Chronic pain: Treatment options and efficacy

Answer

Chronic Pain: Treatment Options and Efficacy, A review of Literature

Chronic pain has become a significant problem in many countries globally. It can be defined as a progressive or persistent pain that is usually resistant to medication and lasts for more than 12 weeks. Studies have shown that about 100 million people suffer from chronic pain in the United States alone (Olsen & Daumit, 2002).  It is in the light of this background that this paper reviews three scholarly articles with regard to chronic pain, treatment options, and efficacy.  

The first article by Ehde, Dillworth, and Turner (2014) entitled, ‘Cognitive-Behavioral Therapy for individuals with Chronic Pain’ introduces the reader to the main theme of the paper (2014). In other words, it analyzes the effectiveness of cognitive-behavioral therapy (CBT) in treating patients with chronic pain; highlights current limitations and gaps of using CBT; and recommends steps that can be undertaken to improve its access and efficacy in the future. According to the article, CBT is considered the “gold standard” psychological treatment for persons suffering from a wide range of pain including chronic pain. Several other studies conducted on the same also reveal that CBT is efficient in reducing pain intensity, distress, and pain-related activity interference (Olsen & Daumit, 2002). Moreover, the article notes that CBT does not have some of the risks commonly associated with chronic pain medications and interventional procedures such as cardiovascular and adverse renal events. Furthermore, CBT provides additional benefits to patients with comorbid conditions such as hypertension, and diabetes.

The article identifies several gaps that limit the use and implementation of CBT in healthcare including access, training, and research problems. Different studies conducted on the same revealed that many individuals suffering from chronic pain and other related illnesses lacked access to CBT programs due to financial constraints, or unavailability of the services in their regions (Ehde, Dillworth, &Turner, 2014). It was also noted that there was a significant knowledge gap existing between research and the widespread adoption of evidence-based CBT interventions for chronic pain in many communities. In this regard, the authors recommend the integration of CBT in areas where persons with chronic pain are commonly seen, particularly in primary care settings so as to make the services more accessible (Ehde, Dillworth, & Turner, 2014). Moreover, they highlight the importance of promoting research initiatives to enhance patients’ receptiveness to treatment and chronic pain management.

The article adopts a layout that is slightly different from the standard approach of journals. In other words, it is synonymous and does not follow the general format of a typical peer reviewed article. In this case, it lacks an abstract and does not highlight the methods used to conduct the research or limitations encountered in conducting the study. The writing style is, however, simple, clear, and straight to the point.

In the second article entitled, ‘An Overview of Pain Management: the Clinical Efficacy and Value of Treatment’, Nalamachu (2013) highlights the safety and efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) in treating and managing pain. He also evaluates clinical treatment guidelines for different types of pains and compares the relative roles of NSAIDS in managing them.  According to the article, effective pain treatment requires a deep understanding of the characteristics and nature of the pain in order to determine the most suitable drugs to prescribe to the patients. In this regard, the author recommends the use of Opioids and NSAIDs such as acetaminophen which is efficient in treating and managing chronic pain. He, however, cautions against the continuous use of NSAIDs due to the negative side effects commonly associated with their long-term use. In other words, studies have pointed out that the long-term use of NSAIDs can result in adverse cardiovascular events, stroke, or stomach bleeding just to mention (Bjarnason & Hayllar, 2013). Moreover, Oipoids have been reported to cause motor impairment, cognitive deficiency, and respiratory depression, in some instances   (Nalamachu, 2013). As a result, the author advises health providers to evaluate their patients carefully before prescribing them with any NSADs, in order to determine their risk factors and enhance the effectiveness of their medication.

The article also provides a few guidelines on the treatment for different types of pain based on the American Society of Anesthesiologists Task Force on Acute Pain Management recommendations. In this case, acetaminophen and gabapentin are recommended for managing postoperative and low back pain as well as topical capsaicin or NSAIDs (topical or oral, including COX-2 inhibitors) for hand and knee pain, among other suggestions.

The article does not follow the typical format of a peer-reviewed article. However, it is clear and easy to understand, making it possible for the reader to connect the author’s main points with the main theme of the article.

 The third article by Rosenblum (2008) entitled, ‘Opioids and the Treatment of Chronic Pain: Controversies, Current Status, and Future Directions’, evaluates the impact of Opioids in managing chronic pain (2008). It also provides recommendations on the various methods that can be implemented to enhance their usefulness. In this regard, the article acknowledges the effectiveness of Opioids in managing and treating moderate to severe pain. That is to say, several healthcare organizations and medical professionals have testified on the efficacy of Opioids to reduce pain, particularly, in patients with advanced medical illnesses such as cancer (Olsen & Daumit, 2002). There are, however, major controversies regarding their safety, functional outcomes, and the possibility of abuse or addiction among patients. The author states that continuous exposure to opioids can result in an increased sensitivity to noxious stimuli in animals and an increased perception of pain in human (Rosenblum, 2008). Besides, recent studies have shown that cases of addiction and a relatively prevalence of substance abuse disorder among chronic pain patients is on the rise globally, thus raising questions about the functional outcomes of Opioids.

  The article recommends the implementation of research initiatives in health Organization to address the controversies surrounding the functional outcomes and adverse effects of Opioids in patients. It also highlights the importance of a universal acceptance of treatment guidelines that acknowledge the dual obligation of the prescriber in optimizing the balance between analgesia and side effects. Besides, it states that the initiative will help in promoting other favorable outcomes, while at the same time monitor and manage the risks associated with Opioids addiction, abuse, or diversion (Rosenblum, 2008). Furthermore, the author believes that research and training will help practitioners determine the most appropriate treatment protocols and patient subpopulation needed to achieve satisfactory outcomes, thus minimizing the negative effects of Opioids in chronic pain patients and other related ailments.

The writing style employed in the article is elaborate, simple, and comprehensive, making it easy to understand. It also provides a deep insight on the impact of Opioids on patients and allows the reader to relate with the subject matter of the paper.