Faced with chronic pain, surgery is not always the best solution: a comprehensive, multidisciplinary approach could offer better prospects for recovery.
A recent systematic review highlights that surgery is sometimes considered too quickly to treat chronic pain associated with low back pain, without a thorough evaluation of alternatives or consideration of potential sequelae. Anne Marie Pinard, Head of the Chronic Pain Service at CHU de Québec-Université Laval and member of the QPRN, stresses the importance of a comprehensive, multidisciplinary approach to patient management.
Dr. Pinard highlights the compartmentalization that exists between surgical and non-surgical treatments, while psychological factors such as anxiety and depression play a key role in the outcome of interventions. These factors, which are rarely assessed before surgery, should be taken into account right from the start of the decision-making process. Chronic pain is a complex condition that is not limited to identifiable anatomical damage. The study underlines the importance of a thorough clinical examination, rather than relying solely on imaging, which can sometimes divert attention to irrelevant abnormalities. If surgery is still necessary in certain emergencies, rehabilitation management for at least a year should be considered before intervention. However, limited access to such care is a major obstacle, often prompting patients and doctors to opt for a surgical solution sooner.
By promoting better education of patients and healthcare professionals, a multimodal and integrated approach would improve the management of chronic pain. In this context, only a minority of patients would actually require surgery, while easier access to rehabilitation would offer significant results without invasive intervention.
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