
03/25/2025
A recent meta-analysis shows that most treatments for acute and chronic low back pain lack meaningful efficacy. Even those that outperformed placebo failed to reach a clinically important difference—meaning they likely don’t translate into real patient improvement.
Pain intensity reduction is often treated as the gold standard outcome, but it doesn’t have to be our only—or even primary—focus.
“Suffering may be related as much to the meaning of pain as to its intensity. Persistent helplessness and hopelessness may be the root causes of suffering for patients with chronic pain yet be reflected in a report of high pain intensity.”
— Ballantyne & Sullivan
“To understand the sufferer, one must understand the narrative, for it is through the story that the patient’s suffering is accessed. This means both hearing the illness story and listening for the suffering narrative therein.”
— Egnew, 2018
There’s value in expanding what success looks like in pain care.
Helping may have less to do with eliminating pain, and more to do with guiding patients through the pain experience—supporting them in returning to valued life activities. This process requires pain reconceptualization and a strong foundation of supported self-management strategies.
Short, powerful read by Ballantyne and Sullivan: https://lnkd.in/ee6b_v8G
Further reading on pain-related suffering from Peter Stilwell https://lnkd.in/eKG_jzVp
NYT article: https://lnkd.in/eFBtKA68