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Pain management – A call to address the market disconnects in NSW

Massage & Myotherapy Australia has today called on all political parties contesting the NSW election to declare policies that overcome the unacceptable market disconnects that prevent effective pain management for people suffering from chronic disease.

The call comes in response to the numerous problems that limit access to effective integrated pain and stress management services available to people in NSW, who live with chronic pain and stress unnecessarily.

Tricia Hughes, CEO of Massage & Myotherapy Australia said that, 'All the available literature suggests that no one pain management response offers the answer, and numerous market disconnects are compounding this challenge'.

‘Leaving it up to individuals to find a qualified professional is no longer a responsible policy response, when the need is so high,’ Mrs Hughes said.

Market disconnects

1. The National Pain Strategy, reports that up to 80% of people living with chronic pain are missing out on treatment that could improve their health and quality of life.

Yet in the absence of a clear integrated New South Wales-based strategy to address this issue, Pain Australia reports that the lack of access to integrated pain management services is acute especially in rural, regional and remote areas and Indigenous communities.

2. The Opiod Management Team which presented ‘Alternative options to codience’, suggested that practitioners discuss non-pharmacological options including heat, massage, psychotherapies, physiotherapies, osteopathy, etc., for patients suffering from chronic pain.

Yet no program exists to integrate the use of various pain interventions using the management of pharmaceutical, allied and complementary health options for patients.

3. The AIHW 2018 cite the Australia’s Physical Activity and Sedentary Behaviour Guidelines which recommend that people aged 18 to 64 exercise at least 150 minutes over 5 sessions per week; and over 65 years, at least 30 minutes per day.

However, limited functionality and increased pain translates to a limited ability to exercise or undertake the recommended exercises and activities as outlined in the Guidelines. There is no support program to address the varying levels of pain and ability to ensure they are suitable for patients.

4. Freeing up muscles, improving mobility and reducing pain have always been the recognised functions and benefits of remedial massage and myotherapy administered by professional qualified therapists. A recent 2017 study by Akerman I.N. et al. concluded that, dispensed opiod prescriptions will triple to over 3.0 million between 2015/16 to 2030/31 and rise from $25mil to $72.4mil annually.

Yet there is no coordinated program to limit the growth while Medicare and private health insurance plans provide limited cover for chronic non-cancer pain involving non-pharmacologic solutions.

‘In the absence of funding and programs that create more integrated services involving pharmaceutical, allied and therapeutic interventions, education and better information for GPs and other health professionals is required,’ Mrs Hughes said.

Importantly, the National Pain Survey indicates that people living with chronic pain want empathic, non-judgemental and well-informed health professionals who want to listen and partner with them.’

GPs have a central role to play in informing their patients about how they can access qualified professional massage therapists and myotherapists with the experience and skills appropriate to given conditions. Health policies that do not recognise this vital role are failing many Victorians,' Mrs Hughes said.

A national workforce survey showed that GPs in rural areas are supporters of professionally-qualified massage therapists (Wardle, J. L. et al. 2013). The survey found that:

  • GPs (76.6%) referred to massage therapy at least a few times per year
  • 12.5% of GPs referred at least once per week
  • 95% of GPs believed in the efficacy of massage therapy
  • 95% of GPs perceived a lack of other treatment options
  • 95% of GPs who had prescribed any complementary and alternative medicine previously were all independently predictive of increased referrals to massage therapy.

GPs also indicated that they were more likely to refer a patient to a massage therapist if they had obtained their medical training in Australia.

Mrs Hughes said, ‘The evidence and need is clear.

‘Research shows that patients whose general practitioner has additional complementary and alternative medicine training have lower health care costs and mortality rates than those who do not. Reduced costs come from fewer hospital stays and fewer prescription drugs (Kooreman, P. et al. 2012).

‘Additionally, older Australian women experiencing chronic bodily pain prefer a concurrent multimodality approach (accessing conventional treatments alongside massage therapy) to cope with their condition (Walker, B.F. et al. 2004).

‘Professional massage therapists and myotherapists offer health services specifically designed to improve mobility, and reduce the symptoms of pain and stress, so people can lead more active lives,‘ Mrs Hughes said.

‘This low cost therapy is readily available locally and can play a more vital role in helping younger and older Victorians to better overcome some of the limitations associated with musculoskeletal injury and disease, and lead to healthier more active lives.

‘Improving public education and information available to health professionals such as GPs about the alternatives available will do much for people suffering from chronic pain,’ Mrs Hughes said.

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