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Evaluation and Management of Chronic Pain for Primary Care

Evaluation and Management of Chronic Pain for Primary Care
Author: Bonnie Huang Hall, MD, PhD
Publisher: Springer Nature
Total Pages: 285
Release: 2020-07-01
Genre: Medical
ISBN: 3030471179

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Primary care physicians are often the first caretakers to whom patients present for chronic pain. The current literature targeted at these providers is sparse, and the existing literature is very broad and large in scope and size. There are no quick pocket guides on this topic that the general practitioner may use as a point of care reference. This first of its kind text provides a practical, hands-on approach to the evaluation and treatment of chronic pain in the family medicine setting. Divided into four main sections, the first part focuses on the general approach to any patient suffering from chronic pain. Chapters in this section include the physical exam, formulating a diagnosis, formulating a variety of treatment plans including medication, physical therapy and psychiatric therapy, and specialist referral, among others. The second section focuses on evaluation and management of the chronic pain patient who requires opioid therapy. This section includes useful guidance on how to convert into morphine equivalents, interpretation of urine drug tests, and helpful office procedures for managing refills. It gives practical guidance on how to prescribe opioid reversal agents and opioid tapering regimens. A systems based approach to managing the patient is also discussed. The third section informs the reader of viable alternative and complementary treatment options. Five main treatment types are discussed each with their own separate chapter. These include musculoskeletal-based therapy, medicinal therapies, sense-based therapy, relaxation-based therapy and physical/exercise-based therapy. Given the controversy and limited training primary care physicians have on marijuana and cannabis, one chapter is dedicated specifically to inform the primary care physician on marijuana as a medicinal therapy for chronic pain. The fourth section focuses entirely on myofascial pain and trigger point therapy. The chapters in this section teach the reader how to examine and diagnose myofascial pain and distinguish between fibromyalgia. They also provide general principles of myofascial trigger point therapy and how to practically perform these in sthe clinical setting. Topics discussed include: trigger point massage, cold and stretch, isometric contraction, trigger point injection, and ischemic compression. It also includes general instruction so that the practitioner can teach patients how to perform trigger point therapy easily in their own home. The last chapter details chronic myofascial back pain and how to examine and practically treat with trigger point therapies. Evaluation and Management of Chronic Pain is a first-of-its-kind pocket-guide text specifically designed for primary care providers. It also appeals to residents, medical students and any other professional interested in treating chronic pain.


Relieving Pain in America

Relieving Pain in America
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 383
Release: 2011-10-26
Genre: Medical
ISBN: 030921484X

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Chronic pain costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the Institute of Medicine (IOM) in examining pain as a public health problem. In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America. To reach the vast multitude of people with various types of pain, the nation must adopt a population-level prevention and management strategy. The IOM recommends that HHS develop a comprehensive plan with specific goals, actions, and timeframes. Better data are needed to help shape efforts, especially on the groups of people currently underdiagnosed and undertreated, and the IOM encourages federal and state agencies and private organizations to accelerate the collection of data on pain incidence, prevalence, and treatments. Because pain varies from patient to patient, healthcare providers should increasingly aim at tailoring pain care to each person's experience, and self-management of pain should be promoted. In addition, because there are major gaps in knowledge about pain across health care and society alike, the IOM recommends that federal agencies and other stakeholders redesign education programs to bridge these gaps. Pain is a major driver for visits to physicians, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority.


Chronic Pain

Chronic Pain
Author: Dawn Marcus
Publisher: Springer Science & Business Media
Total Pages: 444
Release: 2009-01-24
Genre: Medical
ISBN: 1603274650

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Patients with chronic pain present a unique set of challenges to the primary care clinician. In Chronic Pain: A Primary Care Guide to Practical Management, Second Edition, leading pain specialist Dawn A. Marcus, MD, again offers practical, clear, and succinct evidence-based approaches to the diagnosis and treatment of the myriad painful conditions clinicians see in their offices every day, such as headache, back pain, arthritis, fibromyalgia, and abdominal pain. Sections addressing pain management in children, pregnant women, and seniors are also included. This new edition is designed to provide a pragmatic approach to assessing and treating the complex issues and characteristics of chronic pain patients. New chapters expand upon the evidence-based recommendations and practical office tools previously provided, with the addition of new chapters addressing risk management; pain syndromes in the shoulder, upper extremity, and lower extremity; and cancer and end-of-life pain. Chronic Pain: A Primary Care Guide to Practical Management, Second Edition provides strategies and techniques that are designed to improve the confidence with which the primary care physician can approach patients with complex pain complaints, reduce staff stress, and improve patient success.


Chronic Pain

Chronic Pain
Author: Dawn Marcus
Publisher: Springer Science & Business Media
Total Pages: 352
Release: 2007-11-06
Genre: Medical
ISBN: 159259882X

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Patients with chronic pain present a unique set of challenges to the primary care clinician. In Chronic Pain: A Primary Care Guide to Practical Management, leading pain specialist Dawn A. Marcus, MD, offers practical, clear, and succinct evidence-based approaches to the diagnosis and treatment of the myriad of painful conditions clinicians see in their offices every day, such as headache, back pain, arthritis, fibromyalgia, and abdominal pain. Using an engaging case-based approach, the author simplifies the often complex care of patients with chronic pain by providing practical strategies for targeting important symptoms, establishing realistic treatment goals, and efficiently and effectively managing patients. Clinic-friendly instructional sheets (questionnaires, diaries, and chart documentation tools) can be copied directly from the book and used for both education and the monitoring of therapeutic compliance and response. Importantly, Dr. Marcus offers all of these practical applications in the context of the busy office practice. The author also presents invaluable guidelines for prescribing medications and nonmedicative therapies, and provides descriptions, illustrations, and diagnostic criteria to help identify specific, commonly occurring syndromes that produce chronic pain. Additional features include sections on opioid therapy and on chronic pain in special patient groups such as children and adolescents, pregnant women, and geriatrics. Also included is a value-added compact disk containing a companion ebook version of the book for downloading and use in the reader's computer or PDA, and continuing medical education (CME) questions that provide the opportunity to acquire 5 AMA/PRA category 1 CME credits from the American Society of Contemporary Medicine and Surgery. Comprehensive and case-oriented, Chronic Pain: A Primary Care Guide to Practical Management offers busy health care providers a practice-friendly approach to assessing and managing the often complex and time-consuming problems of chronic pain.


