The fallacy of using 50% pain relief as the standard for satisfactory pain treatment outcome

Chronic pain treatment outcomes are difficult to standardize. Pain levels and improvement in pain often do not correlate with functional ability, need for medication, or suffering behaviors. The 50% threshold has become the standard for minimally adequate pain relief. In fact, there is little literature that supports such an outcome as meaningful. Because it is so easy to use, it has become in effect the “gold standard” of outcome. This review challenges its use as confusing and misleading and recommends its cessation. Current attempts at composite measures have promise.

Key words: chronic pain, outcomes, 50% relief, psychosocial factors, determining success

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