Mar 8, 2024 1:30:14 PM | Chronic Pain A History of Pain Management

Pain has been around for as long as humankind and the history of pain management is as complex as it is. In fact, it might be an accurate assumption that the first attempt at rudimentary medicine by the earliest humans ancestors was to address pain. And while we don’t know that for sure, we do know that the way that pain has been treated and managed is ever evolving. From ancient to modern times, addressing pain has been more than simply a topic of interest, but also an area of constant experimentation and innovation in order to reduce or better manage pain.

Early Understanding and Treatment of Pain

Religious beliefs and cultural traditions were the foundations for some of the earliest understandings and treatment of pain. Multiple ancient civilizations understood that pain could be unrelated to an injury or could be the result of something unseen. In some cultures, pain was thought to be the result of spiteful gods, evil spirits, or a test for the faithful. Enduring the pain was commonplace, as was engaging in religious rituals to regain the gods approval or expel bad energy. Other ancient cultures began using plants to try to treat pain, such as the use of the leaves of the coca leaves in Pre-Inca culture or opium in Central and East Asia.

In the 18th and 19th centuries, understandings of pain and how to treat it evolved. Emerging techniques ranged from new medications like morphine used to treat soldiers during the Civil War, to acupuncture being used to treat pain in places like China and Japan, to the beginnings of modern-day anesthesia. While these treatments were a vast improvement in managing acute and chronic pain there was still much to be learned about the connection between pain, the body, and the brain.

Pain Research and Management in the Modern Age

In 1965, two researchers published an article in Science Magazine that bridged the gap between other accepted but competing theories of pain at the time. Their work highlighted that feeling pain was the result of multiple systems within the body and laid the foundations for the understanding that pain can be triggered or amplified by other factors such as stress.

Around the same time, Dr. John Bonica, an anesthesiologist and researcher at the University of Washington was building a model of care  that focused on the person as a whole rather than simply the physical injury or symptom of pain. Together with his colleagues, he founded a multidisciplinary pain clinic that brought together different medical disciplines to devise pain treatment and management plans that focused on the person as a whole rather than simply the physical injury or symptom of pain. Through this work, the International Association for the Study of Pain was formed in the early 1970s and our understanding of how pain works and how to best treat pain vastly increased.

This multidisciplinary approach to pain management continued to increase in popularity over the next two decades, but sadly fell out of favor by the early 2000s.

How the U.S. Treats Pain Today

Today, individuals experiencing chronic pain have several traditional treatment and management options to choose from. The availability and effectiveness of treatment options vary for each person and may include:

• Surgery
• Site injections
• Over-the-counter medications (NSAIDs like aspirin or ibuprofen)
• Prescription Medications
• Topical ointments or lotions

Many of today’s plans also emphasize exercise therapy and physical activity, either supervised by a professional, like a physical therapist, or through at-home exercises. These sessions may also include heat or ice for pain relief and other potential benefits.

Exercise therapy is only one component of an integrated approach that leads to better outcomes for individuals experiencing chronic pain. Particularly for those with conditions such as osteoarthritis, exercise training by a healthcare professional, such as a physical therapist, can be a vital component of a long-term pain management plan⁸. Some types of physical activity or exercise that may be recommended to help address pain might include yoga or tai chi.

While there continues to be medicine that can be recommended for the management of pain, there are also many ways in which pain can be addressed that do not include medication, and those plans may include a number of different methods that together help in treating chronic pain.

The Future of Chronic Pain Management

One approach to managing chronic pain that is experiencing a resurgence within the medical community  is called biopsychosocial. This integrated approach to pain management creates an interdisciplinary team, often consisting of physicians, physiatrists, nurses, physical therapists, occupational therapists, psychologists, among others, who all work together to treat the physical, emotional, and social aspects of pain.

Therapeutic exercise, daily movement recommendations, nutrition modifications, sleep training, mindfulness, and/or working on thoughts and beliefs about pain are just a handful of examples that go along with a team-based approach to chronic pain management. As each person has their own unique experience with pain, types of pain management care plans attempt to find the best course for each individual.

All in all, a crucial part to any chronic pain management plan is to focus on understanding the individual person’s goals and motivations. By understanding what pain has impacted for them, support and care can be tailored to help them regain what they’ve lost.

Our integrated digital chronic pain solution digitizes the biopsychosocial approach, increasing people’s access to best practices that many pain physicians already use.

Contact our team to learn more about how RealizedCare might be able to help evolve your approach to pain in your workforce.