< Back to Press Room

http://www.npr.org/templates/story/story.php?storyId=120381128&sc=emaf

To Help Healing, Doctors Pay More Attention to Pain. Morning Edition. National Public Radio.

November 18, 2009

The old notion that pain is somehow "good" for you should be put to rest for good, say health officials. They are increasingly recognizing that control of pain leads to more rapid recovery for hospitalized patients, and can even cut costs.

While pain can function as the body's alarm that something is wrong, it can also be counterproductive, says Dr. Lynn Webster, who directs the Lifetree Clinical Research and Pain Clinic in Salt Lake City.

"Most of us just want to lie there, because if we move after an operation or major trauma, it hurts. So, it does seem intuitive that's the thing to do so we can heal," Webster says.

But when patients just lie there, Webster says they're putting themselves at risk. "Patients who have good post-op pain control are able to breathe better," says Webster. Deep breaths can prevent the development of pneumonia, which can lead to sepsis and, in severe cases, require that patients be put on a ventilator. If patients can get up and walk fairly quickly after a procedure, then they also decrease their risk of blood clots in the legs which, in some cases, can be fatal.

Controlling Pain Helps Healing

Controlling acute pain in the hospital setting can also decrease a patient's risk of developing chronic pain later on. When people begin to feel pain, Webster says the body begins to set up an inflammatory process in the central nervous system that's "hard to quiet down." For some people, that inflammation begins to feed on itself and, once discharged from the hospital, patients may go on to experience pain for months, even years afterward.

The Wong-Baker facial grimace scale.   UCLA

The Wong-Baker facial grimace scale is a common way for patients to let doctors know how much pain they are in. It goes from zero, which means happy and in no pain, to 10, which is unhappy and as much pain as you can imagine.

Nearly 10 years ago, the Joint Commission, which accredits hospitals, set new standards for how pain should be treated. It recommended that health providers routinely ask patients about the intensity of their pain — and then do something about it.

In fact, measuring pain has been coined the "fifth" vital sign, along with blood pressure, heart rate, temperature and respiration.

In most hospitals nationwide today, there is a 1 to 10 scale for patients to rate their pain. Compared to a decade ago, more hospitals are paying attention to pain management today, says Dr. Linda Hertzberg, an anesthesiologist at St. Agnes Medical Center in Fresno, Calif., and president of the California Society of Anesthesiologists.

The pain scale is often a visual image of a series of circles, starting with a smiley face that begins to diminish, circle by circle, until it becomes a full-blown tearful frown. Zero is no pain; 1 to 2 is considered mild pain; 3 to 6 is moderate pain; and 7 to 10 is severe pain.

Improvements In Treatment

It's nearly impossible to experience absolutely no pain after surgery or a procedure, says Hertzberg. And doctors do want patients to be conscious. Hertzberg says that when patients define their level of pain, it helps doctors target their treatment.

Methods for treating pain have advanced dramatically over the past decade, starting with the discovery in the mid-1980s that medication could be delivered directly into the spinal cord and prevent the brain from ever receiving information about pain, or even the surgery or procedure being performed — the medication literally stops the pain signals in their path.

"There's also peripheral nerve blocks, where you can, say, numb up someone's arm or shoulder, or numb up their leg for a period of up to 24 hours," adds Hertzberg. Advances in nonsteroidal anti-inflammatory pain medications have improved treatment, too, he says.

Webster describes all these changes as "revolutionary." Even so, they haven't filtered down to all hospitals and health care institutions. There are still "a lot of misconceptions" about pain, especially in the medical community, says Micke Brown, a nurse and the communications director for the American Pain Foundation.

Living With Pain

Erica Thiel, has a rare genetic disease MPS 1. Erica Thiel

Erica Thiel, 26, has a rare genetic disorder called MPS I, or mucopolysaccharidosis I. The disorder affects many body systems and can lead to organ damage, so she has undergone multiple surgeries. Thiel now sees a pain specialist.

Erica Thiel, 26, who has a rare genetic disorder involving enzyme deficiency called mucopolysaccharidosis I (MPS I), fell victim to those misconceptions for years. Thiel has had dozens of surgeries and procedures for joint, heart, brain and spinal cord problems. And, she says, she's endured lots of pain in different hospitals, most recently from abdominal surgery.

