The Barriers to Effective Chronic Pain Treatment

The vast majority of chronic pain management experts agree that the treatment of chronic pain should be multi-modal and bio-psychosocial in approach.

Multimodal merely means that the treatment may include various modalities or types, such as physical interventions, medication, injection therapy, to name but a few. This is what we often see and can be said to be true in most cases.

Bio-psychosocial is merely a long-winded way of saying that the psychological and social issues of chronic pain should be addressed at the same time as the medical problems.

Experts then go on to say that it is unlikely for recovery to occur without including this approach, and yet, alarmingly this is what is most often missing from treatment programs.

How did this happen?

There are a number of reasons for this, such as poor undergraduate chronic pain training for physicians and present- day medical appointment times that are way too short, with about 15 minutes or so at one’s own physician, but often less than 10 minutes at a walk-in clinic, in order to do the required education and work.

But there is a less frequently discussed, even bigger problem behind it. It is a medical system that has somehow helped create the unrealistic expectation that we can always rely on rapid and effective ‘solutions’, mostly in the form of chemical compounds, even in the case of chronic conditions such as chronic pain. We still see the effects of this notion in the ongoing opioid crisis.

So clearly, that’s not how things work.

It is also why our treatment outcomes for chronic disorders are relatively poor compared to other diseases and conditions such as acute (recent onset) disease like pneumonia, surgical conditions like appendicitis, and the treatment of traumatic injuries.

photo credit: Rodrigo Curi Unsplash