Historically, chronic 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. Pain management has grown much more sophisticated over the years, especially as chronic pain has moved on from being an afterthought to becoming a major focus for the healthcare industry.
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 this peculiar sense. 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. We are also learning how pain affects us past its usefulness as a mechanism for recognizing and learning to avert certain dangers.
Since our understanding of pain has begun to shift and change, we have been working hard to help patients with 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 a better understanding of why it occurs.
The Biological, Psychological, and Social Costs of Pain
Pain comes with biological, psychological, social costs and a long list of 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.
- Psychologically, the 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 patient’s pain and help their patients through their struggles. There are several methods to help improve a patient’s quality of life at a pain clinic.
Guidelines and Quality Indicators
There are several guidelines for managing pain in nursing homes, clinics, and pain management facilities. They include:
- Clinical Practice Guidelines on the Management of Postoperative Pain
- Pain Management Guidelines by Best Practice Committee of the HCANJ
- Pain Management in Older Adults: Geriatric Nursing Protocols for Best Practice
- ASPAN Pain and Comfort Clinical Guideline
Joint Clinical Practice Guideline from the American College of Physicians and 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.”
“Clinicians should provide patients with evidence-based information on low
back pain concerning 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 efficiently. 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 treating different chronic and acute pain forms, utilizing tests and indicators for measuring pain. For example, the “pain scale” is presented to patients 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.
Quality Improvement and Care Coordination for Prescribing Opioids
While a steady supply of opioid analgesics has been a foundation in pain management for decades, stricter policies encourage 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 managing acute pain – have shown minimal-to-no promise in treating and managing chronic pain. They also still pose a great risk as addictive drugs.
It is not possible yet to completely stop opioids, especially for patients in hospice or terminal diagnosis. In 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.
Family Involvement, Education, and Support
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 living and enjoying 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.