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Drugs for relief of pain in patients with sciatica: systematic review and meta-analysis

BMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e497 (Published 13 February 2012) Cite this as: BMJ 2012;344:e497

Re: Drugs for relief of pain in patients with sciatica: systematic review and meta-analysis

Can’t feel my pain?
Please listen to me doctor!

“Poor listeners”, yes physicians are poor listeners,
People with chronic pain see physicians as poor listeners* The Institute of Medicine committee on pain has so found,
This ‘sadly’ they felt and reported is the reality on ground.**

Most physicians have poor education and training in pain management,
A quarter of primary care physicians ‘feel unprepared’ in its management!*
In their regular clinics physicians are busy with so many sundry complaints,
In their ignorance of pain management, they ignore patient’s pleas on pain.

Physicians’ unscientific knowledge and attitudes towards pain relief-
Are the major impediments to patient’s relief and worsen his grief!
They have fear of giving stronger medicine for patient’s chronic pain,
Their fear of causing addiction is irrelevant in relief of cancer pain.

Why pain relief should be limited to pain specialists?
When pain is so common, shouldn’t it be known well by generalists?
Why pain education is not included in medical curricula?
Why patients have to suffer for our lop-sided curricula?

A patient comes to a doctor for his symptom relief,
If a physician can’t do that it damages patient’s faith and belief.
No use of any good intentions if a doctor is not well trained;
Pain relief is basic medicine in which all of us should be trained.

How can the doctor educate the patient about his pain?
He himself is so uneducated about the cause and relief of pain.
The Institute of Medicine has offered sixteen recommendations,**
They include students’ and clinicians’ prompt pain care education.

*Pizzo PA, Clark NM. Alleviating Suffering 101—Pain Relief. New England Journal of Medicine. Perspective. 2012, Jan 19; 366, No.3, 197-99.
** Institute of Medicine, Relieving pain in America: a blueprint for transforming prevention, care, education, and research. Washington, DC: The National Academies Press, 2011.

Dr Anil Kumar Chawla
Senior Consultant in Medicine,
Ex Associate Professor of Medicine,
Oman Medical College, Sohar, Oman

Competing interests: No competing interests

19 February 2012
Anil K Chawla
Internist
-
Ex Associate Professor of Medicine
Oman Medical College, Sohar, Oman
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