The numbers are staggering. One hundred and sixteen million Americans experience pain that can last from weeks to years. Costs of treatment and lost wages total between $560 and $635 billion each year. Yet treatment does not always relieve a patient's suffering.
In a Perspective published today in the New England Journal of Medicine, researchers outline how significant the problem of pain is in the U.S. and suggest approaches for more effective therapy. The piece recaps last year's Institute of Medicine Report, Relieving Pain in America.
The writers say that undertreated acute and chronic pain is a "significant overlooked problem." Dr. Phil Pizzo, Dean of Stanford's Medical School, is co-author of today's Perspective and led the IOM committee that reviewed the issue last year. In an interview, he described that both patients and doctors have differing approaches to pain and how to manage it. Some patients feel they need to tough it out. Others need someone to listen and work with them. Doctors may be either caring or judgmental about a patient's pain.
Pizzo argues for a "cultural transformation, the need for us to enter in a caring dialogue with an open mind and receptivity and willingness to listen to the individual, spend time understanding and engaging in everything from self-help to directed help."
A key component of the cultural transformation is education, he says. It's startling, but medical schools don't actually teach their students much about treating pain. Today's Perspective reports that half of all primary care doctors feel only "somewhat prepared" to help their patients with pain and about one-fourth of doctors feel "somewhat" or "very unprepared."