SlideShare a Scribd company logo

Managing Acute Pain

•
•
P
pmrjulio
1 of 24
Management Strategies for Acute and Subacute Pain Julio A. Martinez-Silvestrini, MD Medical Director Baystate Physical Medicine and Rehabilitation
Objectives ,[object Object]
Pain ,[object Object],[object Object],[object Object]
Pain generators may be: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Acute pain ,[object Object],[object Object],[object Object],[object Object]
Inflammation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Why? ,[object Object],[object Object]
Medications ,[object Object],[object Object],[object Object],[object Object]
Compliance ,[object Object],[object Object],[object Object],[object Object],[object Object]
Leadbetter “ If pain and signs of inflammation are persistent, repeated efforts to turn off the body’s alarm is not a substitute for finding the cause of the fire.”
Pain Ladder ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
Pain Ladder ,[object Object],[object Object]
Non-steroidal Anti-inflammatories (NSAIDs) ,[object Object],[object Object],[object Object],[object Object]
 
NSAIDs classes Meclofenamate Fenamates Ibuprofen, Naproxen, Oxaprosin Propionic Acids Nabumetone Napthylkanones Meloxicam, Piroxicam Enolic Acids Celecoxib Cox-2 Inhibitors Aspirin, Salsalate Carboxilic Acids Diclofenac, Sulindac, Indomethacin Acetic Acids Selected NSAID Class
Acetaminophen ,[object Object],[object Object],[object Object],[object Object],[object Object]
Acetaminophen ,[object Object],[object Object]
Ceiling effect ,[object Object],[object Object]
Opiates ,[object Object],[object Object],[object Object],[object Object],[object Object]
Opiates ,[object Object],[object Object],[object Object],[object Object]
Opiates ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Compounded agents ,[object Object],[object Object],[object Object]
Tramadol ,[object Object],[object Object],[object Object],[object Object],[object Object]

Recommended

Meds For Pain And Inflammation
Meds For Pain And InflammationMeds For Pain And Inflammation
Meds For Pain And Inflammationpmrjulio
 
Glucocorticoids for optimizing its use 2021( f )
Glucocorticoids for optimizing its use 2021( f )Glucocorticoids for optimizing its use 2021( f )
Glucocorticoids for optimizing its use 2021( f )SafwatElaraby
 
Pain control in ED 2010
Pain control in ED 2010Pain control in ED 2010
Pain control in ED 2010ACMC EM Residency
 
Theramine for the Management of Chronic Pain
Theramine for the Management of Chronic PainTheramine for the Management of Chronic Pain
Theramine for the Management of Chronic PainTargeted Medical Pharma
 
Chronic Pain After Surgery Molecules
Chronic Pain After Surgery MoleculesChronic Pain After Surgery Molecules
Chronic Pain After Surgery Moleculesepicyclops
 
Responsible Pain Management with Theramine
Responsible Pain Management with TheramineResponsible Pain Management with Theramine
Responsible Pain Management with TheramineTargeted Medical Pharma
 
Pain Management Education - WakeMed Pharmacy
Pain Management Education - WakeMed PharmacyPain Management Education - WakeMed Pharmacy
Pain Management Education - WakeMed PharmacyWakeMed Health & Hospitals
 
Percura, Improve Pain and Numbness Associated with Peripheral Neuropathy
Percura, Improve Pain and Numbness Associated with Peripheral NeuropathyPercura, Improve Pain and Numbness Associated with Peripheral Neuropathy
Percura, Improve Pain and Numbness Associated with Peripheral NeuropathyTargeted Medical Pharma
 

Recommended

Meds For Pain And Inflammation
Meds For Pain And InflammationMeds For Pain And Inflammation
Meds For Pain And Inflammationpmrjulio
 
Glucocorticoids for optimizing its use 2021( f )
Glucocorticoids for optimizing its use 2021( f )Glucocorticoids for optimizing its use 2021( f )
Glucocorticoids for optimizing its use 2021( f )SafwatElaraby
 
Pain control in ED 2010
Pain control in ED 2010Pain control in ED 2010
Pain control in ED 2010ACMC EM Residency
 
Theramine for the Management of Chronic Pain
Theramine for the Management of Chronic PainTheramine for the Management of Chronic Pain
Theramine for the Management of Chronic PainTargeted Medical Pharma
 
Chronic Pain After Surgery Molecules
Chronic Pain After Surgery MoleculesChronic Pain After Surgery Molecules
Chronic Pain After Surgery Moleculesepicyclops
 
