Why Effective Pain Management Remains a Challenge

*Nnenna Ugwu*

## **Abstract**

Pain is a subjective expression of neural impulses induced by a stimulus with a capacity to potentially damage tissues of the body. Simply put, pain is the reaction of the body to a potentially noxious or noxious stimulus, which threatens the normal homeostasis if unrelieved. Pain can be managed via pharmacological and non-pharmacological means, and pharmacological agents are the most widely accepted means, which have been shown to have variable effectiveness against pain. The barriers to effective pharmacological pain management in clinical practice are discussed in this chapter.

**Keywords:** analgesics, challenges, pain, pain management, pharmacological agent

#### **1. Introduction**

Despite the consistent scientific interest in pain research and pain management, pain has continued to remain an obstacle which threatens the welfare of patients. The challenging nature of pain has been extensively reported by clinicians and researchers [1–4]. Adequate pain relief is hardly achieved even when pain appears to be the most usually presented symptom by patients in the emergency department [5–8]. Pain accounts for over 40% of all the primary complaints in the emergency department [9], with a greater proportion of these patients reporting moderate to severe degree of acute pain [10]. Considering these reports, it would seem normal to assume that the institution of pain management would be prompt and effective. However, reports across all treatment settings indicate that adequate pain management is hardly achieved, and most patients continue to experience pain despite the institution of pain management strategies. For instance, nearly half of 71 patients and 74% of 842 patients presenting moderate to severe degree of acute pain complained of pain of similar intensity at discharge from the emergency department [7, 11]. The observations from the postoperative setting are also similar to that of the emergency department. Most surgical patients also reported a higher degree of intense acute pain following surgery, with over 73 million surgeries performed annually in the United States [12]. Additionally, 82% of 250 surgical patients expressed pain from the immediate postoperative period until 2 weeks postdischarge, and 86% of these patients experienced moderate to severe degree of pain [12]. Pain was also incriminated in most patient surveys and complaints to health services [13]. It is therefore clear that achieving optimal pain management is still a key issue across treatment settings even though pain is a manageable condition and effective pain management is possible as evidenced in experimental literature.
