Navigating Chronic Pain

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Challenges in managing chronic pain.

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Navigating Chronic Pain

  1. 1. Navigating Chronic Pain<br />A Clinician’s Guide<br />
  2. 2. OBJECTIVES<br />Definition of Chronic Pain<br />Challenges in treatment of Chronic Pain Disorders<br />Indications for referral to chronic pain physicians<br />
  3. 3. Defining Chronic Pain<br />Pain that has become dissociated from its original physical basis<br />Pain that slowly becomes a self sustaining condition that is resistant to traditional medical management<br />Pain that persists beyond 6 months<br />Associated with emotional distress, depression, failed treatments, & adoption of the sick role<br />
  4. 4. Canadian National Pain Study 2002<br />Chronic pain is present in 22 – 39% adults<br />#1 reason for chronic pain: arthritic conditions<br />Prevalence of pain increases with aging<br />Only 36% of patients felt that their pain was effectively Rx<br />68% of MD’s believed that chronic pain could be treated more effectively<br />Moulin D., PR&M, 2002,2003<br />
  5. 5. ECONOMIC IMPACT<br />13% of workers lose a mean of 4.6 hours /wk of productive work time due to common pain conditions<br />Costs to industry $6.2 B/yr (US) 76 % due to reduced performance at work<br />Costs of depression to industry $31 B/yr<br />Equal to impact of CV disease, or Cancer<br /> Stewart et al. JAMA 2003<br />
  6. 6. TREATMENT OF CHRONIC PAIN<br />
  7. 7. ASSOCIATED CONDITIONS<br />
  8. 8.
  9. 9. INDICATIONS FOR REFERRAL<br />Multifactorial causes for pain<br />Pre-operative chronic pain needs to be controlled<br />Post operatively still having pain<br />Non operative pain <br />Not yet surgical<br />On the fence about surgical intervention<br />
  10. 10. GREATEST BENEFIT FROM CHRONIC PAIN MANAGEMENT<br />Non malignant pain<br />Headaches<br />Neck Pain<br />Shoulder Pain<br />Lumbar pain<br />Radicular pain<br />Pain dissociated from physical findings<br />Patients requiring medication regiment<br />

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