2: Chronic pain and disability Flashcards
Define chronic pain
Pain that persists beyond adequate tissue healing time
What is the time-frame for chronic pain
No exact time-frame, but usually set as 12-months
What should all individuals in chronic pain be assessed for
yellow flags
What are yellow flags
factors that indicate a poor disease prognosis
What psychiatric disorder is associated with chronic pain
major depressive disorder
What do NICE say all chronic pain patients should be asked when attending GP
Every time patients attend they should be asked three questions. In the past month have you been bothered by:
- Feeling worthless
- Poor concentration
- Thoughts of death
What is first-line for managing depression in chronic pain conditions
Low-intensity psychosocial interventions
- Facilitated CBT
- Peer support program
What antidepressant can not be offered if on NSAIDs for chronic pain
SSRIs
What antidepressant should not be offered if takin aspirin for pain
SSRIs
If on triptan, what anti-depressant should they not be offered
SSRIs
What is this-line management for depression in chronic disease
High-intensity psychosocial intervention such as individual or group CBT
Define fibromyalgia
Syndrome characterised by widespread pain across the body with particular tender points
What gender is fibromyalgia more common
Female (5:1)
What age is fibromyalgia more common
30-50 year-olds
Describe clinical présentation of fibromyalgia
- Widespread body pain
- Localised tenderness at specific points
- ‘Fibre-Fog’ = cognitive impairment
- Lethargy
- Sleep disturbance
