Pain Management in the Setting of Language Barriers and Global Health

There are multiple barriers to pain managementPain management in the United States and globally. Language, cultural and ethnic differences are significant factors with the increasing heterogeneity of the population globally. There are social, systemic, and biological elements to consider when examining painPain disparities and creating appropriate pain managementPain management strategies in minority groups. Globally, in low- or middle-income countriesLow- or middle-income countries (LMICs), pain disparities exist largely due to limited resources. PainPain and surgical disease account for more than 30% of disease burden worldwide, with the majority of the burden in LMICs where there are significant barriers to pain and anesthesiaAnesthesia care (Size et al. in Anaesthesia. 62:38–43, 2007; Lipnick MS, Dubowitz G, Wabule A. Regional anesthesia in resource-constrained environments. In: Atlas of ultrasound-guided regional anesthesia. Elsevier, Inc.; 2019. p. 405–1;). Patients often have poor or nonexistent analgesicAnalgesics options due to lack of staff available to administer analgesicAnalgesics medications, lack of opioids, education, and perceived safety of opioidsOpioids. Patients then expect undertreatment of perioperativePerioperative and acute painAcute pain to be the norm (Size et al. in Anaesthesia. 62:38–43, 2007). Regional techniques can be helpful in these situations, however, there needs to be adequate resources and trained professionals.