Chronic pain affects the physical, mental, emotional, and spiritual aspects of a patient's life. Daily non-cancer pain in the elderly has been associated with impaired activities of daily living, change in mood, and decreased involvement in social activities. Chronic pain impairs function, can lead to depression, and can even result in suicidal behavior. Chronic pain due to arthritis affects approximately 20 million Americans. This represents almost 50% of all pain sufferers.

What are the barriers to effective pain management?

Barriers to effective pain management are imposed by the health care system, physicians, and by patients themselves.

Patient Barriers:

-Reluctance to report pain to physicians.

-Reluctance to take pain medication

-Lack of education regarding available pain therapies.

-Compromised cognitive function secondary to certain pain medications.

Physician Barriers :

-Inadequate training and knowledge concerning pain management.

-Improper assessment of pain.

-Concern about scrutiny from regulatory agencies.

-Fear of patient addiction.

-Concern regarding analgesic side effects.

-Concern regarding the development of tolerance to analgesics.

Health Care System Barriers :

-Pain management is given a low priority in the system.

-Treatment availability problems exist in the system.

-Treatment access problems exist in the system.

-Inadequate reimbursement for pain management remains a problem.

-The most appropriate treatment may not be reimbursed or it may be too costly for the patient.

Many arthritis sufferers continue to take anti-inflammatory medications that no longer control their symptoms. Physicians, fearful of regulatory investigation, avoid appropriate treatment while switching patients from on ineffective medication to another. Some patients are forced to consider joint replacements prematurely, due to unrelenting, under-treated pain.

The net result of these barriers is that countless patients are forced to endure life instead of enjoy it. The squeaky wheel gets the oil. If your doctor is unable or unwilling to manage your pain insist on a referral to a pain specialist.

Nicholas Messina M.D.

Dr. Messina became a Board Certified Family Practitioner in 1985. He was in solo practice until 1994.He then helped form a group Family Practice in which he served as Vice President.

He left group practice in 1997 and became the Medical Director of a Wellness Center. He was responsible for coordinating the efforts of nutritionists, acupuncturists, massage therapists, exercise physiologists, and Chinese medicine practitioners into integrated medical care plans that were individualized to the patient.

He became the Medical Director of an independent clinical research facility in 2000. He has been the Principal Investigator in over 50 clinical trials involving osteoarthritis, diabetes, hypertension, hypercholesterolemia, chronic pain, depression, anxiety, dry eye, migraine, and diabetes prevention.

He has served as consultant to a nutritional company, and has formulated nutritional supplements.

By way of his website,his vision is to provide a road map for healthy living in today's hectic world.

As the site grows, information on diet, exercise, nutritional supplements, and stress reduction will be provided. Common illnesses will be explained, as well as their treatments.

He will continue to formulate and make available healthy, reliable, nutritional supplements.

Through the miracle of technology, he hopes to spend the same quality time with the many as he now does with the few.

He intends to accomplish this through the addition of free content on medical illnesses, a free newsletter, and eventually the addition of e-books and e-courses on specific topics.