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Pain Core Curriculum Module 1: Basics of Chronic P ...
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Dr. Melissa Weimler from Yale School of Medicine provides a comprehensive overview of chronic pain evaluation, emphasizing the importance of distinguishing between acute and chronic pain. Acute pain serves a protective, life-sustaining role, while chronic pain persists beyond expected healing (usually over three months) and can become a complex disease influenced by genetic, epigenetic, and psychosocial factors. She outlines three pain types: nociceptive (tissue-related), neuropathic (nerve-related), and nociplastic (amplified pain processing without obvious injury), noting these often coexist.<br /><br />Dr. Weimler stresses the biopsychosocial approach, integrating physical, psychological, and social factors in pain assessment. Psychiatric comorbidities such as depression, anxiety, PTSD, sleep disorders, and substance use often overlap with chronic pain and affect treatment outcomes. She recommends using tools like Socrates or PQRST mnemonics to characterize pain, and screening instruments like the PHQ-9 for depression and the GAD-7 for anxiety to assess mental health.<br /><br />A case example illustrates chronic pain progression, highlighting the need for multidimensional assessment including function, medical evaluation, mood, and social context. She cautions against relying solely on imaging findings, as these do not always correlate with pain severity.<br /><br />Ultimately, effective chronic pain management requires comprehensive, patient-centered evaluation and collaborative, multimodal treatment addressing biological and psychosocial aspects to improve function and quality of life.
Keywords
chronic pain
acute pain
nociceptive pain
neuropathic pain
nociplastic pain
biopsychosocial approach
psychiatric comorbidities
pain assessment tools
multimodal pain management
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