The Chronic Pain Epidemic In America Has A Flawed Approach

As of 2011, pain management has entered into a completely new level of social and monetary awareness. A recent study from NIH shows that the total cost of care in the US is over $500 billion for pain and over 100 million Americans suffer from chronic pain of some type.

Let’s examine the traditional pain management methods in the US. 20% of office visits in the US involve a narcotic prescription, with the most common being hydrocodone (Vicodin). Narcotics get prescribed for both chronic and acute conditions. Acute conditions include sporting injuries, herniated discs, back strains/sprains, and operations. Chronic conditions could include degenerative scoliosis, degenerative disk disease, or such pain issues as diabetic neuropathy.

In this day and age, there is a substantial American push for effective pain treatment. Undertreatment of pain is considered beneath the standard of care. So how does it work? It all begins with a low dose narcotic prescription, which all too often blossoms into a repetitive set of prescriptions. Before one knows it, the narcotic prescriptions have blossomed into a veritable mushroom cloud, and narcotic tolerance begins.

There is actually a condition where chronic narcotics can make pain worse than before. This is called opioid induced hyperalgesia (OIH). That is akin to taking a beta blocker to decrease heart rate with the result being tachycardia! There are other substantial narcotic side effects too such as depression, tolerance, constipation, and altered mentation.

The economy of pain management is substantial. Between doctor visits, imaging studies, narcotic prescriptions, interventional procedures, and additional therapeutic modalities, the direct cost itself is substantial. Think about this – every time a procedure is performed, it involves nursing, needles, medication, an x-ray technician, and potentially an implant. With the indirect costs, though, including lost time from work and disability, the costs become staggering.

What is the issue with our current pain management approach? The problem is that the current treatment methods are:

1. Typically short sighted.

2. Typically too focused.

3. Too focused on narcotics.

Being short sighted is alright in a situation such as a post-operative one where short term narcotics are meant to simply help the patient while the wounds heal. But being short sighted with a patient in chronic pain will often have the patient end up in a narcotic cycle. Being focused with pain treatment might mean treating every patient with the same approach -a narcotic prescription and an injection or two.

The best answer to the problem at hand is integrated medicine. This means having different specialists take care of the patient, such as chiropractors, physical therapists, pain doctors, naturopathic doctors, psychologists, and life coaches.

So much of pain is non-organic and may benefit from a psychological approach. This explains why 2 patients with the same painful condition respond so differently to the same treatments. Getting patients back to work and off narcotics can be possible through the combination treatments with PT and chiropractic. There are also plenty of non-narcotic medications that can help with pain such as tramadol, anti-depressants, and neuromodulating ones like gabapentin.

In a Journal of Pain study in 2006, comprehensive integrated programs were shown to produce the best outcomes with return to work rates, functioning, decreasing pain levels, and containing costs of chronic pain. The hope is that as pain centers start to embrace this philosophy of handling chronic pain, more individuals will receive benefits of successful treatment without their existences hinging on their next narcotic dosing.

Want to find out more about Arizona Pain Center, then visit Preferred Pain Center’s site on how to choose the best Phoenix chiropractors for your needs.