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Pain or discomfort in the lower portion of our back and the spinal column is a common phenomenon and can be largely attributed to our changing lifestyles. Wrong posture or inadequate exercise is most often the cause of the pain in the lower spinal column. The treatment of such a pain can vary from a simple over the counter medicine to surgery depending on the severity and the cause. The pain is generally felt in the lumbar and the sacral region and can also affect other areas. A sprain in the muscles or the ligaments constituting the lower portion of the spine can be the most common cause of backache. Some of the other problems that involve pain in the lower back are disc degeneration due...
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Chronic Pain: Barriers to Effective Pain Management

Author:
Nicholas Messina M.D.

Chronic pain affects the physical, mental, emotional, and spiritual aspects of a patient's life. Daily non-cancer pain in the elderly has been associated with impaired activities of daily living, change in mood, and decreased involvement in social activities. Chronic pain impairs function, can lead to depression, and can even result in suicidal behavior. Chronic pain due to arthritis affects approximately 20 million Americans. This represents almost 50% of all pain sufferers.

What are the barriers to effective pain management?

Barriers to effective pain management are imposed by the health care system, physicians, and by patients themselves.

Patient Barriers:

-Reluctance to report pain to physicians.

-Reluctance to take pain medication

-Lack of education regarding available pain therapies.

-Compromised cognitive function secondary to certain pain medications.

Physician Barriers :

-Inadequate training and knowledge concerning pain management.

-Improper assessment of pain.

-Concern about scrutiny from regulatory agencies.

-Fear of patient addiction.

-Concern regarding analgesic side effects.

-Concern regarding the development of tolerance to analgesics.

Health Care System Barriers :

-Pain management is given a low priority in the system.

-Treatment availability problems exist in the system.

-Treatment access problems exist in the system.

-Inadequate reimbursement for pain management remains a problem.

-The most appropriate treatment may not be reimbursed or it may be too costly for the patient.

Many arthritis sufferers continue to take anti-inflammatory medications that no longer control their symptoms. Physicians, fearful of regulatory investigation, avoid appropriate treatment while switching patients from on ineffective medication to another. Some patients are forced to consider joint replacements prematurely, due to unrelenting, under-treated pain.

The net result of these barriers is that countless patients are forced to endure life instead of enjoy it. The squeaky wheel gets the oil. If your doctor is unable or unwilling to manage your pain insist on a referral to a pain specialist.

Dr. Messina became a Board Certified Family Practitioner in 1985. He was in solo practice until 1994.He then helped form a group Family Practice in which he served as Vice President.He left group practice in 1997 and became the Medical Director of a Wellness Center. He was responsible for coordinating the efforts of nutritionists, acupuncturists, massage therapists, exercise physiologists, and Chinese medicine practitioners into integrated medical care plans that were individualized to the patient.He became the Medical Director of an independent clinical research facility in 2000. He has been the Principal Investigator in over 50 clinical trials involving osteoarthritis, diabetes, hypertension, hypercholesterolemia, chronic pain, depression, anxiety, dry eye, migraine, and diabetes prevention.He has served as consultant to a nutritional company, and has formulated nutritional supplements.

Visit Dr. Messina's website at:

http://Physicianformulated.com/

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If you like the article above, you may be interested in the following article which is also related to Pain Relief...

Muscle Pain Relief: An Overview
After an auto mechanic spends hours under a car or a writer spends all day in front of a computer, their muscles later complain at this overextension. Everyone gets a muscle ache once in a while, but chronic muscle pain can be a debilitating condition that deteriorates the quality of life of sufferers. Muscle pain may be the result of a specific injury, a spasm, or a condition that affects ligaments and connective joint tissue, or it may be only one symptom of a broader condition, usually arthritis. It ranges in intensity, from infrequent aches to chronic, disabling pain. Many therapies promise muscle pain relief, and choosing between them depends on the cause of the pain, it’s severity and duration, as well as the preference of the patient. Over-the-counter and prescription medications, including acetaminophen (Tylenol) and non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, help alleviate muscle pain. Certain nutritional supplements may also provide muscle pain relief. Emu oil, for example, which is sometimes used to treat arthritis symptoms, may reduce muscle stiffness and tension. Advocates of massage therapy claim that it can soothe aching muscles by releasing tension and allowing muscles to relax. The ancient tradition of acupuncture employs needles to achieve the same ends. Chiropractic may help ease muscle pain by correcting improper vertebral alignment that puts added pressure on back, leg, and neck muscles. At-home treatments such as ice packs relieve muscle aches, as do physical aides such as back braces or wrist wraps, which reduce muscle strain by helping to hold joints and bones in their proper positions. Specific exercises designed to increase muscle strength and flexibility may be prescribed by a doctor or...
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