A pain physician and an addiction medicine specialist discuss the management of a 38-year-old woman with a 10-year history of low back pain who continues to experience significant pain despite taking high-dose opioids, diazepam and pregabalin.
- Establishing a good therapeutic relationship, excluding dangerous pathology early and involving multidisciplinary care early will help to optimise long-term outcomes for patients with chronic pain.
- It is useful to consider whether the patient is primarily experiencing nociceptive pain, neuropathic pain or a mix of both types of pain.
- The GP’s role in safer opioid prescribing can include monitoring for signs of overuse, considering using a treatment agreement, seeking the patient’s prescription history and performing urine drug screens.
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