Chronic pain comes in many shades.
The descriptions alone can be colorful — throbbing, shooting, aching, burning, freezing, and so many more, according to the U.S. Pain Foundation, which connects and advocates for those living with chronic conditions that cause pain.
With September designated as National Pain Awareness Month, the foundation and others note that patients rarely describe their pain by using only one of those vivid explanations.
Just as there are innumerable ways to describe pain, there are countless conditions that can cause or contribute to chronic pain, experts said.
“When people live with chronic, ongoing pain, it’s a situation that begs for acknowledgment, sympathy, empathy and most of all, relief,” said Cassandra Daniels, a registered nurse. “There are literally tens of thousands, if not millions, of people who live with some form of pain.”
In honor of Pain Awareness Month, the U.S. Pain Foundation plans to host several events and activities they hope will bring together individuals with pain and create more understanding about the challenges those people face.
#PainWarriorsUnite has become the theme for the 2018 campaign, officials said.
“Nearly everyone will experience chronic pain at some point in their lives,” Nicole Hemmenway, the interim CEO of the Pain Foundation, said in a release. “Yet the issue of pain remains at best, overlooked, and at worst, stigmatized by the general public. To fight for better care and resources for people with pain, we need to work together across various health conditions.”
This year, U.S. Pain’s initiative includes a series of online educational events, a daily fact about chronic pain created in collaboration with a different patient or health advocacy group, a monthlong social media challenge featuring special giveaways and the launch of a new blog about pain management and support.
It also includes an infographic highlighting key statistics about chronic pain; and an INvisible Project edition highlighting the stories of staffers who live with pain or are a caregiver for someone with pain.
U.S. Pain’s efforts also include its annual Light Up the Landmarks campaign, which has more than 70 landmarks or buildings set to light up in blue; Beautify in Blue, which decorates public spaces with blue signage; and its proclamations push, in which volunteers have collected proclamations from more than 15 states and 50 municipalities designating September as Pain Awareness Month.
Meanwhile, others remain concerned that those suffering from chronic pain could be adversely affected as the nation continues to endure an opioid crisis.
In a lengthy question-and-answer session posted on the Mayo Clinic’s website, Dr. Tracey E. Harrison, pediatric anesthesiologist at Mayo Clinic’s campus in Rochester, Minnesota, was asked to characterize the state of the opioid crisis in the U.S.
“I think that even given the opioid issues we are having right now, it’s still very important to appropriately and adequately address acute pain resulting from trauma,” said Harrison, who specializes in acute pain management, chronic pain rehabilitation, and hospice and palliative care.
“That may be with opioids and multimodal analgesia,” Harrison said. “I think paying attention to the injury mechanism’s severity and treating the pain adequately, appropriately and having good expectations is important at the outset.”
Physicians need to explain to patients — and understand as providers — that appropriately managed pain does not mean zero pain, Harrison said.
“Patients and their providers often have fear when pain does not resolve as quickly as expected,” she said. “We need to communicate it may be very normal and assure the patient any ongoing reason for pain has been treated appropriately.
“We also can ask patients, ‘What is your comfort goal?’ This goal is the pain score on the Numeric Pain Rating Scale, where 0 is no pain at all and 10 is the worst pain imaginable, above which it would be difficult to be up and out of bed, sleep, eat or visit with friends and family,” she said. “Then we can attempt to get below that level with strategies described above. I think one of the most powerful strategies is informing patients that some ongoing pain may be normal and expected.”
Harrison stressed the importance of physicians reminding patients that the key to recovery is remaining active.
“We need to encourage patients that despite having pain, they need to function appropriately for the time,” she said. “For example, if the surgeon expects the patient to be up and out of bed the day after surgery, this should be conveyed pre-surgically to the patient.
“The provider’s responsibility is then to provide medications to reduce pain so the patient can accomplish this task, such as providing a pain medication dose 30 minutes prior to physical activity,” Harrison said. “And encouraging patients that mobility is important in their ability to heal after a surgical procedure or trauma is an important aspect of their rehabilitation.”