Chronic pain is a widespread health problem with a global prevalence of around 37.3 percent and 41.1 percent in developed and developing countries respectively. By definition, chronic pain is that persists for more than three months since its onset. One of the major problems with the treatment and management of chronic pain is its complex etiology, which makes it highly resistant to the known treatment options. This condition leads to long-term health problems, especially morbidity associated with physical disabilities and mental health issues. Therefore, it is important to investigate the available treatment options and their efficacy. This paper is an extended literature review of three peer-reviewed journal articles on chronic pain, its treatment strategies, and the effectiveness of those intervention measures.
One of the widely preferred treatment options for chronic pain is the use of opioids. According to Grosen et al. (2017), pharmacological interventions are commonly used in different set-ups for the management of chronic pain. However, the efficacy of opioids in the treatment of this health condition is debatable. Grosen et al. (2017) conducted a study to assess some of the predictors that could be used to determine the efficacy of opioids in the management of chronic pain, especially given that these drugs are commonly abused leading to overdosing and addiction. The objective of Grosen et al.’s (2017) study was to “determine whether characteristics of altered pain processing in opioid-naïve patients could be used to predict clinically relevant treatment responses to opioids” (p. 1). The results of this study showed that opioids are not effective chronic pain management options among all people. Therefore, the prescription of these drugs should be personalized and restricted to persons with a high likelihood of a positive response. However, this study was mainly observational and it lacked specificity in its results because the recruited participants had various forms of chronic pain. Therefore, further research is needed to assess the analgesic effects of opioids among people with chronic pain.
In another study, Wilson (2017) conducted a systematic literature review to examine the effectiveness of managing chronic pain using different pain management programs (PMPs), which mostly use cognitive behavioral therapy (CBT)-based multidisciplinary approaches. While the available data shows that PMPs play a significant role in the management of chronic pain, the heterogeneity among the various approaches and measured outcomes makes it hard to determine the effectiveness of such interventions. This study found that combining different approaches in the management of chronic pain yields positive results. Wilson (2017) notes, “The benefits gained from a PMP tend to be maintained at follow-up, although a degree of falling-off occurs over time” (p. 59). Additionally, the available literature shows that physiological treatments are highly effective among children and adolescents (Wilson, 2017). Therefore, given the complex etiology associated with chronic pain, the multidisciplinary approach provided through PMPs is one of the most effective ways of dealing with this problem because patients receive individualized care based on the unique characteristics of their pain. However, this study is a review and it does not add new information to the current debate about the efficacy of PMPs in the management of chronic pain.
Another study by Joypaul et all. (2019) sought to assess the impact of patient education and its role as part of multidisciplinary interventions. Education plays a central role in the management of chronic pain as it creates awareness for patients to understand the underlying causes, predisposing factors, and the various available intervention measures, and this knowledge promotes self-care. According to Joypaul et al. (2019) education alone can “have a limited impact on chronic pain, yet when combined with MD programs, there seem to be additional benefits for chronic pain management, such as increased patient confidence and self-efficacy” (p. 2). The results of this study showed that the available data supports the claim that education, when used with other multidisciplinary approaches, is an effective way of managing chronic pain. When patients are involved in their care, the care outcomes are likely to be improved, especially where outpatient care is involved. However, the majority of studies covered in this review depended on self-reported data from patients, which is subject to bias. Therefore, further research on this area, especially using randomized controlled trials, is needed to further understand the role of education as part of a multidisciplinary approach to chronic pain management.
Chronic pain affects millions of people globally and this problem is compounded by the lack of comprehensive treatment options due to the complex etiology of this health problem. The literature reviewed in this paper shows that while opioids could be effective in treating chronic pain, their efficacy differs from one person to another because some individuals lack the biomarkers needed to respond to these drugs. Another study showed that PMPs are highly effective when managing chronic pain as patients get individualized care based on the nature of their pain. Education also plays an important role in the management of chronic pain as patients become part of the care process and promote self-care. However, further studies are needed to address the various limitations discussed in this paper.
References
Grosen, K., Olesen, A. E., Gram, M., Jonsson, T., Kamp-Jensen, M., Andresen, T., Nielsen, C., Pozlep, G., Pfeiffer-Jensen, M., Morlion, B., & Drewes, A. M. (2017). Predictors of opioid efficacy in patients with chronic pain: A prospective multicenter observational cohort study. PloS one, 14(10), 1-13.
Joypaul, S., Kelly, F., McMillan, S. S., & King, M. A. (2019). Multi-disciplinary interventions for chronic pain involving education: A systematic review. PloS one, 14(10), 1-24.
Wilson I. R. (2017). Management of chronic pain through pain managemenprogramses. British Medical Bulletin, 124(1), 55-64.