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More about pain management

Let's assume we could talk the health insurance industry into paying for treatment focussed on the patient and not on the profitability of the hospitals and the pharmaceutical industry. What would a pain management department look like and how would it treat its patients? First off, it would concentrate all its energies on two quite different functions. Before you can identify the best treatment for a patient, you must diagnose the underlying cause of the pain. The most experienced diagnosticians in the hospital or clinic must therefore work on each patient, using whatever reasonable tests are necessary to reach a reliable diagnosis. The second function is to switch the emphasis on the types of treatment made available. At present, hospitals are run for profit and so base all their treatment decisions on what generates the most profit. In other countries, there is an evidence-based approach. Researchers identify which treatments are the most cost-effective for relieving the patient's problem and only those treatments are used regardless of the level of profitability.

Once the hospital has a reliable diagnosis, it moves to the treatment phase. This may be an interventional procedure to repair damage or relieve the cause of pain. In the case of surgery, there are new less invasive methods. Where surgeons have the experience and the evidence shows good outcomes are likely, they should be used. If invasive procedures are not recommended or require follow-up, we move into the area of physical therapy, psychological counseling, cognitive behavioral therapy and general support services. Here the team aims to teach each patient how to cope with the new physical limitations and the reality of persistent pain. All the research both in the US and in the rest of the world shows these services are the most likely to improve the patient's quality of life. Pain management is as much about the patient's attitude and emotions as it is about the treatment given. Then we get into all the alternative therapies. Again there is excellent research evidence showing that acupuncture and some homeopathic therapies produce excellent results. If there is such evidence available, the hospital or clinic should supply it. Finally, the doctors need to give detailed advice to patients about what drugs to use and when to use them.

In all this, the pain management department is aiming at a simple target. It wants the best long-term result for the patient without relying on the use of drugs. Although there will be some reliance on painkillers like tramadol during the early part of the treatment program, pain management assumes dependence on drugs is a bad thing. People should learn how to make the best of life without relying on pills. So you can buy tramadol for use in the early stages but be prepared to learn how to management and control your pain without its help. In the long term, this saves you from the continuing cost of having to buy the drugs and it also makes you a stronger person. Ignoring all the stereotypes about the stoic people who live with pain, people with the strength of mind to manage their own feelings and emotions generally make better lives for themselves. People who see a pill bottle as the only solution are weak, passive and rarely make anything of their lives.