Doctors need to do more to tackle the problem of pain experienced by joint replacement patients, a European conference has heard.
Experts called for more evidence-based treatments – and called for a multi-disciplinary approach to preventing post-operative pain, which they warned was often neuropathic.
The concerns were raised at a symposium called by EFIC, the European Pain Foundation, in Dubrovnik, Croatia.
The conference heard evidence from systematic reviews that 20% of knee replacement patients report chronic pain as do 9% of hip replacement patients.
Professor Henrik Kehlet, from the University of Copenhagen, Denmark, said: “More recent French, Swedish and Danish studies also prove that a surprising proportion of the patients continue with pain therapies or need even more painkillers after the surgical intervention than before it �- and that cannot be the purpose of elaborate and expensive operations.”
Dr Vikki Wylde, from Bristol University, UK, told the symposium that these might understate the problem. She said the pain was often linked to reports of pain in other parts of the body.
She said: “The current pain assessment tools do not always provide us with comprehensive information. In addition, research suggests that some individuals do not like to admit after surgery just how much pain they suffer because they do not want to seem ungrateful or because the pain after the operation may be a little less intense than before.”
She added: “Chronic pain after joint replacement is multifactorial and therefore it is important that treatment is matched to patient characteristics. This requires a tailored and multidisciplinary approach to treatment.
“Medical care of patients whose pain does not ease after their joint operation must be improved. There needs to be a clear entry into services, and standardised protocols to guide treatment.”
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