Paradigm Shift: Changing how we approach and treat pain...and health.

“Paradigm shift”— we’ve all heard the term at one time or another. It sounds impressive, maybe even a little trendy. But what does it actually mean?

The Oxford Dictionary defines a paradigm shift as “a fundamental change in approach or underlying assumptions.” That’s a mouthful, so let’s break it down.

• Fundamental change — a deep and powerful shift that changes how people think, act, and make decisions over time

• Change in approach — a new way of handling problems and choosing what steps to take

• Underlying assumptions — beliefs we often don’t question, but that shape how things are done and why they work the way they do

In other words, a paradigm shift is a major change in how we think about and respond to problems. It often means questioning beliefs we once accepted as true.

So why is a paradigm shift important in healthcare today?

Despite spending more money per person on healthcare than any other developed country, the United States has worse health outcomes than many of its peers. In pain care, we are facing two crises at the same time: the chronic pain crisis and the opioid crisis. One in four people in the U.S. lives with high-impact chronic pain—more than those affected by heart disease, cancer, and diabetes combined. While opioid overdose deaths may be declining, the country continues to suffer from both drug-related harm and the stigma surrounding pain and opioid treatment. This stigma often keeps people from seeking care and makes clinicians hesitant to treat chronic pain. Everyone loses. Something has to change.

The current approach to pain management focuses heavily on symptoms and pain scores. This mirrors a broader issue in healthcare, where the system often prioritizes treating symptoms over restoring health or preventing disease. This approach has led to a rise in polypharmacy—taking five or more medications—without real improvements in quality of life. In fact, studies show that people with chronic illness who take more than five medications often have worse physical function.

What if we took a different approach?

Instead of stacking medications on top of one another and treating the side effects of one drug with another, what if we focused on finding the root cause of pain and dysfunction? While this idea isn’t new, it has not been widely put into practice. This is where a paradigm shift begins.

A fundamental change would mean shifting our focus away from pain scores and toward identifying the true sources of pain and improving function.

A change in approach would mean carefully evaluating all contributors to pain—physiologic, anatomic (structural), functional, and psychosocial—and creating a treatment plan that addresses the root causes, not just the symptoms.

A change in underlying assumptions means recognizing that lowering a pain score alone does not automatically improve function or quality of life. We now know that improving movement, strength, and physical activity leads to more lasting health benefits. Pain care is not just about reducing pain—it’s about restoring function by addressing what is actually causing pain and disability.

Targeted Pain Treatment (TPT) is a practical application of this paradigm shift. It focuses on accurately diagnosing the source(s) of pain and targeting treatment to the cause. TPT prioritizes function while educating and empowering patients to take an active role in their health.

But this shift doesn’t stop with pain management.

What if we applied the same thinking across healthcare? What if we identified the underlying physical, functional, and psychosocial causes of conditions like diabetes, heart disease, and obesity—and used targeted treatments to address those root causes instead of only managing symptoms? The impact could be enormous, not just nationally, but globally.

It starts with a change in mindset. 

A paradigm shift.

We’re close. Let’s reach the tipping point.

SGV

Dr. Stephanie G. Vanterpool is a pain management physician and educator who advocates for broader access to evidence-based care that improves function and long-term health.