Why self-care pain medicine?

Abstract

Chronic pain is a major problem and takes a terrible toll not only on individuals suffering from chronic pain but also on our health care system at large. Addressing it is the responsibility of us all, but we have fallen into a trap. The massive amount of money invested in research, advertising, and delivery of drugs (nearly $30 billion a year in each activity), especially opioid medications, and other expensive, practitioner-dependent interventions for the treatment of pain has overwhelmed our approach to this condition and obscured other less expensive and more sustainable treatments, particularly those that patients can do themselves. As stated by COL Chester Buckenmeier III and LTG (RET) Eric Schoomaker in the preface article in this supplement issue: At its most basic, pain has been seen historically as a symptom of some other disease or trauma, rather than a disease process of the central and peripheral nervous system that medicine now understands chronic pain embodies. Both the Institute of Medicine and Pain Management Task Force reports charged the medical community to acknowledge that effective pain management requires therapies that treat the whole patient, both physically and through a holistic biopsychosocial model, while also educating the country that chronic pain is a national health problem. More holistic, active, self-care, complementary, and integrative medicine (ACT-CIM) therapies, if effective, should be more sustainable and cost-effective than drug and practitioner dependent treatments. In addition, they are likely to provide additional benefits such as the enhancement of self-efficacy, lower cost, and be self-directed. But are they effective and, if so, which ones and at what intensity and duration? …