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Ouch: Patients Suffering From Docs' Poor Pain Management

Study finds many treatments either ineffective or underused.

ByABC News
June 23, 2011, 1:33 PM

June 24, 2011— -- Cindy Steinberg will never forget the day in March 1995 when chronic pain entered her life.

An accident at work left her crushed under a large file cabinet, resulting in torn ligaments and nerve damage in her back.

"I went from doctor to doctor," Steinberg said. "I tried nerve blocks, various injections, physical therapy and acupuncture."

Still, she couldn't get relief from the terrible pain. After long days of work as a manager of educational media and technology development, she often went home crying.

"I was lying on the floor during meetings," said Steinberg, who lives in Lexington, Mass. "Finally, after about years years, I found an osteopath who told me I had to give up my career."

Steinberg is one of 40 million Americans suffering from chronic pain, and new research has found that the overwhelming majority of people like her are suffering from poor pain management. In fact, a series of new studies found that the medical community isn't doing enough to manage different types of pain, including chronic, post-surgical and cancer-related pain.

Each of the three studies, published in The Lancet medical journal, reviewed treatment options currently available for each kind of pain.

The authors of the study on post-surgical pain said that pain management is improving thanks to regional pain relief, such as epidural analgesias and peripheral nerve catheters. For reasons that are unclear, however, patients are still suffering.

"Despite the introduction of new standards, guidelines, and educational efforts, data from around the world suggest that postoperative pain continues to be managed inadequately," wrote Drs. Christopher Wu and Srinivasa Raja of the Johns Hopkins School of Medicine in Baltimore, the study's authors.

They believe there could be a number of reasons, including a lack of pain assessment after surgery and doctors who simply don't use every available method.

Dr. Patricia Baumann, assistant professor of anesthesiology at the Emory University School of Medicine, said epidurals and other types of regional anesthesia -- or anesthesia administered to a certain part of the body -- are very effective with many of the patients she sees, providing pain relief and preventing the need for opioids such as OxyContin.

"It blows my mind that it's not better utilized," she said. "Sometimes, patients are afraid of epidurals, or the surgeons can't stop long enough to have the epidural placed."

Wu and Raja added that using multiple pain relief techniques at the same time "may lead to substantial gains in the treatment of acute postoperative pain and potential reduction in the development of [chronic pain]."