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  • Print publication year: 2008
  • Online publication date: December 2009

Chronic pain

from General considerations


The approach to the patient with chronic pain should indeed be different to that for a patient with acute pain. Patients with chronic pain conditions tend to take analgesics for far longer than the few days or weeks that suffice for acute pain. Opioids and NSAIDs are often ineffective or contraindicated for chronic pain conditions. Effective analgesia in chronic pain may be gained by the use of antidepressants or anticonvulsants in patients who lack depressive symptoms or seizures. There are many forms of pain contract, but the common element to all is an agreement on a plan for managing chronic pain. One of the most important components of a pain contract is the patient's pledge to safekeep their medicines. Clinicians should be aware that sometimes patients with legitimate pain are relegated to drug-seeking behavior in order to achieve the pain relief to which they are entitled.


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