Patients are Dissatisfied with Chronic Pain Management

by Pamela Katz Ressler, MS-PREP, RN, HN-BC, adjunct faculty Pain Research, Education and Policy Program, Tufts University School of Medicine and PREP-Aired blog moderator

As has been discussed previously in this blog, the under-treatment of chronic or persistent pain places an enormous burden on individuals, the health care system, the economy and our society.  In June 2011, the Institute of Medicine reported that there are an estimated 116 million individuals in the United states who report chronic pain, at an economic cost of $635 billion per year.   According to a recent article by Matthew Brady in the magazine of the site, Angie’s List, (which reviews numerous categories of service and health care providers;) “health care providers in the pain management category garner negative reviews at twice the average of other Angie’s List categories” Additionally, Angie’s List members reported that their “health care provider didn’t take their problem with pain seriously”.

While reports of patient dissatisfaction with chronic pain management are disturbing, they are understandable when one recognizes the paucity of training most clinicians receive in chronic pain management.  According to the Association of American Medical Colleges less than 1 in 4 of the 133 accredited medical schools in the country teach students about chronic pain management and most students receive less than 11 hours of pain management training in their entire 4 years of medical school.

Addressing the systemic lack of comprehensive pain education is a key mission of the Tufts University School of Medicine’s Pain Research, Education and Policy Program (PREP).  The founding director of the PREP program, Dr. Dan Carr, states that the high level of dissatisfaction and complaints among patients seeking effective chronic pain management may reflect the traditional training of clinicians to focus only on objective measures and procedures to alleviate pain, without regard to the social and psychological aspects of persistent pain. “There is an enormous social component to pain,” states Dr. Carr. “Patients will be more satisfied if they feel they have been cared for. That has more to do with their satisfaction with pain control than the actual intensity of their pain.”

While there are no easy answers to chronic pain management; patients, clinicians, educators and health care stakeholders all agree that our current approach to pain management is inadequate and needs to be addressed as we prepare to meet the increasing health needs of an aging baby-boomer population.

What are your thoughts on how we can create a more comprehensive model of chronic pain management?

Add comment December 8th, 2011

PREP Graduates’ Research Collaboration Published in Cochrane Library

by Pamela Katz Ressler, MS-PREP, RN, HN-BC, Adjunct Faculty, PREP Program, Tufts University School of Medicine, PREP-Aired blog administrator and moderator

The Pain Research Education and Policy Program at Tufts University School of Medicine educates thought leaders in the multidisciplinary area of pain.  This is evident by the efforts of two PREP program graduates, one a current Tufts PREP program faculty member and the other a practicing acupuncturist, through their collaborative research concerning endometrial pain and acupuncture.  PREP graduates, Ewan McNichol and Kindreth Hamilton, along with co-author Xiaoshu Zhu, recently published a systematic intervention review; Acupuncture for Pain in Endometriosis in the Cochrane Library.   In this systematic review,  twenty-four studies were identified that involved acupuncture for endometriosis.  One trial, enrolling 67 participants, met all the inclusion criteria.  The authors concluded: “The evidence to support the effectiveness of acupuncture for pain in endometriosis is limited, based on the results of only a single study that was included in this review. This review highlights the necessity for developing future studies that are well-designed, double-blinded, randomized controlled trials that assess various types of acupuncture in comparison to conventional therapies.”

The PREP program applauds our graduates for their continued thought leadership surrounding the global issues of pain research, education and policy.

Add comment September 21st, 2011

Can Love Reduce Pain?

by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP graduate student and PREP-AIRED blog moderator and administrator, Tufts University School of Medicine

