Pain Treatment Does Not Interfere with Diagnosis or Treatment
by Forest A. Tennant, MD, DrPH
 One of the great myths and
barriers to pain treatment is that pain control somehow interferes with the diagnosis and
treatment of underlying or ancillary disease. It is likely that every practicing physician
and nurse has observed a patient being left writhing in agony on a gurney or hospital bed,
because the attending physician or nurse didn't want pain medication to
“interfere” with diagnosis or treatment of some underlying or ancillary disease.
Lore and fantasy have it that an acute abdomen, labor and delivery, cancer, sickle cell
crisis, or rheumatoid arthritis, among numerous other conditions, can’t be adequately
diagnosed or treated if an opioid or other pain medication is administered. Scientific
outcome studies to justify deprivation of pain control on this premise simply don't exist.
Any truth to the myth is surely outweighed by the cataclysmic affects of uncontrolled pain
of catecholamine and adrenal steroid production with their attendant derangements of blood
pressure, pulse rate, blood sugar, and immune system.
Surely a patient whose pain is well-controlled can give a far better history and offer
a better immune-healing system to combat underlying disease than a patient suffering in
pain. Recent studies clearly show that a pain patient controlled with opioids is a far
better automobile driver than one in pain. It follows that any patient with a painful
condition should also have a better outcome if pain is managed first and the underlying
disease second.
Forest A. Tennant, MD, DrPH
Editor in Chief
— Jan/Feb 2004
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