MD Argues "Wallet Biopsy" Approach to Pain in US Hurting People in Chronic Pain

[Cort]

Fascinating article by MD argues US is on the wrong track for helping people in chronic pain.

Yet despite newer, expensive and invasive treatments like spinal fusions and disc surgery, spinal cord stimulators, steroid and painkiller injections, nerve “burning” and of course the excessive use of opioid drugs, chronic pain is becoming worse in the U.S. adult population not better!

The problem is the "wallet biopsy" approach which approaches pain in a one-shot rather than an integrated manner.

For example, almost nine million Americans got pain injections such as corticosteroids in 2010. The injections draw lucrative reimbursements but have limited if any long-term benefit according to the medical literature.

many back surgeries have shockingly low success rates that patients would probably not risk if they were choices offered in traffic — or at the casino...
In fact, “failed back syndrome,” a term frequently heard in the U.S. is an ailment that “does not exist in most of the world,” writes Peter Abaci, MD, in his book Take Charge of Your Chronic Pain because “Most other countries don’t perform spine surgeries at the high rate that we do in the United States.”

He argues that a iopsychosocial approach to chronic pain that includes a physiatrist (a physician specialized in physical medicine and rehabilitation), a physical therapist, a health psychologist and others (occupational therapist, rehabilitation nurse, social worker or vocational therapist) works far better.
Ironically it's also cheaper in the long run that surgery, longterm opioid use, etc.

 

[AnneVA]

At some point, one may need surgery or must turn to longterm opoids but I agree with this that there are other ways to deal with pain that should be first line. Best things for pain here have been physical therapy with someone who helped and did not harm. Dry needling for knotted muscles/trigger points. Competent massage to manage flares. And to a different degree, saline iv for hydration. If you are hypovolemic, tissue and muscles will hurt, circulation is poor in the extremities with pooling. And learning to adapt in daily living skills, work habits as to not provoke pain. Although it took years to find help that went to the root of pain and fatigue, etc. with strategies that helped and to then establish new ways of doing things so as to not provoke problems, it has been the best for long term management.

 

[Cort]

Unfortunately no one-shot solution....

 

[AnneVA]

Agreed. No "simple" solutions. No "cure". Current management and preventative strategies looking forward.

 

[LunaNik]

I agree that we need an integrative approach. For me, prescriptions have a tendency to resolve one symptom, but create five more.