The Reality of Modest Effectiveness
The other day I heard someone make the claim that psychological interventions for persistent, or chronic, pain are at best modestly effective. She went on to rhetorically ask why the field should promote such therapies when the empirical support for them is so unimpressive?
I’ve heard such statements countless times before.
It would be an important point if the field of pain management was filled with effective therapies. Pain management has many offerings in terms of therapies and procedures and, were it the case that these offerings were highly effective, it would make little sense to recommend behavioral therapies that are only modestly effective.
But it is not the case that there are many, highly effective therapies and procedures for the management of persistent pain. With one possible exception, there are actually no highly effective therapies for chronic pain.
A Systematic Review of the Effectiveness of Low Back Surgeries for Pain and Disability, Written for Patients and their Families
It’s common to believe that treatments recommended and performed by healthcare providers are effective. It’s generally understood, for instance, that governmental institutions hold medications to a certain level of scientific scrutiny and, as such, medications have been shown to be effective before healthcare providers are allowed to prescribe them to their patients. Most people think the same is true for procedures that are performed in healthcare. It’s common, for instance, for people to assume that surgeries have undergone governmental-level scientific scrutiny and have been shown to be effective before they are allowed to be performed on patients.
Effectiveness of chronic pain rehabilitation programs
It often comes as a surprise to patients that chronic pain rehabilitation programs are typically the most effective form of treatment for patients with chronic (non-cancer) pain syndromes. As a society, we tend to assume that medications, procedures and surgeries are not only effective, but are the most effective treatments for chronic pain. But, it’s not the case.