Introduction
Pain
is this nation's most under-treated health complaint. It has
personal, social, emotional, and economic consequences that can
be as damaging to the patient and his or her family as the pain
itself. Most patients have more than one kind of pain in the
course of the year.
Pain
has in the past been regarded merely as a symptom of a disease
rather than a disease itself. We now believe that acute pain is
a diagnostic tool, while chronic pain is a disease itself.
- Usually of short
duration.
- Pathology predicts
outcome.
- Patients' mood and
attitude are not as important to the healing process.
- Single-modality
therapy is usually effective.
- Surgery can be
effective.
- Narcotics are
indicated.
- Muscle relaxants can
be helpful.
- Job changes are
unlikely.
- Usually of long
duration (at least three months).
- Psychological factors
are most predictive of chance to recover.
- Depression is a
major obstacle.
- Patient's attitude
is vital in overall treatment program.
- Multimodal therapy.
- Surgery is less
effective.
- Non-narcotics are
more appropriate.
- Sedatives are
contraindicated.
- Active patient
participation in treatment is essential.
- Disability and job
change are likely.
Some signs
of chronic pain are:
- Constant or recurrent
pain that persists beyond the healing period.
- Subjective complaints
disproportionate to objective findings.
- Defies traditional
diagnostic and therapeutic measures.
- Physical and
psychological deconditioning are present.
- Drug-seeking behavior
and doctor shopping are commonly present.
Chronic pain affects 75
million Americans and 50 million suffer with impaired function
secondary to this pain. Americans spend 120 billion dollars
each year on chronic pain treatment and lose 200 billion
dollars in productivity. Annual monetary costs include the
expenses of medical treatment, lost productivity, and
compensation for lost wages. Non-monetary costs include the
patients' and their families' pain and suffering.
Chronic pain is
considered to be our nation's third largest health problem.
Only cancer and heart disease are more prevalent. The Pain
Management Center emphasizes the importance of applying a full
range of services that offer a comprehensive approach to
patient care.
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