Evidence-based pain medicine for primary care physicians

Graves T. Owen, Brian M. Bruel, C. M. Schade, Maxim S. Eckmann, Erik Hustak, Mitchell P. Engle

Research output: Contribution to journalArticle

Abstract

The last several decades have seen a marked increase in both the recognition and treatment of chronic pain. Unfortunately, patients frequently misunderstand both the nature of pain and the best practices for its treatment. Because primary care physicians treat the majority of chronic pain, they are ideally situated to provide evidence-based pain care. The majority of the medical evidence supports a biopsychosocial model of pain that integrates physical, emotional, social, and cultural variables. The goal of this primer is to assist primary care physicians in their understanding of pain, evaluation of the chronic pain patient, and ability to direct evidence-based care. This article will discuss the role of physical rehabilitation, pain psychology, pharmacotherapy, and procedural interventions in the treatment of chronic pain. Given the current epidemic of drug-related deaths, particular emphasis is placed on the alternatives to opioid therapy. Unfortunately, death is not the only significant complication from opioid therapy, and this article discusses many of the most common side effects. This article provides general guidelines on the most appropriate utilization of opioids with emphasis on the recent Centers for Disease Control and Prevention guidelines, risk stratification, and patient monitoring. Finally, the article concludes with the critical role that a pain medicine specialist can play in the management of patients with chronic pain.

Original languageEnglish (US)
Pages (from-to)37-47
Number of pages11
JournalBaylor University Medical Center Proceedings
Volume31
Issue number1
DOIs
StatePublished - Jan 1 2018

Fingerprint

Evidence-Based Medicine
Primary Care Physicians
Chronic Pain
Pain
Opioid Analgesics
Guidelines
Therapeutics
Aptitude
Physiologic Monitoring
Centers for Disease Control and Prevention (U.S.)
Practice Guidelines
Rehabilitation
Medicine
Psychology
Drug Therapy
Pharmaceutical Preparations

Keywords

  • Acute pain
  • Chronic pain
  • Opioids
  • Pain interventional procedures
  • Pain medicine
  • Psychological treatment for pain
  • Rehabilitation treatment for pain

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Evidence-based pain medicine for primary care physicians. / Owen, Graves T.; Bruel, Brian M.; Schade, C. M.; Eckmann, Maxim S.; Hustak, Erik; Engle, Mitchell P.

In: Baylor University Medical Center Proceedings, Vol. 31, No. 1, 01.01.2018, p. 37-47.

Research output: Contribution to journalArticle

Owen, Graves T. ; Bruel, Brian M. ; Schade, C. M. ; Eckmann, Maxim S. ; Hustak, Erik ; Engle, Mitchell P. / Evidence-based pain medicine for primary care physicians. In: Baylor University Medical Center Proceedings. 2018 ; Vol. 31, No. 1. pp. 37-47.
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