Pain is a part of life, from birth to death. In fact, at twenty-four weeks gestation humans are able to experience pain. Pain is useful, it provides a warning sign of an illness or injury. However, once the warning sign is recognized, pain should be treated and managed. Untreated, or inadequately managed pain has consequences that can adversely effect treatment, slow the healing process and cause a lifetime of disability.

Pain is one of the most frequent reasons that cause Americans to seek medical treatment. Surprisingly, inadequate medical treatment of pain, is a serious problem in the United States and is associated with unnecessary suffering, increased healthcare costs, workplace absenteeism and decreased quality of life. Analgesics including opiates are the primary medical treatment for severe pain. Barriers to adequate pain management often include provider: ignorance, fear and prejudice involving the appropriate use of analgesic opiates.

Because pain is identified primarily by self-report, there are certain patients who are at higher risk than others of having their pain under treated. At risk individuals include infants and children, those whose primary language and cultural background differ from their healthcare providers, some elderly patients, and individuals who are developmentally delayed, cognitively impaired, or are severely emotionally disturbed.

Inadequate pain management results in many adverse effects.

• Pain can increase sympathetic nervous system response
• Pain can increase metabolic activity resulting in catabolism, the breaking down of body tissues, which can impair normal healing after injury or surgery.
• Excessive pain increases the risk of deep vein thrombosis and subsequent pulmonary embolus, from decreased mobility and the release of stress hormones that affect blood viscosity.
• Pain can impair effective respiration, increase sodium and water retention, decrease gastrointestinal motility, and increase blood pressure.
• Inappropriately managed pain can cause patients to experience anxiety, depression, and sleep deprivation.
• Untreated pain can even impair an individual’s immune response.
• There is also evidence that acute pain that remains under treated may cause permanent nervous system remodeling and the possibility of a chronic pain syndrome.
  

• Accept a patient’s subjective complaint of pain as accurate and truthful.
• Resist the temptation to discount the value of pain assessment and intervention when other issues seem to take precedence.
• Advocate for appropriate pain management resources.
• Educate themselves about current pain management practices and research in order to meet their obligation to patients.
  

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