Pain and Disability

Pain and Disability
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 318
Release: 1987-01-01
Genre: Medical
ISBN: 0309037379

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Painâ€"it is the most common complaint presented to physicians. Yet pain is subjectiveâ€"it cannot be measured directly and is difficult to validate. Evaluating claims based on pain poses major problems for the Social Security Administration (SSA) and other disability insurers. This volume covers the epidemiology and physiology of pain; psychosocial contributions to pain and illness behavior; promising ways of assessing and measuring chronic pain and dysfunction; clinical aspects of prevention, diagnosis, treatment, and rehabilitation; and how the SSA's benefit structure and administrative procedures may affect pain complaints.


Primary Care Pain Management

Primary Care Pain Management
Author: Charles De Mesa
Publisher: Lippincott Williams & Wilkins
Total Pages: 352
Release: 2019-07-11
Genre: Medical
ISBN: 1975142268

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Authored by experts in pain medicine and internal medicine at the University of California, Davis, Primary Care Pain Management delivers just the right amount of clinically relevant information for primary care physicians, nurse practitioners, and physician assistants. Addressing safe and effective pain management in the primary care setting, it follows a user-friendly, high-yield format for quick reference at the point of care, helping you understand the full range of options for treating patients with chronic and acute pain.


Chronic Pain Management, An Issue of Primary Care: Clinics in Office Practice

Chronic Pain Management, An Issue of Primary Care: Clinics in Office Practice
Author: David O'Gurek, MD
Publisher: Elsevier
Total Pages: 240
Release: 2022-09-28
Genre: Medical
ISBN: 9780323986618

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In this issue of Primary Care: Clinics in Office Practice, guest editor Dr. David O'Gurek brings his considerable expertise to the topic of Chronic Pain Management. Top experts in the field cover this timely topic in depth, including non-pharmacologic and rehabilitative strategies to address chronic pain and management of chronic pain in patients with substance use disorder. Contains 12 practice-oriented topics including comprehensive evaluation for chronic pain; pharmacologic management of chronic pain; trauma and behavioral health care for patients with chronic pain; the use of medical marijuana for chronic pain; ethical challenges in chronic pain management; and more. Provides in-depth clinical reviews on chronic pain management, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.


Practical Chronic Pain Management

Practical Chronic Pain Management
Author: Tariq Malik
Publisher: Springer Nature
Total Pages: 389
Release: 2020-06-19
Genre: Medical
ISBN: 3030466752

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This book focuses on both the management of the pain as well as the pain patient and is formatted as a practical, evidence-based guide to managing chronic pain conditions. It meets the market need for a reference that aides physicians in understanding and improving chronic pain in their patients. Organized across 46 chapters, the book begins with an introduction on chronic pain evaluation, and specifically stresses the importance of complete patient evaluation including social and psychological evaluation. Subsequent chapters then start with an evaluation, medical and interventional options available, how and when to move from one option to another and the level of evidence offered for each intervention. These unique chapter elements provide the reader with a case-based approach to managing their patients. Additionally, a brief discussion of epidemiology and pathophysiology of the disease process is included and the technical aspects of interventional techniques are reviewed. Edited by a leader in the field with international contributing authors across pain medicine, Practical Chronic Pain Management this book is written primarily for anesthesiologists, pain specialists, rheumatologists, and primary care physicians.


Pain Management and the Opioid Epidemic

Pain Management and the Opioid Epidemic
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 483
Release: 2017-09-28
Genre: Medical
ISBN: 0309459575

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Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.


Chronic Pain

Chronic Pain
Author: Michael Margoles
Publisher: CRC Press
Total Pages: 538
Release: 1998-12-29
Genre: Health & Fitness
ISBN: 9781574441031

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Chronic pain affects every aspect of life-physical well-being, mood, stamina, and feelings of self worth and self respect. This book focuses on conquering pain and its related problems through proper management. It offers numerous tools and concepts with which to attack chronic pain and win the battle that more than 35 million people in the U.S. alone fight every day. Virtually all specialists in the health care field must be concerned with pain management-this complete reference offers them strategies for helping their patients, and for patients to help themselves. Chronic Pain: Assessment, Diagnosis, and Management presents a variety of therapies for combating chronic pain, including: Applying external therapy Changing the way patients perceive pain through psychotherapy or other cognitive means Physical therapy and exercises Over-the-counter or prescription medicines to relieve pain, stress, and insomnia caused by discomfort Surgical options The book also contains never before published information on how to prescribe and administer opioids and opioid-containing analgesics for chronic, intractable, and non-malignant pain patients. There is hope for those suffering from chronic pain. This book outlines commonly overlooked problems that, if properly addressed, can make the difference between a patient recovering or effectively managing their pain-or not. Chronic Pain: Assessment, Diagnosis, and Management is full of practical advice and options for anyone suffering from chronic pain and for the doctors who treat them.