What To Do About chronic Pain


When you don’t know how to fix something, it’s tempting to set it aside and just forget about it. But when that “something” is pain — well, there are 116 million adults in the United States alone looking for some help. And telling them “it’s all in your head” or “there’s nothing that can be done” just isn’t acceptable.

That’s the stance of the Institute of Medicine (IOM) and they are throwing their weight behind it. The IOM is calling for a greater dedication to pain research and more money to fund it. There is a need to support researchers as they help find better ways to treat chronic pain,

Experts in pain management want to see new pain medications and therapies for the patients suffering this disease. They are advocating for training and education for physicians. And leaders of the Institute of Medicine (IOM) are asking for better reimbursement for health care professionals who spend the time to really understand and care for these patients.

Where do we begin? Those in charge of this project at the Institute (IOM) say it’s a three-prong problem. First, we need a change in our attitudes about chronic pain and the people who suffer from it. There is enough scientific evidence now to channel our thinking toward the idea that chronic pain is a disease — a long-term, persistent, and disabling disease. It requires every bit of time and resource management as any other chronic long-term health care problem.

Second, pain management needs a face lift. For too long, physicians have been afraid to use narcotic (opioid) pain medications for fear their patients will become addicts. There are plenty of studies to show that opioids are safe and effective. Yes, they require appropriate monitoring but they shouldn’t be withheld out of fear and ignorance.

Third, we need a partnership in health care as it relates to pain management. With proper training and education, the primary care physician can effectively care for many chronic pain patients. Not everyone needs a full-blown, multidisciplinary team approach. But when patients don’t get the help they need and especially in very complex, complicated cases, then referral can be made to a pain specialist or team of professionals at a pain clinic.

The Institute of Medicine (IOM) made several other recommendations of interest:

  • Add required courses to all medical school curriculums on pain and pain management.
  • Licensing and certification exams for physicians should include pain-related assessments
  • Expansion of pain-centered care under Medicare, Medicaid, Workers’ Compensation, and private insurance plans.
  • Remove barriers from physicians (and other health care professionals) billing and receiving reimbursement for the time it actually takes to find a workable solution for these patients.
  • Broaden the research scope to include genetic, psychologic, environment, social, and cultural aspects of chronic pain.

    In summary, the IOM hopes that with more funding, researchers can develop better drugs and better management techniques for chronic pain patients. Finding factors that would predict who will respond to what medications and approaches is another area for scientific study. It’s time to lay down the gauntlet on chronic pain and find workable solutions through the maze of complexities these patients often present. Such an approach will require the coordinated efforts of private, public, and governmental agencies.