Responsible Pain Management with Theramine
Responsible Pain Management with TheramineResponsible Pain Management with Theramine
Responsible Pain Management with TheramineTargeted Medical Pharma
 
Pain Management Education - WakeMed Pharmacy
Pain Management Education - WakeMed PharmacyPain Management Education - WakeMed Pharmacy
Pain Management Education - WakeMed PharmacyWakeMed Health & Hospitals
 
Percura, Improve Pain and Numbness Associated with Peripheral Neuropathy
Percura, Improve Pain and Numbness Associated with Peripheral NeuropathyPercura, Improve Pain and Numbness Associated with Peripheral Neuropathy
Percura, Improve Pain and Numbness Associated with Peripheral NeuropathyTargeted Medical Pharma
 
Natural Options for Sleep Disorders
Natural Options for Sleep Disorders Natural Options for Sleep Disorders
Natural Options for Sleep Disorders Targeted Medical Pharma
 
Recent advances in pain management
Recent advances in pain managementRecent advances in pain management
Recent advances in pain managementKrishna Kishore
 
The Dietary Management of Chronic Pain with Medical Foods
The Dietary Management of Chronic Pain with Medical FoodsThe Dietary Management of Chronic Pain with Medical Foods
The Dietary Management of Chronic Pain with Medical FoodsTargeted Medical Pharma
 
What To Do When Opioids Fail
What To Do When Opioids FailWhat To Do When Opioids Fail
What To Do When Opioids FailBCAGCP
 
Pain drugs
Pain drugsPain drugs
Pain drugsNhelia Santos Perez
 
ANALGESICS PRESENTATION
ANALGESICS PRESENTATION ANALGESICS PRESENTATION
ANALGESICS PRESENTATION GAMANDEEP
 
Paracetamol - widening the horizon in pain managment
Paracetamol - widening the horizon in pain managmentParacetamol - widening the horizon in pain managment
Paracetamol - widening the horizon in pain managmentGiridhar Panpalia
 
Pharmacotherapy of Fibromyalgia
Pharmacotherapy of FibromyalgiaPharmacotherapy of Fibromyalgia
Pharmacotherapy of FibromyalgiaHSK College of Pharmacy
 
Neuropathic agents
Neuropathic agentsNeuropathic agents
Neuropathic agentsyury
 
Neuropathic Pain
Neuropathic PainNeuropathic Pain
Neuropathic PainSrirama Anjaneyulu
 
Ketamine for Acute Pain
Ketamine for Acute PainKetamine for Acute Pain
Ketamine for Acute PainCasey Glass, MD
 
Current concept for management of neuropathic pain
Current concept for management of neuropathic painCurrent concept for management of neuropathic pain
Current concept for management of neuropathic painNeurologyKota
 
Pain Management
Pain ManagementPain Management
Pain ManagementThe Medical Post
 
Analgesics in dentistry
Analgesics in dentistryAnalgesics in dentistry
Analgesics in dentistryDr Saheer Abbas
 
Opioid Hyperalgesia
Opioid HyperalgesiaOpioid Hyperalgesia
Opioid HyperalgesiaChief Anesthesiology Treviso Hub Hospital, Italy
 
dr.Husni - paracetamol iv as a safety analgesic
dr.Husni - paracetamol iv as a safety analgesicdr.Husni - paracetamol iv as a safety analgesic
dr.Husni - paracetamol iv as a safety analgesicDepartment of Anesthesiology, Faculty of Medicine Hasanuddin University
 
Medical management of neuropathic pain
Medical management of neuropathic painMedical management of neuropathic pain
Medical management of neuropathic painSudhir Kumar
 
Opioid pain surgery2010
Opioid pain surgery2010Opioid pain surgery2010
Opioid pain surgery2010Suzana Makowski, MD MMM FACP
 
Recent advances in Pain treatment
Recent advances in Pain treatmentRecent advances in Pain treatment
Recent advances in Pain treatmentDr. Ashutosh Tiwari
 
DPNP
DPNPDPNP
DPNPpreynolds50
 
Donor Acquisition - Lessons from the frontline of the meltdown
Donor Acquisition - Lessons from the frontline of the meltdownDonor Acquisition - Lessons from the frontline of the meltdown
Donor Acquisition - Lessons from the frontline of the meltdownDamian O'Broin
 
Dolor musculo-esquelético
Dolor musculo-esquelético Dolor musculo-esquelético
Dolor musculo-esquelético Sergio Zavala Plaza
 

