Specialized Rural Pain Clinics: Lessons for a Small Country like Lebanon

Background: People with chronic pain and who live in rural communities often lack access to pain specialists. They end up relying on primary care providers who may be less prepared to deal with their conditions. Purpose: The purpose of this study is to survey the existence of specialized pain clinics/services in rural Lebanon. It also aims at highlighting the importance of the existence of such clinics/services rurally. Method: A review of the literature about pain in Lebanon was conducted using PubMed, Medline, Google Scholars, and Research Gate. Another search was conducted using Google Maps to locate any specialized pain clinics in the rural areas. The Lebanese Society for Pain Medicine was also contacted for information about the distribution of specialized pain clinics/services in Lebanon. Results: Our results showed that the total number of pain clinics/services in Lebanon is ten. They are distributed as follows: Five in Greater Beirut including Metn (50%), one in North Lebanon (10%), two in South Lebanon (20%), one in Beqaa (10%), and one in Mount Lebanon (Chouf, Aley, Kesrouan/Jbeil) (10%). The majority (90%) of these services are hospital-based and are governed by the Anesthesia Departments. Moreover, a comprehensive palliative care approach towards pain management in terminally-ill cancer and non-cancer patients is still lacking nationwide. Conclusion and implications: Rural Lebanon is still significantly underserved as far as the existence of specialized pain clinics is concerned. This calls for a quick interference by the health officials considering the fact that a significant proportion of Lebanese people live in the rural areas. In parallel, the international approaches to palliative care for chronic pain should be adopted. Lastly, an alternative to out-of-pocket payment for the consultation fees and treatments should be taken into consideration