Chronic pain Flashcards
1
Q
what are five categories/sources of chronic pain?
A
- gyn
- urologic
- GI
- MSK
- neuropathic
2
Q
what is standard work-up
A
thorough history and physical exam
3
Q
what is the neuromodulatory medication of choice in chronic pelvic pain?
A
- gabapentin or pregabalin
- also duloxetine/TCAs can be used
4
Q
what is the role of TPI?
A
- with saline, anesthetics or opioids can be beneficial for patients who have failed PFPT and medications
5
Q
what should you do with patient already on opioids?
A
- wean
- not considered first line even for patients with cancer/palliative
6
Q
what other adjunctive treatment options?
A
CBT/PFPT/sex therapy can be helpful for psychological/muscular component
7
Q
what is the role of adhesioloysis?
A
- not recommended for pain
- diagnostic laparoscopy is last result if non-focal findings on exam/imaging
- if causing bowel stricture, or with dense uterine adhesions, would do