More Related Content

What's hot

Recent advances in pain management
Recent advances in pain managementRecent advances in pain management
Recent advances in pain managementKrishna Kishore
 
The Dietary Management of Chronic Pain with Medical Foods
The Dietary Management of Chronic Pain with Medical FoodsThe Dietary Management of Chronic Pain with Medical Foods
The Dietary Management of Chronic Pain with Medical FoodsTargeted Medical Pharma
 
What To Do When Opioids Fail
What To Do When Opioids FailWhat To Do When Opioids Fail
What To Do When Opioids FailBCAGCP
 
ANALGESICS PRESENTATION
ANALGESICS PRESENTATION ANALGESICS PRESENTATION
ANALGESICS PRESENTATION GAMANDEEP
 
Paracetamol - widening the horizon in pain managment
Paracetamol - widening the horizon in pain managmentParacetamol - widening the horizon in pain managment
Paracetamol - widening the horizon in pain managmentGiridhar Panpalia
 
Neuropathic agents
Neuropathic agentsNeuropathic agents
Neuropathic agentsyury
 
Current concept for management of neuropathic pain
Current concept for management of neuropathic painCurrent concept for management of neuropathic pain
Current concept for management of neuropathic painNeurologyKota
 
Medical management of neuropathic pain
Medical management of neuropathic painMedical management of neuropathic pain
Medical management of neuropathic painSudhir Kumar
 
Recent advances in Pain treatment
Recent advances in Pain treatmentRecent advances in Pain treatment
Recent advances in Pain treatmentDr. Ashutosh Tiwari
 

What's hot (20)

Natural Options for Sleep Disorders
Natural Options for Sleep Disorders Natural Options for Sleep Disorders
Natural Options for Sleep Disorders
 
Recent advances in pain management
Recent advances in pain managementRecent advances in pain management
Recent advances in pain management
 
The Dietary Management of Chronic Pain with Medical Foods
The Dietary Management of Chronic Pain with Medical FoodsThe Dietary Management of Chronic Pain with Medical Foods
The Dietary Management of Chronic Pain with Medical Foods
 
What To Do When Opioids Fail
What To Do When Opioids FailWhat To Do When Opioids Fail
What To Do When Opioids Fail
 
Pain drugs
Pain drugsPain drugs
Pain drugs
 
ANALGESICS PRESENTATION
ANALGESICS PRESENTATION ANALGESICS PRESENTATION
ANALGESICS PRESENTATION
 
Paracetamol - widening the horizon in pain managment
Paracetamol - widening the horizon in pain managmentParacetamol - widening the horizon in pain managment
Paracetamol - widening the horizon in pain managment
 
Pharmacotherapy of Fibromyalgia
Pharmacotherapy of FibromyalgiaPharmacotherapy of Fibromyalgia
Pharmacotherapy of Fibromyalgia
 
Neuropathic agents
Neuropathic agentsNeuropathic agents
Neuropathic agents
 
Neuropathic Pain
Neuropathic PainNeuropathic Pain
Neuropathic Pain
 
Ketamine for Acute Pain
Ketamine for Acute PainKetamine for Acute Pain
Ketamine for Acute Pain
 
Current concept for management of neuropathic pain
Current concept for management of neuropathic painCurrent concept for management of neuropathic pain
Current concept for management of neuropathic pain
 
Pain Management
Pain ManagementPain Management
Pain Management
 
Analgesics in dentistry
Analgesics in dentistryAnalgesics in dentistry
Analgesics in dentistry
 
Opioid Hyperalgesia
Opioid HyperalgesiaOpioid Hyperalgesia
Opioid Hyperalgesia
 
dr.Husni - paracetamol iv as a safety analgesic
dr.Husni - paracetamol iv as a safety analgesicdr.Husni - paracetamol iv as a safety analgesic
dr.Husni - paracetamol iv as a safety analgesic
 
Medical management of neuropathic pain
Medical management of neuropathic painMedical management of neuropathic pain
Medical management of neuropathic pain
 
Opioid pain surgery2010
Opioid pain surgery2010Opioid pain surgery2010
Opioid pain surgery2010
 
Recent advances in Pain treatment
Recent advances in Pain treatmentRecent advances in Pain treatment
Recent advances in Pain treatment
 
