as individual as pain.

Effective Care Starts With Collaborative Pain Management and Treatment

The only way to accurately determine whether a course of treatment is effective is to consult with the patient directly. Patients must communicate to their doctors how they feel, whether they feel better or worse, and how their condition has changed. Clear and effective communication between a patient and their physician is crucial for managing and eliminating pain over the long term.

By interacting with patients, pain management specialists can also discuss treatment options and determine what course of action works best in the patient’s favor. Pain management is not a matter of getting a formulaic checklist of treatments and working your way down from A to Z – it’s important to organize treatments in such a way that time and resources are spent efficiently and effectively to help the patient find relief, without wasting their time, energy, or financial resources.

Integrating CAM and Conventional Medicine Into Patient-Centered Care

Integrative pain management requires the collaboration between specialists from different practices to come together to benefit a patient’s healthcare. While the modern approach includes various pharmacological and non-pharmacological options, it may be wise to incorporate or consider other forms of pain management, including chiropractic medicine, acupuncture, yoga, spiritual guidance, journaling, and psychotherapy.

While some studies suggest benefits to prescribing acupuncture in place of massage therapy, others contradict these findings. Yet even while alternative medicine seems to be backed by limited data or anecdotal findings, it may benefit some patients to take a collaborative approach to collaborative pain management, taking into account what a patient feels and wishes for, and communicating clearly and effectively with patients to choose treatment options, follow-up appropriately, and determine the best path forward.