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Dr. Ed Covington is the former director of the Cleveland Clinic Chronic Pain Rehabilitation Program and his career has largely centered on understanding and treating pain. He is quick to note that there is no "one right way" to treat pain, but emphasizes that "success comes only from addressing the whole person."

At the beginning of his presentation, he asked one question: "Why talk about pain?" It turns out the simple answer is because it needs to be talked about. We don't know enough and some of what we believe, or have been taught, is simply wrong.

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In fact, it turns out that fully understanding chronic pain may be one of the most effective weapons in treating it. Education and knowledge are critical, not only for the patients, but also for the people providing their care and for patients' families.

He noted that where there is a knowledge gap, there also is potentially a gap in the treatment plan. The problem can worsen if everyone has misperceptions and misinformation. For example, if the healthcare provider doesn't understand how the pain is truly affecting the patient, or the patient is too afraid to try physical therapy, or the family is coddling rather than helping the patient recover, what are the chances for successful treatment?

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Dr. Covington said the problem starts with how little has been added to Descartes' theory of pain. Namely, that pain is caused by a stimulus and travels from the point of impact to the brain. How much pain depends on the stimulus and not on the person experiencing the pain.

This limited theory doesn't address the real pain that is felt even when no cause can be found, or the role of the body or brain in how pain is processed and felt in different circumstances. Ultimately, one of the bigger misconceptions Dr. Covington wants to dispel is that unexplained pain is psychogenic. Not finding the stimulus for the pain doesn't mean it doesn't exist. But it may mean that the healthcare team needs to dig deeper with a patient to understand what is going on.

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To help gain a better understanding of patients, Dr. Covington recommended that providers start with the premise that "Pain IS the disease" and start by focusing on understanding the patient's concerns, fears, and hopes, even when they don't seem related to the pain. He also says providers need to take patient's pain reports at face value.

On the treatment side, Dr. Covington supports a multifactorial approach. He spoke about the benefits of Western medicine options as well as the effectiveness of alternative medicine approaches, noting that studies show acupuncture, message and relaxation techniques can be beneficial.

He told the audience that what's important is listening to the patient and letting him or her know you believe the pain is real and you are truly there to help. "Patients," he reminded the audience, "forgive us for not succeeding. They don't forgive us for not trying."

Please continue to follow the Clinical Impact Symposium 2016 on the Kindred Continuum and on Twitter @KindredHealth.

*Each year the Kindred Clinical Impact Symposium focuses on a topic to enhance clinical practice in the post-acute continuum and to maintain Kindred as a leader in clinical excellence. This eighth symposium focuses on pain management across the continuum. At this week's symposium, held in Louisville, Kentucky, national speakers discuss these topics broadly, while internal speakers bring it home to Kindred attendees from across the country.

By Leslie Leite