Early recognition and treatment are key
Early recognition of the patterns of chronic pain is essential to prevent the downward spiral of chronic pain syndrome and to better manage it and enhance the effectiveness of treatment. The longer the pain persists, the more resistant it becomes to treatment.
In order to effectively treat chronic pain it must first be distinguished from acute pain, as chronic pain requires different treatments. Typical treatments for acute pain, such as rest, immobilization, painkillers, and narcotics, simply worsen chronic pain, escalating the cycle of increasing pain, leading to disability and the development of chronic pain syndrome.
Effective treatment of chronic pain requires a multidisciplinary approach
Chronic pain is a complicated, multifaceted illness that affects every aspect of a person's life including family, work, and everyone around them. Consequently, no single medical specialty can adequately address the needs of someone suffering from chonic pain.
In fact, it has been proven that the only effective way to treat chronic pain is through an integrated, multidisciplinary clinic where all the physical, emotional, and psychosocial issues of the patient and the family can be addressed. The earlier treatment of persistent pain begins, the easier and faster it can be resolved.
Who is on the interdisciplinary team?
At minimum, a good interdisciplinary team should include:
- a physician well versed in pharmacologic and interventional procedures
- a counsellor, psychologist and/or psychiatrist to diagnose and treat psychiatric conditions that may result from, cause, or exacerbate the pain
- a physical therapist or rehabilitation specialist to assess physical conditioning requirements
- nurses knowledgeable about how these approaches may be applied to the patient
The treatment depends on the kind of pain
Treatment of chronic benign pain
- activity
- reconditioning
- education
- non-narcotic means of pain control
Treatment of chronic pain syndrome
- reconditioning
- reduction of inappropriate medications
- treating symptoms of anxiety and depression
- developing coping skills
- establishing social support systems
- taking personal responsibility for recovery
- learning relapse prevention skills
Guidelines for successful chronic pain management
These guidelines are important if patients are to succeed in managing chronic pain:
- Treat the patient as a whole person, taking into account both mind and body.
- Treat the family as well as the patient.
- Provide a "road map"; define primary, secondary, and tertiary levels of care that will be the focus of treatment.
- Implement outcome-based treatment from a goal-based treatment plan.
- Return responsibility for health back to the patient - the patient must learn not to rely exclusively on the physician to deliver the "magic bullet" to cure the condition.