Pain Management Doesn't have to be a Pain: Working and Communicating Effectively with Patients who have Chronic Pain

Abstract

More than 60 million Americans suffer from some type of persistent or recurrent pain sufficient to substantially affect their lives.1 Although effective treatments are currently available, at least 40% of patients treated in the routine practice setting fail to achieve adequate relief from primary pain.2 In a recent survey of Kaiser Permanente (KP) members with various chronic conditions, patients with chronic pain fared the worst in terms of quality-of-life burden, diminished functional status, and lost productivity.3 One reason why this population is difficult to treat is the inadequate communication between clinician and patient regarding treatment and self-management of chronic pain. Communication is the most powerful tool between clinician and patient—a tool that needs to be strengthened by the medical community. Enhancing communication with a patient who has chronic pain can be daunting because so many aspects of the patient's life are affected by the pain. Clinicians never seem to have enough time to discuss all the relevant issues in addition to addressing coexisting health conditions or presenting problems. An approach that makes that task seem possible—and even accomplished successfully—is to realize that we do not need to do more; we instead need to do things differently. To enhance our current abilities and possibly to acquire additional office-based tools and strategies for addressing chronic pain, this article—the first in a series—discusses the challenges and complexities of treating chronic pain. (Upcoming articles in this series will provide more in-depth discussion of pain assessment and management.) The more assured we feel about the direction to give the patient, the more likely the patient will be to follow this direction.