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No Need to Endure Chronic Pain

Experts say new treatments offer respite from daily suffering

FRIDAY, March 1, 2002 (HealthDayNews) -- As many as 50 million Americans endure debilitating chronic pain every day.

The good news is they don't have to suffer.

"Chronic pain is a major epidemic, but people do not have to put up with pain that is affecting their lives. There are remedies that can reduce the intensity of pain and improve functioning, both mentally and physically," says Dr. Elliot Krames, a San Francisco anesthesiologist and a board member of the American Academy of Pain Medicine (AAPM), the primary professional organization for doctors treating pain.

Krames says that as many as two-thirds of the approximately 75 million people who suffer from pain are not getting adequate pain treatment. Among the most common kinds of pain reported to doctors: persistent pain after surgery, particularly in the back and neck; untreated arthritis, which generally affects the elderly; and neuropathic pain caused by diseases such as shingles.

To bring awareness of the importance of pain treatment, Feb. 28 to March 3 has been designated as the first National Pain Awareness Week by the AAPM and the National Pain Foundation (NPF), a non-profit group that provides peer-reviewed information and support to chronic pain sufferers on the Internet. A pain conference will be held in San Francisco this week.

When it comes to chronic pain, you may have so adjusted your life around your pain that you don't even recognize how compromised you have become, Krames says. Perhaps you dress differently because you can't hook your own bra, or you don't cook dinner because you can't stay on your feet. Changes that are more serious can include quitting your job or dropping out of school, or isolating yourself from your loved ones because you're depressed.

"There is often a loss of income, or people lose the relationship of loved ones who don't understand," he says. "Pain becomes a disease in its own right."

Yet, many people do not get the treatment they need, Krames says. The reasons for this are varied, and, thankfully, slowly changing.

"The number one myth that prevents people from receiving appropriate help is the belief that opiate use will inevitably cause addiction, which is absolutely not science," he says, because doctors know how to properly prescribe medication.

Also not true, he adds, is that people will need more and more medication over time because they build up tolerance to the medication.

Many doctors are also uneducated about how to assess and treat pain, as medical schools give short shrift to the subject. Patients themselves can also resist medication, thinking pain is somehow necessary and "good" for them, Krames says.

"But smart people are becoming more aware that pain can be treated. There are more articles in magazines and newspapers, and more and more information [that is now available about pain treatment]," he says.

The medical community is also responding. The American Board of Medical Specialties, which regulates courses of medical study, is looking into recognizing pain management as a primary specialty. In addition, the states of California, Texas and Florida have reevaluated their state's regulations to facilitate pain management treatment, he says.

Finally, Krames says, "the medical industry is being turned on to the treatment of chronic pain."

This means that, in addition to traditional pain remedies like analgesic opiates -- Oxycontin and Duragestic patches are the two most common -- that decrease pain and improve function, companies have designed new drugs that specifically treat different types of pain. Also being developed and manufactured are implantable devices that can deliver pain relief to say, the spinal cord, and new devices to deliver medication to the body more efficiently.

"Although the problem of under-treatment of pain has been widely reported, no one's really focused in on the specifics," says NPF co-founder Dr. Rollin Gallagher. "People are paying attention because of the convention."

The pain conference will host approximately 1,000 health professionals and will include reports on new research, available resources for pain management and the progress being made in providing treatment to chronic pain sufferers.

"We're trying to get people up to speed on the importance of treating pain, not only because under-treatment causes terrible pain, but because it has a negative effect on health-care costs -- people stay in the hospital longer, diseases become worse if pain isn't treated," he says.

What To Do: For doctor-approved information about pain management, including a chat room to talk with others who suffer from chronic pain, visit the National Pain Foundation. Very practical advice about how to rate your own pain level can be found at Ohio State University Medical Center.

SOURCES: Interviews with Elliot Krames, M.D., medical director, Pacific Pain Treatment Centers, San Francisco; Rollin Gallagher, M.D., M.P.H., director, pain medicine, and professor, psychiatry, anesthesiology and public health, MCP Hahneman University, Philadelphia
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