Pain management by the family physician: the family practice pain education project

J Am Board Fam Pract. 2004 Nov-Dec:17 Suppl:S1-12. doi: 10.3122/jabfm.17.suppl_1.s1.

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.

MeSH terms

  • Analgesics / therapeutic use*
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / therapeutic use
  • Arthralgia / diagnosis
  • Arthralgia / drug therapy
  • Back Pain / diagnosis
  • Back Pain / drug therapy
  • Delivery of Health Care
  • Dose-Response Relationship, Drug
  • Family Practice / education
  • Female
  • Humans
  • Male
  • Morphine / administration & dosage
  • Morphine / therapeutic use
  • Neck Pain / diagnosis
  • Neck Pain / drug therapy
  • Pain / drug therapy*
  • Pain Measurement
  • Pelvic Pain / diagnosis
  • Pelvic Pain / drug therapy
  • Physicians, Family*
  • Sex Factors

Substances

  • Analgesics
  • Analgesics, Opioid
  • Morphine