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The needs of a patient in pain
1Division of Rheumatology, University of Pennsylvania Health System, Presbyterian Medical Center, Philadelphia 19104, USA.
Abstract:
Pain affects everyone at some point in their life. However, everyone experiences pain in a highly individualized way, and therefore, the management of pain must also be customized. Of the 3 general types of pain-acute, chronic malignant, and chronic nonmalignant-the latter is the least predictable and, therefore, can be the most difficult to treat. General principles of pain management can be summarized as (1) respecting the pain and the patient; (2) recognizing and addressing the psychosocial aspects of pain; and (3) treating the pain-and the underlying cause-appropriately and in a timely fashion. The best success in pain management relies on a multidisciplinary approach that includes patient education, medications, physical medicine, and psychological counseling. Although a number of effective analgesic drugs are available, all are associated with adverse events. To reduce the risk of these side effects, the patient's specific needs and medical history must be considered before initiating therapy. Central to effective management of chronic pain is a positive physician-patient relationship. Several strategies are discussed to help in building such a connection.
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