I can't seem to get any help for a nagging case of low back pain. Most of the people I have seen didn't seem to even care that I'm in pain. No one even asks me how I feel anymore. I don't know what to do. Should I say something?

Patient-centered pain management is an important part of every health care professional's working day. Dentists, doctors, nurses, physical and occupational therapists, and pharmacists address patient concerns about pain each and every day. Pre-licensure programs to prepare health care professionals are often limited and lacking in their instruction in this area. Students need a core group of classes in order to become more knowledgeable in the area of pain management. They need guidance in understanding how to talk with patients about their pain and work together with other team members to help patients manage their pain. The University of Toronto has spent the last six years perfecting an instructional program to accomplish this task. They have published the results of their work and hope to see other programs use this same model (or develop their own curriculum). The material is covered in one three-and-a-half day period of time. The method of instruction is not just lecture, but also patient cases, large group sessions, and small interprofessional student learning groups. Efforts are made to help students understand the physiology of pain while also seeing the personal side of it from the patient's point-of-view living with chronic pain. All kinds of pain types are included such as acute pain, chronic pain, pain in children and teens, cancer pain, arthritis pain, phantom pain after amputation, and other types of neuropathic (nerve) pain. Students are taught how to assess and manage pain. There is an emphasis on a team approach. Topics covered vary a bit from year to year based on current research and evidence from published studies. It's possible your health care providers have not had such a comprehensive program to teach them how to approach each patient. It's also possible that your providers are on the right track but you need some more information about their approach and what you can expect. Don't hesitate to bring up your concerns and ask questions. It may be that a one-on-one conversation about your particular situation will clear up all your concerns.

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