The Facts about Intractable Pain


Intractable pain is often referred to as IP in the medical world. Intractable means difficult to treat or manage. IP is a type of pain that cannot be controlled with normal medical care. Practical Pain Management defines IP as “pain that is excruciating, constant, incurable, and of such severity that it dominates virtually every conscious moment, produces mental and physical debilitation and may produce a desire to commit suicide for the sole purpose of stopping the pain.” Currently there is no cure for IP leaving many bed bound, home bound or hospitalized. Pain may be so excruciating that patients may not be able to eat or sleep. Patients with IP may notice a spike in their blood pressure and heart rate and high levels of the stress hormone cortisol. The main focus of treatment is reducing discomfort. Treatment is aimed to give patients as much improved life as possible. Most states in the United States have recently passed IP laws or established guidelines and standards to allow physicians to prescribe opioids and other end-stage treatments to these individuals without legal repercussions. Opioids are often prescribed in higher dosage than normal. It is very important to determine which opioid is most effective for each patient. Clinical pain management is very complex for IP. Specific treatment relies on the underlying cause of IP.

There is always has an underlying cause although not everyone with a chronic pain condition will develop IP. There are several causes of IP including, but not limited to, degenerative spinal disease, reflex sympathetic dystrophy (RSD), congenital skeletal disease, migraine-vascular headache, neuropathy, trauma induced headaches, osteoporosis, advanced cancer, and this only names a few. If patients do not respond well to usual chronic pain treatment, including mild opioids, anti-inflammatory medicine, muscle relaxants and others, they could suffer from intractable pain. Patients with Intractable Pain also do not respond to corticosteroid injections. Monitoring of the pain and the intensity is very important. This can be done by using a pain scale, which notes the severity of the pain from 0 (no pain) to 10 (severest pain). This will help in controlling the intractable pain.

If you suffer from intractable pain, be sure that your physician keeps documentation in your chart. Medical management of IP is usually a lifetime treatment which can cause complications in itself. Your chart will need specific details on what specific treatment methods have been applied and the effect of each one.

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