Consider referring any patient with chronic pain to a psychologist or therapist to address the psychological effects of chronic pain.

A trusting patient-clinician relationship is key to the development of an effective treatment plan for chronic pain. Construct a unique plan for each patient, taking into consideration the individual’s experience, circumstances, and preferences. The treatment plan should involve multimodal interventions, promote self-management, and enlist the involvement of a health care team.

Discuss options for taking prescription sleeping medicine, including how often and when to take it and in what form, such as pills, oral spray or dissolving tablets

If your best attempts to get a good night's sleep have failed, prescription sleeping pills may be an option. Here's some advice on how to use them safely.

After obtaining the history, doing a physical exam, reviewing records and diagnostic test results, assign a diagnosis of chronic pain that identifies:

Many patient populations are unintentionally marginalized by both health care providers and health systems. This inequity is especially true with regard to pain management amongst non-white Hispanic, black, and other minority populations.33,34 Several factors should be considered when treating these vulnerable patients. It is the provider’s responsibility to recognize that inequity in this area is due in part, but not limited to, systemic barriers and complex influences such as implicit biases unbeknownst to providers.

The principles of pain management are detailed in this article. Acute pain management, chronic noncancer pain management, and pain management in palliative care are detailed separately.

Central sensitization occurs when there is heightened pain sensitivity in the central nervous system that is not due to a peripheral pain signal generated by an injury or disease state.

When cravings hit, divert your attention with activities like exercise, listening to music, or engaging in hobbies. Keeping your mind and hands busy helps reduce the urge to smoke. The goal is to replace the habit with a healthier alternative.

Current psychological interventions for chronic pain are based on recent advances in our understanding of the complexity of pain perception. Pain is influenced by a wide range of psychosocial factors, such as emotions, sociocultural context, and pain-related beliefs, attitudes and expectations.

Pain diary: regular documentation of the pain intensity to identify peaks and triggers; enables treatment optimization

Urine drug testing. Obtain a urine drug screen (UDS) for all patients on chronic opioid therapy at least once per year, and any time there is a concern for inappropriate use, use of other substances, or diversion.99

Integrative medicine is an approach that combines and coordinates conventional medicine with get more info evidence-informed practices that historically are not mainstream. Emerging evidence suggests a role for many less conventional treatments in the management of chronic pain due to their benefits and safety compared to opioid therapy.

A successful regimen may combine low doses of different types of pain medications to treat different mechanisms of perceived pain simultaneously, increasing medication effectiveness while limiting the risk of toxicity.