In honor of Valentine’s Day and in celebration of “heart month”, February, today’s blog entry asks the question…can viewing a photograph of a romantic partner reduce pain?  This was the research question posed by investigators from Stanford University in a study entitled: Viewing Pictures of a Romantic Partner Reduces Experimental Pain published in PLoS  ONE.  Using functional magnetic resonance imaging (fMRI), the investigators examined fifteen individuals in the early stages of a romantic relationship (first nine months).  Participants completed three tasks under periods of moderate and high thermal pain: 1) viewing pictures of their romantic partner, 2) viewing pictures of an equally attractive and familiar acquaintance, and 3) a word-association distraction task previously demonstrated to reduce pain. Viewing pictures of a romantic partner and the distraction task both decreased the amount of self-reported pain experienced by the study participants.  However greater pain relief was reported while viewing pictures of a romantic partner and this was the only study condition associated with increased activity in several reward-processing regions of the brain.  According to the research team lead by Dr. Jarred Younger,  ”The results suggest that the activation of neural reward systems via non-pharmacologic means can reduce the experience of pain”.   In the clinical setting, creating an environment that encouraging patients to have pictures of loved ones within view may help to achieve more effective pain management.  

What are your thoughts on this study?

1 comment February 14th, 2011

Progress and Challenges in Pain Research

By Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP graduate student, PREP-AIRED blog moderator and administrator

Thank you to Dr. Daniel Carr, founder of the Tufts University School of Medicine’s Pain Research Education and Policy Programs (PREP) for alerting us to a collection of articles in a recent edition of Nature Medicine which review progress and challenges in pain research from the bench to the bedside.  Take a look at some of the interesting issues being addressed with a focus on pain research and treatment.

Click here to view the table of contents

Add comment December 10th, 2010

Do Cortisone Injections Make Pain Worse?

cortisone injectionby Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP graduate student and PREP-AIRED blog moderator

A recent study published by The Lancet (to read the study abstract, click  here ) explores the question of efficacy and safety of corticosteroid injections for tendinopathy, both short-term and long-term. Using a systematic review of randomized control studies, researchers observed that corticosteroid injections reduced pain in the short term compared with other interventions, but this effect was reversed at intermediate and long terms.  

As this research indicates, there is a need for multidisciplinary pain management approaches in the treatment of chronic pain conditions.  What have been your experiences with using corticosteroid injections?

Add comment November 2nd, 2010

PREP-AIRED named Link of the Month

We are honored to be named “link of the month” by the Mayday Pain Project. The Mayday Pain Project was begun in 1994 with a grant from the Mayday Fund in New York as an international educational resource with a goal of empowering people in pain and those who care for them. The Mayday Pain Project website provides accessible, user friendly and professionally authoritative information about pain issues for patients, medical professionals and caregivers.
Thank you to the Mayday Pain Project for recognizing the important role that Tufts University’s Pain Research Education and Policy Programs play in educating tomorrow’s leaders in pain management.

Add comment May 24th, 2009

We Have a Winner: PREP-AIRED

by Pamela Ressler, RN, BSN, HN-BC, MS-PREP student and PREP blog moderator
Thanks to all who participated in the Name Our Blog contest. The entries we received were exceptionally creative and clever, and made choosing a winner extremely difficult for the selection committee. The winning entry, PREP-AIRED was submitted by PREP student Eileen Dube. When asked how she came up with the blog name PREP-AIRED, Eileen stated,

“Basically I thought that the name PREP-AIRED conveyed the idea that in the Pain Research Education and Policy program we are airing our ideas. By airing them we are better prepared to answer questions of others, to think more deeply about things, to see things from a different perspective, and to act. And I love a good play on words any day.”

Congratulations, Eileen!
Here are some of the other great entries we received:
Melzack’s Echo: To recognize Melzack’s pioneering efforts towards pain research, as well the residual echo of its impact
Polemos on Poena: The Greek word for war and the Latin word for pain, preparing us to do battle with pain in our collective work
PPP/Triple P (Pain Program Posting): Recognizing the interactive nature of postings on the blog
Painless: Acknowledging our desire to mitigate pain
We were struck by the thought and creativity, as well as the relevance to the unique PREP program, that went into each of the name submissions. Thank you to all who participated.
Over the next week you will see a new blog heading graphic with the new name: PREP-AIRED, and you will continue to see new content added. The beauty of a blog is the collaborative nature of interaction with others; we welcome and depend on your continued comments and ideas. I am happy to help you post your thoughts or give you suggestions on topics that may be of interest. Feel free to email me at pressler@stressresources.com

Add comment March 29th, 2009


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