Early Intervention May Help Treat Patients At High Risk For Chronic Pain

pain riskAs we’ve said on the blog in the past, early treatment is extremely helpful when it comes to effectively managing a pain condition, but a new study found that early identification of chronic pain risk can ensure those at the highest risk can effectively manage their pain issues.

In a recent study conducted at the Duke University Integrated Pain and Wellness Program, researchers found that a carefully worded two-question survey successfully identified patients who were most likely to develop chronic pain. These patients were then managed with a more detailed risk stratification and holistic services that contributed to better overall outcomes.

“Unlike traditional methods that reactively address chronic pain, this approach proactively provides resources to prevent the development of high-impact chronic pain, ensuring the right patient gets the right resources at the right time—before the problem escalates,” said Padma Gulur, professor in the anesthesiology and population health sciences department at Duke University School of Medicine, and senior author of the study published in the New England Journal of Medicine Catalyst.

Identifying Early Chronic Pain Risk

For the study, researchers provided patients in Duke’s pain and wellness program with a two-question survey that was created after reviewing numerous studies that identified factors lead to poor pain outcomes. The two questions were:

1. Have you ever felt your pain is terrible and it’s never going to get any better? (Y/N)

2. Have you ever used an illegal drug or prescription medication for non-medical reasons? (Y/N)

More than 13,500 – about 12% – responded yes to both questions and were then considered to be at high risk for poor pain outcomes. Respondents were grouped into high, medium and low risk categories, and those at the highest risk were treated with a more personalized treatment plan based on specific needs. Some common treatments for this group included pain management with the help of a pain specialist, referrals for social services and access to behavioral health, physical therapy and nutrition programs.

“The interventions were tailored to meet patients at their current state of pain management and to motivate them toward adopting a more holistic approach,” said Gulur. “The guiding principles emphasize that patients are doing as well as they can with the coping skills they have but, with the right support, they can do better.”

Of the 432 patients at the highest risk of poor pain outcomes who participated in the holistic treatment approach, more than half (51%, 224 patients) reduced their morphine dose within 30 days. That number rose to 299 patients at 60 days and 349 patients at 180 days. Moreover, the program’s treatments were more effective than those achieved through other management strategies.

“By demonstrating the effectiveness of early identification and intervention for patients at risk of poor pain outcomes, this research can inform the development of new therapies and treatment approaches focused on prevention,” Gulur said. “It could lead to improved health services by integrating similar proactive care models into broader health care settings, enhancing scientific understanding, and leading to better health care outcomes through more personalized and preemptive pain management strategies.”

If you answered yes to both of the above questions, or you are struggling to manage a chronic pain issue on your own, follow the lead of the patients in this study and connect with a pain management specialist. Chronic pain is incredibly complex, and you need to work with someone who understands how pain impacts you physically, mentally, emotionally and behaviorally. We take the time to get to know you and ensure your pain concerns are heard and addressed, no matter how long it takes.

For more information about who may be at risk for developing a chronic pain condition or to talk with a provider about a current issue that you’re dealing with, pick up the phone and call Dr. Cohn and his team today at (952) 738-4580.