In the U.S., more than 25 million people with chronic pain. Healthcare expenditures linked to their care exceeds $600 billion each year, which doesn’t account for lost productivity costs. Despite these impressive figures, effective chronic pain care programs are far and few between. When most people think about the pain management business today, they’re likely reminded of the nation’s opioid crisis. But the chronic pain treatment industry involves much more than narcotics or even injections. It demands a comprehensive and holistic approach that only a handful of businesses are pursuing. And as you might imagine, millions of people with chronic pain are unable to find or access these programs.
When it comes to the pain management business in the U.S., the primary focus of care remains on acute pain. In many ways, acute pain management is simpler, responds better to treatment, and can be quite lucrative. In contrast, the chronic pain treatment injury is much less glamorous. Cases tend to be much more complex, often require a combination of interventions, and are highly time-intensive. As a result, the same financial and other incentives that exist for acute pain care aren’t present. But hopefully that is changing as a few innovative companies are beginning to take a fresh look at chronic pain care. And their formula of care might just be the future of the pain management business.
“There are countless providers and companies focusing on the low hanging fruit: people with acute pain. That’s where traditional healthcare excels – injections, surgeries, painkillers. After traditional treatment fails, it’s chronic pain patients like me who are told they’re out of options, forgotten about, and thrown away as too complex.” – Jennie Shulkin, Co-founder and CEO, Override
A Better Chronic Pain Care Model
For many decades, the chronic pain treatment industry has been one that suffers from neglect. In part, this has been due to ineffective therapies. Narcotics pose serious risks of addiction with patients developing tolerance over time. Other therapies like injections, physical therapy, and non-addictive medications have poor response rates in isolation. But the problems plaguing the chronic pain management business goes beyond this. Additional issues include a lack of communication among providers, conflicting strategies of care, and provider frustration. As a result, the vast majority of chronic pain patients go untreated and/or poorly managed.
The perception surrounding the chronic pain treatment industry may be one that sees little hope. But this opinion is far from the truth. In reality, there are many chronic pain centers that have had significant success. By approaching the chronic pain management business from a holistic and team-based perspective, progress is being made. In fact, many report response rates over 65% with proper care compared to a 10% response rate from traditional strategies. By involving pain doctors, therapists, psychologists, and life coaches in the process, better results are being achieved. And with recent insights regarding nervous system reprocessing techniques, outcomes are likely to improve further.
“Most of the companies in the space are primarily targeting musculoskeletal pain but that’s largely acute pain…There’s this broad spectrum of chronic pain that I think most people don’t think of because when they think of pain they think of neck and back pain.” – David Shulkin, Co-founder and Executive Chairman, Override
Team-Focused Chronic Pain Companies
In looking at chronic pain centers that embrace a team-focused approach, their results speak for themselves. Unfortunately, however, in the U.S., there are only about 50 of these types of treatment programs. These centers take a holistic approach and address mental, emotional, and physical aspects of pain. They also stay abreast of the latest pain-related research and interventions. And they tend to provide intensive care services from four weeks up to four months in an effort to establish effective pain control. Naturally, such intense care requires resources, and with so few centers, access is an issue. Regardless, this is the approach the chronic pain treatment industry needs.
In an effort to address this need, some innovative companies are taking a new approach. Override, a pain management business, was founded by Jennie Shulkin and her father, David Shulkin, MD. David was the former VA Secretary under President Trump with a stellar track record of solving major healthcare dilemmas. And Jennie, in addition to her law degree, is a chronic pain patient resulting from two prior brain injuries. Override launched a comprehensive, holistic, team-based chronic pain program that is virtual in nature. Pain specialists, coaches, behavioral health experts, and therapists all convene to provide customized care. And they do this through virtual pain treatment platforms to address the access issue. To date, Override has already received $3.5 million in seed funding and acquired one of the country’s top pain coaching companies.
(Virtual reality is being leveraged to management pain–read how in this Bold story.)
“For a long time, we have thought that chronic pain is due primarily to problems in the body, and most treatments to date have targeted that. [Pain reprocessing therapy] is based on the premise that the brain can generate pain in the absence of injury or after an injury has healed, and that people can unlearn that pain.” – Dr. Yoni Ashar, Former Researcher, University of Colorado, Boulder
Innovative Trends and Future Care
In addition to virtual platforms to address chronic pain treatment industry issues, the pain management business is seeing other innovations as well. One of the most notable ones relates to pain reprocessing therapy or PRT. In essence, research is showing that chronic pain often develops as a result of altered pain perception pathways in the brain. When an injury occurs, tissue damage, scarring, and other aspects can trigger the brain to perceive pain even when acute issues are resolved. PRT thus adopted physical, behavioral and cognitive therapies to “retrain” the brain. This is a hot topic in the chronic pain management business, and one that Override is embracing as well.
In looking to the future of the chronic pain treatment industry, it’s evident major changes are needed. Too many patients are being neglected, and this has both individual and national impacts as a result. In addition, the pain management business suffers from fragmented strategies that fail to utilize team expertise and experience. And many are not up to date on non-narcotic strategies like PRT. As such, the chronic pain treatment industry should be incentivized to adopt care models that work. Thus far, it seems the best hope for this reality depends on investors and companies like Override.
