Full Answer
What is the goal of pain treatment?
It makes sense that the primary goal of pain treatment should be to reduce pain. However, a recent editorial in The New England Journal of Medicine makes a strong case for looking beyond pain intensity when evaluating what is “successful” pain management.
What are the three aspects of pain?
1. Sensory aspects of pain 2. Discriminative aspects of pain 3. Motivational aspects of pain 4. Cognitive aspects of pain 3. Motivational aspects of pain 1. Patients tend to report the most severe or important in their perception. 2. Pain tolerance generally decreases with repeated exposure. 3.
What are the motivational aspects of pain?
Motivational aspects of pain 1. Patients tend to report the most severe or important in their perception. 2. Pain tolerance generally decreases with repeated exposure. 3. The reported pain site is usually the most important to treat. 4. Pain may be referred from a different site to the one reported. 1.
What are some patient stories and goals for managing pain?
Patient Stories and Goals for Managing Pain 1 Reduction of Pain Intensity. ... 2 Enhancement of Physical Functioning. ... 3 Proper Use of Medication. ... 4 Improvement of Sleep, Mood and Interaction with People. ... 5 Return to Work or Normal Daily Activities. ... 6 Patient Story: Birch Peterson. ...
What are the goals of effective pain management?
The first and most major pain management goal is pain control and relief while taking the lowest dose of medications possible. Meaningful pain relief has been proven to improve functionality and quality of life.
What should be the treatment goal for chronic pain?
The goal is to gradually increase function without exceeding limits of pain and discomfort. Patients have been known to increase their physical strength and endurance by 50 to 100 percent over a three-month period.
What is the goal of treatment for acute pain?
Treatment Goals The immediate goals of treatment for patients suffering from acute pain include facilitating functional recovery and reducing pain to a tolerable level.
What is the goal of pain assessment?
A pain assessment is conducted to: Detect and describe pain to help in the diagnostic process; Understand the cause of the pain to help determine the best treatment; Monitor the pain to determine whether the underlying disease or disorder is improving or deteriorating, and whether the pain treatment is working.
What is the treatment of pain?
pain medicines. physical therapies (such as heat or cold packs, massage, hydrotherapy and exercise) psychological therapies (such as cognitive behavioural therapy, relaxation techniques and meditation) mind and body techniques (such as acupuncture)
What is a functional goal in opioid treatment?
In treating pain patients who require opioids, the overall goal is to provide enough pain control to allow the patient to leave their bed or couch, carry on activities of daily living such as dressing and eating, and achieve an improved quality of life.
What is the goal of treatment for acute pain versus chronic pain?
The therapy of acute pain is aimed at treating the underlying cause and interrupting the nociceptive signals. The therapy of chronic pain must rely on a multidisciplinary approach and should involve more than one therapeutic modality.
What is best for acute pain?
Acetaminophen is the first-line treatment for most mild to moderate acute pain. Ibuprofen and naproxen (Naprosyn) are good, first-line NSAIDs for mild to moderate acute pain based on effectiveness, adverse effect profile, cost, and over-the-counter availability.
What is the standard for pain assessment?
Since pain is subjective, self-report is considered the Gold Standard and most accurate measure of pain. The PQRST method of assessing pain is a valuable tool to accurately describe, assess and document a patient's pain.
What are the nursing interventions for pain?
Nursing Interventions for Acute PainProvide measures to relieve pain before it becomes severe. ... Acknowledge and accept the client's pain. ... Provide nonpharmacologic pain management. ... Provide pharmacologic pain management as ordered. ... Manage acute pain using a multimodal approach.More items...•
What are the steps of pain assessment?
Patients should be asked to describe their pain in terms of the following characteristics: location, radiation, mode of onset, character, temporal pattern, exacerbating and relieving factors, and intensity. The Joint Commission updated the assessment of pain to include focusing on how it affects patients' function.
How to assess pain?
Pain is commonly assessed by asking a patient about their pain on a scale of 0 to 10, with 0 representing no pain and 10 being the worst pain imaginable. While this has proved to be a simple and easy test to administer, it evaluates only the intensity of a patient’s pain experience. Tracking and treating patients according to their pain intensity may not accurately reflect the efficacy of therapeutic interventions.
How long does it take for a neuropathic pain to improve?
Patients may not have been told that some treatments take longer than a week before they may notice a benefit, such as those for neuropathic pain. Encourage the patient to track their progress and not just their pain!
What does behavioral measures tell us about a patient?
Behavioral measures evaluating a patient’s social engagement, such as going to church or attending family events, can also tell us a lot about how a patient may be coping with their disease. By focusing more on functional and behavioral outcomes, and less on pain intensity, we can better capture the burden of or improvements in chronic pain.
What is realistic goal setting?
Realistic goal setting is essential and requires two-way communication with the patient. Much like we do with professional goals, applying SMART (Specific, Measurable, Achievable, Realistic, and Time bound) principles to patient goals can increase their chance of achieving a positive outcome.
