Diet. Recommend a Mediterranean pattern of eating to lower inflammation and maintain a healthy weight. Although inflammation is part of the nociceptive process, research into the role of diet in modifying inflammation is in its early stages. The Mediterranean pattern of eating, characterized by a high intake of fruits, vegetables, whole grains and an emphasis on omega-3 fatty acids, has been established as a dietary pattern that lowers inflammation especially in the setting of cardiovascular disease.
The prevalence of chronic pain in the US is difficult to estimate, but its impact is profound. Fifty to eighty million Americans experience daily pain symptoms. The cost of pain management is approximately $90 billion annually.
The strong evidence for the contribution of psychosocial factors in pain experience, particularly in explaining disability attributed to pain, has led to the development of multidisciplinary pain rehabilitation programs (MPRPs) that simultaneously address physical, psychological, and functional aspects of chronic pain disorders.
The differing pathophysiology for acute pain and chronic pain requires different approaches to their diagnosis and treatment. Effective acute pain management has been shown to improve both patient satisfaction and treatment outcomes, and reduce the risk of developing chronic pain.
Assess the degree of functional impairment to help determine the urgency for addressing the acute pain issue. For example, weakness may require a more aggressive strategy with early intervention, such as advanced imaging.
Principles for managing opioid use disorder in pain patients. The treatment of pain patients who exhibit evidence of opioid use disorder requires heightened monitoring, or discontinuation of opioid therapy and initiation of addiction treatment.
Multiple contacts about opioids. The patient generates multiple telephone calls, visits, or other contacts to the administrative office requesting more opioids or early refills, or for problems associated with the opioid prescription.
A logical rationale for an intervention does not ensure the patient’s acceptance and participation in it. A patient’s acceptance of therapy is influenced by several complex factors, including characteristics of illness and identity.
Be familiar with transdermal and buccal buprenorphine. Sublingual buprenorphine should be initiated only by prescribers trained in its use. It can provoke acute opioid withdrawal if not done correctly.
Painful procedures: common in pediatric ICU patients, preterm neonates, and children with malignancy IV cannulation
After initiating an opioid, see the patient within 1-2 weeks. Then see them at least monthly until they reach a stable opioid dose with improvement in pain and function.
Suzetrigine For moderate to severe acute pain First dose on an empty stomach; subsequent doses can be taken with food
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Help you determine whether there is a generic version, which is typically less expensive than brand-name medicine