The “right” goal when managing pain
It makes sense that the primary goal of pain treatment should be to reduce pain. However, a recent editorial in The New England Journal of Medicine makes a strong case for looking beyond pain intensity when evaluating what is “successful” pain management. The “balancing act” of managing chronic pain Here is the problem: For people with chronic pain, the pain affects nearly all aspects of their lives. But at the same time, treatments to relieve chronic pain also have the potential to influence many aspects of a person’s life. Our best pain-relieving drugs have lots of unpleasant side effects. Even non-drug interventions (like physical therapy) and complementary therapies (such as acupuncture) usually don’t have just one single effect. This means that, if we prioritize pain reduction over every other outcome, we may wind up doing as much harm as we do good. In particular, the authors of the editorial suggest that focusing only on lowering pain intensity, and creating a moral mandate to relieve pain, have contributed to the opioid crisis in this country. Over the past few decades, we have seen steady increases in opioid prescriptions, cases of opioid misuse and abuse, and related overdose deaths. Patient surveys also show that people with chronic pain care about more than just experiencing less pain. They care about enjoying life more, having a strong sense of emotional well-being, increasing their physical activity, improving sleep and reduci...
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