The Consequences of Untreated Pain

The Consequences of Untreated Pain — Pain News Network – June 2017 – By Roger Chriss

Pain is an alarm signal requiring attention. Whether the pain lasts minutes or months, it demands a response.

To ignore pain is to invite serious consequences, from burned skin or an infected wound to a damaged joint or dysfunctional nerve. It is for this reason that healthcare professionals ask patients where it hurts.

Recent research found the consequences of untreated pain go farther and deeper than are generally recognized:  

  • JAMA Internal Medicine reported that older people with chronic pain experience faster declines in memory and are more likely to develop dementia.
  • Pain Medicine reported that osteoarthritis and related joint pain were strongly associated with memory loss.
  • Arthritis Care & Research reported that pain severe enough to interfere with daily life was associated with an increased risk of mortality.

In the latter study,

  • people who were “often troubled with pain” had a 29% increased risk of dying, and
  • those who reported “quite a bit” or “extreme’ pain” had 38% and 88% increased risk of mortality,

according to Medical Dialogues.

As I wrote in a recent column, under treatment of pain is common, and the CDC opioid prescribing guidelines and groups like Physicians for Responsible Opioid Prescribing (PROP) are making things worse by demonizing opioids

These results are new, but they are far from unique. For years researchers have been finding that chronic pain conditions have major long-term medical consequences

“The role of opioid analgesics has been distorted to the point where the word ‘oxycodone’ uttered in front of a patient in my palliative medicine clinic is met with raised eyebrows,” wrote Susan Glod, MD, in a recent op/ed on “The Other Victims of the Opioid Epidemic” published in The New England Journal of Medicine

In 2011, Pain Medicine reported that chronic pain

“negatively impacts multiple aspects of patient health, including

  • sleep,
  • cognitive processes and
  • brain function,
  • mood/mental health,
  • cardiovascular health,
  • sexual function, and
  • overall quality of life.”

In 2016, a study in the Journal of Pain Research reviewed the research literature and found that chronic pain

“has significant consequences for patients, as well as for their families, and their social and professional environment, causing deterioration in the quality of life of patients and those close to them.”

Although opioid therapy includes possible cognitive side effects, so do anticholinergic muscle relaxants, which have been shown to increase the risk of dementia. Similar risks exist for many other treatment modalities.

The best results are often obtained in pain management programs that combine drug therapy with physical therapy or other modalities tailored to the individual patient’s needs

Persistent pain is a danger sign that a major and potentially life-threatening toll is being exacted on the human body and mind.

We do not have the luxury of ignoring or undertreating chronic pain conditions.

Good pain management is one of the best ways to improve long-term outcomes and quality of life.

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