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A framework for management of chronic pain
P Amadio1, D M Cummings, P B Amadio
1Jefferson Medical College, Philadelphia, Pennsylvania.
American Family Physician
|November 1, 1988
Summary
Effective chronic pain management needs motivated physicians. A comprehensive assessment is crucial, avoiding routine narcotic use for non-cancer pain to ensure patients receive appropriate treatment.
Area of Science:
- Pain Management
- Psychiatry
- Medical Ethics
Background:
- Chronic pain presents a significant challenge in healthcare, requiring specialized physician engagement.
- Patient care is often complicated by underlying psychiatric issues, secondary gain factors, and prior treatment responses.
- The physician's role is critical in either facilitating or hindering effective pain management.
Purpose of the Study:
- To outline essential components for successful chronic pain management.
- To emphasize the importance of a thorough patient evaluation and physician attitude.
- To provide guidance on appropriate pharmacological interventions, particularly regarding opioid analgesics.
Main Methods:
- A comprehensive review of factors influencing chronic pain management strategies.
- Analysis of the physician's role in the patient's treatment journey.
- Discussion of diagnostic considerations including pain etiology, psychiatric comorbidities, and psychosocial factors.
Main Results:
- Successful chronic pain management hinges on physician motivation and a holistic patient assessment.
- Identifying the root cause of pain, psychological factors, and secondary gains is paramount.
- Previous therapeutic responses and illness behavior must be evaluated to tailor treatment.
Conclusions:
- Physicians must be actively involved as part of the solution, not the problem, in managing chronic pain.
- Narcotic analgesics should be reserved primarily for cancer pain or end-of-life care.
- A thorough, individualized approach is essential for optimizing outcomes in chronic pain patients.