Chronic pain treatment has become a $635 billion a year "biz" in the US. More is spent per year on low back pain, neck pain, spinal disorders, headaches, arthritic and musculoskeletal pain and other pain conditions than on heart disease ($309 billion), cancer ($243 billion), and diabetes ($188 billion)! No one would complain about the cost if patients were getting better. But the sad fact is the $635 billion spent every year is being misspent because, despite a flood of narcotics, failure-prone surgeries and new, expensive procedures, pain patients are not getting better. They are getting worse and often becoming lifelong patients. Pain conditions now represent $11.6 to $12.7 billion a year in the US in lost work day s, with many workers not returning to their jobs at all, How do we get to this state of affairs?
The problem is the maze of government and insurance red tape and clueless decision-makers which I call the "Healthocracy." It over-screens and over-treats pain conditions, benefiting the medical device, pharmaceutical and insurance industries a lot more than patients. By focusing on short-term treatments at the expense of long-term solutions, the Healthocracy creates a wide swathe of permanent patients that is growing every day. In fact, despite the a 300 percent increase in the Healthocracy of narcotics, surgeries, devices and epidural and facet injections, the number of Americans suffering from chronic pain has risen from 50 million in 1990 to 100 million today. Yes, we are getting worse.
There are many things physicians do not understand about pain. Despite medical advances, they can't say why one person is disabled by pain that another barely notices or why debilitating pain persists without clear physiological cause.
But what physicians do know is that pain is a body/mind phenomenon that requires that the whole person be treated--not just the symptoms. They do know that when patients are given both physical and psychological therapy and take an active part in their own care, their pain resolves.
Most of the chronic pain treatments the Healthocracy promotes today are passive like surgeries, injections, devices, other interventions, passive physical therapy and pills. The patient's job is to do nothing, and take directions and somehow heal.
Before the mind/body aspects of pain were understood, physicians treated pain as a purely biological phenomenon and "covered up" symptoms with surgery and pain medications. Thanks to the profit-driven treatments of today's Heathocracy and its short-term orientation, the pendulum has swung back to "narcotics 'n surgery." Patients are again treated as symptom bearers instead of people. Patients are actually told by the Healthocracy that they couldn't be in pain because the procedure "worked"as if they are not the ultimate authority on their own pain. This kind of body-only treatment of pain didn't work before and it doesn't work now!
Yet there is a model that is more effective for pain. In the 1960s and 1970s, multidisciplinary pain programs developed in most hospitals and medical settings that addressed pain with a physical therapist, health psychologist, occupational therapist, nurse, social worker, vocational therapist, a recreational specialist and posturenot just surgery and narcotics. The results were more positive and lasting but of course the Healthocracy made less money.
As many know, chronic pain is more than just pain that lasts longer than six monthsit is a condition that mercilessly chips away at your physical and psychological wellbeing. It affects your body, mind, emotions, finances, vocation, family, friends, lifestyle and eventually your spiritual condition itself. It can lead to suicide. Yet, in our Healthocracy, seeking relief is disheartening. The good news is multidisciplinary pain programs (sometimes call interdisciplinary) are still available in the USand well worth seeking out.
(Article changed on January 6, 2019 at 14:46)