On Wednesday, September 29, the U.S. Pain Foundation held a webinar that addressed some of the major concerns facing pain care and management in the U.S. today.
A culmination of our Pain Awareness Month initiative, #PainCounts, the webinar focused on issues like disparities in health care, the toll of chronic pain on a person, the benefits of multidisciplinary care, and what needs to be done to help people with chronic pain receive the care they need.
Moderated by U.S. Pain Foundation CEO Nicole Hemmenway, the panel featured Carmen Renee Green, MD, dean of the CUNY School of Medicine (CSOM) at The City College of New York, Amy Goldstein, MSW, the director of the grant-funded initiative Alliance to Advance Comprehensive Integrative Pain Management, and Gwenn Herman, LCSW, DCSW, founder and Clinical Director of U.S. Pain’s Pain Connection.
A lack of resources
A large question that surrounds pain care in the U.S. is, on its face, a simple one—is the country doing enough to provide people with chronic pain the support they need? For the panelists, the answer was also a simple one.
“There’s not enough being done,” Dr. Green said. “You know, there are millions of people who live with chronic acute, chronic, or cancer-related pain. There are people who suffer who have challenges getting employment and access to high-quality care.”
This is especially true when it comes to the most beneficial treatment approach—multidisciplinary care.
“People with pain are not getting access to the care that they need and want in a comprehensive, multidisciplinary way,” Goldstein said. She explained that one of the more pressing challenges with providing this care is just getting the various providers on the same page.
“You may be working with your primary care physician, nurse, physical therapist, and psychologist or social worker, who are all connecting with you, but they’re not usually connecting with each other about you,” Goldstein said. “The onus may likely be on the person with pain to sort of put it all together, as opposed to somebody kind of helping connect and coordinate that care.”
The importance of multidisciplinary care is well known in the chronic pain community, but it can be difficult to get the health care system on board.
“A lot of what we talk about in our support groups is the importance of having a treatment plan that includes every aspect, Herman said. “Including acupuncture, reiki, massage, everything, cold heat, therapies, medications, and medical cannabis. It’s so important that we implement everything and that there’s a rare doctor that really knows how to work in that multidisciplinary system. So educating doctors and young ones coming up is of major importance.”
Health care, disparities, and chronic pain
The panel also tackled what needs to happen for real improvement in pain care to be commonplace.
“I would say that most of our pain researchers were probably at least a few decades behind in the research that should be done,” Dr. Green said. “So we still need to ask the NIH and our professional organizations and foundations to actually fund worthwhile research.”
Herman stressed that obtaining the research is just the beginning of the work, however.
“Once the research is there, we need the treatment and we need the money to implement all these treatment programs,” Herman explained. “And then getting insurance to pay for the treatment that we chronic pain patients need.”
Dr. Green also touched on the critical need for more population data and confronting bias in the health care profession.
“We’ve criminalized certain problems, whether it be pain, whether it be the use of opioids. People have suffered because of that,” Dr. Green said. “Whose story do we hear? A woman comes in with several children or even one child, and we may dismiss her. Or someone with a little dirt underneath their nails as opposed to someone who comes in with a tie. How do we look at the person who has privilege—the person who has the better job, the person who has more literacy, the person who can speak the language. All those things come into play when we think about disparities.”
Earlier in the discussion, Hemmenway stressed the importance in remembering that there are millions of real people—not just statistics—living with chronic pain whose voices far too often go unheard.
“We need to be looking at the obstacles that individuals are facing and that their stories count,” she said. “All of the stuff that we are going through is important. What can we do to help hopefully improve pain management in the future?”