Afraid to Travel? The Analysis of Chronic Pain's Treatment Failure as a Probable Cause.
In pain, excruciating pain. Pills, patches & potions are not working. Feeling very upset, guilty and useless that we've had to return early from our holidays as my back & legs did not function too well. Feeling "what's the point"? I feel so guilty all the time for what I'm doing to my family and the burden I've become (Excerpt from social media, edited)
Introduction
One of the most common hindrances to travel for chronic pain warriors is pain treatment failure. Chronic pain can be challenging to treat, as it often does not respond well to conventional therapies such as medications, surgery, or physical therapy. Many people with chronic pain experience treatment failure, meaning their pain persists or worsens despite receiving adequate treatment. Treatment failure can have negative consequences for the patient and the healthcare system, such as increased costs, reduced adherence, and decreased satisfaction.
In this article, you'll:
Understand why chronic pain treatments fail.
Uncover the promoters of chronic pain treatment failure.
Receive tips and strategies to overcome chronic pain treatment failure.
Read for insights on chronic pain treatment/management failure.
What is treatment failure?
Treatment failure is simply a situation where a medical intervention does not achieve the desired or expected result. Various causes, such as incorrect diagnosis, drug resistance, poor adherence, adverse effects, or insufficient dosage, can lead to treatment failure for any medical condition.
For chronic pain, treatment failure refers to the inability of pain treatments or pain management strategies to achieve adequate pain relief and functional improvement.
Why is understanding chronic pain treatment failure critical?
Treatment failure of chronic pain can have many negative consequences for you and society. Some of the common consequences include:
Physical impairment:
Your ability to perform usual physical activities, such as work, household chores, hobbies, or exercise, will be affected. The physical effects of chronic pain quickly lead to deconditioning, muscle weakness, reduced mobility, and increased risk of falls and injuries.
Psychological distress:
Treatment failure of chronic pain adversely affects your mental and emotional health with problems such as depression, anxiety, anger, frustration, guilt, or low self-esteem. Your mood, personal motivations, and social relationships will also be affected.
Intellectual impairment:
Your attention, memory, concentration, and decision-making abilities are affected by unrelenting chronic pain, resulting in the slowed performance of mental tasks and learning difficulties.
Sleep disturbance:
Ongoing pain will interfere with your quantity and quality of sleep. You then become continually tired and irritable. Lack of sleep also impairs your immune function and increases sensitivity to pain.
Economic consequences:
Your healthcare costs will increase, coupled with reduced productivity, absenteeism (or even presenteeism), disability, and unemployment or underemployment. Chronic pain is financially constraining, which in turn affects your overall well-being.
*Allostatic load is the sum total of life events contributing to chronic stress.
Why do pain treatments fail?
Inadequate assessment and diagnosis:
Chronic pain requires a thorough evaluation of its causes, mechanisms, and impact. A correct diagnosis will guide the choice of appropriate treatments. However, many healthcare providers lack the time, skills, or resources to perform a comprehensive assessment of chronic pain patients, leading to many chronic pain sufferers receiving treatments that do not address their specific needs.
Inappropriate treatments:
Some treatments may not be effective for certain types of pain or patients. For example, conventional pain relievers are ineffective for nerve pain (neuropathic pain), and surgeries and nerve blocks do not address widespread chronic pain.
Lack of biopsychosocial, multidisciplinary approach to pain management:
The occurrence and the magnitude of chronic pain are influenced by biological, psychological, social, and environmental factors. These should ideally be addressed in a comprehensive pain management plan, often involving several healthcare professionals and disciplines (coordinated multidisciplinary teams).
Access to multidisciplinary pain management clinics can be difficult due to limited availability, affordability, or referral system requirements. The appointment waiting times can be lengthy. In the meantime, self-paced pain management programs can complement single-provider or uncoordinated care.
Poor patient-provider communication and collaboration:
Effective chronic pain management requires a collaborative relationship between the patient and the healthcare provider. You should be involved in decision-making and share responsibility for the treatment plan. Your pain management doctor should educate you about chronic pain and its management and provide support and guidance throughout the treatment course.
