Pain management is a complex and multifaceted field, often requiring a nuanced understanding of the science behind it. This is particularly true for rheumatologists, who frequently encounter patients suffering from chronic conditions like fibromyalgia. However, according to Philip J. Mease, MD, of the Swedish Medical Center and the University of Washington, many rheumatologists may not be fully equipped to handle pain management.
Dr. Mease, speaking at the Basic and Clinical Immunology for the Busy Clinician symposium in Scottsdale, Arizona, noted that many rheumatologists are not adequately trained to understand pain in a comprehensive manner. This lack of understanding can lead to a reliance on immunomodulatory medications, which, while effective in some cases, may not be the most suitable approach for all patients.
To understand why this is the case, it’s important to first understand what pain is. Pain is a complex sensory and emotional experience that is associated with actual or potential tissue damage. It’s not just a physical sensation, but also an emotional one. It’s a signal from your body to your brain that something is wrong.
In the context of rheumatology, pain is often a chronic issue. Conditions like fibromyalgia, for example, are characterized by long-term, widespread pain. This type of pain is not always well-understood, and it can be difficult to manage. It’s not as simple as just treating an injury or infection – it’s a complex, ongoing issue that requires a comprehensive approach.
This is where the importance of understanding the science of pain comes in. By understanding the mechanisms behind pain, rheumatologists can better tailor their treatment approaches to the needs of their patients. This might mean using a combination of medications, physical therapy, and psychological support, rather than just “hammering patients with immunomodulatory medications”, as Dr. Mease puts it.
Immunomodulatory medications work by altering the immune system’s response to inflammation and pain. They can be very effective in managing certain types of pain, particularly those associated with inflammatory conditions. However, they’re not a one-size-fits-all solution. Some patients may not respond well to these medications, or they may experience side effects. Others may have pain that’s not primarily driven by inflammation, and thus may not benefit from immunomodulatory medications.
This is why a comprehensive understanding of pain is so crucial. By understanding the different types of pain and their underlying mechanisms, rheumatologists can better determine which treatments are likely to be most effective for each individual patient. This might mean using different types of medications, or it might mean incorporating non-pharmacological treatments like physical therapy or cognitive-behavioral therapy.
In conclusion, managing pain in rheumatology is a complex task that requires a comprehensive understanding of the science of pain. It’s not enough to just prescribe medications – rheumatologists need to understand the underlying mechanisms of pain and tailor their treatment approaches accordingly. By doing so, they can provide better care for their patients and help them manage their pain more effectively.
To read the full journal article, head to https://www.healio.com/news/rheumatology/20240222/managing-pain-should-be-more-than-hammering-patients-with-immunomodulatory-medications