Chronic PainWhat to Learn From Chronic Pain Treatment Around the World

What to Learn From Chronic Pain Treatment Around the World

When you envision treating chronic pain, do you immediately think of pain medicines in a bottle? The conditioning to view pain medication as the first line of defense against chronic pain is unique to the United States. Other countries approach pain management quite differently, and we can learn a lot by studying chronic pain treatment around the world.

The perception of chronic pain 

One of the most revealing discoveries about chronic pain management is the perception of chronic pain in the United States versus other countries. A 2017 study revealed that 1/3 of Americans feel pain “very often” or “often.” In contrast, just 11% of people in South America and the Philippines feel pain that often.

The frequency of chronic pain in the United States may be related to a few different factors, including:

  • obesity: This condition can lead to and aggravate chronic pain. Americans have a higher rate of obesity than those in other countries.
  • increased consumption of painkillers: This can also contribute to chronic pain issues. 
  • mental health challenges: Conditions such as depression can make chronic pain symptoms worse.

Chronic Pain Treatment Around the World

Chronic pain treatment around the world

In addition to the amount of chronic pain that people report, people in different countries actually view the idea of pain differently. For instance, in South Africa, pain is seen as a sign of weakness. But in China, pain is often seen as something that is meant to be endured.

A society’s beliefs can shape how its citizens think of pain. This can affect the actions they will take in an attempt to relieve it. People in South Africa or China may not report pain to their doctors until it has become too severe due to these beliefs. This can change the treatment options available.

Access to healthcare

In many countries, chronic pain patients may have better access to pain relief and health care than U.S. citizens have. Places such as Canada, Switzerland, and Singapore offer universal health care. This helps to remove barriers for chronic pain patients who wish to seek medical treatment.

In the United States, access to chronic pain management is contingent on a number of factors. This includes health insurance. But even with health insurance, patients still need to be able to cover copays, out of pocket costs, and prescription costs.

Patients with chronic pain may put off treatment. This is especially true if they don’t have health insurance or if they don’t have the funds to cover costs. But even with health insurance, some potentially helpful treatments such as osteopathic treatments or acupuncture may not be covered. This puts a barrier between patients and the medical care they need. 

Learn more about chronic pain treatments around the world here: 

Effective treatments for chronic pain

The methods used to address chronic pain differ from country to country. In the United States, we tend to turn to opioids first. In fact, the United States consumes about 80% of the global opioid supply.

One opioid – hydrocodone – is widely used in the United States. Americans consume about 99% of its supply. Unfortunately, opioid use has resulted in enough deaths to be considered an epidemic. This crisis is lead by issues such as:

  • doctors prescribing opioids without explaining side effects
  • significant addiction risk of opioids 
  • patients receiving opioids in situations where their use isn’t warranted 

Chronic pain treatment around the world differs though. Throughout Europe, specialists prescribe opioids and tighter regulations restrict their use. Opioids are largely only used to treat cancer pain. But here in the United States, opioids are used for both cancer pain and non-cancer long-term pain.

Chronic Pain Treatment Around the World opioids and chronic pain

Instead of turning to opioids or pain medication for pain management, other countries are more likely to use other management techniques. In Japan, concerns over pain medication addiction mean that alternative treatments are often used, including massage and acupressure. And in traditional Chinese medical care, lifestyle changes and acupuncture are often incorporated when treating chronic pain.

Europe also incorporates complementary and alternative medicine for pain management. National health care systems reimburse these approaches when administered through a patient’s primary care. Treatments such as massage therapy and physical therapy are frequently used. This combination can lead to an increased quality of life for pain patients.

While alternative techniques can be well-paired with traditional medicine, regulation for natural health practitioners is also important. This arrangement prompts regular communication between patients, traditional doctors and natural health practitioners. 

Takeaway lessons

The United States can learn a lot about effective chronic pain management by looking at how other countries treat pain. Various factors have led to the current approach toward pain, including our lack of universal health care and oft-prescribed opioids.