During her hospital stay, Thiel was treated by a number of medical residents. "I just kept asking them if there was something different we could do for pain control. I felt awful," says Thiel. "I couldn't sleep. I couldn't roll from side to side. They kept telling me to go to sleep, try to relax. I spent hours that night in tears, really upset."

Thiel says she was nearly hysterical because she thought that nobody believed her — they thought her pain was all in her head.

Thiel now goes to a pain specialist who helps coordinate her care whenever she is admitted to the hospital.

Webster says it can be challenging for doctors to treat pain, because it's subjective and, therefore, difficult to measure. There's no physiological test or X-ray that can tell doctors exactly how much pain patients feel, and where.

No Universal Measure Or Fix

And, because we are all genetically different, we may respond to the same amount of pain in different ways, says Webster. Some patients feel severe pain as a result of certain types of surgery or procedures, while others feel only modest or mild pain. In addition, each patient has a different response to pain relievers.

"There may be a tenfold difference in our response from one individual to another with the same drug given for the same amount of pain stimulus," says Webster, adding that "this is not something that has been appreciated for long within the medical field, and probably is still not appreciated by most physicians who are not in our field."

Health professionals like Webster would like to see the treatment and management of pain standardized as a medical specialty that is as rigorous as cardiology or pulmonology. In the meantime, Webster says patients should be their own advocates, sitting down with their physician, surgeon or nurse before any surgery that's not an emergency, and talking about what kind of pain can be expected and the various options available to control it.

Spread the word. Help us education, research and save lives.

Facebook   Twitter
Donate Now

Media Coverage

November 16, 2012
Physicians take lead role in confronting opioid misuse, but still face hurdles: This is the second in a series exploring the intersections between effectively caring for people living with chronic pain and the rise in unintentional poisoning deaths due to prescription painkillers. (The first post is here.) The series will explore the science and policy of balancing the need for treatment as well as the need to prevent abuse and diversion. This week’s story looks at clinical efforts to reduce the risk of opioid abuse and overdose while still caring for patients; the next story will explore the role of public health officials in curbing opioid abuse. Read More

November 14, 2012
AMA webinar spells out 8 ways physicians can curb opioid misuse: The Association holds the first in a series of webinars to teach doctors more about appropriate pain management. Read More

September 17, 2012
FDA Warns of Serious Skin Burns from Topical Pain Relievers: FDA Warns of Serious Skin Burns from Topical Pain Relievers Read More

July 3, 2012
Methadone deaths may have peaked, feds say: CDC » Doctors are more cautious about prescribing methadone for pain because of federal, state warnings. Read More

April 9, 2012
Filling In the Gaps on Pain Prescriptions: Filling In The Gaps On Pain Prescriptions Read More

April 5, 2012
Opioid Rotation Practices Linked to Fatalities: Opioid Rotation Practices Linked to Fatalities Read More

April 3, 2012
Switching Opioids Increases Risk of Overdose Death, Study Says : Switching Opioids Increases Risk of Overdose Death, Study Says Read More

April 2, 2012
Changing Opioids Causing More Overdose Deaths : Changing Opioids Causing More Overdose Deaths Read More

April 1, 2012
Doctors kill thousands due to 'death tables,' Utah expert says in new study : Reference tool responsible in death toll from prescription painkillers Read More

April 1, 2012
Opiate conversion charts killing patients : Opiate conversion charts killing patients Read More

March 8, 2012
What Whitney Houston Teaches Us: Whitney Houston has died from an as-yet unknown cause, but prescription medications are rumored. Her struggles with substance abuse are well documented, because she honestly shared them with the public in hopes of finding her road back. Celebrity deaths bring to our attention the national public health crisis with prescription drugs, and the list is growing: Health Ledger, Anna Nicole Smith, Corey Haim, Mike Starr. These people are not apart from or above us but hold a mirror up to our own lives. Most healthcare practitioners and counselors know a client, a friend or even a family member who has met the same tragic fate. Read More

March 2, 2012
LifeSource Co-Founder Lynn R. Webster, M.D. Receives Inaugural AAPM Presidential Excellence Award for Education: The American Academy of Pain Medicine initiates award to honor Dr. Webster’s work on the AAPM Safe Opioid Prescribing Initiative. Read More

January 12, 2012
The Chronic Pain Problem : Millions of Americans are affected by debilitating chronic pain, and diagnosis and treatment remain a challenge. Read More

