Benefits of Pain Management

WHY SEE A PAIN SPECIALIST?

If you suffer from some type of chronic or long-lasting pain, chances are you have already seen your general or primary care physician for it. That's a good thing! GPs or PCPs have an abundance of medical knowledge to provide you with some relief. While they are your first resource for any health concern, one of the best ways your GP/PCP can help and support you is to refer you to a pain specialist who will provide thorough pain management care. After all, if you suffer from a chronic illness, for example, with your lungs, you will likely be referred to a pulmonologist (lung specialist), because they know more about the lungs. 

WHAT A PAIN SPECIALIST CAN DO FOR YOU

Pain management providers are trained to treat and manage a wide variety of specific chronic pain issues, and are therefore fully equipped to answer any of your pain-related questions and can offer more insight in terms of outcome goals (i.e. what is it that you want to achieve from pain management and what is the best way to get there). They are dedicated to helping you achieve long term comfort and relief, instead of just a temporary one that you might find in your PCP or GP's office. 

Nurse practitioner and pain specialist, Tabitha Garrison, of Shenandoah Pain & Palliative Care Clinic, has the appropriate equipment and trained individuals in her clinic to focus solely on managing patients' chronic pain. She states, "here in SPPCC, we have an in-house lab to quickly run any necessary tests, we have certain speciality equipment to help diagnose and alleviate any chronic pain symptoms, and in my 28 years of medical experience, I have been fully trained to work with chronic-pain patients, including the ability to prescribe proper medications that not all physicians are licensed to do. In fact, we have an in-house medical compliance officer that helps us navigate all the legalities of prescribing medications."

BENEFITS OF PAIN MANAGEMENT CARE

Overall, seeking pain management care allows an individual to work closely and consistently with a pain specialist who is experienced in creating the most suitable treatment plan for the individual's specific type of chronic pain. Having this consistent and customized treatment plan allows not just a temporary relief from symptoms, but overtime, leads to a higher chance of minimizing the severity of the pain for a long period of time, thus improving quality of life. 

Palliative care explained

People often believe “Hospice Care” and “Palliative Care” are the same. However, that is not true. The goal of this article is to provide more detailed information on what palliative care truly is and how it is different from hospice care. 

PALLIATIVE VS. HOSPICE

These two types of care do in fact aim to provide patients and their families with as much comfort as possible while they endure life-threatening, serious, and/or long-lasting illnesses. However, the similarities end there. 

Hospice care is an option for people at the end of life. Typically, patients who decide on hospice care have been told by their doctor that they probably have fewer than 6 months to live. In contrast, palliative care is a good choice for patients who have illnesses that are serious and debilitating, but may last for many years. 

The World Health Organization (WHO) states in more detail that palliative care:

• Provides relief from pain and other distressing symptoms
• Affirms life and regards dying as a normal process
• Intends neither to hasten or postpone death
• Integrates the psychological and spiritual aspect of patient care
• Offers a support system to help patients live as actively as possible until death
• Offers a support system to help the family cope during the patient’s illness and in their own bereavement
• Uses a team approach to address the needs of patients and their families, including bereavement counseling, if indicated
• Will enhance quality of life, and may also positively influence the course of illness 
• Is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications (Sepúlveda, Marlin, Yoshida, & Ullrich, 2002, p.94-95). 

In summary, palliative care utilizes a “holistic-care” approach. Its primary goal is improving the quality of life of patients (of any age) and their families who are facing problems associated with all types of serious, chronic, and life-threatening illnesses’ At the same time, it provides relief from the symptoms and stress of the illness by means of psychosocial, spiritual, and practical medical support. It does not just serve individuals who are dying. 

For more information on the difference between palliative and hospice care, the National Hospice and Palliative Care Organization (NHPCO) has provided this guide you can click on and visit. 

The importance of pain assessment

In the medical field, pain assessment is defined as a process that physicians conduct to assist with creating a diagnosis by detecting and evaluating pain symptoms described by patients, with the idea that by assessing pain, physicians are able to understand the patient’s condition more so that they can come up with a treatment plan, should an issue that warrants one be detected.

With that, it is believed that a thorough and accurate pain assessment is the key to good and effective pain management practices. This first step creates what can be perceived as a domino effect. When a provider properly evaluates pain, then the best treatment plan can be created, then effective pain management care can be delivered, and then finally, the patient can experience pain relief. 

