What they Need to get Better Jay R. Skidmore, PhD Clinical Health - - PowerPoint PPT Presentation

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Mar 04, 2024 280 likes •418 views

Incurable Chronic Pain Patients: What they Need to get Better Jay R. Skidmore, PhD Clinical Health Psychologist & Director Multidisciplinary Pain Management Program Northwest Return To Work Rehabilitation Center Audience Response Question

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Incurable Chronic Pain Patients: What they Need to get Better

Jay R. Skidmore, PhD

Clinical Health Psychologist & Director Multidisciplinary Pain Management Program Northwest Return To Work Rehabilitation Center

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Audience Response Question

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SKIDMORE

Audience Response Question

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SKIDMORE

Audience Response Question

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Typical Path to Chronic Pain

Onset of symptoms
Recurrent episodes
Seek medical help
Rx: Analgesics +
Rx: Search for dx
Physical therapies
Psychiatric referral
Scan for symptoms

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Biological Changes in Chronic Pain

Nociceptor sensitization
Activation of silent nociceptors
Chronic muscle tension and TPs
Chemical changes in spinal cord
Somatosensory changes in cortex

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PsychoSocial Changes in Chronic Pain

Postural and behavioral adaptations
Loss of confidence; postpone life goals
Remaining questions, & fears about dx
Decline in health habits & fitness levels
Self as patient: doctor shop, seek relief

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What Patients WANT

Validation of “real” injury, pain & suffering
Medical tests to find/prove injury and pain
Medical diagnosis (mechanical view pain)
Note: Psych factors imply pain isn’t “real”
Every conceivable medical treatment …
Eliminate pain; restore prior perfect life

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What Patients NEED

Validation of their injury, pain & suffering
Broader explanations of medical findings
Guidance to sensible medical treatments
Unhook from ineffective & palliative TXs
Come to accept some pain/SX as normal
Focus less on SX; more on health habits
Develop effective steps for rebuilding life

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A Logical Continuum for Medical Health Care

Get necessary DX tests, then d/c these
Use soft DX for musculoskeletal pathology
Short-term pain interventions (anesthetics)
Mid-term sensible meds, then d/c these
Refer for active physical therapy exercise
Integrate any psych care with med care
Refer to structured pain/rehab program
When does Best TX = No further TX?

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True True False False

Pre Post Comparison

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SKIDMORE

True True False False

Pre Post Comparison

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SKIDMORE

True True False False

Pre Post Comparison