What is the most common reason for seeking medical care?
Pain
What are the functions of pain?
#NAME?
What is pain that lasts less than 30 days?
Acute pain
Pain that typically lasts 1-6 months?
Subacute pain
Pain that lasts over 6 months
Chronic pain
What are types of pain?
#NAME?
If the peripheral and central nervous systems are functioning correctly and there is pain, what kind of pain is it?
Nociceptive
Visceral, deep somatic, and superficial pain are what kinds of pain?
Nociceptive
What is pain that is vague and radiates in common patterns?
Visceral nociceptive
What is pain in bones, ligaments, tendons, muscles, fasciae, and blood vessels?
Deep somatic nociceptive pain
What is pain that is relatively well-defined and easy to locate?
Superficial nociceptive pain
What type of pain results from a malfunction of the nervous system?
Neuropathic pain
What can direct injuries, disease, or improper connections after healing cause?
Neuropathic pain
Tingling, burning, electrical, pins and needles are sequelae of what? What type of pain is this?
#NAME?
Hyperalgesia and allodynia are associated to what? What type of pain is this?
#NAME?
What type of pain is HA, abdominal pain, muscle aches, lower back pain, occasionally due to mental illness, and commonly caused by grief, social rejection, and emotions?
Psychogenic pain
What type of pain has no physical cause, can co-occur with other types of pain, and can be present in people with grief/stress?
Psychogenic pain
What type of pains has no physical/psychosocial cause, sometimes fall into very well defined syndromes (fibromyalgia) , and may or may not remain idiopathic?
Idiopathic pain
What type of pain extends beyond the expected period of healing and can cause changes in the diencephalon and dorsal horns in of the spinal cord?
Chronic pain
What is chronic pain?
Abnormality of the nervous system?
What is the goal of therapy for chronic pain?
Build a life that the pt can enjoy
What types of things can be helpful goals for chronic pain?
#NAME?
What are guidelines for chronic pain?
- Have a written guideline, and use it consistently for all your patients with chronic pain.- Base it on a national guideline- Protect yourself, your patients and your community- Don't discriminate. Period.
Behavioral medicine, physical medicine, pharmacologic agents, neuromodulation, interventional approaches, and surgical approaches are Tx options for what?
Chronic pain
What are things that behavioral medicine can do for chronic pain?
#NAME?
Tai Chi, aqua therapy, and physical therapy are what type of therapy?
Motion
What type of therapy can improve ROM, functionality, and help train the patient to work through pain without feeling disable by it?
Motion therapy
Physical/occupational therapy, massage therapy, acupuncture, chiropractic, naprapathy, and homeopathy are what type of medicine for pain?
Physical medicine
What therapies are used for neuromodulation for pain?
#NAME?
What are interventional options for chronic pain?
Trigger point injections, nerve blocks, facet injections, neurolysis, and intrathecal/epidural medication injection/pumps.
What should we watch for when suggesting APAP/NSAIDs?
Medication-overuse headache
What drug is not prescribed if there is bleeding/bleeding disorder and must be administered slowly?
Ketorolac (IM)
What type of pharmacologic agents can be used if muscle spasms are causing the pain?
Muscle relaxants
PBG, GBP, CBZ, OXC, and LTG are what type of drugs?
Anticonvulsants (nerve stabilizers)
What type of drugs are amitriptyline, nortriptyline, and trazodone? What do they help with?
#NAME?
What SNRI's can be used tp treat chronic pain, especially with depression and daytime pain?
Duloxetine, venlafaxine, and desvenlafaxine
What are alpha 2 agonists that are useful for pain and muscle spasm?
Clonidine, tizanidine, and guanfacine
What topical agents can be used to treat chronic pain?
Capsaicin, menthol, lidocaine, ibuprofen, and gabapentin
What topicals are used when oral meds are not well tolerated?
Ibuprofen and gabapentin
What are feature of lidocaine and marcaine?
#NAME?
What are effective agents for acute, sharp, moderate/severe, and visceral/deep somatic pain?
Opiates
What agents have no evidence for long-term Tx of chronic headache or osteoarthritis?
Opiates
Maximum medical improvement (MMI) definition
When further improvement or healing can not be reasonably expected.
What can be given by a trained specialist when the pt reaches MMI?
An impairment rating