Treating acute vs. chronic pain
Treating acute vs. chronic pain
Treating acute pain is generally pretty straightforward. The first step is to treat the underlying issue, e.g. by immobilizing a broken bone with a cast or taking antibiotics for a bacterial infection. If that isn't enough, the next step is to focus on relieving the pain itself. This is often done pharmacologically - or, in other words, with medication. If over-the-counter drugs aren't effective enough, a doctor may prescribe stronger painkillers such as opioids (e.g. morphine, tramadol, oxycodone, etc.). Even though these drugs are highly addictive and tend to carry a lot of side effects, they rarely lead to any long-term consequences when taken as prescribed and for a short period of time.
Treating chronic pain, however, is a lot more complicated for several reasons:
- Since there are such a large amount of factors that cause and maintain chronic pain, the treatment must take all of them into account. Treatments that only focus on the physiological parts of the pain are rarely successful.
- Long-term use of strong painkillers such as opioids will almost always lead to tolerance and addiction. This means that you will need increasingly large doses to keep achieving the same pain relieving effect, and that you will get abstinence symptoms if you stop taking the drugs.
- Opioids carry a lot of unpleasant side effects, e.g. sedation, dizziness, nausea, vomiting, and constipation. Many of these often affect your daily life and your ability to work. While this usually doesn't matter when treating acute pain for 1 or 2 weeks only, it's not a healthy and realistic solution in the long run.
Unfortunately, there is still a lack of knowledge about chronic pain management, even among healthcare professionals. Studies have shown that a lot of doctors and nurses approach it the same way as acute pain - with painkillers. When that doesn't help, the patient is often told that there aren't any other options and that they just need to learn to live with it.
Not only does inadequate treatment cause unnecessary suffering, but it also increases the risk of mental illness, exacerbates the pain, and reduces the patient's life quality. What is more, it leads to countless emergency department visits and high rates of sick leave, which costs society a fortune.
Treatment goals
In a perfect world, the goal would be to find and treat the underlying issue and get rid of the pain completely. Unfortunately, that is rarely possible. When initiating treatment, it's important for the patient to understand this so that they can set sensible goals and have realistic expectations.
The main goal of chronic pain management is for the patient to be able to live a full and rewarding life despite the pain. In practice, this may include:
- Relieving the pain as much as possible with as few side effects and long-term consequences as possible
- Learning how to cope with the pain that you can't get rid of
- Improving your day-to-day function
- Increasing your life quality, e.g. by participating in meaningful activities, working, or having a good social life
Although it is A LOT easier said than done, it's important to find balance. On one hand, you should strive to live a meaningful life and try not to allow the pain to stop you from living it the way you want to. On the other hand, you also need to accept your limitations and make adjustments accordingly.