November 2, 2011
Study shows Utah a leading state in painkiller deaths : A new study shows that painkiller abuse has not only reached epidemic levels in the United States, but overdose deaths continue a disturbing rise. Read More

November 1, 2011
Prescription Painkiller Overdoses in the US: Overdose deaths from prescription painkillers have skyrocketed during the past decade. Read More

September 14, 2011
Family: Player died from methadone overdose: Family members say a North Carolina high school quarterback died after a big victory last month after accidentally overdosing on some of his grandmother’s pain medication. Read More

August 26, 2011
Dr. Webster Pain Med Safety Interview: Host: Dr. Brian Grieves Radio station # (715) 524-2194 About: Dr. Brian Grieves is a radio show host at WTCH-AM, an affiliation WOTE-AM, both radio stations at Wisconsin. Every Saturday he gives his professional advice on "Health Talk" to his avid listeners in Shawano. Prior to working as a chiropractor, Grieves earned his Bachelors degree from the University of Wisconsin, a doctorate degree from Northwestern College, and his Masters Degree in Public Health from the University of Massachusetts. Read More

June 30, 2011
Dramatic increase of prescription-drug abusers seeking treatment: Dr. Webster joins KCPP to discuss trends in prescription drug abuse. Read More

June 23, 2011
'Rapid detox' a quick fix for opiate addiction?: USA Today Read More

June 15, 2011
LIFESOURCE ANNOUNCES NEW STUDY FINDINGS AVAILABLE ON DEATHS RELATED TO PRESCRIPTION OPIOD THERAPY: Nonprofit organization strives to address one of the nation’s biggest healthcare problems Read More

April 27, 2011
American Pain Foundation Announces New NSAID and Acetaminophen Pain Medication Safety Module and Public Service Announcement for PainSAFE Read More

April 20, 2011
U.S. Aims to Reduce Overdose Deaths, But Will the New Plan Work?: U.S. Aims to Reduce Overdose Deaths, But Will the New Plan Work? By MAIA SZALAVITZ Wednesday, April 20, 2011     The Obama administration announced on Tuesday a new initiative to reduce prescription painkiller Read More

April 19, 2011
Striving Toward Quality Pain Management: The epidemic of untreated chronic or recurrent pain has lasted for decades, yet millions of people are still not adequately treated. One significant barrier to effective pain management is that clinicians and patients are often reluctant to talk about pain... Read More

April 11, 2011
National Prescription Drug Abuse Expert From Utah To Present At Public Town Hall Meeting In Reading: Medical experts and law enforcement provide insights on adolescent prescription drug addiction Read More

March 22, 2011
National Prescription Drug Abuse Experts To Meet With White House Policy Makers: Experts will address prescription pain medication misuse and accidental overdose deaths with the White House Office of National Drug Control Policy Read More

March 10, 2011
National Prescription Drug Abuse and Overdose Deaths Expert Addresses Healthcare Professionals In Houston: Lynn R Webster, M.D. Read More

February 12, 2011
For Some Troops, Powerful Drug Cocktails Have Deadly Results: February 12, 2011 This article was reported by James Dao, Benedict Carey and Dan Frosch and written by Mr. Dao.   In his last months alive, Senior Airman Anthony Mena rarely left home without a backpac Read More

February 5, 2011
There are ways to help, prevent prescription drug abuse:   CHARLESTON, W.Va. -- Recently The Charleston Gazette ran a series on the emerging epidemic of prescription drug abuse. In a state with the highest rate of drug-related deaths, highlighting prescription drug abuse is an important public Read More

January 24, 2011
Morphine/Oxycodone Combination Superior to Separate Components: Montreal Read More

January 20, 2011
I Am An Addict:   Millions of older Americans are making this confession. Families are being torn apart. The good news: There's help Clean and sober for more than five years, Ron Dash has rebuilt his marriage and his life. “When I saw what Read More

January 10, 2011
Patients suffer when doctors are too scared to prescribe pain pills : Patients suffer when doctors are too scared to prescribe pain pills Monday, January 10, 2011; 8:36 PM    Every American should be concerned about the kind of message sent by the Jan. 2 front-page article "Doctors who pre Read More

December 15, 2010
Chronic pain patients, providers get new website:       Kathy Hahn Read More

