The Paradox of Pain Care in the USA

Living with chronic pain in the current American health care model today is a paradox. If I had access only to prescription pain medications, my pain would not be managed. If I had no access to prescription pain medications, my pain would not be managed.

To effectively manage pain, there is no single treatment tool that will ‘fix’ the problem. Sadly most healthcare plans only cover prescriptions, shots or surgery as long term chronic pain treatments. Physical therapy is limited to a handful of visits. Acupuncture, massage and other alternative treatments are not covered by healthcare plans and not accessible for people who are unable to pay the out of pocket expense for these valuable treatment options.

The people unable to pay or unable to speak for themselves are the ones that are vilified as drug seekers, addicts, malingerers and a drain on our society. Chronic pain has been criminalized to the point that people with pain who rely on valid prescriptions for their medications are blamed for the fatal or debilitating consequences of misuse and abuse actions of others who have acquired similar medications without valid prescriptions.

If the conversation and media focus is on the fatalities due to misuse/abuse, then we all miss out on identifying the problem. The problem is NOT that prescription medications (including opioids) are used to treat chronic pain. The problem IS that prescriptions are often the ONLY treatment option provided by most healthcare plans.

The solution is to ensure that all people at all socio-economic levels have access to all treatment options for effective pain management. Physical therapy should not be limited to a handful of visits. Acupuncture, massage, meditation, nutrition counseling, sleep facilitation, TENS units, relaxation training…. should all be offered as part of a comprehensive healthcare plan.

When I’m injured, taking medications damps down the pain enough for me to get some sleep, get to physical therapy, get acupuncture, and feed myself to start it all over again. Meditation, distraction and relaxation exercises keep my head clear, enable me to keep track of symptom variations (good and bad) and find some peace. Epsom salt baths, self-massage, heat and ice are all cost effective ways to help myself heal. All of this together gives me hope that I will be able to get back to a lower level of pain that doesn’t prevent me from moving forward.

I live with Ehlers-Danlos syndrome (EDS), a genetic connective tissue disorder that has caused painful joint dislocations since childhood. Chronic pain is a part of my life. It is not my whole life as long as I have access to all of the treatment options.