Expert recommends pain ‘demedicalisation’

ENCOURAGING the demedic­al­isation of chronic pain and promoting patient self-management could relieve pressure on doctors, according to an international expert.

“One of the beliefs we have in our culture is that if you have pain you should see a doctor,” said Emeritus Professor David Morris, from the University of Virginia.

Due diligence must be done (“ensure there is not a tumour pressing on a nerve”) but after ruling out such a diagnosis it was an option for a person to declare themselves a “non-patient”, he said.

Professor Morris, author of the award-winning book The Culture of Pain, is not a clinician but has studied issues surrounding pain management and will be keynote speaker at a workshop for primary healthcare providers hosted by Chronic Pain Australia in Canberra on 25 July to coincide with National Pain Week.

Professor Morris said there was value in reducing the amount of drug treatment for some patients.

“In pain clinics, patients often have to undergo detoxification because they are over-medicated,” he said,

adding it should be considered on a case-by-case basis. He emphasised the importance of narrative between doctor and patient.

But he conceded this was a “hard sell” in medicine due to time constraints.

Patients often said their pain complaint was not believed by their doctor. “I think it is really important to trust the patient’s self-report. It is one piece of data that tends to be marked subjective and viewed with suspicion by the physician,” he said.

Dr Chris Hayes, medical director of the Hunter Integrated Pain Service (HIPS) will tell the seminar that a major challenge for GPs was how to “use prescription drugs less and active management more”.

However, GPs had been “rolling up their sleeves” to deal with the burden of chronic pain in the community, he said.

In collaboration with GPs, the pain service recently developed simple toolkits for use in primary care, available on its website.

Go to www.hnehealth.nsw.gov.au/pain then click on “Information for health professionals” to access the toolkits.