Joint Base San Antonio, Texas (Sept. 1, 2016) -- September is Pain Awareness Month and the U.S. Army is working to effectively measure and treat patients' pain and recovery using the new Pain Assessment Screening Tool and Outcomes Registry (PASTOR).
Pain is the most frequent reason U.S. patients seek physician care according to the National Institutes of Health and chronic pain is a critical issue affecting the readiness of our fighting force.
To address Soldiers' pain issues, Army Medicine leadership have established Interdisciplinary Pain Management Centers (IPMCs), IPMC Light clinics, and Primary Care Pain Champions to provide state-of-the-art rehabilitative, integrative and interventional pain care.
"Pain Management in the Army enhances the functionality of our Soldiers by addressing their chronic or acute pain and reducing the necessity for opioids; allowing our Soldiers to be ready to serve," said Joseph Phillips, Pain Program Manager, U.S. Army Surgeon General's Office.
"The issue with addressing pain is that currently we lack an evidence-based data system to drive clinical and programmatic decision making."
Phillips explains that patients can describe their pain in different ways; what may be a described as a pain level of 9 on a 10-point scale by one patient, may be described by another as a 3.
Also after treatment, one patient may describe their reduction in pain as moving from 9 to 3 and another as 3 to 2 but both have regained the same level of functionality due to the reduction of their chronic or acute pain.
"The PASTOR tool allows for a more efficient way to judge pain using self-reported questions about the level of functionality, movement, and lifestyle to evaluate pain and improvement through treatment," said Phillips.
The PASTOR tool originates from an eight-year, $100 million National Institutes of Health program that developed the patient reporting tool.
"With PASTOR we can generate outcome driven data that can help us to decide which treatments are most effective for different types of pain and we can better allocate resources and specialties to the clinics, stated Phillips.
"While one treatment may show a reduction in pain for neck and lower back issues it may not show a reduction in leg or nerve pain and now we can evaluate the effectiveness of the different treatments or modalities."
The Army Pain Program aims to decrease a patient's dependence on the health care system and opioids through treatment regimens that require aggressive physical therapy, weight loss, smoking cessation, and regular exercise. Treatment goals are individually developed with the patient and patient's family.
Additionally, Army pain clinics implement a wide range of treatments to assist Soldiers in managing pain including steroid injections and implantable neural stimulators as well as alternative treatments such as active neuromuscular re-education, yoga, tai chi, qigong, acupuncture, chiropractic care, therapeutic massage, and breathing exercises.
PASTOR is currently in a three-site pilot including Madigan Army Medical Center Joint Base Lewis McChord, Wash., Walter Reed Army Medical Center, Washington, D.C., and Balboa Naval Hospital, San Diego, Calif., but will soon expand to the other pain management facilities across the U.S. Army.
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