Chronic pain is a disease that affects the nervous system. Most general practitioners would rather have their toenails pulled out or have root canals than treat a patient with chronic pain. Why? Well, here are two of the most common reasons.
First, pain management and pain management are absent from the American medical school curriculum. Many say that veterinarians are better educated and trained to treat pain than a general practitioner.
As such, most general practitioners do not consider chronic pain to be a disease. The general thought among most of them is that it is nothing more than a symptom that does not need further attention.
Second, is the fear of malpractice lawsuits and losing your medical license. The effect that general practitioners have is chilling when we look at the limitations in their choices about how to manage a patient’s pain. They fear losing their license if the medical board thinks they are prescribing too many controlled substances that can relieve pain.
A recent study that examined physicians’ attitudes and thoughts about pain management found shocking results. More than half of those who participated in the study felt unprepared to deal with the chronic pain experienced by their patients.
When we consider that there are more than 100 million people here who suffer from chronic pain and just over 3,000 specialists treating pain, we need our primary care physicians to address that gap in patient-to-caregiver ratios.
Opioid-related deaths
Between 1999 and 2008, the CDC reported that this country experienced a fourfold increase in opioid-related deaths. It was also reported that a third of those opioid-related deaths were related to the highly effective drug, methadone.
And while there’s a lot of controversy surrounding those statistics, it’s a clear message that doctors aren’t adequately treating chronic pain among their patients. During this period, untrained doctors were encouraged to prescribe methadone as a pain medication. They unintentionally overdosed their patients with the drug. How?
Methadone accumulates in the body during the first week a patient takes it. It is slow-acting and can reach a harmful level without the doctor or patient realizing it.
Because this type of information is circulating now, those death rates have dropped. In fact, prescription control systems and extended-relief pill formulations are said to be credited with reducing that mortality rate by twenty-five percent.
Instructed to suck it
And while it’s a good thing that the death rate has dropped, we still have a pain crisis in this country today. There are general practitioners who simply advise their patients to “suck it up.” This leads us to a better understanding of the medical research that has been done that has shown the need for chronic pain to be treated effectively.
Because when left untreated, the central nervous system can be affected by chronic pain through “neuroplasticity.” This causes “short circuits” in the spinal cord that cause pain signals to be sent to the brain without the presence of a pain stimulus. We are still learning about the detriment when chronic pain is left untreated.
Anyone who lives with chronic pain understands that their pain never completely goes away. And each person has their own level of tolerance. For some, a level of 3 or 4 is tolerable and their prescribed opioid analgesia may eliminate 20% of their pain. They can receive interventional treatments such as medical branch neurotomy and reduce their pain by up to 50% if the technician is good.
In addition to primary care physicians receiving more training on how to work with and treat chronic pain patients, patients need to be honest with their physicians. It is because of those who take advantage of their doctors, some people see more than one doctor for the same thing. It is because of those people who are becoming addicted to opioids and other medications that we are now in this position.