Nova Scotia worked fast, particularly when waiting lists to see doctors skilled in pain management reached in some areas 5 years. The recommendations in Nova Scotia’s 2006 Action Plan proposed a comprehensive chronic pain care model, programs for prevention of chronic pain, resources to support administration, remuneration of health providers, research and education, an organized “common” wait list, creation of specialized pathways within the system to facilitate the “flow of patients”, and last but not least, evaluation and monitoring of the system to ensure it delivers what it promises. Similar to Quebec, changes in the system are working their way through.

You may ask: Where are all the other provinces? In a capsule “very much behind”.

I remember complaining publicly in newspapers, radio and TV appearances for the past 27 years that I practice chronic pain management exclusively, that chronic pain is considered “unsexy”, “non remunerative” and “labour intensive” by governments, administrators and policy makers. As I said before, chronic pain has been “the elephant in the room”. But we have reached a threshold now and the “elephant” is making it onto the radar of administrators and governments. It cannot be ignored anymore. Our population is growing older (and chronic pain increases with age). Canadians are more aware today and know to ask questions about their health care. Research is showing the tremendous cost of chronic pain to our pockets and our spirits. Science not only brings knowledge to explain why chronic pain may persist indefinitely, but also teaches us that if we do not deal with it early and effectively when it is acute (as in our hospitals after surgery), it transforms itself to chronic forms which are difficult to treat. Vaccines can now prevent the appearance of chronic pain in some conditions (for example for mature patients who may develop shingles and post-herpetic neuralgia). Wellness programs and self-management programs in the hands of patients (consumers) can also help. Programs of comprehensive care as those I discussed have proven their effectiveness.

So, it is time to face the epidemic of chronic pain in a serious and organized approach in all regions and provinces of Canada.

In my next column, I will tell you what ACTION Ontario, the organization I work with to educate and advocate on behalf of patients with neuropathic pain, has done to promote a comprehensive chronic pain strategy in Ontario.

Read one of Doctor Mailis-Gagnon’s previous columns

Chronic Pain: The Elephant in the room that no one wants to see Read more

A primer on Neuropathic Pain Read more

Neuropathic Pain treatments Read more

Neuropathic pain treatments: Medicines other than conventional drugs Read more

Invasive treatments for neuropathic pain Read more

Neuropathic pain: Physical and psychological treatments Read more

Invasive treatments for neuropathic pain Read more

Dr Mailis-Gagnon Answers your questions on Neuropathic Pain Read more

You can also obtain also a lot of information on neuropathic pain at www.actionontario.ca