Abstract
Pain is a complex condition and warrants a multidisciplinary approach based on a bio-psycho-social
model. Whilst often successful in acute pain, pharmacological treatment is rarely
successful on its own in the management of chronic pain due to the high number of
patients needed to treat to achieve a clinically meaningful improvement in function,
quality of life and pain scores. There are also significant side effects in the short
and long term. Recent re-analysis of clinic trial data focused on individual responder
rates, showed that there is a cohort of patients who achieve 50% pain relief with
subsequent improvement in physical function. To avoid intolerable side effects from
medication used for chronic pain, titration needs to be slow and aimed towards the
agreed risk–benefit between patients and treating physician with a clear plan for
weaning and cessation if these goals are not achieved. Pain-orientated physiotherapy,
either on its own or as part of a pain management programme, should be offered and
medication reduced or weaned after restoration of function has been achieved.
Keywords
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Article Info
Publication History
Published online: May 21, 2022
Royal College of Anaesthetists CPD Skills Framework: PainIdentification
Copyright
© 2022 Published by Elsevier Ltd.
