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Guidance for Using CAM to Manage Pain

There are many different treatment options available to lessen the effects of chronic pain, improve functioning, and enhance quality of life. According to current estimates, more than 116 million Americans are living with chronic pain. Physicians who manage patients with chronic pain often find it challenging to treat because what works for one person doesn’t always work for another (see also, Striving Toward Quality Pain Management). Effective pain management plans must be individualized, and integrative approaches—which include a combination of treatment options—are often needed. CAM Use More Common to Manage Pain Complementary and alternative medicine (CAM) is increasingly being used by patients to assist in their fight against chronic pain. CAM has been defined as a group of diverse practices and products that are not generally considered part of conventional medicine as practiced by physicians and allied health professionals. CAM practices are often grouped into two broad categories: 1) natural products and 2) mind and body medicine. “More than 83 million people in the United States use some form of CAM therapy to manage and treat their health problems, including pain.” It’s estimated that more than 83 million people in the United States use some form of CAM therapy to manage and treat their health problems, including pain. More than $33.9 billion a year is spent on out-of-pocket visits to CAM practitioners and for the purchase of CAM products, classes, and materials. Some of the most common pain-related reasons people seek CAM therapies are for back, joint, and neck pain, arthritis, severe headaches or migraines, and fibromyalgia. An Important Initiative on CAM Education To further educate healthcare providers, the...

Chronic Pain: Analyzing the Public Health Burden

There has been greater recognition over the past several decades of the pervasiveness of poorly assessed, poorly treated chronic pain, culminating recently in an Institute of Medicine report quantifying this healthcare issue. Evidence also suggests that the quality of and access to assessment and treatment of pain are poorer for racial and ethnic minorities. “This is a very large public health problem,” says Perry G. Fine, MD. “The issue has become even more important because of its concurrent overlap with the liberalization of prescribing patterns for opioid analgesics to treat chronic, non-cancer pain.” Chronic Pain is a Costly Problem Well over 100 million people in the United States are living with chronic pain that has some debilitating effect on their daily lives, costing society over $600 billion a year in direct medical costs and lost productivity. According to the American Pain Foundation, pain affects more Americans than diabetes, heart disease, and cancer combined (Table). The duration of pain in adults aged 20 and older who report having pain is longer than 1 year for 42% of patients (Figure). As these health and economic tolls have made their mark, they have exposed training gaps for healthcare professionals in recognizing and treating chronic pain adequately. “With some additional training and by adopting well-established practice guidelines, the risks of abuse can be managed and limited for both patients and physicians.” “We have not established a systemic approach to comprehensively prevent and treat chronic pain,” says Dr. Fine, “and comorbid psychiatric disorders can further complicate issues of treatment selection and adherence. Physicians are doing their best to return their pain patients to optimal...
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