Chronic Pain Management in Patients With Comorbidities

“As the population ages & individuals live long enough to be burdened by multiple comorbid conditions, the face of the chronic pain patient has changed, & so have the challenges confronting the clinicians involved in their care. Now, more than ever, it is important [for Pain Specialists] to integrate knowledge from the various fields of medicine when treating the chronic pain patient. By focusing on the understanding of the complex patient’s co-morbidities and the practical application of various therapeutic modalities when treating pain” [1], Pain Doctors can achieve the best possible optimum results

So What is Comorbidity, Exactly?

Comorbidity occurs when an individual experiences more than one disease or condition simultaneously. Conditions described as co-morbidities are often chronic or long-term conditions [2].

Treating the Whole Person

Leading Pain Specialists take a biopsychosocial approach, & are mindful that: “the patient with multiple comorbidities is a whole person whose clinical picture represents a complex interaction of multiple factors, & is not merely the sum of the symptoms from each separate condition. The best chance clinicians have in aiding these patients, is to consider the distinct disease mechanisms at play & recognize the need for them to be targeted in parallel for optimal management” [1]

To that end, when you have your first consultation with a Pain Doctor, they will review your medical history, ask you pertinent questions, conduct an in-depth examination, and undertake any necessary tests and scans. If you prepare a daily ‘Pain Dairy,’ to show the Pain Consultant, it will be prove very beneficial, as it will help them attain a clear picture of your symptoms, and potential underlying cause. The diary should be divided in to 24 hours, and give you enough space to record where you feel the pain, what are were doing before, and at the time the pain came on; how long the pain lasted, and what you were doing when the pain ceased.

Once the Pain Specialist has been satisfied that they have attained an accurate diagnosis for all the patient’s issues; they will then proceed to compile a Holistic Personalised Treatment Plan, which can be started on right away. This is likely to include both conventional, and the latest state-of-the-art cutting-edge treatments.

 

References

[1]. Giamberadino et al (2013). “Pain Comorbidities: Understanding and Treating the Complex Patient.” Pain Medicine, Volume 14, Issue 5, May 2013, Pages 763–764.
https://academic.oup.com/painmedicine/article/14/5/763/1816889

[2]. Centers for Disease Control and Prevention (2022). “Comorbidities.”