Chronic pain

Question 1

What is the International Association for Study of Pain (IASP) definition of chronic pain?

Answer 1

Persistent or recurring pain lasting longer than 3 months

Question 2

Give 2 general associations of chronic pain?

Answer 2

Emotional distress

Functional disability

Question 3

What is the prevalence of chronic pain in the general population, and how does this change with age?

Answer 3

Prevalence around 23% and increases with age so that 30% older adults are affected

Question 4

What are the 3 most common types of chronic pain?

Answer 4

Back, headache, joint pain

Question 5

Is chronic pain equally common in men and women?

Answer 5

No, chronic pain is more common in women than men

Question 6

What is the primary aim of investigating chronic pain?

Answer 6

Determine possible cause of chronic pain

Question 7

Give 2 reasons why patient history is important in investigation of chronic pain?

Answer 7

To identify any past occurrences that could have caused pain such as bone injury or disease

To determine how pain affects lifestyle

Question 8

Give 5 examples of tests done when investigating chronic pain?

Answer 8

Blood tests

electromyography to assess muscle activity

radiological imaging

nerve conduction studies,

physical examination to assess mobility

Question 9

Give 2 reasons why management of chronic pain is a multidisciplinary, biopsychosocial approach?

Answer 9

Addresses multiple aspects of pain

Includes patient’s perspective and goals

Question 10

Give 7 examples of nonpharmacological therapies for chronic pain management?

Answer 10

individualised exercise

behavioural therapies such as CBT

relaxation techniques

hypnosis

virtual reality programmes to provide distractions

physiotherapy

psychological counselling

Question 11

Give 3 examples of topical analgesics used to manage chronic pain?

Answer 11

Lidocaine

NSAIDs

Capsaicin

Question 12

When are steroid injections used to manage chronic pain?

Answer 12

To provide immediate pain relief

Question 13

What type of chronic pain are anticonvulsants and antidepressants used to manage?

Answer 13

Neuropathic pain

Question 14

In what situation is opioid therapy considered for chronic pain management, and what happens if this requirement isn’t met after starting opioid therapy?

Answer 14

Benefits for pain and function outweigh risks of opioid use and if this doesn’t occur, opioid medication use should be stopped

Question 15

When are sustained-release opioid medications used, and give 3 examples?

Answer 15

Sustained-release opioids such as oxycodone, methadone, fentanyl patches
used for moderate-severe pain that has failed other pharmacotherapies

Question 16

Give 5 examples of opioid medications prescribed for management of chronic pain caused by cancer?

Answer 16

Methadone, fentanyl, codeine, morphine, tramadol

Question 17

Give 7 side effects of opioid therapy?

Answer 17

sedation (drowsiness)

nausea and vomiting

physical dependence which causes withdrawal symptoms

tolerance (repeated doses eventually require higher amount to have equal effect)

respiratory depression

addiction

overdose death