Opinion

There is no quick fix for chronic pain but there is a path forward

The pain specialist is the third Mrs. Brown has seen this year in search for a quick-fix cure for her chronic pain problem. Despite an endless traumatizing loop of clinical visits, countless medical tests, and a laundry list of medications, no one has told her that she has a chronic disease called chronic pain. No one has explained what chronic pain is, how it occurs and how to manage it.

Mrs. Brown is not alone. Many of our patients share similar stories and belong to the nearly 8 million people living in Canada who struggle with chronic pain that interferes with their daily activities, turning simple tasks into annoyances at best and excruciating experiences at worst. It often coincides with anxiety, depression, poor sleep health and, for some, substance-use dependence.

Our systems are failing Mrs. Brown and those like her advocating for their health. We are treating chronic pain like it’s an acute pain problem. It’s not. We need to take a new approach.

All too often, pain patients are sent from specialist to specialist, referred for more tests or passed along to community clinics that focus on procedure-based interventions that only provide short-term relief. Treating chronic pain as an acute problem reinforces the idea that patients need to be heavily reliant on doctors and medications for relief.

Our inefficient management of chronic pain is costly to everyone. Chronic pain currently accounts for more than $17 billion a year in direct health-care costs and $23 billion a year in indirect costs. Most funding is spent on expensive, quick-fix interventions with minimal evidence to improve outcomes. Instead, health-care dollars should be diverted to interdisciplinary programs for long-term pain management.

We need to empower patients to manage their disease in ways that help them function effectively despite their pain.

With diabetic patients, we don’t just treat them with short acting insulin – we also encourage them to be active participants in managing their condition through diet and exercise. Chronic pain demands the same approach. We need to empower patients to manage their disease in ways that help them function effectively despite their pain. This allows the patient to be an active participant in care, which is crucial for a condition that will last a lifetime.

People in pain shouldn’t have to wait to learn how to manage their condition. Patients and practitioners need resources to help guide them through the complexities of chronic pain. In a pan-Canadian effort led by The Ottawa Hospital, the Power Over Pain portal bridges some of the gaps in our system by supporting people living with chronic pain through proven educational approaches, including self-management courses, educational materials, live workshops, peer support and counselling.

As a first-of-its-kind in Canada, this is a way patients can access the support they need right away, especially during extended wait times for specialized care. Health-care providers can tailor recommendations of resources on the portal for their patients and can use portal content to create programs within their own clinics.

Patients need to be at the centre of their own care, and they need to manage their pain for what it is, a chronic disease. If not, there will be many more individuals like Mrs. Brown, who put their lives on hold in pursuit of a cure that doesn’t exist. The time to reimagine chronic pain care is now – we can’t afford not to and the millions of suffering Canadians can’t afford to wait.

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Authors

Tania Di Renna

Contributor

Tania Di Renna, MD, is the Medical Director of the Toronto Academic Pain Medicine Institute. Associate Professor at the University of Toronto Department of Anesthesiology and Pain Medicine. She is also a Staff Anesthesiologist at Women’s College Hospital and University Health Network.

Rachael Bosma

Contributor

Rachael Bosma, PhD, is research lead at Toronto Academic Pain Medicine Institute. She is also the co-director at the University of Toronto Centre for the Study of Pain.

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