Nonopioid analgesics are first-line agents for pain; prescribe them alone for mild to moderate pain and in combination with opioids for severe pain. [14]
The prevalence of chronic pain in the US is difficult to estimate, but its impact is profound. Fifty to eighty million Americans experience daily pain symptoms. The cost of pain management is approximately $90 billion annually.
The strong evidence for the contribution of psychosocial factors in pain experience, particularly in explaining disability attributed to pain, has led to the development of multidisciplinary pain rehabilitation programs (MPRPs) that simultaneously address physical, psychological, and functional aspects of chronic pain disorders.
Massage therapy. Consider massage therapy as part of a multimodal treatment plan. Massage therapy is manual manipulation of muscles and connective tissue to enhance physical rehabilitation and improve relaxation.
Assess the degree of functional impairment to help determine the urgency for addressing the acute pain issue. For example, weakness may require a more aggressive strategy with early intervention, such as advanced imaging.
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Pain location. Pain drawings are frequently used for patients to identify the location of pain. A drawing on an anatomical outline can provide a quick impression of the breadth and character of the presenting pain complaint.
And taking certain prescription sleeping pills can lead to drug misuse or drug dependence, so it's important to follow your health care provider's advice.
Consider methadone for its prolonged duration of effect, which is useful for longer term therapy and minimizes euphoria with low doses.
Pain diary: regular documentation of the pain intensity to identify peaks and triggers; enables treatment optimization
Potential risks of opioid use for all patients include: physical adverse effects; cognitive impairment; social, personal, and family risks; failing urine screening; potential for opioid misuse.
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Treatment. In the treatment plan, address both the underlying cause and the associated acute pain. In developing a treatment plan for the acute pain, consider the degree of tissue trauma, the patient’s situation, and any unique patient factors.