Pain is the most common reason patients seek medical care. 9 in 10 Americans regularly suffer from pain. About 50 million Americans suffer from chronic pain. Chronic pain is defined as pain that continues 3 to 6 months after onset or expected time of recovery. Chronic pain can be debilitating and by definition disrupts sleep and normal living and serves no adaptive purpose. The most common cause of long-term disability is chronic pain. Undertreated chronic pain can impair an individual’s ability to carry activities of daily living, diminish one’s ability to work, and diminish overall quality of life.
Patients with undertreated pain can also suffer from anxiety, anger, fear, and depression. Additionally, according to the American Pain Society, undertreated pain can negatively impact a patient’s relationships and social life. In total, undertreated pain has significant physical, psychological, and financial consequences. Chronic pain is a form of chronic stress and will bring the same physiological consequences that other forms of stress bring. This includes cardiovascular problems such as increased heart rate, elevated blood pressure, hypercoagulation (increase blood clots), gastrointestinal issues including poor appetite, constipation, and delayed gastric emptying, musculoskeletal issues including muscle spasms, and impaired mobility and function. Stress also impairs the immune system and affects the endocrine (hormones) system. All of these issues serve to worsen chronic pain and the vicious cycle continues.
My Approach to Pain Management
My approach to pain management is to treat pain with the least amount of medication that is effective in relieving pain. By relief of pain, I do not mean the total absence of pain. That goal is far too often unattainable and generally leads to abuse of pain medications. Therefore, the assessment of pain is critical and an ongoing process. The relief that is reasonable and attainable is the relief that allows for improved functionality and ability to carry out one’s life and to work. Many of the psychological problems will then take care of themselves with the improved functionality.
Adverse Effects of Opiate Medications
Adverse effects of opiate medications include drowsines1s, dizziness, sleepiness, constipation, nausea, rash, itching, physical dependence, and potential for addiction. Because of these adverse reactions, caution must be taken when using these pain medications. I advise patients to use pain medication when they really need it as opposed to when they are having minor pain. Addiction is a set of behaviors associated with compulsive seeking and/or use of opiates. Caution is also advised when taking opiates with other sedative medication, as the effects can be cumulative. Additionally, many of these medications contain acetaminophen, which can be toxic to the liver.