DPNP
DPNPDPNP
DPNP
 

Viewers also liked

Donor Acquisition - Lessons from the frontline of the meltdown
Donor Acquisition - Lessons from the frontline of the meltdownDonor Acquisition - Lessons from the frontline of the meltdown
Donor Acquisition - Lessons from the frontline of the meltdownDamian O'Broin
 
El dolor osteo-articular y músculo-esquelético
El dolor osteo-articular y músculo-esqueléticoEl dolor osteo-articular y músculo-esquelético
El dolor osteo-articular y músculo-esqueléticoInterbenavente
 
Progressive rehabilitation for low back pain
Progressive rehabilitation for low back painProgressive rehabilitation for low back pain
Progressive rehabilitation for low back painSpinePlus
 
Rehabilitation for back pain
Rehabilitation for back painRehabilitation for back pain
Rehabilitation for back painSpinePlus
 
LBP - Diagnostic Radiology UPR
LBP - Diagnostic Radiology UPRLBP - Diagnostic Radiology UPR
LBP - Diagnostic Radiology UPRE ML
 
Lumbar exam in patients with Chronic Pain
Lumbar exam in patients with Chronic PainLumbar exam in patients with Chronic Pain
Lumbar exam in patients with Chronic Painpmrjulio
 
Dolor: comprender la fisiopatología y clasificación. Dr Hugo A. Fornells
Dolor: comprender la fisiopatología y clasificación. Dr Hugo A. FornellsDolor: comprender la fisiopatología y clasificación. Dr Hugo A. Fornells
Dolor: comprender la fisiopatología y clasificación. Dr Hugo A. FornellsHugo Fornells
 

Viewers also liked (11)

Donor Acquisition - Lessons from the frontline of the meltdown
Donor Acquisition - Lessons from the frontline of the meltdownDonor Acquisition - Lessons from the frontline of the meltdown
Donor Acquisition - Lessons from the frontline of the meltdown
 
Dolor musculo-esquelético
Dolor musculo-esquelético Dolor musculo-esquelético
Dolor musculo-esquelético
 
El dolor osteo-articular y músculo-esquelético
El dolor osteo-articular y músculo-esqueléticoEl dolor osteo-articular y músculo-esquelético
El dolor osteo-articular y músculo-esquelético
 
Progressive rehabilitation for low back pain
Progressive rehabilitation for low back painProgressive rehabilitation for low back pain
Progressive rehabilitation for low back pain
 
Rehabilitation for back pain
Rehabilitation for back painRehabilitation for back pain
Rehabilitation for back pain
 
LBP - Diagnostic Radiology UPR
LBP - Diagnostic Radiology UPRLBP - Diagnostic Radiology UPR
LBP - Diagnostic Radiology UPR
 
Lumbar exam in patients with Chronic Pain
Lumbar exam in patients with Chronic PainLumbar exam in patients with Chronic Pain
Lumbar exam in patients with Chronic Pain
 
Low Back Pain
Low Back PainLow Back Pain
Low Back Pain
 
Miologia
MiologiaMiologia
Miologia
 
Dolor: comprender la fisiopatología y clasificación. Dr Hugo A. Fornells
Dolor: comprender la fisiopatología y clasificación. Dr Hugo A. FornellsDolor: comprender la fisiopatología y clasificación. Dr Hugo A. Fornells
Dolor: comprender la fisiopatología y clasificación. Dr Hugo A. Fornells
 
Tipos de dolor
Tipos de dolorTipos de dolor
Tipos de dolor
 

Similar to Managing Acute Pain

Cancer Pain: Introduction and Medical Management
Cancer Pain: Introduction and Medical ManagementCancer Pain: Introduction and Medical Management
Cancer Pain: Introduction and Medical Managementyury
 
Pain Management Current & Newer Modalities
Pain Management Current & Newer Modalities Pain Management Current & Newer Modalities
Pain Management Current & Newer Modalities Dr Sachin Pawar
 
Pain management strategies & effects on wellbeing
Pain management strategies & effects on wellbeingPain management strategies & effects on wellbeing
Pain management strategies & effects on wellbeingmiranda olding
 
Interventional Techniques For Cancer Pain Management.
Interventional Techniques For Cancer Pain Management.Interventional Techniques For Cancer Pain Management.
Interventional Techniques For Cancer Pain Management.guest7342323
 
05 Opioid Analgesics Upd
05 Opioid Analgesics Upd05 Opioid Analgesics Upd
05 Opioid Analgesics UpdNurse Uragon
 
Clinical Pharmacology - Analgesics
Clinical Pharmacology - AnalgesicsClinical Pharmacology - Analgesics
Clinical Pharmacology - AnalgesicsSteven Sager
 
