Even though pain is the #1 reason Americans seek medical care—with chronic pain affecting one in four U.S. adults—most health care providers receive fewer than 10 hours of formal education on how to treat it. Imagine entering your career tasked with healing—yet never being taught to address your patients’ most common and debilitating complaint.

That’s the dangerous paradox at the heart of American medical education.

A new report from the U.S. Pain Foundation, based on survey responses from 176 health care providers, exposes a hard truth: The system is setting clinicians up to fail—and patients are paying the price. 

While 92% of providers said they were interested in more training in pain management, just 17% had received extensive instruction in trauma-informed or culturally responsive approaches—critical skills for managing complex, chronic conditions.

Perhaps most alarming, half of all respondents admitted they feel underprepared to treat chronic pain at all.

The American medical system is not just failing patients. It’s also failing the professionals who are desperately trying to make it better. 

A System Built to Miss the Mark

Chronic pain is one of the most pervasive, complex, and costly health issues in America. And yet, it’s routinely overlooked in clinical training, medical licensure, and continuing education. The result? A nation of providers who struggle to meet the needs of real people with real pain.

Over 65% of providers said managing patient expectations around pain relief is a major hurdle. Another 61% pointed to the emotional and psychological aspects of chronic pain—including depression and anxiety—as challenges they face in providing care.

These aren’t rare encounters; 38% of providers treat chronic pain daily, and another 28% see patients with chronic pain several times a week. The types of pain they treat run the gamut: neuropathic, musculoskeletal, nociceptive, nociplastic, inflammatory, and more.

Providers shared challenges and gaps in their own words :

“[We need] better training and education for health care providers on the biopsychosocial model of pain and disparities in pain care for underserved populations, improved access to interdisciplinary pain treatment programs—there are far too few, and waiting lists are long—and innovative, low-cost technologies that can be incorporated into pain care in an equitable way.”

Ill-Equipped to Meet Pain’s Full Complexity

Only about half (52%) of providers surveyed said they believe mental health support is adequately integrated into pain care—despite most agreeing it is essential. They’re too-often asked to manage complex pain without knowing how to address its psychological, social, and cultural dimensions— and most systems offer little training in how to do otherwise. 

“[We need] greater access to mental health resources for patients and their families.”

“Lack of mental health knowledge is a major barrier to many physicians [in] adequately supporting those with chronic pain, and often their approaches can be damaging or triggering… Much more education is needed.”

Pain doesn’t occur in a vacuum—it lives at the intersection of biology, psychology, identity, and environment. Yet only 17% of providers say they’ve received extensive training in trauma-informed or culturally responsive care. That means most clinicians are expected to treat pain without fully understanding how trauma, race and ethnicity, language, gender, disability, or poverty shape a patient’s experience—or their ability to access care.

While 44% reported receiving some training, nearly 30% of providers said they want more and better education in this area.

“[We need] culturally sensitive awareness material for patients and training materials for HCPs.”

“[Improve] practitioners’ understanding and respect of diverse communities and diseases in these communities.”

“Decrease the barriers to practice in a biopsychosocial framework.”

When Regulations Undermine Care

Many clinicians report that regulatory constraints and systemic interference limit their ability to offer individualized, compassionate care and to prescribe appropriate medications. In many cases, rather than ensuring safety, these barriers often penalize the very professionals trying to help.

• 32% said pharmacists or insurers had interfered with their clinical decisions
• 30% said regulations hindered their ability to personalize care
• 24% said they now spend significantly more time on documentation, prior authorization, or compliance tasks
• 17% said patients were forcibly tapered or denied medications
  

“When we have to force a patient to go to another pharmacy because we cannot order enough [due to restrictions], it can affect their pain management contract… They are seen as ‘drug-seeking,’ but through no fault of their own.”

“There is so much fear around prescribing opioids from the provider side—and the patients are suffering.”

Providers Want to Learn—But Need the Support to Do So

The clearest takeaway from the survey? Providers know that the status quo isn’t working. And are urgently calling for tools, collaboration, and systems that support whole-person, effective pain care.

Top areas where providers want more training or resources include:

• Pain management training and resources: 92%
• Access to newer, evidence-backed technologies and therapies: 43%
• Education in multidisciplinary care models: 41%
• Better understanding of the intersection of pain and mental health: 37%
  

Yet many reported having limited access to training and few opportunities for collaboration.

What’s more, some pointed to the value of learning from the very individuals they’re trying to help—acknowledging the value of patients’ expertise in their own experiences:

“[Offer] educational seminars where patients are able to describe their experiences.”

Beyond Meds: The Push for Multimodal Care

Despite these barriers, most providers are already leaning into whole-person, multimodal pain care, with respondents sharing their most-commonly-prescribed treatments:

• 73%: restorative approaches such as physical or occupational therapy
• 56%: behavioral approaches like CBT and mindfulness
• 54%: medications
• 44%: self-management techniques like pacing
• 29%: complementary therapies such as acupuncture or chiropractic care
  

Yet many reported insurance and policy barriers that restrict them from offering evidence-based care, time constraints, and siloed systems that block patients from accessing these options. Providers described interdisciplinary programs as too few and overburdened with long waitlists, insurance that rarely covers behavioral or alternative treatments, and systemic barriers that prevent them from offering the care they know works.

“[We need] more resources for CBT-based therapies—insurance often limits what therapies families can participate in.”

“It’s easier to access surgery than multidisciplinary team pain input.”

“[Patients need] access to care and better insurance coverage. Kids can’t do PT when the copay is $100 per visit, [and there are] long waits for specialty appointments and terrible access to mental health support.”

“[We must] allow providers and patients to decide the treatment, not the insurance company or the government… These are barriers patients do not need, and are not making things any safer for patients. It’s compromising their health and well-being.”

What Needs to Change—Now

When asked what one change would most improve care for people with chronic pain, providers offered hundreds of insights. Some of the most common included:

• More training in pain science and communication
• Greater access to interdisciplinary teams
• Increased insurance coverage for non-drug therapies
• Stronger mental health integration
• Equity-focused models for underserved populations
• Better insurance reimbursement for evidence-based, non-invasive care
• Pre-licensure education in pain care

Let’s Equip Providers to Succeed—Not Fail

The conclusion is clear: when we fail to train providers in chronic pain care, we fail everyone. We delay diagnoses. We increase costs. We erode trust. We allow suffering to continue—not out of malice, but out of systemic neglect.

Health care providers are ready. People living with chronic pain are desperately waiting. The time for action is now.

Let’s stop training providers to fail—and start giving them what they need to succeed.

To learn more about the U.S. Pain Foundation’s Pain Awareness Month initiative, click here.