title: Pain management by the family physician: the family practice pain education project.
abstract: Pain is a common complaint of patients who visit a family physician, and its appropriate management is a medical mandate. The fundamental principles for pain management are: placing the patient at the center of care; adequately assessing and quantifying pain; treating pain adequately; maximizing function; accounting for culture and gender differences; identifying red and yellow flags early; understanding and differentiating tolerance, dependence and addiction; minimizing side effects; and being familiar with and using CAM therapies when good evidence of efficacy exists. The pharmacologic management of pain requires thorough knowledge of nonsteroidal anti-inflammatory drugs, cyclo-oxygenase-2-specific inhibitors, and opioids. A table of equianalgesic dosages is useful because patients may need to move from one opioid to another. Accompanying this article are papers discussing 5 common pain disorders seen by family physicians, including: neck pain, low back pain, joint pain, pelvic pain, and cancer/end of life pain. The family physician who learns these principles of pain management and the algorithms for these common pain disorders can serve patients well.
authors.affiliation: Riverside Family Practice Residency Program, Riverside Methodist Hospital, Columbus, OH 43214, USA. bopee@ohiohealth.com
authors.forename: Edward T
authors.initials: ET
authors.lastname: Bope
authors.forename: Alan B
authors.initials: AB
authors.lastname: Douglass
authors.forename: Alan
authors.initials: A
authors.lastname: Gibovsky
authors.forename: Tanya
authors.initials: T
authors.lastname: Jones
authors.forename: Laeth
authors.initials: L
authors.lastname: Nasir
authors.forename: Trish
authors.initials: T
authors.lastname: Palmer
authors.forename: Sunil
authors.initials: S
authors.lastname: Panchal
authors.forename: Francine
authors.initials: F
authors.lastname: Rainone
authors.forename: Peter
authors.initials: P
authors.lastname: Rives
authors.forename: Knox
authors.initials: K
authors.lastname: Todd
authors.forename: James D
authors.initials: JD
authors.lastname: Toombs
mesh_terms: D000700:Analgesics / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D018771:Arthralgia / Q000175:diagnosis / Q000188:drug therapy; D001416:Back Pain / Q000175:diagnosis / Q000188:drug therapy; D003695:Delivery of Health Care; D004305:Dose-Response Relationship, Drug; D005194:Family Practice / Q000193:education; D005260:Female; D006801:Humans; D008297:Male; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use; D019547:Neck Pain / Q000175:diagnosis / Q000188:drug therapy; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement; D017699:Pelvic Pain / Q000175:diagnosis / Q000188:drug therapy; D010821:Physicians, Family; D012737:Sex Factors
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D009020:Morphine