UK & Europe
One in Four: this was the startling statistic of the UK population, aged between 16-75, said to be affected by chronic pain, the BBC reported.
It focuses on the longstanding response to pain - medication. The report helpfully reminds us of the key themes of the updated NICE Guidelines and their focus on a regime of exercise, physical therapies and psychological therapies designed to promote confidence and independence.
Medication, whilst not entirely dismissed, is no longer a prime consideration in isolation. The same can be said for Pain Management Programmes, another frequently seen modality of treatment in pain cases. A clinical lead for NICE explained that the prescription of medication is often a response to the patient’s distress rather than a clinically sound decision.
The report alludes to the interplay of psychosocial elements in chronic pain cases and how they can intensify the pain experienced, supporting the need for psychological and community-based support. The emphasis and primary goal, according to a pain specialist, is for both patient and treating clinicians to alter their understanding of pain.
In a related article, The Guardian recently reported on studies suggesting that anti-inflammatory medication, such as Ibuprofen, may be linked to developing chronic pain. The theory is based on inflammation being the body’s natural protective response to injury and blocking this may adversely impact upon recovery.
The small scale research is very much in its infancy and has not yet led to any recommendations in change of medications, but the general hypothesis would support the holistic approach of the NICE Guidelines.
Legal practitioners are all too aware that the NICE Guidelines have given strength to Defendants’ arguments in civil claims in opposing potentially significant claims for future interventions and treatments; nerve blocks, trigger point injections, Pain Management Programmes – which can be pleaded as a lifetime claim. Expert evidence recommending these long standing and “traditional” treatments without setting out the alternatives, per NICE, will likely be challenged as at least contrary to the modern approach.
A more crucial aspect of these reports, however, is their proliferation in mainstream media. By moving the coverage out of a niche space occupied by medical practitioners and personal injury lawyers, increased media coverage will hopefully lead to wider discussion and debate, and with that a better understanding of what “pain” is, and how it can be best addressed. Consideration, support and development of the NICE Guidelines might provide a more effective outcome than the potentially unnecessary pill currently being swallowed by claimants presenting with pain conditions.