Patients are familiar with being asked: “On a scale of 1 to 10, what is your pain?” Over the last 20 years, treatment of pain has been a focus for health care institutions and providers.
“Unfortunately, there is much that health care providers do not know or understand about pain,” explained Karl J. Haake, MD, of Mercy Pain Clinic in Carthage. “Patients and providers often equate the treatment of pain with the prescribing of a pain medication.”
Due to the increased focus on treating pain, usage of opioid-type pain medications such as hydrocodone and oxycodone has increased dramatically. The Centers for Disease Control and Prevention has declared an opioid crisis in America because these are among the most prescribed medications in the U.S.
As the number of these prescriptions has increased, so have the number of associated deaths. Americans now are more likely to die due to an opioid-related death than due to an automobile accident. According to the CDC, opioid-related deaths have increased five-fold in women over the last 10 years.
“What is painful for one person is not necessarily painful for another. This is why a one-size-fits-all approach rarely works in the treatment of pain,” Dr. Haake said. “Pain is a uniquely individual experience. All of us experience pain at some point in our lives, whether it is pain due to a broken arm, pain due to surgery or pain due to the loss of a loved one. Pain is influenced by prior experiences or thoughts, emotions and actual or potential tissue damage.”
In addition, according to Dr. Haake, there is a big difference between acute and chronic pain. Everyone likely experiences some type of acute pain, but not everyone experiences chronic pain.
In 2011, the Institute of Medicine made recommendations regarding the treatment of pain that include taking a multidisciplinary approach. Rather than just prescribing a “pain pill,” treatments should include other types of medications, procedures to relieve or treat pain, behavioral treatments and lifestyle improvements. The patient and the health care provider must take an active role in alleviating pain.
“My approach is to find the source of the pain, find effective and safe treatment options, improve the patient’s functionality and help the patient cope with pain,” he said. “We want to treat the problem, not just treat the symptoms.”
In addition, patients who suffer from serious psychological conditions, like depression or anxiety, are more likely to also have physical pain that lasts longer than three to six months, according to Dr. Haake, who has an undergraduate degree in psychology.
“Someone may be suffering pain, but untreated psychological problems can exacerbate physical pain,” he said. “I stress the importance of treatment for psychological problems as a key aspect in the treatment of pain.”
Dr. Haake also provides treatment that includes injections in the back and neck and other interventions, such as spinal cord stimulation therapy and radiofrequency ablation to decrease pain signals in nerve tissue.
“The goal is to break the cycle of pain and move the patients away from having to rely on pain medications,” he said.