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No clear answers for treating chronic pain

2:38 PM, June 9, 2008

Chronic or recurrent pain affects more than 75 million Americans. That fact has received a lot of attention among health professionals in the last decade. But, according to a new study, doctors often aren't sure what treatments will help their individual patients.

The study, in the June issue of Journal of General Internal Medicine, drew several conclusions:

  • None of the clinical trials on opioid pain-relievers, such as morphine, Percocet and Vicodin, lasted longer than four months, even though most people with chronic pain have symptoms for a long time (that's why they call it chronic) and are prescribed these drugs for long periods of time.
  • There's a dearth of information on herbal remedies versus other pain medications in spite of the fact that management of chronic pain is one of the major reasons people turn to alternative medicine.
  • Chronic pain often goes hand-in-hand with major depression, but little is known about the impact of treating both the pain and the depression together.
  • Pain assessments, such as 0-to-10 scales, have become very popular. But studies suggest that using the assessments may have little effect on treatment of the patient's pain.

Says the study's author, Matthew J. Blair, of Indiana University School of Medicine:

Many primary care doctors "have not been well trained in pain management. And while many are paying more attention to pain than ever before. . . they don't know what treatment will work for a given patient. They want guidance and we found very limited information."

The lesson here may be to turn to a pain specialist for help in managing chronic pain -- if you have health insurance that will cover that, of course.

- Shari Roan

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Comments

As an acupuncturist who's specialized in treating chronic pain (three years in pain management at Kerlan-Jobe Orthopaedic Clinic) I'd find all this reporting hilariously out-of-date if it wasn't so horrendously tragic.

There are a number of effective ways of treating chronic pain. The structure of medical science today creates blinders that keep decision-makers from perceiving what hundreds of thousands of ordinary people already know from their "anecdotal" experience ... that acupuncture works.

Homeopathy and nutrition can work in many cases too. Ask my 87 year old mother.

I'm amazed there aren't more comments on this. Acupuncture may work for some people, opiods for others, medical marijuana for others. There are treatments for chronic pain. However, there is a stigma. Many people assume that patients are seeking treatment because they want drugs. Any chronic pain patient would be happy to get rid of the drigs as long as the pain is gone. Otherwise, chronic pain is a neverending tragedy.

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After a brief stint as a sports writer, Shari Roan turned to health journalism and has covered the topic for The Times for 18 years. She is the author of three books and the mother of two daughters, both teenagers who refer to her as a "health freak." She likes to jog, watch baseball and is very happy that dark chocolate contains some health benefit.
Jeannine Stein writes about fitness, sports medicine and obesity for the Health section. She’s a gym rat from way back and never met an elliptical trainer she didn’t like. Well, maybe one or two. She tempers exercise with a steady diet of reality television because she believes it’s all about balance.