Chronic pain is a common and often difficult to treat compliant in family practice. It is estimated that nearly half of the 76.2 million Americans with chronic pain suffer on a daily basis.1,2 In 42%, that pain has lasted longer than 1 year.1 Undertreated, chronic pain has significant personal, economic, and social impact. Patients with chronic pain experience decreased function, productivity, and socialization as well as psychological complications such as depression and anxiety. Pain management is not straight forward and there is often difficulty in determining etiology of pain and discomfort when prescribing treatment.

In Practical Aspects of Chronic Pain Management: A Case-based Approach, 3 case vignettes are used to demonstrate and reinforce issues and challenges family physicians often encounter when treating patients with chronic pain: 1) managing a new patient requesting a refill of pain medication, 2) negotiating treatment goals and managing residual pain, and 3) caring for elderly patients with chronic pain. Knowledge and concepts reviewed in the previous 4 activities within this series will be applied.

Learning Objectives:

• Recognize risk factors and red flags associated with drug diversion and apply strategies to manage chronic pain in at-risk patients
• Accept a patient's assessment of level of pain and function as the best indicator of that pain and gauge of treatment outcome
• Develop a plan of care that addresses pain as well as emotional and functional status
• Differentiate the role of long-acting and short-acting opioids in the treatment of chronic pain
• Assess the risks vs benefits of long-term NSAID use in elderly patients with chronic pain
• Appreciate the role of family and caregivers in assessing a patient's level pain and function