December 9, 2010
Should an Overdose Antidote Be Made More Accessible?:   I've been writing about naloxone — the antidote to overdose of heroin, oxycodone or similar drugs — for more than 10 years, most recently for TIME here. The dru Read More

November 9, 2010
Addiction to painkillers hobbles more patients : ST. LOUIS — Nichole Marie Case unwittingly became dependent on opioid painkiller drugs. She's not alone. The National Institute on Drug Abuse estimated in 2008 that 1.85 million people in the United Stat Read More

October 25, 2010
Opioid safety is focus of $1 million-a-year educational initiative :   Opioid safety is focus of $1 million-a-year educational initiative Industry-supported PainSAFE targets how physicians and patients can avoid abuses and misuses of pain treatments. A group that represents patients living with pai Read More

February 11, 2010
The Effect of Academic Detailing on Curbing Opioid-Related Deaths in Utah

February 11, 2010
Root Cause Analysis for Unintentional Overdose Deaths Involving Opioids in Chronic Pain Patients Reveals Disproportionate Methadone Involvement

February 11, 2010
Costs of Oral Pain Medications Pre-IT Pump Implantation Compared to Post-IT Pump Implantation: A Retrospective Analysis

February 11, 2010
Select Medical-Legal Reviews of Unintentional Overdose Deaths

February 11, 2010
Comparison Of The Theoretical Cost Of Morphine And Prialt

November 18, 2009
To Help Healing, Doctors Pay More Attention to Pain. Morning Edition. National Public Radio.: The old notion that pain is somehow "good" for you should be put to rest for good, say health officials. They are increasingly recognizing that control of pain leads to more rapid recovery for hospitalized patients, and can even cut costs. Read More

November 28, 2006
National Expert from Utah Spearheads Educational Campaign: FDA Issues Methadone Warning: Providing Safe Access to Pain Medications. SALT LAKE CITY, Utah – November 28, 2006 – The Food and Drug Administration issued a warning yesterday to healthcare profe Read More

October 24, 2006
Prescription Medication Deaths Are On The Rise: Six Steps You Should Know: National Expert Calls for "Zero Unintentional Deaths" with Brigham City Physicians  SALT LAKE CITY, Utah – National pain medicine expert Dr. Lynn R. Webster will present his education campaign entitled Read More

October 18, 2006
Local Pain Medicine Specialist Calls for Zero Unintentional Deaths: National Education Campaign Comes to Brigham City Community Physicians. SALT LAKE CITY, Utah – October 18, 2006 – Dr. Lynn R. Webster, President of the Utah Academy of Pain Medicine and Medical Directo Read More

October 18, 2006
National Expert Calls for Zero Unintentional Deaths: National Expert Calls for "Zero Unintentional Deaths" with Hawaiian Physicians SALT LAKE CITY, Utah – National pain medicine expert Dr. Lynn R. Webster will present his education campaign entitled “Zero Unintentional Overdose D Read More

September 27, 2006
Methadone Related Deaths On The Rise : Six Steps You Should Know SALT LAKE CITY, Utah – Dr. Lynn R. Webster, President of the Utah Academy of Pain Medicine and Medical Director of Lifetree Clinical Research® & Pain Clinic in Salt Lake City, announces six steps to avoid acci Read More

September 20, 2006
Local Pain Medicine Specialist Calls for Zero Unintentional Deaths: Statewide Education Campaign Goes National SALT LAKE CITY, Utah – Dr. Lynn R. Webster, President of the Utah Academy of Pain Medicine and Medical Director of Lifetree Clinical Research® & Pain Clinic in Salt Lake City, announced that h Read More

September 18, 2006
Local Pain Medicine Specialist Calls For Zero Unitentional Deaths: National Education Campaign Comes to St. George Community SALT LAKE CITY, Utah – Dr. Lynn R. Webster, President of the Utah Academy of Pain Medicine and Medical Director of Lifetree Clinical Research® & Pain Clinic in Salt Lake City, a Read More

June 8, 2006
Dr. Lynn R Webster Kicks Off Statewide Education Campaign: LOCAL PAIN MEDICINE SPECIALIST CALLS FOR ZERO UNINTENTIONAL DEATHS SALT LAKE CITY, Utah – Dr. Lynn R. Webster, President of the Utah Academy of Pain Medicine and Medical Director of Lifetree Clinical Research® &a Read More

Go to Press Room