Thursday, February 25, 2016

How Necessary Is Pain Management?

Pain management may consist of a variety of specialties, including anesthesiology, neurology, psychiatry, and physical medicine and rehabilitation.  Recently, especially due to increases in the recreational use of opiates, many physicians are becoming more hesitant to prescribe narcotics.  However, chronic pain is a problem for an estimated 100 million Americans.  Clearly, there is a need for such treatment.  The question is how should this treatment be performed. 
Some of the best pain clinics probably include specialists from all the above mentioned disciplines.  In this way, a patient's pain treatment could be tailored to their individual situation.  For example, someone who had experienced psychological trauma might benefit more from the psychiatrist, whereas someone who has back pain after surgery would need intervention from an anesthesiologist.  Eventually, the physician would have to cut back the medication to prevent addiction.  According to the article, one physician says he "uses a multidisciplinary approach that could include surgery, yoga therapy and Pilates," which works 90% of the time to wean patients off of their medication. 
Unfortunately, chronic pain is rarely entirely relieved, and so patients should not expect perfect results from their treatment.  It is also important to note that consultations, which may be greatly beneficial, are not always covered by insurance.  This is especially difficult for neurologists, who can spend hours at a time talking to individual patients.  Insurers might see better results and ultimately save money if they reimburse for more holistic approaches to pain relief instead of merely procedural interventions.  
Is it possible to convince insurers to do this, however?  What happens to patients who become addicted?  Will they seek narcotics from other sources if pain management physicians drop them?  And are other specialists successful in weaning patients off their medication if the problem is truly chronic?  Feel free to comment!


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