Mary Pat Aardrup, Former Executive Director of the National Pain Foundation, on the Challenges in Chronic Pain Management
Loolwa Khazzoom: What are some of the biggest challenges facing people living with chronic pain?
Mary Pat Aardup: About eight years ago, we conducted a series of focus groups throughout the country, to identify the greatest challenges that people in pain were experiencing. The most significant challenge, hands down, was lack of validation.
The lack of validation comes from employers and, sadly, physicians. It comes from family members and friends. Pain is an invisible disease that is a very, very difficult path on which to find yourself, because it truly impacts every single corner of your life — careers, finances, relationships. Everything is compromised.
When you’re not feeling well, and no one can see a splint or a cast or a wheelchair, people have a tendency to question whether or not your condition is real. Pain is still viewed as a character flaw. That attitude is a major hurdle to overcome.
I think we are beginning to overcome some of it, and we are beginning to recognize that pain is the fifth vital sign: When doctors check blood pressure, they check all the vital signs. Now they also check for pain.
But oftentimes, and very sadly, the pain is not believed. So people in pain are not only dealing with the pain and all of the major ramifications that come along with the pain, but they also are dealing with wondering whether or not what they are experiencing is real.
Although pain accounts for 80% of all of physicians’ business, very few health care professionals have had any training in pain at all. There have been numerous studies about this, but if you contact anyone who’s recently graduated from a medical school program, you’ll find out that pain has never been offered as a course or even as an elective. The condition is not getting the type of attention that it deserves.
LK: When Americans are in chronic pain, what do they most commonly turn to?
MPA: Sadly, a lot of people self-medicate because they aren’t being believed. Tossing pain medication at a patient might be all that a doctor knows how to do, in terms of pain management. And so one of two things will happen:
Doctors either will say, “That’s all we can do for you, and you’re going to have to learn to live with it,” or they will indicate that maybe the pain is all in the patient’s head. And that is a very discouraging thing for people in pain to hear. Doctors are not aware of all of the treatment options that are available. They haven’t had training.
LK: Why is it that with 80% of patients presenting symptoms of pain, the medical system is still so far behind in learning how to treat it?
MPA: There is more of an emphasis on treating disease. What we’re trying to do as an industry is to have pain recognized as a disease in and of itself. You need to treat the pain just as seriously as you treat the disease.
We formed The National Pain Foundation in order to empower people with the information they need, to understand that there are options. I would definitely go so far as to say that under-treatment of pain is probably the most serious public health issue facing our country today. And it’s only going to get worse, as the baby boom population begins to age.
LK: What are your thoughts on drug-free remedies for chronic pain?
MPA: Every option needs to be explored. There are many legitimate techniques that work. Validating what people are going through, however, is probably the most critical piece in treatment. When people feel believed, and they feel that what they’re going through is real, then some great things can happen.
Mary Pat Aardrup is the former executive director of the National Pain Foundation. The organization was established in 1998 to advance the recovery of people in pain, through information, education and support.