We need policies for chronic pain sufferers that work
'We all know the benefits of exercise, but many people who have debilitating chronic injury, disease and pain don’t or can’t exercise. What do people with chronic pain do when they can't exercise?
‘We need policies that work to overcome these barriers, and the recent announcement by Federal Minister for Health, Greg Hunt of $6.8 million in funding for initiatives to improve understanding of pain is very welcome,’ said Andrew Gallagher, President Massage & Myotherapy Australia.
‘While exercise in all its forms is recommended as a primary response to four of the highest risk chronic disease factors[i] identified by the Australian Institute of Health and Welfare (AIHW) involving body mass, high blood pressure, musculoskeletal disease, and back pain, there is a glaring gap in funded programs to address chronic pain levels that prevents exercise.’
Mr Gallagher said, 'If people suffering from chronic illness and pain can’t exercise, the question then remains– how can we help them exercise more and manage their chronic conditions better?
‘The obligations of healthcare and political leaders are clear. We need to develop and fund policies that promote and support a mix of responses that overcome the barriers to better pain management and higher levels of exercise.
‘The upcoming election provides opportunity for all political parties to address this national issue in their policy platforms by recognising the range of efficacious medical and therapeutic interventions that help to reduce pain and enable pain sufferers to move freely and exercise more,’ Mr Gallagher said.
‘Education and pharmaceuticals are only part of the solution. All the available literature suggests that no single pain management response offers the answer. Since opioids are no longer available over the counter, the importance of finding alternative cost effective therapies to manage chronic pain is even more pressing for pain sufferers.
‘This presents an opportunity to strengthen universal access to affordable quality health care through the central role that General Practitioners play in informing and managing the health conditions of their patients.
‘Supporting GPs with information and funding for access to a mix of responses from pharmaceuticals to clinical therapies will at least give pain sufferers the medical and financial opportunity to find solutions that work best for them.
‘Funded access to allied and complementary pain management services such as remedial massage that is of clinical benefit needs to be part of the mix', Mr Gallagher said.
‘Clinical studies indicate that massage improves mobility and reduces pain for people dealing with issues involving body mass, low physical activity levels, high blood pressure, musculoskeletal disease and back pain.
‘As part of their Federal election promises, we call on all political parties to declare detailed policies to improve the plight of pain sufferers through integrated and preventative healthcare at the primary care level. For example:
1. Public awareness—facilitate improved education, awareness and access to appropriately-qualified massage therapists and myotherapists for GPs, allied health practitioners, and the general population.
2. Insurance—strengthen the private health care system by encouraging/incentivising Health Funds to offer higher levels of health insurance rebates for clinical massage therapy and myotherapy.
3. Public funding—extend the Medicare Benefits Schedule for Occupational Therapy to include professional appropriately-qualified massage therapists and myotherapists as recognised allied health service providers under the GP Management Plans and/or referral only.
‘While professional massage therapists and myotherapists do not offer cures, they do offer health services specifically designed to improve mobility, and reduce the symptoms of pain and stress, so people can lead more active lives,‘ Mr Gallagher said.
‘Massage is an intervention of patient choice because it provides a cost effective efficacious response that frees up muscles, improves mobility and reduces pain, when administered by professional, qualified therapists.
‘This low cost underutilised workforce offers therapies that are readily available locally.
‘Funded programs that improve public education and information available to health professionals such as GPs and the community about the alternatives available will benefit people suffering from chronic pain,’ Mr Gallagher said.
The AIHW 2018[ii] cites the Australian Physical Activity and Sedentary Behaviour Guidelines[iii] which recommend people aged 18 to 64 exercise for at least 150 minutes over 5 sessions per week; and over 65 years, at least 30 minutes per day.
These activities can reduce premature death by as much as 23% and cancer-related mortality by up to 31%.[iv] They may also reduce the associated pain symptoms of chronic conditions such as osteoporosis and sarcopenia (loss of muscle mass and strength) in older Australians—conditions that may limit functional capacity and increase the risk of falls.[v]
The National Pain Survey found that people living with chronic pain want empathic, non-judgemental and well-informed health professionals who want to listen and partner with them. They want validation that their pain is real, that their mental health is challenged by it, and that resources for both pain and mental health are needed.
More information and research about massage and managing high risk diseases identified by AIHW is available.
[iv] Stamatakis E. et al. 2017, 'Does Strength-Promoting Exercise Confer Unique Health Benefits? A Pooled Analysis of Data on 11 Population Cohorts With All-Cause, Cancer, and Cardiovascular Mortality Endpoints', 187(5) · October 2017.
[v] Peter D. Hart, 'Muscle Strengthening Activity in Addition to Physical Activity and Health-Related Quality of Life in Adults', World Journal of Preventive Medicine, 3.2 (2015): 24-27.