MANAGING PAIN

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MANAGING PAIN

• Chapter 8

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Medical Treatments for Pain Non-opiate
Analgesics

• Act peripherally
• NSAIDS
• COX inhibitors
• Advil, Vioxx, Aleve
• Steroidal Drugs
• Suppress immune system
• Cortisone, Prednisone

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Medical Treatments for Pain Opiate Analgesics

• Act centrally via endogenous opiate system
• Short-acting
• Long-acting
• Problems
• Tolerance
• Dependence

4
Medical Treatments for Pain Skin Stimulation

• Massage
• Great as an adjunct
• TENS
• Mixed results
• Acupuncture
• Effective for a number of types of pain
• Reduces the need for meds

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Medical Treatments for PainSurgery

• Surgery to reduce pain
• Brain surgery ablate thalamus
• For intractable pain (cancer)
• Surgery to restore function
• Surgery for merely pain relief should be avoided
• Back
• Carpal Tunnel

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Psychosocial Interventions to Improve Coping
w/Pain

• Hypnosis
• Biofeedback
• Relaxation Training
• Behavior Modification
• Cognitive Therapy/CBT
• Multimodal Approaches

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Relaxation Training

• Variety of techniques utilizing relaxation,
  distraction and re-focusing
• Generally Effective and Cheap
• Progressive Muscle Relaxation
• Meditative Relaxation
• Mindfulness Meditation
• Guided Imagery

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Behavior Modification Programs

• Selectively reinforce new and more adaptive
  coping behaviors
• Exercise
• Activities
• Communication
• In regards to pain - extinguish pain behavior

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Cognitive Therapy/CBT

• CT Reappraisal Coping Skills and Emotional
  Expression CBT CT Behavior Mod
• Inoculation Training (CBT)
• Conceptualization
• Skill acquisition and rehearsal
• Application and follow-through
• Overall CT CBT Effective for many conditions
• Table 8.5 in your book
• LBP
• Recurrent Abdominal Pain
• Rheumatoid Arthritis
• Many more