Narcotic painkillers continue to be a mainstay within the surgical arena. Doctors are ready to prescribe drugs like Percocet and OxyContin when they believe post-surgical pain warrants it. But is there another way? Is there a more holistic way to approach surgical pain?
Allentown, PA TV station WFMZ recently ran a story featuring Mercy Medical Center surgeon Dr. Lauren Nigro, a story in which she suggested a movement within her own specialty to treat pain before, during, and after surgery in order to avoid narcotic painkillers.
By taking a holistic approach, doctors who treat surgical pain in this way hope to reduce the chances that a patient will suddenly be excessively uncomfortable following surgery. The thinking makes sense from a chronic pain management standpoint as well.
Dr. Nigro explained during the interview what a typical scenario looks like. Patients are prescribed acetaminophen they take for several days before their surgeries. During surgery, a nerve block that can remain active for several days is employed. Finally, non-opioid pain medications and non-steroid anti-inflammatory medications are prescribed following surgery.
This revolutionary approach more or less applies a pain management concept to surgical procedures rather than the more traditional approach of treating pain after the fact. Managing it all the way through reduces the highs and lows patients experience. The thinking is that they feel better as a result.
Treating surgical pain in this way may not be the norm, but it is well worth looking into and developing further. Based on our experience as pain management doctors, we know that how patients perceive pain influences how effectively that pain can be managed. So minimizing the differences between highs and lows makes a lot of sense.
Think of it in terms of mood swings. A doctor treating a patient for a mood disorder wants to minimize the swings so that the highs are never too high and the lows are never too low. Keeping the patient's mood on a more even keel is an important part of the treatment.
Managing surgical pain would seem to benefit from a similar principle. And if the approach works well for managing surgical pain, it might work for managing chronic pain as well.
Where this gets tricky is determining the best holistic strategy for chronic pain. It is one thing to manage surgical pain until the patient fully recovers. But chronic pain can persist for years. It's an entirely different animal. The important thing to note is that prescription drugs are not always the answer.
So many patients wind up at pain clinics because their primary care physicians haven't been able to come up with solutions other than writing prescriptions. This isn't a knock against GPs. They are doing what they are trained to do. Pain management doctors look at things a little bit differently. At least they should.
By the time a patient shows up at a pain clinic for the first time, prescription drugs have already been tried. They haven't worked.
In some cases, it is a matter of having not tried the right medications. But in other cases, effective pain management requires a different approach. For many patients, everything from behavioral changes to physical therapy and alternative treatments are more appropriate than yet another prescription.
It would appear as though managing pain through a more holistic approach can help surgical patients feel better. What if we applied a similar mindset in the chronic pain arena? A more holistic approach could make an enormous difference.