In their research, Korff and colleagues have observed a continuum of chronic pain, with no distinct class of chronic pain patients. No clear demarcation distinguished persons with possible or probable chronic pain from those with less significant and enduring pain. They state: “Chronic pain should be viewed as a condition whose future implications are inherently uncertain and mutable, rather than as a fixed trait identifying patients with intractable pain.
“The potential for change, indeed the likelihood of change, is an important and oft-neglected feature of chronic pain. For these reasons, the terms possible and probable chronic pain, appropriately emphasize the inherent uncertainty of long-term pain outcomes, with improvement always possible.”
This approach shifts the focus from the potentially stigmatizing labeling of ‘’chronic pain patients” to the likelihood of steps that might reduce future risks of significant pain and dysfunction.
The authors conclude by saying, “By broadening the defining features of chronic pain to include factors other than pain duration, both clinicians and patients may become more aware of opportunities to improve outcomes when pain continues past the normal time of healing.”
So now that we better understand the nature of this pain, can we say something important about the conventions of drug prescription? Animal models made a contribution, but have proven insufficient to the challenge. That’s coming up next. See you then.