5 Things I Wish I Learned in Medical School about Managing Pain - HCPLive.com

With most medical schools devoting only a few curriculum hours to pain management training, many physicians begin their medical career underprepared to meet the needs of patients suffering with chronic pain. Here, Barry Cole, MD, identifies several key concepts that would help improve pain care in the US if only more physicians would learn about them sooner. Pain is highly variable, personal, and cannot be managed with "blanket" order sets. How much someone hurts with a painful condition is based upon past pain experiences, understanding of the present pain circumstance, expectations and outcome, and may be colored by anxiety, depression, substance use/misuse, and more. Two people with similar accidents, injuries, surgeries, or medical conditions will have different intensities of pain. How much pain one tolerates is unique and variable, but not static. Thinking that a simple order set involving tramadol for mild pain, hydrocodone for moderate pain, and buprenorphine, fentanyl, hydromorphone, morphine, oxycodone, oxymorphone, and/or tapentadol for moderate to severe pain is naïve. Pain medications are not all the same. There are many pain-relieving agents representing several different pharmacological groups. Starting at the periphery and working toward the CNS, there are topical anesthetics, capsaicin, and menthol products; to control inflammation there are non-steroidal and steroid-based anti-inflammatory agents; to modulate pain there are anti-depressa...
Source: Psychology of Pain - Category: Psychiatrists and Psychologists Source Type: blogs