Torvanger, Mari. – The more, the better?

In Norway we are privileged to have a well-established health-care system where everyone is entitled to receive the health-care they need. However, what exactly it is that people need is not necessarily obvious. Nor is it always a matter of resources at hand or doing things “perfectly by the book”. The picture i have taken is a made-up time schedule for a chronic pain patient, more or less representative of a week in more intensive rehabilitation. It is filled up with expertes, interdisciplinarity and with it; expensive premises and equipment amongst other things. One can only imagine the amount of resources and costs behind it.

While it should be celebrated that we have such a system, and perhaps an understanding of the importance of investing in health, many patients are not getting any better. Despite the fact that the amount of money appropriated to this has increased, numbers show that there is actually a slight increase of the population reporting having chronic pain. (Ørstavik, 2018) In a broad european epidemiological study, concerning the scope and consequences of chronic pain, Norway comes on top in occurrence (Breivik et at., 2005). It’s also reported that the musculoskeletal pain are responsible for 46% of the sick-leave, and 33% of the disability benefit. (Ihlebæk & Lærum, 2004)

How we approach this is therefore of hugh consequences to our society, not to mention to the patients themselves. As it seems we are only scratching the surface of how complex pain can be, there is a broad agreement that it needs a psychosocial approach. Perhaps it is easy to think that when we have a complicated problem like this, the more money we spend, the better the outcome? That we need more data, more experts, more analysis etc..? Is it how our culture and society work? Is it the decreasing amount of physical activity? Is it the amount of time we spend on social media? Or is it a combination of them all? Or perhaps none of the above? No matter the data we collect, the money involved, and in what direction the science is pointing us, I think it’s important to remember that the greatest expert on the person in front of us, in in fact that person. That perhaps what that person need, is not another expert, or expensive assessment, but just one person who truly listens and sees that person as a whole. Easy to say, difficult to do. I can of course only speak for myself, but being better at that part of being a physiotherapist i believe is the most valuable thing I can invest in, and i would for example like to see more of our education having an emphasis on this.  

References:

• Breivik, H., Collett, B., Ventefridda, V., et al. (2005). Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment. European Journal of Pain, i trykk.
• Lunde, L.-H-, & Nordhus, I. H.,  (2006, 27. Oktober) Kognitiv atferdsterapi i gruppe ved kroniske smertetilstander: Erfaringer fra en smerteklinikk. Psykologtidsskriftet.no. Hentet fra: https://psykologtidsskriftet.no/fra-praksis/2006/10/kognitiv-atferdsterapi-i-gruppe-ved-kroniske-smertetilstander-erfaringer-fra-0
• Ihlebæk, C., & Lærum, E. (2004). Plager flest – koster mest. Muskel-skjelettlidelser i Norge. Nr.01/04. Bergen: Nasjonalt ryggnettverk.