ABOUT ONE IN 10 PEOPLE experience chronic post-surgical pain (CPSP). This means that of the 400 million people who have operations each year worldwide, about 40 million may develop ongoing moderate to severe pain that interferes with their ability to lead a productive, enjoyable life. But despite these staggering statistics, and their associated personal challenges as well as health-care and workplace productivity costs, we know very little about CPSP’s causes and how best to help.
“By intervening as early as possible after surgery and providing integrated, multidisciplinary care, we have a better chance of preventing or minimizing chronic pain”
Psychology professor Joel Katz explores this problem by working with a large multidisciplinary team of Toronto health professionals to identify CPSP’s main risk factors. He and his colleagues—which include physicians, clinical psychologists, nurse practitioners, and physiotherapists—have pioneered the Transitional Pain Service (TPS), a Toronto General Hospital (TGH) program that’s the world’s first to comprehensively address CPSP. The clinicians are examining CPSP at three stages: preoperatively, postoperatively in hospital, and in an outpatient setting for up to six months after surgery. The TPS team members collaborate to create a customized, integrated treatment plan aided by a cutting-edge mobile app and digital platform, Manage My Pain.
TPS’s proactive, cooperative and intensive approach contrasts with the long wait times most CPSP patients face at chronic pain clinics. By addressing the issue early, TPS can prevent patients’ transition from acute to chronic pain and reduce suffering and disability.
Since its start at TGH in 2014, TPS has helped about 600 patients. Katz, who has received multiple awards from the Canadian Pain Society and American Psychological Association for his contribution to pain research – and recently has been recognized as a “World Expert” in postoperative pain research by Expertscape, an online database that works to objectively rank individuals and institutions by their expertise in more than 27,000 biomedical topics – has identified the key risk factors of CPSP: pre-existing chronic pain; opioid use; a history of anxiety or depression; and previous trauma. The program has led to patients experiencing less pain, psychological distress and opioid use. “By intervening as early as possible after surgery and providing integrated, multidisciplinary care, we have a better chance of preventing or minimizing chronic pain,” says Katz.