Role of the Brain in Chronic Pain: Painfully Absent in Medical Curricula

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Novel Treatment for Chronic Pain

According to NOI, chronic pain may be a lingering phantom that the brain refuses to forget long after an injury has occurred.  A person can learn how to conquer this pain in two steps:

  1. Understanding why and how the brain can signal pain even after an injury has healed.
  2. Practicing methods of reprogramming the brain’s perception of the injury until the pain signal disappears.

Pain Management is not Part of Medical School Curricula: Photo by By Taqu

Chronic Pain Management and Medical Education

Decoded Science asked Thomas Giles, Marketing Director of NOI, if the new information in Explain Pain is being incorporated into the curricula of medicine and allied health professions. Giles responded:

We are constantly educating health professionals (PT’s Occupational Therapists, Psychologists and Medicos) as they register for our courses. We are also hosting our second international conference this April in Adelaide.”

In spite of this important discovery about chronic pain, the majority of educational institutions in the United States and Canada do not include treatment of chronic pain in their curricula for licensure of physicians and allied health professionals.

Challenges to Incorporating Pain Management in Medical Curricula

According to the IOM, the problem with adding pain management to the medical curricula for licensure is that the curriculum is fixed, with no room for additional hours without taking away from other subjects.

However, the IASP is concerned that, although physicians are motivated to put their patients’ best interests at heart, ignorance in treating chronic pain causes them to adhere to traditional drug therapy for non-acute pain. The IASP identifies five crises in pain management today, two of which are listed below:

 “(2) Inadequate education of primary care providers about pain and how to treat it,

   (3) the largely unknown value of opioid treatment for patients with chronic, nonmalignant pain,”

The IOM also notes that both health care professionals and the public are largely ignorant of the nature of chronic pain. Its recommendations for improvement in the treatment of chronic pain include:

  1. Graduate programs must offer standardized training in caring for pain.
  2. Teach the public about the nature of chronic pain and alternative treatments that do not require medication.

The Future for Chronic Pain in Medical Curricula

The Institute of Medicine is optimistic that medical schools will make room in the curricula for the treatment of chronic pain.  To follow is the closing statement of the IOM’s “Blueprint for Action:”

 “Given the burden of pain in human lives, dollars and social consequences, relieving pain should be a national priority.”

Resources:

International Society for the Study of Pain. Pain Clinical Updates. (2012). Accessed March 12, 2012.

Moseley, G.L. Teaching people about pain:  why do we keep beating around the bush? Pain Manage. (2012 2[1], 1-3).  Accessed March 12, 2012.

Institute of Medicine of the National Academies. Relieving Pain in America a Blueprint for Transforming Prevention, Care, Education, and Research. (2011). Accessed March 12, 2012.

Neuro Orthopaedic Institute. Healthy Notions of Self Through Neuroscience Knowledge. Accessed March 12, 2012.

Watson, J.W., McGillion, M., Hunter, J., Choiniere, M., Clark, A.J., Dewar, A., Johnston, C., Lynch, M., Morley-Forster, P., Moulin, D., Thie, N., von Baeyer, C.L., Webber, K. A survey of prelicensure pain curricula in health science faculties in Canadian universities. (2009). Pain Research and Management. 14(6): 439–444.  Accessed March 12, 2012.

Butler, D. and Moseley, L. Explain Pain. (2003). Noigroup Publications, Adelaide, Australia.

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