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Please list methods and techniques you use to address these components of pain management.
Muscle Relaxation
Psychological/Emotional
Anti-Inflammatories
Manipulation & Physical
Therapies
Meditation & Distraction
Pain System Medications
Copyright Rory F. Richardson, Ph.D., FICPPM, 2009 Balance in Pain Management
Some of the keys to pain management is the monitoring of pain relief and level of function.
Optimally, both are high. If function reduces with the increase in pain relief, the method of painmanagement needs to be reviewed and changed so function is optimal. W hen examiningfunction, the patient and the provider need to monitor four major areas (see list below). Areas of Function
T Emotional
T Interpersonal
T Physical
T Cognitive
Dependence vs. Addiction
Addiction to pain and anxiety medications is a major concern for health care providers. Theterm “Pseudo-Addiction” is used when an individuals behavior may appear to be that of anaddict but, in fact, is not. In some cases, the level of maintenance medication is not highenough to provide effective relief from pain. It is also very common for individuals who are ona maintenance dosage of pain medication to be concerned about running out of themedication. In both cases, medication seeking can occur.
The challenge is to use all forms of pain management to provide the level of relief necessaryfor basic daily function and some quality of life. An individual showing Pseudo-Addiction will:
T not take more medications than is necessary to relieve the pain and may sometimes take
T not take dosages which result in euphoria, T not show signs of intoxication.
They will:T follow recommendations of the physician,T focus on the potential side effects of the medication, T focus on the consequences of the side effects.
There are behaviors that are frequently misunderstood which do not show addiction butproviders are sensitive too raising concerns. The behaviors which are less likely to beindicators of addiction are:T complaining about needing a higher dosage,T hoarding drugs for periods when symptoms are increased,T acquiring similar medications from different prescribers for different purposes (i.e., a person on chronic pain medications through their PCP getting an acute pain reliefmedication from a dentist for dental pain). Individuals who are Addicted will
T attempt to achieve euphoria,
Copyright Rory F. Richardson, Ph.D., FICPPM, 2009 T increase the amount used beyond a point of relieving pain,T show signs of intoxication.
They will not:T focus on side effects,T be concerned with consequences of side effects,T follow physician recommendations.
Other addictive behaviors include:T selling prescription medications,T forging prescriptions,T stealing another patient’s drugs,T using the medication in a different way than recommended (i.e., IV, smoking, etc.)T seeking pain medication from multiple providers,T using different pharmacies for similar medications without knowledge of the prescribers,T repeatedly losing their prescription,T buying medications from street dealers,T mixing medications and alcohol to attain a state of euphoria.
Copyright Rory F. Richardson, Ph.D., FICPPM, 2009

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