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How can you help clients manage chronic pain?

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Chronic pain is a common and complex condition that affects many clients in case management. It can interfere with their physical, emotional, and social well-being, and pose challenges for their treatment and recovery. As a case manager, you can help your clients manage chronic pain by using some effective strategies and skills. Here are some tips to guide you.

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1 Understand chronic pain

The first step to help your clients manage chronic pain is to understand what it is and how it differs from acute pain. Chronic pain is pain that lasts longer than three months or beyond the expected healing time of an injury or illness. It can be caused by various factors, such as nerve damage, inflammation, or psychological stress. Unlike acute pain, which is a warning signal of a problem that needs attention, chronic pain is often persistent and unpredictable, and does not respond well to conventional painkillers. Chronic pain can also affect your clients' mood, sleep, cognition, and behavior, and increase their risk of depression, anxiety, and substance abuse.

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Dr. Sherry McAllister

President, Foundation for Chiropractic Progress (F4CP) | Podcast Host of "Adjusted Reality" | Health & Wellness | Championing Whole Being Care
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Creating an environment for the chronic pain patient to feel comfortable expressing their current needs accelerates care. Achieving this atmosphere from the healthcare side means evaluating the clinic with a chronic pain sensitivity. Consider simple elements like: does the chairs in the office have arms that a patient can use to get up and out of the seated position. What music is playing? How loud is it? Temperature of office? Lighting? How are they accommodated for in treatment? (Pillows, pads etc.) How long do they wait in the waiting room? Treatment that can accommodate the patients needs encourages better trust and communication.

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2 Assess chronic pain

The next step to help your clients manage chronic pain is to assess their pain level, impact, and coping strategies. You can use standardized tools, such as the Brief Pain Inventory or the Pain Disability Index, to measure the intensity, location, frequency, and duration of their pain, as well as how it affects their daily activities, relationships, and quality of life. You can also ask your clients about their pain history, triggers, relief methods, and goals. This will help you understand their pain experience, identify their strengths and needs, and tailor your case management plan accordingly.

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3 Educate chronic pain

Another step to help your clients manage chronic pain is to educate them about their condition and the available treatment options. You can provide them with accurate and evidence-based information about the causes, mechanisms, and effects of chronic pain, and how it can be influenced by biological, psychological, and social factors. You can also explain the benefits and risks of different pain management approaches, such as medication, physical therapy, acupuncture, cognitive-behavioral therapy, mindfulness, relaxation, and self-care. You can also encourage your clients to ask questions, express their concerns, and participate in decision-making about their pain management plan.

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Ani Shenian, PharmD, BCPS, APh

LinkedIn Top Healthcare Voice | Clinical Pharmacist | Pharmacogenomics consultant ????| The Nutrigenomics Pharmacist?
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I would add 4 pillars of health to manage chronic pain as cornerstone for whole person care. Stress: It can play a major role in exacerbating chronic pain. I often offer practicing meditation, mindfulness and deep breathing, as stress reduction techniques. Exercise: Can also be a stress reliever for majority of people, light intensity or walking 30 minutes daily if tolerable. Diet: Indispensable factor to boost overall health. I suggest trying an anti-inflammatory diet by eliminating foods that cause inflammation, such as red meat and refined carbohydrates specifically for chronic pain situations. Sleep: Lack of sleep can exacerbate chronic pain. Getting quality sleep is also important for stress management, and addressed at each follow up

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4 Support chronic pain

A crucial step to help your clients manage chronic pain is to provide them with ongoing support and encouragement. You can use motivational interviewing, active listening, and empathy skills to build rapport, trust, and collaboration with your clients. You can also use positive reinforcement, goal-setting, and problem-solving skills to help your clients achieve their pain management goals, overcome barriers, and cope with setbacks. You can also link your clients to relevant resources and referrals, such as pain specialists, peer support groups, or community services, to enhance their access to care and social support.

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5 Monitor chronic pain

The final step to help your clients manage chronic pain is to monitor their progress and outcomes. You can use regular follow-ups, feedback, and reassessment tools to track the changes in their pain level, impact, and coping strategies. You can also use outcome measures, such as the Patient Global Impression of Change or the Patient Health Questionnaire, to evaluate the effectiveness and satisfaction of their pain management plan. You can also adjust your case management plan as needed, based on your clients' feedback, preferences, and circumstances.

Chronic pain can be a challenging condition to manage, but as a case manager, you can make a difference in your clients' lives by using these strategies and skills. By understanding, assessing, educating, supporting, and monitoring your clients' chronic pain, you can help them improve their physical, emotional, and social well-being, and achieve their recovery goals.

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Jeff K.

Improvement requires more than whistleblowing. Poking the bear to inspire meaningful conversation can be helpful.
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Too often, strategies don't incorporate the social support structure of the patient. For example, is the patient a blue-collar, primary breadwinner and must keep up with younger co-workers who are in better health and physical condition? Is the home environment free of aggravating conditions like stairs, narrow hallways? Are chairs of a height that allows for ease of sitting and standing? The bottom line is that pain is a convergence of fluid environmental, behavioral, and health factors. Monitoring chronic pain requires not only management of the patient's physical condition, but also an understanding of factors that contribute to their ongoing and future circumstances.

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6 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?

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Jeff K.

Improvement requires more than whistleblowing. Poking the bear to inspire meaningful conversation can be helpful.
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A difficult challenge is that by the time a patient is in a chronic pain state, coping habits and other compensatory behaviors are likely deeply ingrained. The challenge then, is to assist the patient in adopting more appropriate behavior. The first suggestion I make is to maintain a diary with minimal details of the weather, diet, and activity - at the minimum. The activity is intended to look for triggers or behaviors that may aggravate their pain. I also recommend not taking their pain medications in anticipation of pain. Many patients confess to taking their chronic meds ahead of schedule, or popping breakthrough meds if they think they may aggravate their condition (like vigorous exercise or Black Friday marathon shopping).

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How can you help clients manage chronic pain?

1

2

3

4

5

6

1 Understand chronic pain

2 Assess chronic pain

3 Educate chronic pain

4 Support chronic pain

5 Monitor chronic pain

6 Here’s what else to consider

Case Management

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How can you help clients manage chronic pain?

1

2

3

4

5

6

1 Understand chronic pain

2 Assess chronic pain

3 Educate chronic pain

4 Support chronic pain

5 Monitor chronic pain

6 Here’s what else to consider

Case Management

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感谢您的反馈

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