Dennis C Turk and team set out to evaluate how effective most commonly used therapies are for the treatment of chronic pain over the last ten years. They wrote that overall effectiveness remains poor and inconsistent, despite major advances in understanding the mechanisms that underlie pain.
The authors wrote:
"Of all treatment modalities reviewed [drugs, surgery, interventional, behavioural, rehabilitation, and alternative], the best evidence for pain reduction averages roughly 30% in about half of treated patients, and these pain reductions do not always occur with concurrent improvement in function."
Approximately 1 in every 5 people worldwide has chronic pain. In the USA alone, over $210 billion annually are spend on treating chronic pain - annual costs in the UK for just back pain are estimated to be between $26 and $49 billion.
As current treatment on their own do not appear to provide adequate relief from pain and improvements in physical and emotional functioning, the authors believe future research should concentrate on combining different drugs, drugs with psychological therapy, as well as medications with somatic treatments.
Few studies have evaluated combinations of therapies.
Treatment should have a multi-faceted approach, involving the whole person. For treatment to be effective, the researchers say that the effectiveness of physical and emotional functioning should be assessed, data from patients should be gathered, as well as adverse events - instead of just focusing on how severe the pain is.
The researchers stress:
"A great need exists for research that goes beyond asking the questions of whether a particular treatment is effective, to addressing what treatment is effective, for which patients, on what outcomes, under what circumstances, and at what cost.
(conclusion) These results suggest that none of the most commonly prescribed treatment regimens are, by themselves, sufficient to eliminate pain and to have a major effect on physical and emotional function in most patients with chronic pain...There is a crucial need for assessment of combination treatments, identification of treatment response, and the assessment of the benefit of matching of treatments to patient characteristics."
Link to full series paper 3
Written by Christian Nordqvist