Pain relief after musculoskeletal trauma

This thesis showed that, in spite of seemingly similar nociception (pathophysiology), there are substantial cultural differences in experiencing and managing pain after surgery of musculoskeletal trauma. The United States and Canada are in the midst of a crisis of opioid use, misuse, overdose, and deaths related to overdose. Driven largely by the increase in prescriptions by healthcare providers starting in the 1980s, this was a direct effect of overstatement of the benefits and understatement of the risks of using opioids by advocates and pharmaceutical companies. Patients and surgeons often look for opioid pain medications as a solution to treat (ongoing) postoperative pain, perhaps unaware that they are actually addressing psychological distress or less effective coping strategies with opioids. In fact, many patients (at least in the Netherlands) are equally satisfied with much safer and non-addictive pain medications after surgical treatment of musculoskeletal trauma. Evidence is gaining that effective coping strategies, better mood, and less stress are more effective pain relievers than biomedical factors such as operative technique or medications. We should make good use of these opportunities to provide better and much safer treatment options to handle pain relief.