According to the Agency for Healthcare Research and Quality (AHRQ), a federal agency established in 1989, there are three major barriers to effective pain management:

  1. the health-care system
  2. health-care professionals
  3. clients

The health-care system is slow to hold itself accountable for assessing and relieving pain. Many professionals suggest that assessment of pain be included with the measurement of taking vital signs, such as temrerature, pulse, respiration, and blood pressure. Pain assessment would be the fifth vital sign. It is helpful to remember that heart rate and blood pressure may increase with acute pain but not necessarily with chronic pain. The belief is that routinely assessing and relieving pain would prove more cost effective than ignoring the issue. Health professionals are not always educated about the meaning of and assessment of pain management and may be concerned about the use of opioids (narcotics), mainly due to possible addiction. Clients and their families also have concerns about opioid use and potential addiction. Clients may believe that chronic pain cannot be effectively treated. In all situations, education is a key element for health-care professionals and for clients and their families.

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Health-care professionals can be frustrated in their attempt to treat individuals who experience pain, especially when the cause of pain is not readily identifiable. Clients in pain may be frustrated and confused, too, especially if the pain is unbearable.