The fact that the opioid crisis is so rampant in the United States highlights the need to find alternative chronic pain treatments. While many other countries are able to use more holistic treatments like massage or acupuncture to complement traditional medicine, that remains a challenge here in America.

Chronic Pain Treatment Around the World doctor discussing chronic pain with patient

Until health insurance companies cover more alternative treatments or universal health care is established, accessing a variety of pain management techniques will remain a challenge for patients. This is especially true for those who have limited financial reserves. Secure and open access to health care will allow patients to seek treatment for pain sooner and give them more options for treatment. 

One of the greatest challenges in pain management is that a technique that works for one patient won’t necessarily work for another. There is no one size fits all approach that can be applied to chronic pain. However, we can learn from the effective approaches that succeed in other countries and work to implement them here in the United States.

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Pain Cream SHOP
  1. Utter non-sense. The current “Opoid Crisis,” certainly never affected me. Also, I have a Medtronic Pain Pump and can’t even get my US doctor to go above 25% of its capacity!!! Keep in mind, the pain pump provided no euphoria or “high” whatsoever. It is very interesting to see this article as the writer clearly does not have severe Chronic Pain!

  2. Paige, I’ll start by saying that we do NOT have an opioid crisis in the US. We have an illegal fentanyl crisis. Fentanyl pours in from China something like shipping containers, or it comes across our southern border. This war on opioids has caused so much harm to chronic pain patients.

    I have tried every method out there to control chronic pain. I have used physical therapy, massage, water aerobics, psychology, TENS units, and opioids. When taken as prescribed, opioids are safe and effective. I still go to the gym and go swimming as much as possible, but covid kind of got in the way of that for a while. Those help to keep me active. The psychologist to whom our pain clinic referred me eventually said, “I don’t know why they sent you to me. You obviously need pain meds and this is not in your head. They are wasting a valuable resource by sending you here.” Not only that, but it wasted a lot of my time going to those sessions. The psychologist was top notch and I really liked talking to him, but the pain is not in my head.

    I hurt my back 11 years ago. I had to crawl everywhere and had no quality of life. Imagine having to push your breakfast across the floor while crawling on your hands and knees to get to a comfortable chair. Imagine having to practically crawl into a physicians office just to get seen.
    While many people have back surgery, everyone I know has had to go on to have many more surgeries. One of our friends had his implantable TENS unit removed and was told he could have no further back surgeries. Our pain management doc told us that of back surgery patients, 1/2 get better, 1/3 get worse, and 1/3 stay the same. I don’t like those odds.

    With proper pain management, I am now able to visit my daughter who lives in CA; I am now able to travel in general (been on many cruises since 2011 (many solo), and I can now sit comfortably to play tournament bridge. Pain meds haven’t addled my brain. I am able to shop and visit other relatives. Without pain management, I would have absolutely ZERO quality of life. You can’t think your pain away.

    There are many reasons for chronic pain treatment–not just back issues. Conditions such as peripheral neuropathy, fibromyalgia, etc. require some form of pain management. The US has cut back on opioid prescriptions as well as opioid production. The problem with opioid prescriptions began in the US in 2016 when the CDC sent out a set of guidelines to PCP’s about pain management. This document was written by a psychiatrist named Andrew Kolodny. My wishes for “Dr.” Kolodny and a truck collision know no bounds (Sorry, but he needs to experience intractable chronic pain.) The harm that document has caused the chronic pain community goes way beyond what Kolodny may have intended. The CDC is currently rewriting these guidelines, but they have done way too much damage. There are certainly bad docs who overprescribed or sold opioids out of their offices, but they are rare compared to legitimate physicians.

    PCP’s rarely write opioid scripts any longer due to fears of a DEA raid and/or of losing their licenses to practice medicine as well. But many pain management physicians also thought these guidelines were for them too. A great many of them cut back the dosage on their opioid scripts or stopped writing them altogether. This left many pain patients with no where to turn–except to the street.

