Chronic pain management focuses on the individual, not on the pain

As a retired spinal pain physician, whose patients with low back pain had a mean episode duration of 2.5 years and those with neck pain had a mean episode duration of pain of 1.3 years, I welcome the review by Kang and colleagues.123 These studies confirm the considerable extent of both spinal and extraspinal comorbidity, sleep disturbance, and psychological distress that Kang and colleagues mention.23 I also recognise the “heartsink” patients who have usually seen many consultant colleagues for a wide variety of complaints and those with hypersensitivity. I accept that some patients do need further investigations, but they can be discussed in a manner that does not induce further anxiety—for example, to ensure that there is no contraindication to intensive rehabilitation. Expressing a clear interest in the individual’s family, work, and interests will begin the process of building confidence and hope in the clinical paths being recommended.The review, however,…
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