Mallick-Searle Theresa, Sharma Kristin, Toal Philip, Gutman Asya
Stanford Health Care, Division of Pain Medicine, Redwood City, CA, USA.
Kessler Institute for Rehabilitation, West Orange, NJ, USA.
J Multidiscip Healthc. 2021 Feb 10;14:335-347. doi: 10.2147/JMDH.S288401. eCollection 2021.
Chronic pain is often associated with functional limitations that have a huge impact on patients' lives. However, despite being relatively common, chronic musculoskeletal pain is still viewed by some as a symptom of another disease rather than its own condition, and is therefore poorly addressed. This is compounded by other challenges in the field, including education gaps for both healthcare professionals and patients, a lack of universal and comprehensive assessment tools, poor societal perceptions of chronic pain, and the current stigma around the use of opioids. Here, we review the current chronic musculoskeletal pain management landscape in the United States and offer professional insight into emerging methods that can be used to improve patient outcomes, in particular, the achievement of meaningful functional goals. This perspective incorporates our combined multidisciplinary (psychiatry, psychology, nursing, physical therapy, and general medicine) experience and insights. We believe that chronic pain is a multifactorial experience and treatment requires an integrated, multidisciplinary approach from a range of healthcare providers. For the best patient outcomes, this team should work together to assess and treat the patient as a whole, addressing their pain and also providing education, empowerment, and support to enable patients to set and achieve meaningful functional goals that will provide real improvement in their quality of life. We believe that the healthcare community should elevate the conversation around chronic musculoskeletal pain management beyond that of just pain, to encompass the meaningful benefits that improvement in functional outcomes brings to patients.
慢性疼痛常伴有功能受限，这对患者的生活产生巨大影响。然而，尽管慢性疼痛较为常见，但慢性肌肉骨骼疼痛仍被一些人视为另一种疾病的症状而非一种独立病症，因此未得到充分治疗。该领域的其他挑战使情况更加复杂，包括医疗保健专业人员和患者的教育差距、缺乏通用和全面的评估工具、社会对慢性疼痛的认知不足，以及目前围绕阿片类药物使用的污名化。在此，我们回顾了美国目前慢性肌肉骨骼疼痛的管理现状，并对可用于改善患者治疗效果的新兴方法提供专业见解，特别是实现有意义的功能目标。这一观点融合了我们多学科（精神病学、心理学、护理、物理治疗和普通医学）的综合经验和见解。我们认为，慢性疼痛是一种多因素体验，治疗需要一系列医疗保健提供者采用综合、多学科的方法。为了实现最佳的患者治疗效果，这个团队应共同努力对患者进行全面评估和治疗，解决他们的疼痛问题，同时提供教育、增强其能力并给予支持，使患者能够设定并实现有意义的功能目标，从而切实改善他们的生活质量。我们认为，医疗保健界应将围绕慢性肌肉骨骼疼痛管理的讨论提升到不仅仅关注疼痛的层面，还应涵盖功能结果改善给患者带来的有意义益处。