    Because of the cutback of opioid prescriptions, or no prescription at all, many chronic pain sufferers have turned to street drugs where they unknowingly obtained oxycodone or vicodin laced with synthetic fentanyl. Because fentanyl is so much more powerful, it causes overdoses.
    Others have turned to suicide because their pain was so intractable that they had no quality of life.

    Now I am very sorry that there are so many overdoses in this country. But most are not from prescription opioids; they are from illicit street drugs. Synthetic fentanyl is cheap and, when cut with oxy or Narco, can reap great gains to a dealer.

    When prescription opioids are taken as directed, they are rarely addictive. Many would have you believe otherwise. I can cut back on what I take and not feel any effect. I take as needed which is how my script is written. I am dependent in much the same way I am dependent upon my high blood pressure meds. Truthfully, after 10 years, I do still get relief. My doctor always asks and always follows all of the DEA regs. Fortunately, I go to a hospital based pain management clinic. There are compassionate doctors there. When I had foot surgery a couple of years ago, my pain doc told me to take my meds every four hours, if necessary. Turns out the nerve block worked really well, and I didn’t need meds beyond what I needed for my lower back pain. I took no extra–but I had the option and was told to call if I needed help.

    Now if you go to a renowned hospital such as the Cleveland Clinic for surgery, don’t expect to get any pain meds following surgery unless you started in the ICU. Instead, you are sent home on Tylenol or NSAIDS which do nothing for post-surgical pain. Many hospitals are following the same procedures. You don’t get addicted to pain meds in 5 days of post op or dental opioids. You rarely get addicted at all. The percentage of the naturally occurring addictive gene is less than 1 %. This is when taken as directed. I don’t take pain meds to get a high (which you get if you take too much). I take them for relief and a decent quality of life.

    Recently, my pain doc asked me to speak to first year medical students at a renowned national medical school. They had had a lecture about chronic pain, then broke up into smaller groups via a Zoom meeting. One med student, after I had spoken of my personal experience, told them we have an illegal fentanyl crisis, NOT a prescription drug crisis. He told me this was very different from the lecture they had just heard

    Many will argue that legal opioids get into the wrong hands. Kids steal from Grandma’s purse or they have leftover meds from a surgical/dental procedure which kids find. The solution is simple: we keep our pain meds locked up. Georgia had a statewide campaign a couple of years ago. This should be a national campaign pushed by the CDC. Georgia had billboards all along the highways. I thought this was a wonderful idea and would be a great campaign all over our country.

    I direct you to a chronic pain advocate who is named Red Lawhern. Read some of the articles he has written. He is also on Facebook. At the moment he is on a couple of week sabbatical for family reasons.

    I would also direct you to Claudia Merandi who is also a chronic pain advocate and has testified before the Rhode Island legislature. She, too, is on FB and has a group called “Don’t Punish Pain Rally”. These two people can give you a different perspective on chronic pain and what it’s like to live with it. Claudia developed Krohn’s disease at the age of four! She knows chronic pain.

    I think you would benefit from some other points of view.


    • I agree with you Carol. Canceling low dose legal pain medicine for patients in high impact chronic pain because addicts are overdosing on illegal fentanyl makes as much sense as canceling Albuterol breathing treatments for asthmatics because there are people who are dying from smoking cigarettes.
      Stop the criminals don’t tie the hands of law abiding doctors and don’t cause more suffering in patients who were unfortunate enough to have been the victim of someone else negligence leading to a life of high impact chronic pain.
      Retired nurse and high impact chronic pain sufferer.

    • Carol, where in the USA can I even find a doctor who will take pre-existing pain pump patients? Also, as stated above, my doctor will not go above 20-25% of the pain pump’s potential, due to “anecdotal evidence,” which is not even empirical data. Any help at all, would be greatly appreciated – I don’t know how much longer I can do this?

  3. I’m in the us with a brother who has trigeminal neuralgia with two failed brain surgeries, not doctor will help us no one will prescribe him medication. He is at his breaking point and no one will help.


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