By Stephen Grinsted
Below are seven strategic steps that I believe are necessary for people undergoing chronic pain management to learn in order to overcome obstacles for obtaining appropriate and effective chronic pain management. The rational and more in depth explanation for each of the following steps can be found in my book Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. Please watch m y video below and then read the remainder of my post.
Developing an Initial Multidisciplinary Pain Management Plan: The first step of effective pain management is utilizing a multidisciplinary assessment protocol. The patient needs to objectively examine their current pain management program. They should list each of the medications and non-pharmacological pain management interventions they are currently using and answer pertinent questions about each one. They also need to list their professional and personal support system, identifying the strengths and weaknesses of each.
Looking At Pain Objectively: This component explores how to increase the patients’ understanding of their pain and how to use that knowledge to improve their pain management. They need to learn the different aspects of pain—acute and chronic—and the bio-psycho-social components of pain as well as the difference between pain and suffering. They should learn about the stress-pain connection and how to rate their stress and pain levels accurately. Finally they need to explore how their thinking, emotions, behaviors, and social relationships change when they’re having a “bad” pain day.
Understanding and Managing Depression: Since depression frequently affects people in chronic pain, in this component patients need objective and easy to understand information about depression and what constitutes effective depression management. They should learn how to accurately rate the type and level of depression symptoms they experience and then develop their own personal six-step depression management plan.
Exploring Effective Use of Medication: This component starts with educating patients about some common, and possibly misunderstood, terms like medication abuse, dependency, pseudo addiction, and addiction. Patients need to learn how to use a Red Flags checklist to see if they have a problematic relationship with their pain medication. They also need to learn the role of denial and finally explore the benefits and disadvantages of using appropriate pain medication.
Developing An Effective Pain Management Plan: In this component patients are exposed to the concept of a Pain Management Agreement and how to deal with urges/cravings that could tempt them to use pain medication in an inappropriate manner. They should develop a nonpharmacological (non-medication) pain management plan and learn to utilize a pain journaling process to increase their pain management skills.
Exploring Biological versus Psychological/Emotional Symptoms: This component focuses on explaining ascending versus descending pain signals and exploring and scoring the patients’ biological and psychological/emotional pain symptoms. Patients also need to look at how their TFUARs (thinking, feeling, urges, actions, and social reactions) change on a bad pain day and how to manage their TFUARs more effectively.
Finalizing the Pain Management Plan: This component ties everything together by teaching patients to identify and rate their bio-psycho-social-spiritual pain management goals. Then they should learn how to improve their existing pain management foundation and test this new plan to make sure it is effective.
If you want to learn more about effective pain management for someone undergoing chronic pain management with coexisting disorders including addiction check out my book Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System.
For anyone wanting advanced skill training in working with patients suffering with chronic pain and coexisting disorders I’m presenting a dynamic three day Addiction-Free Pain Management® Certification Training coming up in April 9-11, 2015 at our office in Sacramento. Space is limited so check it out and REGISTER NOW!
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