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Pain management scale

Pain ClinicDepartment of Anesthesiology

The UTMB Department of Anesthesiology Pain Clinic offers psychological services to patients in with chronic pain. Chronic pain requires a perspective that incorporates the following psychological factors: affective, behavioral, cognitive, and sensory-physical. The focus is on multiple facets to assist in the study, treatment, and assessment of chronic pain. Chronic pain is a complex condition influenced by a variety of factors, including physiological, behavioral, environmental, and social variables. Psychological interventions include a thorough assessment of the psychosocial characteristics of the pain, cognitive behavioral therapy, relaxation training, stress management and biofeedback. This is done in conjunction with the anesthesiologist who is primarily focused on the biological treatment of pain with the goal to improve the quality of life for the patient.

Chronic Pain Rehabilitation is defined as the treatment of patients with nonmalignant chronic painful conditions by an organized interdisciplinary team, with a focus on restoring the patient to his or her highest attainable physical and emotional functioning, maximizing self-management skills, promoting independence from health care, and reducing subjective pain intensity when possible. Chronic pain rehabilitation is not a curative model. It is a restorative model, with emphasis on improving function and independence, not just reduction in subjective pain intensity. By definition, it is typically more labor intensive for the provider and patient, with active physical and behavioral/psychological therapies emphasized. The patient is mandated to take an active role in working what the treatment team and not just be a passive recipient of procedural and pharmacological interventions. Although such treatments may be part of the treatment plan, they are not the focus of care, particularly if they foster or perpetuate passivity and dependence in the patient.

Psychological pain assessment can help increase understanding the significant factors in a patient's pain. Chronic pain is typically defined as pain that persists for more than six months. Assessment can also exclude or confirm significant pre-existing psychopathology and personality traits of individuals who experience chronic pain.

Typical characteristics of patients with chronic pain include:

  1. Significant interference in normal day to day activity from the pain;
  2. Emotional Distress;
  3. High pain intensity; and
  4. Social support is low.

A Multidisciplinary team (Physician/Nurse/Psychologist/Physical Therapist/Surgeon) approach is part of the treatment team for patients with chronic pain, with the goal of returning patients back to work, or in improving the quality of their lives.