Ouch! That Hurts—Chronic Pain Management

Ouch! That Hurts—Chronic Pain Management Paul Lyons, MD Senior Associate Dean for Education Chair, Family Medicine University of California Riverside School of Medicine

The two enemies of human happiness are pain and boredom—Arthur Schopenhauer

Just the Facts • Pain that lasts longer than 3-6 months • 19-30% of all adults • 116 million Americans • associated with depression, anxiety, sleep disturbance, decreased activity

When I was young I thought money was the most important thing in life; now that I am old I know that it is—Oscar Wilde

It Costs How Much? • ~$600 Billion per year in US • $261-$300 billion per year direct health care cost • $4000-$7000 in extra health care cost per person per year • ~$300 billion per year in lost productivity • Work days missed • Annual work hours • Hourly wages

Pain is as diverse as man. One suffers as one can—Victor Hugo

Types of Pain • Nociceptive • Neuropathic

It is easier to find men who will volunteer to die than to find those who are willing to endure pain with patience—Julius Caesar

#1—Set Reasonable Goals If you don’t know where you’re going you’ll end up somewhere else—Yogi Berra

To truly laugh, you must be able to take your pain and play with it—Charlie Chaplin

#2—Focus on Function Before we make love my husband takes a pain killer—Joan Rivers

The art of medicine consists in amusing the patient while nature cures the disease—Voltaire

Medication Options • Analgesia • Antiepileptics • Gabapentin • pregabalin • Antidepressants • Duloxetine • amitriptyline

One of the first duties of the physician is to educate the masses not to take medicine—William Osler

Non Pharmacologic Treatment • Cryotherapy • Heat • Physical/Occupational Therapy • Exercise • TENS

You know what they call alternative medicine that’s been proved to work? Medicine—Tim Minchin

Additional Therapies • Hypnosis • Massage • Acupuncture • Chiropractic

Ouch! That Hurts—Chronic Pain Management