This month, we're discussing chronic pain and highlighting a recent guideline put out by the Department of Veterans Affairs and the Department of Defense outlining its appropriate management and treatment. Chronic pain is one of the most common medical conditions. In the U.S. alone, approximately 100 million adults experience chronic pain and, as a healthcare professional, you encounter individuals suffering from chronic pain at every level of your practice.
The VA/DOD has proven to be a tremendous resource over the years, publishing research and various guidelines covering topics that deeply effect veterans and the professionals who work with veterans - this guideline is no different. The VA/DoD Clinical Practice Guideline for Opioid Therapy for Chronic Pain presents information for veterans to be educated about opioids, their risks, and the fact that treatment for chronic pain can be limited. With the opioid epidemic reaching epic proportions, proper management of pain is necessary.
Chronic pain is defined as pain that persists after the body has healed most tissue damage - usually three months or longer. Chronic pain can be caused by many different conditions such as arthritis or diabetes. It may be worsened by some lifestyle factors such as inactivity, stress, nicotine dependence, poor sleep, unhealthy eating, or substance use.
Studies report nearly 45 percent of soldiers and 50 percent of veterans experience pain on a regular basis. There is significant overlap among chronic pain, post-traumatic stress disorder (PTSD), and persistent post-concussive symptoms. Data from the National Health Interview Survey shows that American veterans experience a higher prevalence of pain and more severe pain than nonveterans. Although opioids play an important role in the management of acute pain, studies have shown their place in treatment of chronic pain can be limited and long-term use can bring many side effects.
Veterans are presented with possible goals for chronic pain treatment such as restoring physical and emotional function, improving overall quality of life, and the ability to manage pain and return to a healthy lifestyle. Proper pain management can also correct issues associated with pain such as muscle weakness, poor sleep, and diet.
In the guideline, options for treating chronic pain are presented such as self-management, non-drug treatments, CAM alternatives, and non-opioid treatments.
Veterans are given a list of questions to ask their healthcare providers including what treatment options could be beneficial, as well as an explanation of what opioids are and the risks and benefits of opioids with special attention to the definition of addiction and abuse.
The VA/DOD guideline encourages veterans to educate themselves in alternative pain treatments and to become active in their pain management plan in partnership with their healthcare provider. Seen as a tool, the guideline is a great place to begin a discussion about chronic pain and the management of that pain, along with suggestions of reasonable goals for pain control.
If you're interested in learning more about this subject, here is a link to the full guideline (about 6 pages) that you can review:We strongly encourage everyone to take a look at the guideline. It provides an excellent framework for professionals and patients alike to learn more about the treatment of chronic pain. This is a great platform from which to start the conversation regarding proper pain management.