Patients living with Pain

What are the barriers to patients’ access to pain treatment? Are there more barriers for elderly patients and children? If so, why?

A 1999 study, Chronic Pain in America, found that only 1 in 4 of those with pain received adequate treatment. ["Chronic Pain in America," survey conducted for American Pain Society, American Academy of Pain Medicine and Janssen Pharmaceuticals, 1999.] Recently, the under treatment of pain has begun to receive professional scrutiny. Additionally, the national media has drawn focus to the addiction issues that often arise. However, there are still many people forced to live a lower quality of living because of under treatment of their pain.

Charles Argoff, M.D:

There are at least several major barriers to patients’ access to pain treatment. First, many patients are still not aware of the existence of the subspecialty of pain medicine and therefore of the available therapies for symptom control. All too often, certainly depending upon the community, "pain management" to a patient may be either the use of solely chiropractic care or acupuncture. However, this leads into another obstacle- many health care providers still view "pain" as an annoying symptom that whiny patients describe as opposed to acknowledging that chronic pain most often represents a complex disease that needs to be assessed and treated as such - no different than chronic diabetes or chronic heart disease. Patients do not need to justify their angina or hyperglycemia; patients should not have to justify their pain in a manner that may inhibit many from bringing it up in the first place.

Proper pain assessment is critical to the proper diagnosis and management of patients with any type of pain problem. The elderly and children may have particular difficulty either due to cognitive decline or due to age appropriate language development issues with conventional pain assessment tools. The use of the “faces” scale for pain assessment for example, is one attempt to help with proper pain assessment in these populations.