What are the barriers to pain management?

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Pain is a significant public health problem in the United States. While the understanding that pain is an important biological signal has always been appreciated by health care professionals, management of pain has now come under significant scrutiny following its recognition as the fifth vital sign. Since the measurement of pain is not objective, the answers to questions regarding how to best manage the problem are not always self-evident. Current measures to resolve this may be ineffective and fraught with side effects and complications.

Multiple modalities, including interventional procedures (spinal cord stimulators, spinal injections, peripheral nerve stimulators, TENS unit) and noninvasive techniques (massage therapy, acupuncture), are available for the treatment of pain. These modalities are invasive, with additional barriers of access. (e.g. getting an appointment with a masseuse, driving to the appointment, etc. or depending on a partner to hold a handheld device for you). 

The one therapy that has been around for over 200 years – that has broken the barriers of access,  is pharmacotherapy.  Pain medications are readily available and often effective. However, their Achilles heel is their many side effects and complications. Kidney, heart, liver, and stomach problems, as well as the crisis of this century, the opioid epidemic, is attributable to the habit-forming side effects of narcotic pain medications.

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