Drug treatment of chronic pain conditions is essentially a complete (>97%) failure

If costs, adverse effects, and other clinical and ethical failures were included in this discussion, then the medical treatment of chronic pain would be seen as a complete disaster.

Drug treatment of common chronic pain conditions is essentially a complete (>97%) failure, providing nearly zero therapeutic benefit.

If costs, adverse effects, and other clinical and ethical failures were included in this discussion, then the medical treatment of chronic pain would be seen as a complete disaster.

Graphical representation of the medical mismanagement of common chronic pain conditions—fibromyalgia, osteoarthritis, low-back pain, neuropathic pain, and inflammatory arthritis—showing zero-low effectiveness and confidence in commonly used drugs for these common pain conditions. None of the commonly used drugs in the treatment of intermediate-term and long-term pain demonstrate at least a moderate benefit (ie, exclusion of small benefit or no benefit) and at least moderate strength of evidence (ie, exclusion of low-level evidence); in other words, all treatments are essentially failures using a reasonable modicum of moderate efficacy and moderate evidence for intermediate/chronic pain. Duloxetine for neuropathic pain and NSAIDs for inflammatory arthritis are the only two treatments that show moderate benefit with moderate quality of evidence but only for the treatment of short-term pain—generous inclusion of this data for short-term pain shows that at least 97.6% of medical treatments can be considered failures and/or unreliable since all other treatments lack moderate-or-better efficacy with moderate-or-better evidence. Data from page 562-3 of Raymond et al, Nonopioid Pharmacologic Treatments for Chronic Pain published in American Family Physician (2021 May) based on Agency for Healthcare Research and Quality (AHRQ) publication 20-EHC010 published April 2020. If costs, adverse effects, and other clinical and ethical failures were included in this discussion, then the medical treatment of chronic pain would be seen as a complete disaster. © 2024 Dr Alex Vasquez • InflammationMastery.com • HealthyThinking.substack.com