Can Internal Medicine Help Manage Chronic Pain?
Chronic pain is an American epidemic. As a society, we’re grappling with meaningful ways to help patients find relief while remaining mindful of the devastating effects of opioid abuse. One thing we’re learning on our journey as a country and community is the vital role primary care and internal medicine doctors play in supporting patients with chronic pain. Our primary care physician is often the person we trust most and whose advice we’re most ready to follow.
What Is Chronic Pain?
According to the Centers for Disease Control, around 20 percent of US adults experience chronic pain. That’s more than 50 million people nationwide. We define chronic pain as lasting three months or more. In addition, around
seven percent of adults live with “high impact” pain that severely impacts daily activities. As patients and loved ones understand, chronic pain can be debilitating and prevent people from doing things they value, including work, family and beyond. We also appreciate chronic pain’s negative impact on society, including lost productivity and rising healthcare costs. Patients in all locations and circumstances need appropriate and accessible pain management. This often means relying on a trusted primary care doctor as a partner in finding solutions.
Chronic Pain: How Can Primary Care Doctors Help?
Every day, internal medicine physicians hit the ground running to improve our patients’ lives. We’re the people who know our patients best: their medical histories, their challenges and concerns, and their victories and successes. The American Academy of Family Physicians is one organization that has explored primary care doctors’ essential role in chronic pain management. As AAFP notes, we’re often called on to treat pain associated with other conditions, including cancer, migraine or tension headaches, diabetes with neuropathy, arthritis, fibromyalgia, neuralgias, neck and back disorders, facial pain disorders, bowel disorders and pelvic disorders. We also know that chronic pain is more likely to affect patients with poor general health,
disabilities and lower incomes and those who live outside of urban centers. As AAFP points out, primary care doctors should be comfortable managing routine chronic pain and identify when the patient needs a referral to a specialist. We must also watch for abuse or misuse of medications. We carefully consider which medications to choose, including non-opioids like tramadol for mild and moderate pain or opioids for severe pain, with a precise medical diagnosis and controlled distribution.
Many patients are most comfortable working with their primary care doctor. As we develop pain management plans, we consider numerous factors. We identify conditions we can treat with physical therapy or surgery, including joint pain. We assess and treat existing disabilities and underlying conditions, including diabetes, COPD and other chronic illnesses. We understand the importance of identifying obstacles when patients are not following treatment plans. Chronic pain is often associated with mental health conditions and/or substance abuse. Addressing underlying mental health challenges with medications and referrals for therapy is part of our role. Finally, we recognize that referral to a pain management specialist may be needed, especially in cases of medication misuse or when a treatment plan is not helping patients successfully navigate daily life.
Chronic Pain Management at Revive Health
We do treat chronic pain for a carefully selected patient panel, patients will need to sign a contract with practice and abide by appointments and random drug testing.