4 Efficacy of multidisciplinary pain centres: an antidote to anecdotes

Chronic pain is difficult to treat successfully. The lack of satisfactory outcome from the traditional medical, pharmacological and surgical approaches was an impetus to the development of specialty treatment facilities—multidisciplinary pain centers (MPCs). With health-care costs continuing to rise, the clinical efficacy and cost-effectiveness of MPCs have recently been challenged. In this chapter, it is argued that the efficacy of treatment for chronic pain should be evaluated on multiple criteria: reduction in pain, use of analgesic medication and utilization of the health-care services. Increases in functional activity, return to work and closure of disability claims should also be considered. The published results for MPCs are reviewed in comparison with alternative treatment methods. The results suggest that MPCs are more effective than alternative monodisciplinary approaches. Furthermore, it is concluded that MPCs can produce saving of billions of dollars in terms of health-care expenditure and indemnity costs.