There are a variety of pharmacological and non-pharmacological approaches in managing chronic pain. These are broken down to six major categories; they are pharmacological, interventional, neuromodulation, physical medicine, behavioral medicine and surgical approaches (1). A coordinated multidisciplinary team approach and detailed patient's history is essential in tailoring a patient-specific treatment plan that will meet treatment goals. A number of randomized systematic reviews found strong evidence that multidisciplinary approach including bio-psychosocial rehabilitation improves functional status when compared with non-multidisciplinary care (2,3). Here, we will focus our discussion on some of the advantages and disadvantages of medical management versus interventional management of chronic pain.
Pharmacological approach represents the most commonly used therapeutic option in the management of chronic pain. These include
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It can be administered alone or part of a multi-disciplinary approach in relieving symptoms. It delivers pain-relieving medication directly to the source of pain in musculoskeletal pain conditions and their effects are often immediate and long lasting. They are often used to reduce opioid side effects or gain better analgesic efficacy. However, serious complications have been reported in the literature. The Closed Claims Project Database has reported 284 chronic pain management claims were reported between 1970 and 2000; 96% of the claims were related to interventional pain management techniques (10). Seventy-eight percent of these were related to nerve blocks and injections. Paraplegia or quadriplegia, epidural abscess, chemical injury from spinal cord injections, epidural hematoma, even more alarming death and brain damage were some of the reported complications; most commonly reported was pneumothorax and spinal cord nerve injury
First of all the author provides a well know resource The World Health Organization. This Organization is a specialized agency of the United Nations who has been around for many years. It’s a well reliable facility which provides estimates of patients who obtain pain medication for chronic pain. The author also states that the drug is a stimulant that relieves severe pain and produces a highly addictive powerful feeling of well – being. (Berrettini, 2016)
The patients who are in pain requires pain relief, but many of them with chronic pain have trouble with prescribed opioids either due to psychosocial problems
The selected policy Essence of Care 2010: Benchmarks for the Prevention and Management of Pain, includes the latest benchmarks on the management of pain and its prevention. It presents up to date reviewed views, with the aim to deliver
The practice of patient-controlled analgesia (PCA) has been around for approximately four decades now. During this time there have been improvements to the technology and the understanding of how to use this form of patient pain control; however, there continues to be concern related to the safety and efficacy of PCA. As this analysis proceeds it will briefly explain what PCA is and how it is used, then delve into the benefits and the safety issues surrounding PCA use as it pertains to the patient and the nurse. Some of the benefits of PCA include improved pain management, improved use of nursing resources, increased patient satisfaction, and reduced pulmonary issues (Hicks, Sikirica, Nelson, Schein & Cousins, 2008). Some of the safety
Traditionally, doctors prescribed opioid treatments for pain-related medical conditions. Chronic pain in particular is difficult to treat. While the search for a cure is underway, the best most patients can hope for is effective management of their condition.
The paragraphs below describe the predominant clinical practice gaps in current management of chronic pain. As NPs increase their knowledge and competence in these areas, it is anticipated that changes in clinical practice will
Pain is a common symptom that is associated with numerous medical issues, including musculoskeletal problems that physical therapist see on a day to day basis. There are several different ways to treat pain and one of them is to provide a means of releasing opioids in the body to alter the pain experience. In fact, there are three different types of opioids: naturally occurring (endogenous or exogenous substances such as natural endorphins or poppy), semisynthetic (exogenous substances that contain both natural and synthetic agents), and synthetic agents (man-made substances used to mimic the effect of natural substances) used to decrease the symptom of pain.1
The availability of prescription painkillers has increased substantially, painkillers are drugs that deal with the nervous system, it blocks pain and the patient will feel a “high”. The most common prescribed drugs
These may include multimodal analgesics, opioids, repositioning, and
It is a challenge to manage pain in older adults. The course of action, effect and
Because severe pain is more difficult to control, Mrs R may become anxious and fatigued, and may also withdraw again from the regimen if there is no success in achieving pain relief; therefore, the preventive approach needs to be considered. (Wells, 2014). For an effective pain control pain, Mrs R should also keep a daily record of her pain. Writing a diary can help empower the patient in her own care, give her confidence and increase self-efficacy (Bastable, 2014). Also, a strategy of pain management is to combine opiods with non-narcotics, such as Tylenol, in order to enhance pain relief and to slowly decrease the use of narcotics overtime (Lewis, 2014). Mrs R was explained to always follow the right dosage of medication to optimize the narcotic results. A complete assessment of pain should be performed: PQRST. Pain is a subjective concept and the patient must describe the pain in order to provide an effective care plan (Jarvis, 2013). Responses to pain medication should be documented to facilitate communication between health care providers, therefore to maximise effective pain management strategies (Lewis, 2014). The use of non-pharmacological therapy for pain is also recommended to Mrs R because it helps reduce the dose of an analgesic/opiod required to control pain and helps to minimize analgesic side effects, and also promote the release of endorphins which inhibit pain signals (NCBI, 2010). Mrs R is encouraged to use distraction such as watching TV, listening to the radio/music, which redirect the attention on something and away of the pain. Imagery can also be proposed to divert the focus away from the pain by stimulating the client’s imagination to develop sensory images. Relaxation strategies can also be used to help Mrs R to be free of her anxiety and stress, and to reduce muscle tension (Lewis,
As a chronic pain sufferer, you should know that you're not alone. Chronic pain impacts many people and, as a result, is the subject of much research and experimentation. This means there is a wealth of information available about pain management. Invest some time researching pain management methods and give them a try to see what works best for you. People have used hypnosis, biofeedback, meditation, acupuncture and many other methods of pain control with varying results. Research and experimentation under your doctor's supervision may be the only way to know what works best for
It is a hard decision for health care providers to decide the best pain medication for their patients, as there are many types and strength of painkillers. After taking that into consideration, the practitioner have to decide on the length of duration to ensure that patients do not slowly develop tolerance to their specific pain medication. Lastly, they have to be cautious that patients do follow their instruction to prevent possible abuse and withdraw from the addictive painkillers. The use of painkillers is ideal for acute pain, and not for chronic pain. Patients should always find alternatives before submitting themselves into using pain medications. Painkillers should be used as a last resort, and healthcare providers should have second thoughts before prescribing any addictive painkillers that may result in abuse. It is their duties to monitor the patient regularly and ensuring that the medications are not being used for recreational purposes. Healthcare providers are the patient’s best advocates and they have to carefully decide the best suitable pain treatment for their
Most medical treatment for chronic pain includes from pharmaceutical treatments for pain management, which can range from over-the-counter medicines like aspirin to prescription drugs. The problem with chronic pain management treatments that involve drugs is that they lose their effectiveness. Worse they actually can create more chronic or that can add to the chronic pain cycle.
Pain is a basic mechanism in life that helps the body identify that something is wrong or dangerous. Without pain, the body would be severely damaged without realizing it. Pain can become an inconvenience when it spirals out of control; chronic pain, for example, leaves many miserable and unable to enjoy life to its fullest extent even with traditional medical intervention. Around 80% of people report chronic pain in their lifetime (Holtzman & Beggs, 2013). People afflicted by chronic back pain turn to modern medicine for relief, but even these alternatives are not always 100% effective.