Is tracking pain intensity a good indicator of therapeutic intervention?
Tracking and treating patients according to their pain intensity may not accurately reflect the efficacy of therapeutic interventions. Rather than focusing on a pain score, it may be more beneficial to emphasize the importance of functional and behavioral goals.
Can pain score be 0?
It can cause a patient to oversimplify their condition and become fixated on a number. Furthermore, their pain score will likely never reach 0, which can be frustrating and disappointing for some. Rather, guide their attention toward establishing realistic, measurable goals that focus on quality of life and function.
What is the primary goal of pain treatment?
I always believe that the primary goal of pain treatment should be to reduce pain. Once you have accomplish that you can move on to treat the main problem
What do people with chronic pain care about?
Patient surveys also show that people with chronic pain care about more than just experiencing less pain. They care about enjoying life more, having a strong sense of emotional well-being, increasing their physical activity, improving sleep and reducing fatigue, and participating in social and recreational activities.
What does it mean when pain reduction is prioritized over every other outcome?
This means that, if we prioritize pain reduction over every other outcome, we may wind up doing as much harm as we do good. In particular, the authors of the editorial suggest that focusing only on lowering pain intensity, and creating a moral mandate to relieve pain, have contributed to the opioid crisis in this country. Over the past few decades, we have seen steady increases in opioid prescriptions, cases of opioid misuse and abuse, and related overdose deaths.
Does behavioral therapy help with opioid adherence?
Robert Jamison at Harvard-affiliated Brigham and Women’s Hospital showed that a behavioral treatment to improve opioid adherence among chronic pain patients actually reduced rates of medication misuse among patients most likely to misuse these drugs. The “success” of pain treatment is very individual.
Is pain a common event?
Pain is a very common event for almost every person, which occurs in any way in his lifetime. but it differs from person to person, as per his health condition. Apart from medicines, few therapies also work for the pain management.
Is pain management multimodal?
The future of pain management. The editorial’s authors also suggest that pain-management treatments that are not just individualized but also multimodal (that is, they combine several different therapies) may produce the largest benefits with the fewest harms.
Does a drug reduce pain?
For some people, the risk of abuse is small, the side effects are minor, and the drug reduces their pain significantly. For others, these drugs reduce pain only a little, while the fatigue and cognitive side effects are so bad that it is hard to carry out routine activities like driving or going to work.
Does CBT help with pain?
CBT improved all aspects of pain except
Should T/F be part of pain management?
T/F. Bowel regimen should be a part of every pain management plan
Can triptans be used for slow onset migraines?
fast onset migraines. Slower acting triptans can be used for slow onset migraines.
What is the objective of chronic pain?
The patient's foremost objective in visiting the doctor is to make the pain go away (sooner, rather than later). Unfortunately, finding the right treatment regimen is a long-term, sometimes difficult, process. The patient can be discouraged by treatment setbacks in the forms of side effects (excessive sedation) from opioid analgesics or the recurrence of high levels of pain.
What is the function based treatment strategy for chronic pain?
Pain experts recommend a function-based treatment strategy that focuses on restoring some or all of the pain patient’s normal activities. The clinician should learn what activities a patient has stopped doing as a result of chronic pain and then establish weekly or monthly objectives for restoring these activities using a multi-modal treatment approach. In collaboration with the patient, the clinician can create a scale where the lowest end is the patient's ability to engage in only one of his normal activities - sleeping - and the highest end would be all of his activities - sleeping, eating, working, recreation, etc.
What is pain score?
A patient’s pain score is just one of several measurements of successful chronic pain treatment. Small reductions in pain are considered major successes if they lead to increased function. Realistic functional goals should be set collaboratively between the prescriber and patient.
What scales do doctors use to measure pain?
Doctors treating chronic pain patients often use quantitative tools to measure patients' treatment progress. But, simple zero-to-ten scales, happy-sad faces, or x's on a drawing of a body may not necessarily offer objective or quantitative information. Different patients have different levels of pain tolerance; one person's "3" is another person's "7." Also, a less-than-candid patient could over-report levels of pain.
Is zero pain realistic?
Read the latest info. "Zero" pain is not realistic, achievable or desirable. A patient’s pain score is just one of several measurements of successful chronic pain treatment. Small reductions in pain are considered major successes if they lead to increased function.
Is it hard to find the right treatment for pain?
Unfortunately, finding the right treatment regimen is a long-term, sometimes difficult, process. The patient can be discouraged by treatment setbacks in the forms of side effects (excessive sedation) from opioid analgesics or the recurrence of high levels of pain.
What is the treatment plan for chronic pain?
A treatment plan for management of chronic pain should include: 1. Negotiation with the patient to set personal goals for pain management. 2. Discussion of ways to improve sleep and stress. 3. An exercise program to improve function and fitness. 4.
How to determine if a patient is willing to be an active participant in pain management?
