Chronic noncancer pain (CNCP) is a big challenge for pain doctors as well as for the patients who suffer from it. The complete elimination of pain is rarely achieved for any substantial period. Therefore, patients and pain management specialist should discuss treatment goals that include reducing pain, maximizing function, and improving quality of life. The best pain management outcomes can be achieved when chronic pain management addresses co-occurring mental disorders (e.g., depression, anxiety) and when it incorporates suitable nonpharmacologic and complementary therapies for symptom management.
A multidisciplinary team approach provides a breadth of perspectives and skills that can enhance outcomes and reduce stress on treating pain doctor. Although it is ideal when all relevant providers work within the same system and under the same roof, often a collaborative team must be coordinated across a community. A treatment team can include the following professionals: Primary Care doctor, Chiropractors, Physical Therapist, Psychologist, and Pain Management Specialist.
Goals for treating chronic pain in patients are as follows:
- Treat CNCP with non-opioid analgesics as determined by pathophysiology.
- Recommend or prescribe nonpharmacological therapies (e.g., cognitive–behavioral therapy [CBT], exercises and therapy to decrease pain and improve function).
- Treat comorbidities.
- Assess treatment outcomes.
- Interventional pain management-Epidural steroid injection, nerve block and ablation, joint injections, spinal cord stimulator and more.
- Initiate opioid therapy only if the potential benefits outweigh risk and only for as long as it is unequivocally beneficial to the patient.
Key Points
- Pain treatment goals should include improved functioning and pain reduction.
- Treatment for pain and comorbidities should be integrated.
- Non-opioid pharmacological and nonpharmacological therapies, including CAM, should be considered routine before opioid treatment is initiated.
- Opioids may be necessary and should not be ruled out based on an individual’s having an substance abuse history. The decision to treat pain with opioids should be based on a careful consideration of benefits and risks.
- Addiction specialists should be part of the treatment team and should be consulted in the development of the pain treatment plan, when possible.
Call our Houston Pain Doctors at Houston Spine and Joint Pain Consultants.
Source
https://www.ncbi.nlm.nih.gov/books/NBK92054/
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