2 Chronic Pain

Question 1

What is chronic pain?

Answer 1

1. Painful condition that lasts longer than 3 months
2. Pain that persists beyond the reasonable time for an injury to heal
3. Pain that persists 1 month beyond the usual course of an acute disease

Question 2

Goal of therapy in chronic pain

Answer 2

Pain reduction and return to functional status
(Complete eradication of pain is not a reasonable endpoint in most cases)

Question 3

The most important task of the emergency physician in chronic pain management

Answer 3

To distinguish chronic pain from acute pain that heralds a life- or limb-threatening condition

Question 4

The sharp pain from acute injuries, including fractures, rarely continues beyond _______

Answer 4

2 weeks.
Pain in an injured body part beyond this period should alert the clinician to the possibility of nerve injury

Question 5

Reminders in chronic pain management

Answer 5

1. Opioids are NOT recommended for the primary treatment of chronic pain in the ED.
2. The need for longstanding treatment of chronic pain conditions limit the safety of NSAIDs
3. Referral to the appropriate specialist is one of the most productive means to aid in the care of chronic pain patients who present in the ED

Question 6

Primary treatment of transformed migraine

Answer 6

Stop prior medications
secondary treatment:
Celecoxib or prednisone taper

Question 7

Primary treatment of poststroke pain

Answer 7

Pregabalin
Secondary treatment:
Gabapentin

Question 8

Primary treatment of phantom limb pain

Answer 8

Gabapentin
Secondary treatment:
Amitriptyline

Question 9

Pregabalin or Gabapentin are also the primary treatment for

Answer 9

postherpetic neuralgiaD

Question 10

Duloxetine is the primary treatment for

Answer 10

Fibromyalgia
Chronic back or neck pain
Painful diabetic neuropathy