Skip to main content

Chronic Pain Management: An Evidence-Based Approach

Jennifer Reidy, FAAHPM, MS, MD and Vandana Nagpal, FACP, MD Reviewed 06/2022
 


BASICS

  • Chronic pain is defined as pain persisting beyond the time anticipated for normal tissue healing, usually >3 months.

  • Over time, neuroplastic changes in the CNS transform pain into a chronic e...

DIAGNOSIS

Two general categories of pain: 
  • Nociceptive pain (response to tissue damage):

    • Somatic: skin, bone, soft tissue disease; described as well localized, sharp, stabbing, aching

    • Visceral: visceral ...

TREATMENT

  • Goals of treatment are to restore function and decrease pain.

  • Treatment should always include exercise, cognitive-behavioral therapy (CBT), patient and family education, yoga, massage, relaxa...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Maintain a nonjudgmental approach.

  • Assess and document benefits, risks, pain levels, functioning, and quality of life.

  • Universal precautions:

    • Infor...

REFERENCES

1
Institute of Medicine, Committee on Advancing Pain Research, Care, and Education. Relieving Pain in America: A Blueprint for Transforming P...

ADDITIONAL READING

  • Bohnert  ASB, Guy  GPJr, Losby  JL. Opioid prescribing in the United States before and after the Centers for Disease Control and Prevention’s 2016 opioid ...

SEE ALSO

The SARS-CoV-2 pandemic led to a significant decrease in access to clinics and procedures for chronic pain management (7). 

CODES

ICD10

  • G89.29 Other chronic pain

  • G89.21 Chronic pain due to trauma

  • G89.28 Other chronic postprocedural pain

SNOMED

  • 82423001 Chronic pain (finding)

  • 431481001 chronic pain due to injury (finding)

  • 27904700...

CLINICAL PEARLS

  • Start with the presumption that a patient’s pain is real.

  • Emphasize that a pain-free life may not be possible—better function and quality of life are shared goals.

  • Use a multidisciplinar...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

×