Healthcare providers have been doing everything they can to help relieve patient pain for as long as there have been doctors and nurses. Even ancient healers without medical degrees took on the responsibility of managing pain. But what we now know as pain management in the modern era was born from three systemic changes introduced in the 1960s. What were those changes?
- The recognition that pain can occur without tissue damage.
- The recognition that pain can be chronic, persistent, and debilitating.
- The introduction of multidisciplinary pain clinics.
Patients visiting a KindlyMD clinic in Utah now have the benefit of working with healthcare providers who understand chronic and persistent pain. KindlyMD recognizes that tissue damage is not always necessary to create pain. Their clinics utilize a multidisciplinary approach to manage pain.
Pain Without Tissue Damage
Although Dr. John Bonica was likely not the first physician to propose the possibility of pain without tissue damage, he is credited as being the one who brought it to the attention of the medical community and essentially forced recognition of the fact. The Sicilian-born anesthesiologist was also a professional wrestler and is credited as the father of pain medicine as a discipline.
Bonica was a rather accomplished wrestler from his high school days through a professional career that helped him pay for medical school. But so many years of professional wrestling left him with a lifetime of chronic pain. He made it part of his life’s mission to find better ways to treat chronic pain than western medicine offered at the time. He pioneered the idea of pain management as a medical specialty.
Recognition of Chronic Pain
Chronic pain has existed for as long as humans have roamed the earth. But prior to the 1960s, it was not readily recognized by western medicine. That changed thanks to the work of British nurse Dame Cicely Strode Saunders. In addition to forcing recognition of chronic and debilitating pain, Saunders also introduced the ideas of palliative and hospice care.
Her work is credited with opening western medicine to the idea that pain and its underlying causes couldn’t always be cured. She championed the idea that people experiencing incurable pain still deserved treatment. They deserved medical help to manage their pain as much as possible.
Multidisciplinary Pain Clinics
About the same time Saunders’ work was being recognized, the first multidisciplinary pain clinics began opening in the U.S. The way these clinics provided care was revolutionary at the time. Rather than a single doctor taking on sole responsibility for a group of patients, the clinics combined providers and specialties in a collaborative way.
Most of the clinics made an effort to merge pharmacology with physiotherapy and psychology. In so doing, they were able to take a more comprehensive approach to figuring out why a person was experiencing pain and then doing what was possible to mitigate it.
It was also about this time that western medicine began taking a second look at opioid medications. Previously treated with skepticism due to their high potential for addiction and abuse, opioid medications were back on the table at these new pain management clinics.
Where We Are Today
More than fifty years later, pain management is still a specialty of American medicine. Pain management clinics still rely on a multi-disciplinary approach. But as clinics like KindlyMD have demonstrated, there is less of a reliance on opioid medications. Providers and the clinics they work for are eager to recommend other therapies as an alternative. The success they and their patients enjoy today can be traced back to the pivotal 1960s.