Chronic nonmalignant pain in primary care

Robert P. Jackman, Janey M. Purvis, Barbara S. Mallett

Research output: Contribution to journalReview article

35 Scopus citations

Abstract

A systematic approach to chronic nonmalignant pain includes a comprehensive evaluation; a treatment plan determined by the diagnosis and mechanisms underlying the pain; patient education; and realistic goal setting. The main goal of treatment is to improve quality of life while decreasing pain. An initial comprehensive pain assessment is essential in developing a treatment plan that addresses the physical, social, functional, and psychological needs of the patient. One obstacle to appropriate pain management is managing the adverse effects of medication. Opioids pose challenges with abuse, addiction, diversion, lack of knowledge, concerns about adverse effects, and fears of regulatory scrutiny. These challenges may be overcome by adherence to the Federation of State Medical Boards guidelines, use of random urine drug screening, monitoring for aberrant behaviors, and anticipating adverse effects. When psychiatric comorbidities are present, risk of substance abuse is high and pain management may require specialized treatment or consultation. Referral to a pain management specialist can be helpful.

Original languageEnglish (US)
Pages (from-to)1155-1162+1164
JournalAmerican family physician
Volume78
Issue number10
StatePublished - Nov 15 2008

ASJC Scopus subject areas

  • Family Practice

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    Jackman, R. P., Purvis, J. M., & Mallett, B. S. (2008). Chronic nonmalignant pain in primary care. American family physician, 78(10), 1155-1162+1164.