Chronic Pain Syndrome (Archived)

Excerpt

Chronic pain is a leading chief complaint in an adult ambulatory care setting. Patients should be evaluated for the nature of their pain both physically and psychologically in addition to how pain has affected every aspect of life. The treatment goal of chronic noncancer pain (CNCP) is to improve function; therefore, setting expectations and providing education surrounding techniques to decrease pain intensity and frequency of flares to improve quality of life.

In Europe, many studies reported a significant influence of CNCP on different aspects of quality of life. Chronic pain impairs the patients’ perception of their general health, interferes in daily activities which results in withdrawal and isolation from family and friends thus increasing the risk of depression. Chronic pain has a detrimental economic impact as well which includes lost workdays. In a 6-month study, the average lost workdays were 7.8 with about 22% of patients in this study having a minimum of 10 missed workdays. These numbers increased when the patient had a major depressive disorder.[4]

There are pharmaceutical and non-pharmaceutical treatments for CNCP. In the management of CNCP, physicians should always consider a multidisciplinary approach to providing treatment options as chronic pain does not respond to medical monotherapy alone. Treatment options include medications, interventions: both injection therapy and surgical, psychological therapy, physical therapy, and alternative complementary modalities which include acupuncture[5].

Management of CNCP ideally includes the involvement of different specialties to provide care including the primary care physician, pain specialist, psychologist, and physical therapist to provide education, therapy, and monitor progress[6].