September is International Pain Awareness month. This month we highlight the importance of a multidisciplinary and individualized approach to pain management.<\/p>\n
Chronic pain is pain that continues or recurs for more than three months<\/a>. Chronic pain may be either primary<\/a> (not attributed to another diagnosis) or secondary<\/a> (a symptom of an underlying health condition). Although it may be seen as a symptom, the World Health Organization recognizes chronic pain as a disease in its own right in the eleventh version of the International Statistical Classification of Diseases and Related Health Problems, which came into effect in 2022<\/a>.<\/p>\n The Canadian Pain Task Force describes<\/a> chronic pain as \u201ca public health emergency in need of action.\u201d As of 2019, an estimated 7.6 million people<\/a> across Canada \u2013 one in five Canadians \u2013 were living with chronic pain. As a result of population growth and aging, that number is expected to reach<\/a> as many as 9 million Canadians by 2030 \u2013 an increase of 17.5 percent.<\/p>\n Chronic pain negatively affects patients\u2019 lives in many ways:<\/p>\n quality of life<\/a><\/p>\n Chronic pain also has a significant economic impact<\/a>. Health Canada estimates that in 2019 alone, the combined direct and indirect cost of chronic pain was between $38.2 and $40.3 billion. In 2030, that number is estimated to grow to between $52 and $55 billion \u2013 a total increase<\/a> of 36.2 percent from 2019.<\/p>\n Finally, the COVID-19<\/a> pandemic has led to increased pain and disability for people living with chronic pain, and has created disruptions in healthcare that have reduced access to support and treatments that help to maintain their quality of life.<\/p>\n Evidence and clinical experience suggest that any approach to management of chronic pain should be individual, multimodal, and multidisciplinary.<\/p>\n Pain is subjective<\/a> and multidimensional<\/a>, incorporating sensory, emotional and cognitive components: where the pain is felt in the body, and the intensity of that sensation; the unpleasantness of the experience; and how a person interprets and reacts to the pain (for example, with fear or anxiety). Pain is also highly personal<\/a>, influenced by a myriad of factors unique to each person. Pain is thus a profoundly individual experience. There is no \u201cone size fits all\u201d solution to management of chronic pain; instead, treatment should be tailored to each patient\u2019s particular needs, experience, and circumstances.<\/p>\n Chronic pain is complex<\/a>; a single intervention is rarely enough to reduce patients\u2019 suffering and improve their quality of life. Instead, it is best addressed by a multimodal approach that takes into account the various aspects of the patient\u2019s experience of chronic pain: physical, cognitive, psychological, and behavioural.<\/p>\n Treatments for chronic pain range<\/a> from traditional and non-traditional pharmacotherapy through physiotherapy and psychological support to interventions such as intrathecal therapy, neurostimulation and radiofrequency ablation. Complementary and alternative medicine may also play a role.<\/p>\n The diverse facets<\/a> of chronic pain suggest that patients should be treated by a multidisciplinary team. Patients are more likely to receive an accurate diagnosis and to benefit from interventions tailored to their particular needs. Such a team<\/a> usually includes three physicians (for example, a primary care physician, an anesthesiologist or pain specialist, and a psychiatrist) and several other healthcare providers. The members of the larger team will vary according to the patient\u2019s particular health condition and circumstances, and may include<\/a> specialists, pharmacists, physiotherapists, dietitians, complementary therapists, occupational therapists and medical social workers.<\/p>\n The benefits of this approach include diagnosis of pain at an early stage, a wide range of treatments, the opportunity for the patient to discuss interventions with appropriate healthcare providers, and continuity of care. Research has consistently shown<\/a> that multidisciplinary pain treatment leads to reduced pain intensity. Other benefits of this approach include improvement<\/a> in physical function, quality of life, emotional stress, and behavioural outcomes.<\/p>\n While the evidence<\/a> shows that multidisciplinary pain clinics are clinically and economically effective, waiting lists are long (up to 18 months<\/a>). As a result, primary care clinicians may find themselves taking on a lead role in pain care for patients with chronic pain.<\/p>\n Clinicians:<\/strong> Learn about the role of antispasmodics in managing the abdominal pain, cramping and discomfort of functional gastrointestinal disorders by taking this complimentary course<\/a>.<\/p>\nWhy is it Important?<\/strong><\/h2>\n
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decreased<\/ul>\n<\/li>\n<\/ul>\n
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Management of Chronic Pain<\/strong><\/h2>\n
An Individual Experience<\/strong><\/h3>\n
Multimodal Intervention<\/strong><\/h3>\n
A Multidisciplinary Team<\/strong><\/h3>\n
Chronic pain in primary care<\/strong><\/h3>\n