A new plan for action on pain in rural and remote Australia

None of us are immune to pain. Although when it comes to chronic pain, it appears that those of us who live beyond Australia’s urban centres are particularly disadvantaged, with both prevention and management resources severely lacking.

People who live outside major cities are 23 per cent more likely to experience back pain, and are also 30 per cent more likely to have a long-term health condition due to an injury. There are many factors behind these statistics, including the location of physically demanding jobs in industries such as agriculture, fisheries, forestry and mining in these areas.

Yet despite the clear need in these areas for best-practice pain management, arguably more so than their urban counterparts, access to these services is woefully absent with a lack of specialists and allied health professionals and with GP’s professional training in pain management inadequate.

What’s worse is that without adequate pain management available in rural and remote areas, there is a greater reliance on pain medications to treat chronic pain not being recommended for long term use.

The Cost of pain report prepared for Painaustralia by Deloitte Access Economics reveals some very concerning data. While one in five GP presentations concerns chronic pain, medications were used to manage more than 68 per cent of cases. The highest rates of prescribing to manage pain were experienced in rural areas (72 per cent), with the lowest rates of referral to another health professional also experienced in rural and regional areas (13 per cent)

Overall, Australia needs to ensure the treatment options offered to the millions of people who are looking for help in addressing their pain extend well beyond a prescription or, at least, work in conjunction with medication to give people the best opportunity of managing or ideally overcoming long term debilitating pain.

This is the crux of Australia’s first National strategic action plan for pain management. This new Plan is an opportunity to recognise that every one of the 3.4 million people living with chronic pain is different. The Plan makes more than 50 recommendations, including: recognising chronic pain as a condition in its own right, and the need for better education and awareness as well as access to multidisciplinary care. The Plan will go before Health Ministers for endorsement in the coming weeks.

In rural and regional Australia, moving towards best-practice pain management includes actions like putting in place proven good quality ‘mini pain programs’ to provide coordinated care packages and increasing the capacity of health practitioners. There are excellent existing models including the Pain Revolution Local Pain Educator (LPE) program and other models in South Australia and Western Australia that embed capacity in regional and rural communities in pain management and education.

There are also good models of practice in Primary Health Networks (PHNs) involving expert education programs and individual case management. Broadening capacity within existing primary and community health services in general pain management services is a cost-effective way of addressing the issues. Expanded telehealth programs to provide access to specialist pain services in regional areas is also recommended.

Poor access to pain management services has an enormous impact on the health and wellbeing of our rural and regional communities. If we can address the impact of pain in regional Australia, we will go a long way towards improving the health of communities in general. We need to do much better to address the needs of some of Australia’s communities that are most impacted by chronic pain.