Editor's Message

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June 2004

By Sarah Schmelling

It's a simple idea: talk with a person experiencing pain to understand what they are feeling and, by doing so, determine the most efficient treatment possible. But surprisingly, this concept-the basis of the quickly growing field of pain management-is a relatively recent theory. It has been only in the last few decades that practitioners have focused on the importance of the communication of pain as a means to better health care.

One of the primary problems in pain management, researchers have concluded, is that there is no common pain language. Both patients and practitioners lack the vocabulary to describe how pain feels, how often and in what ways it occurs, and where. This lack of consistent dialogue becomes apparent when looking at recent research, such as a study in the January 26 Archives of Internal Medicine, for which researchers at the University of Chicago interviewed just under 6,000 patients of an urban medical center. Of these patients, 59% said they suffered pain, and 18% said their pain was inadequately controlled. "We found that patients hospitalized in a general medicine service carry a heavy pain burden," the authors wrote.

As reports like this continue to come in, what can rehab professionals-pain specialists or not-do to work on their clients' pain on an everyday basis? One solution comes from the American Pain Foundation, which in April launched "Target Pain," an initiative to improve communication between health care providers and chronic pain patients. The organization will provide both patients and providers with resources to help them distinguish and describe the main components of chronic pain. These tools include a "Pain Notebook" that patients can use to record their daily pain experience and treatment in words and graphics. For practitioners working with clients who use the notebooks, there is also a quick reference card that will help them share vocabulary and descriptions. The foundation hopes that by educating health care professionals and the community at large, communication about pain will become much clearer and, therefore, much more beneficial.

There are two articles in this issue that share this theme-that better treatment and results can stem from looking at a fairly obvious, but not yet well-researched, simple idea. The first is our cover story, "The Secret Garden" (page 14), which profiles the Rusk Institute's Glass Garden, where therapists are learning the power of nature in pediatric rehab. The second, "Eye of the Beholder" (page 30), describes the connection in a prosthetic user's mind of how the device looks, with how it actually works. Again, it's surprising that these fundamental ideas that can lead to better treatment are truly right before our eyes.

--Sarah Schmelling
cwolski@medpubs.com

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