Yeah so to clarify, pain management departments generally deal with chronic conditions. My back hurts, I have migraines, I have a neural condition, etc. Many times, chronic pain is treated at the symptom level: here’s a opioid for your back pain, for example, or here’s a drug to make your migraines endurable when they inevitably happen. The problem is that, often, chronic pain is the result of a treatable condition elsewhere in the bodily system: you have back pain because you sit like a slug, or because you’re depressed, or your core is weak and you’re not supporting yourself correctly.
In these cases, treating the cause treats the symptom. Treating the cause in this way is massively beneficial to the patient for a variety of reasons: no drug dependencies, no side effects from those drugs, and of course, the symptoms are weakened or stopped altogether. Unfortunately, symptom treatment is extremely common. I can’t base this on any data, but anecdotally, it appears to be the most common treatment method by a landslide.
What this means is you have people (who VERY OFTEN have solvable problems) addicted to opioids or on powerful medications whose side effects are fucking profound, and the doctors literally have no endgame. This addiction, these side effects - this is just your life now, and no one is incentivized to improve it for you, the patient. Ideally, you’d be on no medications, and not have these problems, but your treatment is not geared towards that, and so no improvement is made, or expected to be made.
It is also worth mentioning that there appears to be evidence that opioids can wholly create or exacerbate pain in people addicted to them, thereby ‘necessitating’ dosage increases or continued dependency. Pain management specialists have described this to me as a result of new neural pathways for that pain growing in strength, like a frequently-revisited memory, in combination with the reward center firing off. Again, anecdotally, my experience corroborates this 100%.
Essentially, chronic pain management currently appears to be dominated by acute pain management treatment methodology, which leaves the patient beleaguered by side effects (I can’t stress enough how crippling these can be), sometimes addicted, and in spite of these prescriptions, still in pain.
(and of course, addendum to say that some conditions can only be treated at the symptom level, and that medications are not themselves bad.)