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Pain Relief and Behavioral Medicine
Pain care in an era of opioid restrictions
Posted June 23, 2014
Greetings and a warm welcome to you.
This post, first published in 2014, was edited in January 2020.
Sound Bites on Empowered Relief
- 100 Million Americans live with ongoing pain of some type – you are not alone. (National Pain Strategy 2016)
- Pain is influenced by many factors, including your thoughts, emotions, attention, sleep, medical conditions, stress, race, and gender, just to name a few (Bushnell, Ceko, Low 2013). Behavioral medicine focuses on those factors over which you have some control. Improving those factors helps reduce the impacts of pain in your life. (Darnall, Scheman, Davins et al 2016)
- Behavioral medicine empowers you to better self-manage distress, pain, and other symptoms by actively engaging in evidence-based skills and practices. (Darnall; Nature 2018)
- There is an ethical imperative to treat pain comprehensively -- meaning addressing the individual factors that influence pain. (Darnall, Carr, Schatman 2016)
- Things you do everyday can influence your pain. Behavioral medicine keeps you focused on the things that will help your pain, and help you live better and do more within the context of medical conditions.
- Historically, opioids were over-prescribed for chronic pain, and other treatment modality were emphasized less. Now, with opioid restrictions in effect throughout the US, there is great interest in other pain treatment modalities, such as behavioral medicine. That said, it's important to remember that some people need opioid medications for pain management and their access should be protected. I advocate strongly on this topic. (Darnall, Juurlink, Kerns et al 2018)
- There is no 'one-size-fits-all' treatment for pain. Pain is an individual experience, and so is one's treatment response. (Darnall BD, The Hill, 2018; Darnall BD, Pain Medicine, 2019).
- Behavioral medicine should be integrated into a 'whole person' pain care plan, regardless of what other treatments a person is receiving.
This column is about bringing you information to help you gain empowered relief.
With warm regards,
Beth
References
1. National Institutes of Health Interagency Pain Research Coordinating Committee. National Pain Strategy 2016. http://iprcc.nih.gov/National_Pain_Strategy/NPS_Main.htm
2. Bushnell, Ceko, Low. Cognitive and emotional control of pain and its disruption in chronic pain. 2013. Nat Rev Neurosci; 14(7): 502-11.
3. Darnall BD, Scheman J, Davins S, Burns JW, Murphy JL, Wilson AC, Kerns R, Mackey SC. Pain Psychology: A global needs assessment and national call to action. Pain Medicine. 2016; 17(2): 250-263. http://www.ncbi.nlm.nih.gov/pubmed/26803844 (open access)
4. Darnall B. To treat pain, study people in all their complexity. Nature 2018 May; 557 (7703):7. PMID: 29717254. (open access)
5. Darnall BD, Carr DB, Schatman ME. Pain Psychology and the Biopsychosocial Model of Pain Treatment: Ethical Imperatives and Social Responsibility. Pain Medicine. July 2016. PMID: 27425187. http://dx.doi.org/10.1093/pm/pnw166
6. Darnall BD, Juurlink D, Kerns R, et al. International Stakeholder Community of Pain Experts, Leaders, Clinicians, and Patient Advocates Call for an Urgent Action on Forced Opioid Tapering. Pain Medicine, Volume 20, Issue 3, 1 March 2019, Pages 429–433. https://doi.org/10.1093/pm/pny228 (open access)
7. Darnall BD. Addressing the Dual Crises of Pain and Opioids: A Case for Patient-Centeredness in Research and Treatment. The Hill. October 31, 2018. https://thehill.com/opinion/healthcare/414140-addressing-the-dual-crise… (open access)
8. Darnall BD. The National Imperative to Align Practice and Policy with the Actual CDC Opioid Guideline. Pain Med. 2019 July 23. https://doi.org/10.1093/pm/pnz152 (open access)