With the shortened doctor-patient consultation times, this process is often incomplete, leaving you incompletely evaluated, unheard, and dissatisfied. These incomplete interactions increase the risk of the right treatments not being prescribed. Again, self-paced programs can plug this gap and empower you to make correct, informed treatment decisions.
Does a lack of empathy, trust, respect, or understanding affect your interactions with healthcare providers, including pain management doctors?
Lack of patient education and self-management skills:
Chronic pain management requires professional interventions, patient education, and self-management skills working in tandem. Patient education helps increase your knowledge and awareness of chronic pain and its treatment or management options.
Self-management skills can help you overcome chronic pain and its consequences in daily living, especially between your pain clinic and other healthcare appointments. Some self-management skills are taught by psychologists, including relaxation techniques and cognitive-behavioral therapy (CBT).
What are the promoters of chronic pain treatment failure?
Lack of awareness:
Many chronic pain sufferers and healthcare providers lack in-depth knowledge of the available treatment options and resources.
Lack of recognition:
Healthcare providers may not recognize or validate the pain experiences of people living with chronic pain conditions, often dismissing their pain as normal aging, hormonal changes, or psychological issues. This is true for most chronic pain conditions and syndromes like fibromyalgia, trigeminal neuralgia, chronic low back pain with or without sciatica, complex regional pain syndrome (CRPS), and chronic post-surgical pain.
Lack of access:
Many people affected by chronic pain may not have access to adequate and affordable healthcare services for their pain condition. They may face challenges such as long waiting times, limited availability of pain specialists or multidisciplinary teams, high costs, or lack of insurance coverage.
Lack of empowerment:
Many people living with chronic pain conditions may not feel empowered to advocate for their pain treatment needs and preferences.
Prevention and management of treatment failure
The prevention and management of treatment failure of chronic pain require a multi-pronged approach that involves:
A comprehensive assessment:
Your healthcare providers should conduct a thorough medical history and extensive physical examination, request rational diagnostic tests and imaging, and do an extensive psychological evaluation. This intense and complete medical evaluation aims to characterize the pain, its severity, and its adverse effects, identify the cause and contributing factors, plan treatments, and management approaches, and identify any coexisting conditions or factors that may affect the treatment outcomes.
A personalized treatment plan:
You and your healthcare provider should work together to develop a treatment plan that suits your pain condition, preferences, and goals. The treatment plan should include a combination of pharmacological and non-pharmacological interventions targeting chronic pain aspects, such as inflammation, nerve transmission, mood, cognition, behavior, and coping skills.
A regular follow-up:
Your response to treatment should be monitored regularly using objective and subjective measures, such as pain intensity, function, quality of life, satisfaction, and adherence. Your care provider should adjust your treatment plan accordingly based on the feedback and progress.
Good communication:
You and your healthcare providers should communicate openly and honestly about the expectations and goals of treatment and any concerns or difficulties that may arise during the treatment process. Your healthcare team should educate you on the nature and management of chronic pain and the benefits and risks of different treatments. The healthcare provider should listen empathetically and respectfully to your perspective and experience.
A supportive network:
You should have access to adequate resources and support from family, friends, or professionals who can provide emotional, practical, or informational assistance. Participate in self-management programs or support groups to enhance your knowledge, skills, and confidence in coping with chronic pain.
Conclusion
Prevention and management of chronic pain treatment failure necessitates a holistic and collaborative approach, placing you at the center of decision-making. Recognizing that each individual's pain experience is unique, a comprehensive strategy should include efforts to understand aspects of your chronic pain condition and the contributors to treatment failure. Management of chronic pain treatment failure begins with reevaluating your existing treatment plans. The subsequent steps will explore alternative therapies, focusing on tailoring interventions to address the specific issues. As a proactive participant in your care, your input becomes invaluable in shaping a path forward.
With your participation central, the collaborative pain management strategies aim to manage chronic pain's complexities and empower you with choices that align with your needs, wants, preferences, and motivations. The empowerment gives you victory over chronic pain and its adverse effects to live a fulfilling, fully functional life that includes enjoyment of leisure.
