Key Takeaways from Stanford’s Back Pain Day 2016

According to Dr Mackey, successful enactment of the NPS will allow clinicians to "treat chronic pain as the chronic disease [they] know it to be, and as the public health crisis that [they] know it is."

Last week, Stanford’s division of back pain medicine held its annual “Back Pain Education Day.”1 This free of charge day-long event was co-chaired by Sean Mackey, MD, PhD, chief of the division of pain medicine and Beth Darnall, PhD, and Clinical Pain Advisor board member and clinical associate professor, both at Stanford University School of Medicine.

Their aim with this event was to educate back pain sufferers, provide them with an improved understanding of their condition as well as with tools that they could later apply.

The day was organized around short presentations by back pain experts spanning the fields of medicine, psychology, nutrition, physical therapy, “representing the whole gamut of the experience of back pain,” in Dr Mackey’s words, and whom the audience could consult.

As Dr Mackey pointed out, about 1 in 3 Americans suffers from chronic pain, with associated costs of up to $635 billion. “While pain can be a symptom of another condition, when it becomes persistent, it can become a disease in its own right, one that fundamentally impacts just about every organ system in our body” added Dr Mackey.

He reminded the audience of the main points highlighted in the Institute of Medicine’s (IOM) report on chronic pain, which emphasizes preventive care and stresses the importance of a collaborative, comprehensive, community-based and inter-disciplinary approach to treatment.2

Pain is associated with a number of negative effects that include emotional distress such as anxiety, depression and anger. Sleep and quality of life tend to be also affected in affected individuals, and fatigue plays a key role in the condition. Because of these effects, individuals affected by pain often withdraw from friends and family, “the exact opposite of what they should be doing,” noted Dr Mackey.

A follow-up to the IOM report, the National Pain Strategy (NPS)3, an action plan with “specific goals, actions, time frame, resources and accountability” highlights key areas of chronic pain treatment.

The NPS calls for: 1. Population research to improve the quality and use of collected data, “to figure out what works for whom and under what circumstances,” and employ a precision medicine approach to the management of chronic pain; 2. Prevention and care to facilitate access to treatments, expand access to self-management programs, and acquire a better understanding of treatments that are effective, so as to later standardize these; 3. Address disparities in care; 4. Facilitate access to services and reimbursement for effective treatments; 5. Improve early and continuing professional education; 6. Improve public education and information, in particular, regarding safe opioid use.

According to Dr Mackey, successful enactment of the NPS will allow clinicians to “treat chronic pain as the chronic disease [they] know it to be, and as the public health crisis that [they] know it is.”

“What can we all do?” then asked Dr Mackey. “First, you can put pressure on the [federal government]. Talk with your representatives in Congress. Let them know of the importance of the National Pain Strategy,” he concluded.

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  1. Stanford back pain education day 2016. Available at: Accessed September 19, 2016.
  2. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Mil Med. 2016;181(5):397-399.
  3. Von korff M, Scher AI, Helmick C, et al. United States National Pain Strategy for Population Research: Concepts, Definitions, and Pilot Data. J Pain. 2016. doi: 10.1016/j.jpain.2016.06.009. [Epub ahead of print]