Chronic Pain: Treat or Refer? - CME Paid Option-Chronic Pain: Treat or Refer?

Video Transcription

Video Summary

Dr. Jennifer Ha's Lunch and Learn session on chronic pain management focuses on understanding and treating chronic and persistent post-surgical pain through a comprehensive biopsychosocial approach. She highlights that many surgical patients present preexisting chronic pain, which may worsen postoperatively. Chronic overlapping pain conditions and psychological and social factors significantly influence pain maintenance and treatment success, requiring a multidisciplinary care team including pain specialists, psychologists, physical therapists, and nutritionists. Treatment goals prioritize improving function and quality of life rather than solely reducing pain intensity. Diagnostic tools like MR neurography help identify nerve-related pain sources, guiding interventions such as nerve blocks, radiofrequency ablation, cryoneurolysis, and peripheral nerve stimulation. While opioids may be cautiously used short-term, the emphasis is on non-opioid therapies. Emerging non-invasive neuromodulation methods like transcutaneous electrical nerve stimulation (TENS), repetitive transcranial magnetic stimulation, and vagal nerve stimulation offer additional options. Dr. Ha stresses early referral to pain specialists for complex cases to optimize perioperative pain management. Regarding medical cannabis, she advises caution due to inconsistent dosing and potential adverse effects, recommending established therapies first. The session concludes with encouragement for practical patient education, realistic goals, and ongoing communication across care teams to effectively manage chronic pain.

Keywords

chronic pain management

biopsychosocial approach

post-surgical pain

multidisciplinary care team

non-opioid therapies

neuromodulation techniques

patient education