Michael J Kuhar

CHRONIC PAIN Chronic or persistent pain is defined as pain that lasts for longer than six months. Chronic pain can stem from cancer, illness, injury, or postsurgical changes. Often, persons with chronic pain suffer from syndromes that cannot be confirmed by laboratory tests. These chronic pain syndromes include central pain syndromes, fibromyalgia, headache, lower back pain, myofascial pain syndrome, neuropathic pain, and phantom limb pain. Frequent locations of chronic pain include the back, head, joints, chest, abdomen, and extremities. Chronic pain is common and its sufferers are more likely to have anxiety or depression, have poor perception of their health, decreases in their quality of life, and experience a disruption of their livelihood than those who are not in pain.

In most cases, there is no cure for the chronic pain so treatment is aimed at pain control and rehabilitation. Unfortunately, chronic pain is often ineffectively treated because physicians can be reluctant to prescribe strong, potentially addictive medications. The ineffective pain treatment is compounded by commonly associated conditions such as depression, insomnia, fatigue, and a decrease in general physical functioning. Therefore, treating the pain alone is not sufficient.

The optimal approach to the chronic pain sufferer is an interdisciplinary team that may be comprised of a pain management physician, nurse specialist, psychologist, physical therapist, pharmacist, and vocational counsellor. The physician conducts a thorough assessment of the patient and determines the appropriate medical interventions. The psychologist conducts a thorough psy chological assessment, educates the patient on techniques to reduce pain, and tends to any associated mental health illnesses. The nurse specialist acts as a case manager and educator. The physical therapist ascertains the patient s physical endurance, flexibility, and strength and conducts the physical rehabilitation process. The vocational counsellor identifies and devises strategies to allow the patient to return to work. In addition to dispensing medications, the pharmacist will review past and present use of medicinal agents and educate the patient on the proper use of medications.

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