The Ultimate Guide to Pain Management

The Ultimate Guide to Pain Management

Blog Article

The focus in chronic pain assessment differs from the evaluation of acute pain, which assumes a specific underlying injury or disease that treatment will cure. Begin chronic pain assessment with the history and physical examination. Important components of the initial evaluation are summarized in Table 3 and are detailed below.

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Herbal supplements. Patients frequently request information about herbal supplements. The evidence for the use of some supplements is growing. Many are safe and may be considered when patients are interested. See Table 6.

Disposal. Advise patients how to dispose of unused opioid medications safely and securely. Many options for disposal exist. Having unneeded opioids in the home is a vulnerability for patients and their families.

Medical comorbidities. Obtain a thorough past medical history, with attention to conditions that may raise the risk for harm with pain treatment.

Neonatal pain Injectable Steroids assessment Scoring systems for acute and postoperative pain in infants evaluate physiological parameters , behavioral changes , and/or contextual factors.

Nociceptive pain is caused by tissue damage due to injury or inflammation, rather than harm to the central or peripheral nervous system. This is the primary type of pain involved in patients with arthritis, musculoskeletal inflammatory disorders (tendinosis, bursitis), or structural spine pain.

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Opioid tolerant patients. Morphine is the default choice, unless contraindicated. Morphine can be prescribed by all routes, unlike oxycodone. It has a straightforward dose calculation with a predictable analgesic interchange and conversion between parenteral and oral dosing.

Physical therapy. If patients have functional deficits or secondary pain generators that directed therapy may improve, refer them to physical therapy.

Contraindicated in patients with a recent MI and in the perioperative period of CABG (exception: low-dose aspirin in the management of acute MI) Avoid NSAIDs, if feasible, in patients with bleeding disorders and those who will soon undergo surgery or an invasive procedure. See “NSAIDs” for further information.

Transcutaneous electrical nerve stimulation (TENS). Consider TENS either along with physical therapy or as an adjunct to multimodal treatment. TENS applies low voltage electrical stimulation using skin contact electrodes.