Reflective accounts

Chronic pain in adults

Reading the CPD article helped improve my understanding of the importance of identifying chronic pain. Chronic pain may occur on its own or as a feature of other chronic conditions, and it may be nociceptive or neuropathic, or a combination of the two.

Reading the CPD article helped improve my understanding of the importance of identifying chronic pain. Chronic pain may occur on its own or as a feature of other chronic conditions, and it may be nociceptive or neuropathic, or a combination of the two.

The aim of nursing interventions in patients with chronic pain is to enable them to manage pain so that they can stay active and participate fully in life. The initial assessment is essential to improving outcomes. In addition, collaboration between the patient and healthcare team is important in achieving goals.

Patients with chronic pain often have difficulty in accessing appropriate treatment and support. Older adults are less likely to report chronic pain, and their pain is more likely to be poorly managed because of assumptions that pain is a normal part of the ageing process, their unwillingness to ask for help and cognitive and communication difficulties.

The CPD article emphasises the importance of a holistic approach to assessing and managing patients with chronic pain. Screening tools for chronic pain should be used in conjunction with a full biopsychosocial assessment considering the patient’s lifestyle, psychological risk factors, tolerance and the effect pain has on their quality of life.

Time spent at the outset allowing patients to describe their pain and the effect it has on their lives and mental wellbeing, as well as a full health assessment. It also provides a better basis for tailoring treatment to the individual, improves outcomes and gives a baseline against which the effects of interventions may be measured.

Picture: Science photo library

There are many approaches to helping patients manage pain. The care plan should be realistic and achievable so that patients are encouraged to participate in their own pain management. Self-management should be encouraged because patients who are actively engaged in their treatment will achieve better outcomes than patients passively accepting treatment.

Pharmacological therapies are often the first treatment for chronic pain management and work well in many patients. They may not be sufficient to prevent disability from pain in some patients, and psychological therapies may be necessary to help them cope with the effects of the pain.

Exercise and physiotherapy treatments are effective in managing chronic pain. Keeping active helps maintain physical function and quality of life, as well as having psychological benefits. Curtailing activities for fear of exacerbating the pain makes it more likely that an individual will become disabled by pain.

These psychological ‘yellow flags’ should be addressed sensitively to prevent the latter from happening. Early referral for psychological therapy can help prevent disability in patients identified as at risk.

The CPD article made me think about the wider consequences of pain for patients in my practice. If a patient is showing signs of chronic pain, reports pain or is prescribed regular analgesia, I will ensure that they have been fully assessed and appropriate interventions have been considered.

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