Management of Difficult Chronic and Terminal Pain Flashcards
what is chronic pain?
lasts weeks to months after tissue repair is resolved, or persists due to ongoing chronic disease
what is joint disease associated with?
myofascial pain
disuse atrophy
deformed joint structure can cause neuropathic pain
joint restrictions
what are the types of neurologic pain?
spinal nerve impingement
peripheral nerve impingement/damage/inflammation
brain
what are some nutraceuticals?
joint diets
adequan injections
fish oils
why is treatment of chronic pain difficult?
very little evidence except for feline and canine osteoarthritis
needs an integrative approach
what are the main causes of chronic pain?
moderate to severe, inoperable osteoarthritis
muscle/tendon disorders
autoimmune disease, chronic infections
neurologic disease
failed surgery or post trauma cases
medical conditions
cancer
can neurological dysfunction cause muscle and joint dysfunction?
yes
can cancer therapy cause chronic pain?
yes
how does cancer cause pain?
invades visceral, nervous, bone, soft tissues
inflammatory, neuropathic
skin ulceration
cancer therapy
what can cause peripheral nerve impingement/damage/inflammation?
trauma
cancer
autoimmune
diabetes
post-amputation
what should you palpate muscles for?
muscle consistency
myofascial pain
what are the initial treatment options for chronic pain patients?
medications
surgical options maybe
lifestyle aids/comfort measures
non-pharmacologic pain relief and mobility support
what is acupuncture a good option for?
severe or moderate pain
largely safe
what oral medications are available for chronic pain?
NSAID
amantadine
gabapentin
anti-depressant
acetaminophen dog only
when is weight loss critical?
chronic musculoskeletal pain
