Pain management has grown much more sophisticated over the years, especially as pain has moved on from being an afterthought to becoming a major focus for the healthcare industry.
Historically,pain has been critical to helping medical professionals assess a patient’s health and well-being throughout centuries. Pain management in its modern form can be traced back just a few decades to a landmark study in 1973. The study identified the undertreatment of pain as a serious issue in modern Western medicine. Most patients reported having pain severe enough to impair their functioning. The study also showed that those patients had limited or inadequate analgesic therapy.
Further research into the effects and nature of pain led to a greater understanding of what this peculiar sense is. We are also learning how pain affects us past its usefulness, as a mechanism for recognizing and learning to avert certain dangers. Pain, as we understand it, is more than just our body’s response to certain stimuli. It is an individual experience, a sense that we can be hurt significantly, and be psychologically and physically impaired. The sensation of pain taxes our endocrine and cardiovascular systems, making us more prone to disease and sickness. This also drastically raises our tendency to become depressed.
Since our understanding of pain has begun to shift and change, we have been working hard to help patients who are in a lot of pain. Often, this has been by way of giving them pills – the kind of medication that makes the pain go away, at least for a little while. This sparked other criticisms, and the recent opioid crisis has pushed many to advocate for a different approach to tackling pain, and better understanding why it occurs.
Biological, Psychological & Social
Pain is biological, psychological, and social, and it also features a long list of biological, psychological, and social consequences. Some pain can originate in the mind, although it is rare that a person experiences chronic pain without any physical cause or injury.
Biological causes are far more straightforward, describing the pain of a healing broken arm, or a slipped disc. Finally, pain cuts us off from the ability to interact with others as we usually do. The social cost of pain can be immense, disabling you and removing you from your usual day-to-day activities.
To effectively treat pain and better manage it at pain clinics for the express purpose of improving a patient’s quality of life, it is important to grasp how pain can affect every aspect of life, and how widespread its effects are when it becomes a constant in someone’s life. Pain gets in the way of everything and can make even coming in to work an impossibility.
Biological, psychological, social – biopsychosocial for short. Pain clinics must understand the full scope of their patients’ pain and help their patient through their struggles. There are several methods to help improve a patient’s quality of life at a pain clinic.
Guidelines & Quality Indicators
There are several guidelines for the management of pain in nursing homes, clinics, and pain management facilities. They include the Clinical Practice Guideline for the Management of Postoperative Pain released in 2002, the Pain Management Guideline developed by the HCA of New Jersey in 2006, the guidelines of the Geriatric Nursing Protocols for Best Practice in 2003, and the ASPAN Pain and Comfort Clinical Guideline, released in 2003.
The guidelines from the American Pain Society, for example, dictate that when treating low back pain, clinicians should conduct a “focused history and physical examination to help place patients with low back pain into 1 of 3 broad categories.” Also, that “clinicians should provide patients with evidence-based information on low back pain with regard to their expected course, advise patients to remain active, and provide information about effective self-care options.”
The key here is to help specify the nature of each patient’s case in an efficient manner. This helps them further individualize their treatment and explain exactly how their pain is affecting them. Further, it guides them on what treatments might be most effective in helping them get back on the right track.
These guidelines utilize evidence-based reasoning to help clinicians establish clearer protocols for how to deal with different forms of chronic and acute pain. The protocols also utilize several different tests and indicators to tell the level of a patient’s pain. For example, the “pain scale” is presented to a patient in pain to understand how they’re hurt. The scale goes from minor discomfort to delirious pain, the kind that leaves a person unable to speak at all.
Cutting a Reliance on Opioids
While a steady supply of opioid analgesics has been a foundation in pain management for decades, stricter policies are encouraging clinicians and physicians to prescribe fewer prescription pain killers. Researchers are hard at work looking for safer, non-addictive alternatives to opioids like Vicodin and Codeine.
Unfortunately, these drugs – while very helpful in the management of acute pain – have shown minimal-to-no promise in the treatment and management of chronic pain. They also still pose a great risk as addictive drugs.
It is not possible yet to completely stop the use of opioids, especially for patients who are in hospice or have a terminal diagnosis. In cases of extreme discomfort and pain, such as cancer patients, opioids are sometimes the only way to relieve pain. These drugs help those who might otherwise not live a “normal” life finally find a way to rejoin society.
Nonetheless, helping patients through a multimodal approach, working with them to explore alternative treatments, and utilizing relaxation techniques and therapies to help patients feel comfortable at the pain clinic is important.
Educating the Family
Quality of life shouldn’t begin and end at a patient’s hospital or clinic. A big part of ensuring that a patient’s quality of life is upheld and improved upon is helping the family figure out how to transition the patient from life at the clinic to life back at home.
There are countless potential challenges in helping the family understand a patient’s needs and helping them set up the right kind of environment for the patient to continue to live and enjoy a normal quality of life.
While we have come a long way in recognizing and improving our ability to fight pain and live in better harmony with it, there is still a lot to explore and understand about pain and pain management.