The chronic pain management landscape is complex, with many moving pieces. Doctors and patients do their very best, but there are a lot of areas that could be improved. To get an idea of why finding the care you need can sometimes be so difficult, we’ll be delving into some of the challenges related to chronic pain care below.

Chronic pain care has a PR problem

Chronic pain is quite widespread in the US, and many of us either know someone dealing with it, or experience it ourselves. Yet patients aren’t always aware that pain specialists exist, and that new methods of pain management are constantly being tested and improved. The healthcare system could improve how it spreads information about pain treatment and could tell a better narrative about the possibility of getting professional care for chronic pain.

A pain specialist may not be very accessible 

Pain specialists do exist, but there are only about 7000 of them for 50+ million Americans suffering from chronic pain. To break it down, that’s one doctor for every 7,143 patients. Even if every specialist saw about twenty patients a day for a full year without vacations, they still wouldn’t be able to treat everyone! 

Why aren’t there more specialists? It might be helpful if students in medical school received more training in pain management. It might also help if pain management were a more widely understood and promoted specialty. Just as many patients aren’t aware that pain specialists exist, doctors in training are likewise not always aware that pain management is a career possibility.

Pain specialists tend to cluster in large cities, meaning that many Americans don’t live within a manageable distance from a pain specialist, and thus face extra challenges in receiving care. While telemedicine can help with this, it would also help if chronic pain management specialists were more evenly distributed or more readily accessible.

People suffering from chronic pain don’t always feel heard or supported

When they do find providers, patients with chronic pain often face the challenge of getting their providers to understand what they’re going through. Pain varies from person to person, meaning that it’s difficult to describe pain and to standardize chronic pain management. 

Appointment times can be short, which may not give patients and doctors enough time to discuss all pertinent symptoms and arrive at personalized solutions. Finding the right combination of approaches can take a long time and a lot of trial and error, which is often frustrating for both patients and providers. 

To complicate matters, chronic pain sufferers often feel pressure from themselves or others to minimize their pain levels, push through discomfort and “just deal with it.” Anxiety, depression and other mental health challenges can go along with chronic pain, making it more challenging to get to appointments, manage paperwork and follow treatment regimens. Mental and physical care isn’t always coordinated at the clinical level; record keeping and data handling isn’t always coordinated across medical systems, either.

There is also the complicated history behind treating pain

Some early cultures used extracts from willow bark, while others tried leeches, electric fish, and coca leaves. Most options for painkillers and anesthetics simply weren’t ideal, so pioneering doctors would use restraints and speedy operating techniques instead of trying to keep patients out of pain.

Opium, derived from poppies, was one of history’s go-to painkillers. Once synthetic, opium-like drugs called opioids were developed, the medical system believed it might finally have discovered a better answer to pain.

In the 1980s and 1990s, medical schools taught doctors to prescribe opioids so that patients no longer had to suffer so much. Since then, however, hundreds of thousands of Americans have died from narcotic-related overdoses, prompting the CDC to release updated recommendations for how opioids should be used to treat chronic pain in a clinical setting.

The trickle-down impact within the doctor’s office is a growing reluctance to prescribe opioids. Researchers are now developing alternate painkillers, and some pain specialists have shifted away from a solely biological view of pain management to a more holistic, all-encompassing view of how to treat pain for each patient (this is called the biopsychosocial model). 

Pain remains challenging to understand and control

Part of the reason pain has been so difficult to manage is that it doesn’t “cure” as easily as other conditions. It can intertwine with other health conditions in complex, complicated ways. Since the brain interprets pain signaling, part of how the body processes pain is psychological, which can complicate pain analysis and treatment. 

Doctors and other health care providers aren’t immune from psychological factors, either. Often they become so invested in their patients’ success, it becomes almost unbearable to “fall short” in offering their patients relief. In response, some care providers can become hardened, finding it easier to believe patients are misrepresenting their pain than to admit the medical system can’t always drive pain away. 

In summary, there are a lot of reasons pain management within the U.S. can feel so grueling and uncertain. It’s not just you, we promise. 

New ways to think about chronic pain 

Though it can be spotty, by no means is the treatment landscape hopeless. Pain specialists are finding success by taking customized approaches that combine exercise, topical creams, nutritional supplements, mental pain management techniques, and more. 

At Clearing, we follow this approach to stack the odds in your favor. We bring you the cutting-edge approaches science has found so far, and we determine what combination of pain management techniques and products might work best for your particular kind of pain. However badly it hurts, we want you to know that we’re not going anywhere.