Acute and Chronic: From Pain Management to Addiction Treatment On-Demand-Video

Video Transcription

Video Summary

The video transcript describes an expert discussion on the mechanisms of acute and chronic pain, factors that contribute to the transition from acute to chronic pain, and the multifaceted approaches to pain management, including both pharmacological and non-pharmacological treatments. The speaker emphasizes the poorly correlated relationship between biological factors and pain severity in chronic pain, highlighting the necessity to address psychosocial contributors and biological injury.<br /><br />The chronic illness management model is likened to strategies used for diabetes, hypertension, depression, and anxiety, focusing on symptom management and functional improvement rather than eradication of the condition. Various mechanisms of pain, including nociception, the contribution of different nerve fibers (e.g., myelinated alpha-delta fibers and unmyelinated C fibers), and the release of pain-related chemicals like prostaglandins and substance P are explained.<br /><br />The transcript details medications for pain management, including opioids, NSAIDs, and ketamine, and their respective mechanisms and risks. Opioids are noted for their risk of masking pain perception rather than treating pain itself, which can lead to issues like re-injury. Non-pharmacological options such as heat/cold application, spine manipulation, acupuncture, massage, electrical stimulation methods like TENS, and behavioral therapies including cognitive-behavioral therapy (CBT) are proposed as supplementary treatments.<br /><br />The latter part of the transcript introduces the concept of "time-based pacing" to manage activity and prevent exacerbation of pain, aiming to improve functionality without leading to prolonged inactivity and an escalating pain cycle. Various psychiatric comorbidities, including depression, anxiety, PTSD, and personality disorders, are discussed as factors that complicate chronic pain, pointing out the vital importance of treating these accompanying conditions to enhance overall pain management outcomes. <br /><br />The discussion culminates with patient case studies and recommendations on how to approach chronic pain through a comprehensive evaluation and individualized treatment planning.

Keywords

acute pain

chronic pain

pain management

pharmacological treatments

non-pharmacological treatments

psychosocial contributors

biological injury

nociception

nerve fibers

opioids

NSAIDs

ketamine

cognitive-behavioral therapy

psychiatric comorbidities

individualized treatment