While it makes sense, assessing pain is often an undervalued and rushed step. No one is to blame, since it is understandable to want to focus on the end result – the alleviation from all the symptoms. But did you know that this automatic desire to rush is what actually often leads to unsuccessful treatments? In fact, one research study discovered that one of the primary issues that inhibits chronic pain patients from obtaining good control of their pain, and therefore, lasting relief, is the lack of pain assessment (Anderson, Mendoza, & Valeroo, 2000). Yet again, another piece of information that supports the claim of how important pain assessment is to optimal pain management care. The question though is, how does one perform a highly effective assessment of a patient’s pain?

There are objective and standard ways of assessing pain, which providers are trained to perform. Through their years of educational and practical experiences, they are aware of these approaches and without a doubt, are able to conduct it thoroughly. So, why then do certain patients still end up unable to receive the correct treatment or management plan for their pain issues due to poor assessment? 

According to this research study, not only should pain assessment be regular, ongoing, individualized, and documented, providers must also have the ability to focus on and understand the patient. Meaning, providers must show empathy towards their patients, listen carefully to their story, and do their best to understand what their patients are experiencing. This can best be done by utilizing empathy. Through empathic understanding, providers are then able to separate patients from their problems, thus allowing them to perceive their patients as people in need of help and support, instead of merely individuals composed of symptoms that need to be treated. Ultimately, such approach leads to a positive pain management outcome.  

Overall, not only is pain assessment important, it is also crucial that providers take the time to listen to their patients while evaluating their pain. It is not always enough to just ask if one is in pain or not and then assign a numerical value to that pain (i.e. from a scale of 1-10, how much in pain are you). Part of a proper and effective assessment of pain is giving patients the opportunity to tell their story and discuss their experiences openly. For instance, it is important for a provider to know and understand not only the location and duration of a patient’s pain, but also the various factors (if any) that either alleviate or further aggravate it. There are also instances wherein it is important for providers to seek how patients perceive pain and the potential treatments for it, if a provider is to come up with the best treatment and management plan. After all, stories are able to teach, validate, and offer reflection, which then molds how patients are cared for and how their issues are managed in the long run. 

Defining chronic pain

Every now and then, we experience unfortunate things that lead to bodily pain. There are days when we pull a muscle while working out, we stub our toe while walking barefoot around the house, we accidentally pound our thumb instead of the nail while building new furniture, we get random back spasms from time to time, or we sprain an ankle due to one wrong step while walking around the neighborhood. These are just a few examples of the myriad of common injuries that are definitely not fun to experience but tend to go away quickly. This is not to say that these should not be taken seriously. Any minor injury when gone untreated, has the potential to turn into something worse, but for the most part, taking the proper dose of over-the-counter pain relievers (like ibuprofen or acetaminophen) is deemed enough to get relief from pain caused by something like a sore neck.

But what about this term that people seem to frequently use to describe their pain called “chronic pain?” How is it different and clinically defined, such as what characteristics should be present for an injury or any type of physical pain to be considered “chronic” (i.e. length and severity of pain)?

To answer this question, it is first necessary to understand that chronic means “long-term.” Thus, chronic pain means pain that is persistent and does not just go away after a few days. The pain from whatever injury or underlying condition it came from continues to be felt for months or even years. By definition, a recent research study claimed that chronic pain is, in general, pain that lasts for a minimum of 3 months (Mills, Nicolson, & Smith, 2019).

Experiencing chronic pain is common. However, it is regarded as a highly distressing issue, which impacts the lives of those who endure it and that of society as well. Chronic pain usually occurs as a result of an injury or a disease, often arising from a series or combination of multiple events. However, it is determined as a separate condition on its own, and not just a symptom of a particular ailment. This is why chronic pain has its own medical definition. 

All that said, it is important for medical practitioners to address chronic pain. This is usually done (and done well) by identifying the causes and the effects of one’s pain. To reduce the impact of chronic pain, not only medically speaking, but also on the quality of life of an individual, it is also important that a proper treatment plan – one that takes into account the many factors that contribute to pain – is created. 

This is why in Shenandoah Pain and Palliative Care Clinic; our team aims to get to know our patients on a deeper level. Here, we believe that our patients have stories to tell and we strive to listen to them to understand the root cause of their pain, so that a customized treatment plan that our provider believes is most beneficial to the patient can be created. 

 

Reference

Mills, Sarah E. E., Nicolson, K. P., & Smith, B. H. (2019). Chronic pain: a review of its epidemiology and associated factors in population-based studies. British Journal of Anaesthesia., 123(2), 273-283.