Thoughts On Pain

A few years ago there was a frank, open, and honest discussion about pain among patients, staff, family and community members that was quite enlightening.  Several important and interesting things were brought up that today’s “Opiate Abuse” culture could learn from:

  • Patients need to be included in discussions about their pain, and pain management plans.
  • People have differing pain tolerances – some can stand only a little pain while others feel they can handle a great deal of pain.
  • People have differing pain expectations.  They may not understand the full implications of what will happen and/or what options may be available to help them.
  • Clinicians sometimes expect that patients must be feeling pain (or shouldn’t be feeling pain) when that may not necessarily be the case.
  • Clinicians (i.e. physicians and nurses) should always discuss the following types of things with the patient:
    • How much pain can usually be expected in this type of situation?  How long could it last?
    • Perhaps some pain will have to be present, it is not always possible (or wise) to completely get rid of all the pain.
    • What is the patient’s expectation around pain relief?
    • Does the patient want pain medications?
    • Does the patient desire no pain medications?
    • Has the patient had reactions to pain, or other, medications?
    • What is the patient’s pain goal? (it may not always be zero)
    • What is the patient’s normal pain level? (esp. for chronic pain patients)

The important thing to remember is that every person is an individual.  The more open and frank the discussion between patients and clinicians is, the better the outcomes will be for all concerned.

There is no “one size fits all” solution to pain and pain management.  Person-centered care is the answer.  The more that society, government officials, the health care industry, and the media start working to that end, the better off individuals, their families, and the country will be.

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