May 1, 2015

It’s time to pay attention to chronic pain



So says a new national pain strategy from the Department of Health and Human Services. You can influence the strategy with your comments.

An estimated 25 million Americans have chronic pain that significantly limits their ability to work and enjoy life. For decades, doctors have focused on finding physical causes of chronic pain and prescribing drugs and procedures to stop it. More often than not, this simplistic approach has failed. It has increased the use of opioids such as Vicodin, OxyContin and Percocet, leading to a dramatic rise in opioid involvement in overdose deaths: more than 16,000 in 2010. Now, the U.S. Department of Health and Human Services has drafted a new “National Pain Strategy” that calls for changing the way we think about ongoing pain.

Draft strategy now available

I chaired one of the work groups that developed the strategy, so I know that it recommends bold new approaches to research and to helping patients. Specifically, it:

  • Recognizes that chronic pain affects the whole person.
    Many factors influence how people experience and adapt to pain, whether they seek treatment, and how they respond to it. These factors are not just physical and genetic but include cultural, economic, and environmental influences. Seeing chronic pain as affecting the entire person will change how we study, diagnose, and treat it.
  • Recommends investing in an integrated approach to pain that includes prevention, assessment, and self-management; improving access to effective treatment; and treating people with pain with respect
    Health care and pain research should strive to give patients and their primary care doctors more information and tools for preventing, understanding, and coping with chronic pain. The National Pain Strategy also recommends that pain specialists and primary care clinicians work together to develop optimal care plans for patients with complex chronic pain conditions.
  • Focuses on improving health care policy for pain
    The strategy calls for clinical practices related to pain to be strongly grounded in evidence about what works to reduce pain in most people, while tailoring care to individual needs. The strategy recommends changing health care incentives so that doctors are rewarded for providing better care, rather than for providing additional tests and treatments that don’t work. 
  • Emphasizes public education and communication to address stigmas and misperceptions about chronic pain
    The strategy states that chronic pain is a disease in its own right that requires individualized care. It recommends helping patients manage pain in ways that maximize quality of life when pain cannot be eliminated.
  • States that research is key. 
    The National Pain Strategy recognizes that we need to discover basic mechanisms of pain and more effective treatments. 

Express your views by May 20, 2015

I believe the National Pain Strategy will help patients and doctors by focusing our attention and resources in clinical areas that have not received the attention that they deserve. But what do you think? Read the draft National Pain Strategy and let us know.  

Health and Human Services wants to hear from you by May 20, 2015 at or by mail to Linda Porter, PhD, NINDS/NIH, 31 Center Drive, Room 8A31, Bethesda, MD 20892.


Michael Von Korff, ScD