1. Determine if the diagnosis of source of pain is correct. 2. Determine if the current regimen is adequate or different combinations of drugs and non-drug therapy are required . 3. Determine if the patient is willing and able to be an active participant in his or her pain management. 4. All of the above. 4.
Why is acetaminophen used for pain management?
Acetaminophen is especially useful in both children and adults because it has no effect on platelets and has fewer adverse effects than NSAIDs. Pain assessment to determine adequacy of pain management is important for all patients. This assessment is done to: 1. Determine if the diagnosis of source of pain is correct.
What is an opiate used for?
Opiates are used mainly to treat moderate to severe pain. Which of the following is NOT true about these drugs?
What is the main class of pain medication?
One of the main drug classes used to treat acute pain is NSAIDs. They are used because:
What chemicals promote the spread of pain locally?
4. Pain may be referred from a different site to the one reported. 1. Patients tend to report the most severe or important in their perception. The chemicals that promote the spread of pain locally include: 1. Serotonin.
What is acute neuropathic pain?
Acute neuropathic pain is caused by lack of blood supply to the nerves in a given area. 3. Referred pain is present in a distant site for the pain source and is based on activation of the same spinal segment as the actual pain site. One of the main drug classes used to treat acute pain is NSAIDs. They are used because:
When OUD is diagnosed, pain management should continue in conjunction with addiction treatment?
When OUD is diagnosed, pain management should continue in conjunction with addiction treatment when there is ongoing chronic pain. Address ongoing chronic pain with a selection of non-opioid and non-pharmacologic therapies, concurrent with initiation of an evidence-based addiction treatment modality. Clinicians who are unable to directly provide addiction treatment in an office-based setting should work closely with the addiction treatment provider to address ongoing pain. This requires ongoing consultation including a specific patient release to consult with the addiction treatment provider.
What is the role of opioids in pain management?
Develop a multi-modal, active pain management plan with the patient to achieve these goals. Titration of opioids only to pain or self-reported functional status is not recommended. This often leads to accelerating doses based on a perception that higher doses will effectively ameliorate pain or improve function.
Why are urine drug screens important?
Urine drug screens can play an important role in monitoring patients on COAT. Although there is limited evidence that routine use of UDS improves patient outcomes, current opioid prescribing guidelines recommend routine use of UDS in chronic pain patients (CDC, 2016a; ICSI, 2017). Urine drug screens can identify other substances used by the patient and/or when the patient is not adherent to his or her treatment regimen. Clinicians should use the results of a UDS to guide treatment decisions and referral to the appropriate level of care. The results of UDS cannot be used to diagnose substance use disorder or confirm diversion.
How much of the daily MME dose of the previous stable opioid agent should be reduced?
If substitution or conversion is indicated, use opioid conversion tables only as guidance. Doses of the new opioid should be reduced by 30-50% of the daily MME dose of the previous stable opioid agent to account for incomplete cross-tolerance.
What is the responsibility of a clinician when prescribing opioids?
Clinicians must recognize that the decision to prescribe opioids for chronic pain requires: ongoing, active risk assessment; frequent monitoring; responsibility for the patient’s safety and management of the conditions that contribute to the patient’s pain experience.
When to prescribe opioids for coat?
Prescribe immediate release/short acting opioids when initiating COAT. Long-acting/extended-release opioids should be reserved for patients with established opioid tolerance and in whom the prescriber is confident of the patient’s medication adherence.
Why do you call back on a pill count?
Patients should be aware that pill counts are possible as part of their COAT and contact information should be kept updated. If the pill count results in fewer or greater pills than expected, schedule a visit with the patient to discuss the results. Possible reasons for a discrepancy in the number of pills include diversion and misuse, but may also be a result of misunderstood directions, overprescribing, opioid-induced hyperalgesia, or an attempt to cope with an emerging mental health condition.
What is the primary goal of chronic pain management?
The primary goal in chronic pain management is that the cause of the pain should be found and cured, enabling the individual to resume with normal activity and daily life.
What scale do you set your pain goal on?
Once done, you will be again asked to set your pain goal on the same scale .i.e. based on how much pain relief do you want and till what degree do you want to be free from pain (on the scale of 0 to 10)
What is the best scale for pain management?
You will be asked to do the following: On a scale of 0 to 10, rate your current level of pain. This is with the assumption that 0 is a level of no pain, 5 is the moderate level of pain and 10 is the worst imaginable pain.
What is measurable goal?
Measurable – The goal you set should be measurable in concrete terms. For instance, instead of ‘Being more active’, it is better to set a goal, like – ‘Increasing the amount of activity by 5 minutes every week’.
What is practical goal?
Practical – The goals should be viable and you should possess the ability to achieve the same. Do not compare your goals with others in the same condition, as there could be a series of factors which could vary, such as age, profession and overall health.
Why is goal setting important?
Research strongly indicates that goal setting facilitates effective pain management, especially in the case of chronic pain. A recent report released in context of pain management in older adults revealed that setting goals led to better ...