Living with Chronic Pain Title: Presentation Information Developed - - PowerPoint PPT Presentation

Living with Chronic Pain

Title: Presentation Information

• Developed by Monika Patel, MD.
• Funding provided by Florida Blue Foundation and the Florida Medical

Malpractice Joint Underwriting Association.

• Visit pami.emergency.med.jax.ufl.edu to learn more.

Agenda

• Common Pain Conditions
• Multimodal Treatment
• Prevention of Adverse Events
• Available resources

Chronic Pain is ongoing pain for several months to years

Cognitive Functioning

Genetics Religion

Clinical

How Does Pain Affect Us?

• Pain is multidimensional, affecting people

physically, psychologically, socially and spiritually.

• Patients’ responses to pain may be related to:
• genetics, age, gender

, ethnicity, socioeconomic and psychiatric factors, catastrophizing, culture, religion, previous experiences, patient perceptions and expectations, etc.

5

Pain

Demographics

Cognitive Functioning

Genetics Culture Psycho- social Religion Clinical

My Friend Arthr?

Osteoarthritis

• Wear and Tear of the Joints
• Thinning of the cushioning between the joint
• Inflammation

Osteoarthritis Joint Pain

• Knee osteoarthritis
• Hip osteoarthritis
• Shoulder impingement

“Arthr” in the spine

• Facet Arthropathy, Spondylosis, Osteoarthritis
• Block the pain signal from the joint

My Back Gave Out!

Disc Degeneration

• Jelly in the Doughnut has dried or squeezed out
• Common in the neck and lower back
• Can have associate arm or leg pain

Epidural Injection

• Bathes the nerve with anti-inflammatory medication
• Provide short to long term relief

Broken Bone

• Vertebral Compression Fracture
• Hip Fracture
• Wrist Fracture
• Ankle Fracture

Muscle Strain

• Pulled muscle
• Lifting or carrying objects
• Trigger Point Injections

strengtheory.com www.allbackedtogether.com

Tendonitis

• Over use injuries
• Dequervain’sTenosynovitis
• Medial and lateral epicondylitis

www.robertsonfamilychiro.com

Phantom Pain and Neuroma

• Amputations due to limb circulation problems or infection
• Traumatic amputation with heavy machinery or car accident
• Phantom pain- residual limb painful feeling
• Neuroma- painful nerve bundle at the distal end

Nerve Injuries

• Post surgery
• Crush or minor injury
• Complex regional pain syndrome

www.practicalpainmanagement.com www.preferredpaincenter.com

Nerve Injuries

• Peripheral nerve injuries –stocking or glove distribution
• Ilioinguinal nerve- groin pain
• Trigeminal nerve- facial pain

Multimodal Care

• Medications
• Lifestyle changes to reduce tension and stress
• Use Ice or Heat
• Get Exercise
• Proper Nutrition
• Healthy Body Weight
• Adequate Sleep
• Yoga
• Meditation

Pain Management Specialists

• Comprehensive approach
• Evaluation of imaging, mechanism of injury, prior treatments
• Interventional techniques
• Collaboration with PT /OT and occupational therapies
• Medications including adjuvant treatments
• Pain Palliation modalities

PREVENTION

Short Acting Opioids

• Codeine
• Tramadol
• Tapentadol
• Hydrocodone
• Oxycodone
• Morphine
• Hydromorphone

Long Acting Opioids

• Buprenorphine
• Fentanyl
• Morphine ER
• Oxycodone ER
• Methadone

Contact your Doctor Immediately!

• Sleepiness or confusion
• Bad dreams or hallucinations
• Constipation
• Sweating
• Nausea/vomiting
• Itching
• Dry mouth
• Increased risk of falls
• Opioid dependence/addiction
• Respiratory depression
• Overdose leading to death

Naloxone Nasal Spray

• Educate yourself and loved ones on use in Emergencies
• Available by prescription
• Available at your local drug store over the counter
• Life Saving
• Works for 10-15 minutes, allows time for rescue to arrive

Fall Prevention

FLOORS:

• Remove loose rugs
• Slip free mats
• Remove cord or wires in common

walking areas

• Repair uneven floors
• Mindful of wet floors

STAIRS:

• Repair loose steps
• Ensure strong hand rails

BATHROOM:

• Handrails in the bath tub
• Sitting shower chair
• Slip free mats

VISION:

• Improve lighting
• Eye Glasses
• BALANCE:
• Don’t over reach
• Use a cane or walker
• Wheelchair for long distance
• Core strengthening exercises

References

Rathmell, James P. Atlas of Image-Guided Intervention in Regional Anesthesia and Pain Medicine: Edition 2. Lippincott Williams and Wilkins. 2012. Benzon, Honorio Raja, Srinivasa. Fishman, Scorr. Liu, Spencer. Cohen, Steven. Essentials of Pain Medicine: Edition 3. Elsevier Health Sciences. 2011. Raj, Prithvi. Lou, Leland. Walman, Steve. Staats, Peter. Radiographic Imaging for Regional Anesthesia and Pain Management. Churchill Livingstone. 2002 PAMI Educational Videos: http://pami.emergency.med.jax.ufl.edu/resources/pami-educational-pain- videos/