Principles of Pain Management

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Top Contributors - Nupur Smit Shah, Admin, Kim Jackson and Rishika Babburu

Introduction

Pain is an unpleasant sensation ,and it is physiological and psychological experience that is subjective in nature. Accurate assessment of pain along with implementation of effective interventions is necessary for successful management program . Untreated pain can lead to reduction in quality of life for patients and their families which in turn increases the burden of health care professionals and hospitals.

Persistent pain is the major cause of disability. Various factors like biological, psychological and socio-environmental play role in pain manifestation. The central principle of pain is to protect the body from perceived or real danger.Studies support the use of non pharmacological strategies such as physiotherapy, cognitive behavioral therapy approaches, TENS, acupressure to reduce or cut down the use of medications.

Guidelines For Pain Management In Acute Musculoskeletal Injury

There are various strategies to manage pain after acute musculoskeletal injury.

Cognitive Strategies

• Consider using music strategy, aromatherapy and approaches based on cognitive behavioral therapy
• Talk about reduction of pain, expected duration of recovery, patient .
• Patients should be made to understand that they feel more pain , than the actual severity of pain. This is due to psychological involvement such as depression anxiety or post traumatic stress. Such pain perceptions are treat with psychosocial interventions and resources.

Physical Strategies

• Use of TENS, proper elevation of the affected extremity, immobilization and cryotherapy units.

Role Of Beliefs In Musculoskeletal Pain Management

• Belief's play an important role in behavioral and emotional responses to Musculoskeletal pain.
• The beliefs are modifiable and they are considered as first line of treatments by the clinicians.
• Beliefs can be defined as : "fundamental truth governing behavior"
• As per the Common sense model

From the IASP Curriculum Outline on Pain for Physical Therapy

1. Demonstrate an ability to integrate the patient assessment into an appropriate management plan using the concepts and strategies of clinical reasoning
2. Understand the principles of an effective therapeutic patient/professional relationship to reduce pain, promote optimal function and reduce disability through the use of active and where appropriate, passive pain management approaches
3. Assist patients to develop a daily routine to support achievement and, where necessary, readjustment of habits and roles according to individual capacity and life situation
4. Understand the need to involve family members and significant others including employers where appropriate.
5. Use a person-centered perspective to formulate collaborative intervention strategies consistent with a physical therapy perspective