3.) Chronic Pain: Treatment continuum

From: Helen Dynda (olddad66@runestone.net)
Mon Aug 27 13:14:13 2001

3.) Chronic Pain: Treatment continuum Pain produces anxiety and muscle tension. The tense, contracted muscles eventually produce spasms, which causes more pain. In response to pain, the muscles continue to contract, creating a pain-spasm-pain cycle. In order to reduce pain, this cycle must first be broken. There are three strategies for controlling chronic pain: early intervention, an interdisciplinary approach, and an individualized, goal-directed care plan that considers multiple treatment options.

It is essential that patients and families understand and accept that cure from pain is not a realistic goal of a pain treatment program. Health professionals should reinforce achievable and realistic goals: controlling pain, decreasing suffering, decreasing the use of healthcare services, and restoring function. The first step in the treatment continuum is an evaluation of the problem, diagnosis, and establishment of treatment goals that are realistic for the patient and provide some predictability for the payer.

Patient and family involvement and education are at the core of a pain management program. Education helps patients manage their lives and regain the sense of control that has been lost due to pain. Patients and families benefit from learning about the physiology of the affected body systems, the pain cycle, body mechanics, the purpose and side effects of medications, assertiveness techniques, problem-solving skills, communication techniques, nutrition, and effective sleep habits. Pain behaviors are modified by reinforcing healthy behaviors that facilitate self-management of pain and by de-emphasizing behaviors that remind patients and those close to them of their pain.

Patients with chronic pain may attempt to avoid it by limiting their activities. Over time, lack of exercise and movement causes physical deconditioning. To improve conditioning, patients may benefit from an individualized exercise program designed by a physical therapist. The exercise program emphasizes increased functioning, strength, flexibility, and endurance. As the patient’s activity level increases, he or she should also learn pacing techniques that assist with well-being and avoidance of injury.

Stress management skills are an important part of chronic pain management. It’s helpful to teach behaviors that can become part of daily routines as adaptive coping strategies to manage the anxiety and depression that often accompany chronic pain. Cognitive-behavioral strategies include progressive muscle relaxation, biofeedback, guided imagery, distraction, meditation, and humor.

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The above information is from:

[]] Chronic Pain: Stopping a Downward Spiral


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