Think of the last time you had a surgical procedure done. There's a good chance you were told what to expect leading up to and during the surgery, but did anyone tell you what would happen after? Did a doctor or nurse inform you of how intense the pain would be afterwards and what to expect during your recovery?
And even beyond those details, how much were you taught when it came to self-care after the fact? Did you know and feel confident about what you could and should do to improve your chances of a full recovery and to minimize your pain in the process, and to minimize your chances of developing chronic post-surgical pain?
While in some cases patients leave the hospital or doctor's office with a comprehensive list of what to expect and do after their procedure or when it comes to their chronic pain condition, many don't. This lack of information can lead to confusion, frustration, more intense pain, and even an inability to completely heal.
This article will explore why doctors don't always provide patients with a full picture of what's going to happen and why this needs to change in the future. It'll also explain why this type of education is so crucial and how it benefits patients, especially those who deal with chronic pain.
The Current State of Chronic & Postoperative Pain Education
While some surgeries are so commonplace and minimally invasive that people don’t usually stress as much about having them done (like cataract surgery, for instance), other surgeries are literally life-altering. A patient who anticipates undergoing a more significant surgery might experience feelings of anxiety and dread leading up to it. Afterwards, depending on how their recovery goes, they may struggle with ongoing pain that impacts nearly every aspect of their life, including their sleep, social interactions, and work.
A mastectomy (a surgical operation that removes the entire breast) is one example of a surgery that has the potential to drastically impact a patient. In fact, one study published by the British Journal of Anaesthesia discovered that 65% of women between the ages of 30 and 49 experience chronic pain in its aftermath (1). Which begs the question: what are physicians doing to prepare their patients about the pain they may experience both during and after the surgery?
The same study includes a table that displays the prevalence of chronic postoperative pain. Depending on the type of surgery, the incidence of chronic pain after an operation ranges from 5% to an unbelievable 85%. See below:
The fact is that, despite the importance of postoperative and chronic pain education, not all patients are told what to expect during recovery, what self-care techniques they should implement, or how intense their pain might be. Or they are given this information but aren't in a state to fully comprehend it due to fatigue, sleep deprivation, pain, or side effects from medicine (2). In other cases, patients don't fully understand the information they are given because too much of it is provided in a written format, the doctor doesn't fully understand their needs to address them properly, or the information given isn't on par with the patient's current level of knowledge (3).
The Benefits of Establishing Pain & Recovery Expectations
While many times there is a disconnect between the healthcare provider's attempts to educate the patient and what the patient actually absorbs, when this is carried out correctly it can be very beneficial to the patient. In a study that looked at how pain education impacted patients who suffered from chronic pain, study participants who were given information about their condition (hence reframing their perspective on the pain and changing their self-care regimen) experienced less intense pain and an increased expectation of recovery (4). The idea is that teaching patients to reconceptualize their pain through education helps them to better cope with it.
Another study found that educating patients with total knee arthroplasty about pain management techniques using a simple educational card cut median opioid use by almost 50% (5). So, in other words, patients who are taught how to manage their pain using more natural methods are less apt to rely on highly addictive opioids to control it. In addition, informing pain sufferers about the side effects of their condition, ways to prevent it from getting worse, and possible treatments may reduce their potential dependence on pain medications, the amount of time and money they spend on their condition, and the number of calls and visits they make to healthcare providers.
Plus, when a doctor invests in educating their patient, they establish a partnership with them that can lead to increased compliance (6) (of performing self-care, including taking medicine.) This, in turn, helps to bring about better outcomes for the patient, including a higher quality of life.
The Changes That Need to be Implemented
In an ideal world – hopefully, the future – healthcare providers will take the time to discuss in detail the topics of pain intensity, recovery expectations, pain management methods, and treatment options with all their patients. They won't just hand over a short pamphlet. And with this knowledge, patients will be better equipped to manage their pain, cope with it, and perhaps even overcome it.
Doctors might consider using Mariano's VEMA model to provoke and create opportunities for their patients to learn (7). The VEMA model includes 1) validation, 2) education, 3) motivation, and 4) activation. The doctor would start by validating their patient's experience and symptoms. They would then educate the patient by offering guidelines and concerns. To motivate them, the doctor would engage the patient through discussion and questions. Finally, activation would take place once the doctor and patient together have created goals and an action plan to reach them.
A Final Word From Lin
Like many others, you've likely experienced a time when you didn't get all the information you needed from your doctor about your condition or health procedure. Given that this lack of information can lead to negative consequences – like not knowing when your pain will lessen or go away – it's imperative that healthcare providers start placing an emphasis on pain education.
A remote health platform that serves people who are seeking to end chronic pain, Lin will pair you with a caring health coach who will listen to your pain experiences and inform you of what you can expect. Lin supports many people both before and after operations for issues like long-standing back, neck, and shoulder pain. This kind of support makes a world of difference. Contact us today and we’ll help you find the best solutions for your chronic pain so you can move beyond it and get back to living your best life.