Discussing Chronic Pain: Patients and Doctors Need to Assess Quality of Life

Dr. Mark Borigini Health Guide
  • A recent article in Mayo Clinic Proceedings discusses a problem many patients and doctors have: discussing chronic pain.

    The researchers found that over 20% of patients who responded to questionnaires stated that they had not informed their physicians that they suffer from chronic pain. And these were patients who truly seemed to be suffering, as 70% had moderate or severe pain, and almost 50% had pain for eight days or more. Many of these patients felt the pain was interfering with their daily activities.

    It would appear that physicians should take a more active role in assessing their patients’ sense of well-being—which should include determining whether significant pain is or is not present. It may be that physicians do not want to open that Pandora’s box, as this might lead to the prescribing, or the fear of over-prescribing, controlled substances. Unfortunately, untreated or undertreated pain causes an increase in the use of healthcare resources, and can result in the loss of millions of dollars in lost workplace productivity.
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    And while there are many different methods whereby chronic pain may be treated successfully, there are those patients who will have the need for chronic controlled substance analgesics. There will always be a risk for abuse, but patients might cooperate with physicians by showing a past history of responsible controlled substance use, by keeping these medications in a secure location, and by consenting to answer questions about possible abuse.

    If prescribing providers take the time to work with pharmacists, patients and caregivers, the abuse potential can be reduced and the quality of pain management can be increased.

    Another study presented at the 2006 annual meeting of the American Academy of Neurology found that many primary care physicians do not derive satisfaction from the care of chronic pain patients; and this seems to be related to a lack of formal training in this subject during medical school and residency. It is hoped that this will change, particularly as the population is aging, and thus at risk for suffering from chronic pain, whether it be related to arthritis or osteoporosis or past injuries. As with many things, with education, there will be more understanding and a greater benefit to those who suffer from chronic pain.

    I hope that these pages will be helpful to providers and patients who in their own ways deal with chronic pain.

    I welcome your questions and commentary.
Published On: August 18, 2006