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Chronic Pain Management: An Evidence-Based Approach Reviewed 5/2013

Jennifer Reidy, MS, MD
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BASICS

  • Epidemiology
  • Risk Factors
  • General Prevention
  • Pathophysiology
  • Etiology
  • Associated Conditions

DIAGNOSIS

  • History
  • Physical Exam
  • Tests
  • Differential Diagnosis

TREATMENT

  • Medication (Drugs)
  • Additional Treatment
  • Complementary and Alternative Medicine
  • Surgery

ONGOING CARE

  • Follow-Up Recommendations
  • Patient Education
  • Complications
The following is an excerpt....
BASICS
  • Chronic pain is pain persisting beyond the time of normal tissue healing, usually >3 months.
  • Over time, neuroplastic changes in the CNS transform pain into a chronic disease itself. Pain levels can exceed observed pathology on exam or imaging.
  • Pain experience is inherently related to emotional, psychological, and cognitive factors.
  • An epidemic of undertreated pain coexists with an epidemic of prescription drug abuse in the US. Use a systems-based practice to safely and effectively prescribe opioids when indicated for chronic nonmalignant pain.
Epidemiology
Incidence

Incidence is rising, but exact rate is unclear. The annual economic cost of chronic pain in the US is estimated at $560–635 billion (1).

Prevalence

In the US, an estimated 100 million adults ...

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