What To Consider When Choosing Pain Care
Pain Care Part 2: Four Goals To Set When Considering Pain Treatment
For many injured workers, their pain from injury lasts for weeks or months. Some remain in pain for years, even decades. Here are four goals to keep in mind when considering pain care for these workers.
Goal One: Stop the hurting. Reduce the pain.
This is common sense, but the tools available to the doctors vary in usefulness and patient safety. Drug treatment is what most patients think of first. It brings its own risks of dependency, and over time through a process called hyperalgesia, pain killers can actually increase pain sensitivity. Experts warn about the use of opioids too early in a patient’s treatment regimen. A less powerful drug or drug-free option may be as effective, less risky, and less costly.
Opioids are the most prescribed for relief of chronic pain. Medications that fall within this class include hydrocodone (such as Vicodin), oxycodone (such as OxyContin and Percocet), morphine, fentanyl, and others.
Goal Two: “Do no harm” – Prevent complications. Reduce side effects.
Conservative treatments for pain are inherently safe, such as electro-stimulation, cognitive behavioral therapy, physical therapy and guided exercise. Not so with opioids, which are Schedule II drugs, meaning that they have valid medical uses but also high potential for psychological or physical dependence. In a state of dependence, the patient has a hard time weaning off of the medication even if the drug is not proving very useful. Then there is addiction: a constant, unrelenting need to seek the drug even when it is harmful. And the most serious side effects to consider for Schedule II drugs: they can lead to overdoses and death.
Surgery to remove pain also comes with risks. A worrisome share of surgeries lead to complications that can include an increase in prescribed pain killing drugs.
Goal Three: Economize
The best treatment for pain may also be the least expensive. Many of the most expensive workers’ compensation claims include one or more failed surgeries and unending prescriptions of opioids. The drug costs can be especially high because, when opioids are used additional drugs are often prescribed to address the side effects of the opioids. It’s both good medical care and good economics to encourage alternatives to surgery and drugs. There is less risk of complications.
Claims managers should get to know well the non-surgical and drug-free options available for their claimants. Perhaps with the help of a case manager, they can describe to their claimants and treating physicians these alternative approaches; which can ultimately result in fewer risks and lower costs.
Goal Four: Get back to living.
For chronic pain patients, the hope to regain an active life rests in part by learning how to cope with – not eliminate – their pain. The good news is that there is a wide-range of drug-free treatments available to help pave the path of reduced pain without incurring additional side effects.
When powerful painkillers came on the mass market some twenty years ago, few paid close attention to more than pain relief. Today, experts in pain treatment for injured workers now want to see real improvement in a patient’s physical and mental state. They say that an active life is desirable, possible and needed. They even say that an injured worker who reports pain relief but is not improving in functioning is in fact sliding backwards.
The goal is to achieve a state where the pain is manageable and range-of-motion and/or mobility is increased or restored. Drug-free treatment options such as electrotherapy as well as physical and behavioral therapy make this goal possible. Knowing that this state can become a reality with the right type of treatment leads to a more positive outlook and mindset; which is the basis for getting back to a more active and enjoyable lifestyle.