Chronic Pain Management: An Evidence-Based Approach

Chronic pain is typically 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...

Nociceptive pain (two types)

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

• Visceral: visceral inflammation/inju...

Goals of treatment are to restore function and decrease pain while balancing risks and benefits of therapies.

Interdisciplinary teams offer the most effective approach to treating the physica...

It can be difficult to identify appropriate pain relief–seeking behavior from inappropriate drug seeking

Maintain a nonjudgmental approach.

Assess...

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 guideline. Ann Intern Med.
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G89.29 Other chronic pain

G89.21 Chronic pain due to trauma

G89.28 Other chronic postprocedural pain

338.29 Other chronic pain

338.21 Chronic pain due to trauma

338.28 Other chronic postoper...

Start with the presumption that a patient’s pain is real, even if pathophysiologic evidence is initially lacking.

Emphasize that a pain-free life may not be possible—better function and...