Medications for pain & inflammation
Medications for pain & inflammationMedications for pain & inflammation
Medications for pain & inflammationshayiamk
 
Multimodal analgesia Al Razi hospital Kuwait
Multimodal analgesia Al Razi hospital KuwaitMultimodal analgesia Al Razi hospital Kuwait
Multimodal analgesia Al Razi hospital KuwaitFarah Jafri
 
chronic pain management.pptx
chronic pain management.pptxchronic pain management.pptx
chronic pain management.pptxPrithviRaj535583
 
Acute Pain Management Presentation 2013.ppt
Acute Pain Management Presentation 2013.pptAcute Pain Management Presentation 2013.ppt
Acute Pain Management Presentation 2013.pptThomas464022
 
Acute pain management and preemptive analgesia
Acute pain management and preemptive analgesiaAcute pain management and preemptive analgesia
Acute pain management and preemptive analgesiaZIKRULLAH MALLICK
 
CHRONIC PAIN ----Management Update.ppt
CHRONIC PAIN ----Management Update.pptCHRONIC PAIN ----Management Update.ppt
CHRONIC PAIN ----Management Update.pptAHQMSBr
 

Similar to Managing Acute Pain (20)

Chpn hpna ppt #2 pain management
Chpn hpna ppt #2 pain managementChpn hpna ppt #2 pain management
Chpn hpna ppt #2 pain management
 
Cancer Pain: Introduction and Medical Management
Cancer Pain: Introduction and Medical ManagementCancer Pain: Introduction and Medical Management
Cancer Pain: Introduction and Medical Management
 
Pain Management Current & Newer Modalities
Pain Management Current & Newer Modalities Pain Management Current & Newer Modalities
Pain Management Current & Newer Modalities
 
Cancer pain
Cancer painCancer pain
Cancer pain
 
Pain Management
Pain ManagementPain Management
Pain Management
 
Postanesthetic care
Postanesthetic carePostanesthetic care
Postanesthetic care
 
Medco CE - Topical Pain Management
Medco CE - Topical Pain ManagementMedco CE - Topical Pain Management
Medco CE - Topical Pain Management
 
Pain management strategies & effects on wellbeing
Pain management strategies & effects on wellbeingPain management strategies & effects on wellbeing
Pain management strategies & effects on wellbeing
 
Interventional Techniques For Cancer Pain Management.
Interventional Techniques For Cancer Pain Management.Interventional Techniques For Cancer Pain Management.
Interventional Techniques For Cancer Pain Management.
 
05 Opioid Analgesics Upd
05 Opioid Analgesics Upd05 Opioid Analgesics Upd
05 Opioid Analgesics Upd
 
Clinical Pharmacology - Analgesics
Clinical Pharmacology - AnalgesicsClinical Pharmacology - Analgesics
Clinical Pharmacology - Analgesics
 
Medications for pain & inflammation
Medications for pain & inflammationMedications for pain & inflammation
Medications for pain & inflammation
 
Multimodal analgesia Al Razi hospital Kuwait
Multimodal analgesia Al Razi hospital KuwaitMultimodal analgesia Al Razi hospital Kuwait
Multimodal analgesia Al Razi hospital Kuwait
 
Pain management
Pain management Pain management
Pain management
 
Pain leal
Pain lealPain leal
Pain leal
 
Pain management
Pain managementPain management
Pain management
 
chronic pain management.pptx
chronic pain management.pptxchronic pain management.pptx
chronic pain management.pptx
 
Acute Pain Management Presentation 2013.ppt
Acute Pain Management Presentation 2013.pptAcute Pain Management Presentation 2013.ppt
Acute Pain Management Presentation 2013.ppt
 
Acute pain management and preemptive analgesia
Acute pain management and preemptive analgesiaAcute pain management and preemptive analgesia
Acute pain management and preemptive analgesia
 
CHRONIC PAIN ----Management Update.ppt
CHRONIC PAIN ----Management Update.pptCHRONIC PAIN ----Management Update.ppt
CHRONIC PAIN ----Management Update.ppt
 

Managing Acute Pain

  • 1. Management Strategies for Acute and Subacute Pain Julio A. Martinez-Silvestrini, MD Medical Director Baystate Physical Medicine and Rehabilitation
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10. Leadbetter “ If pain and signs of inflammation are persistent, repeated efforts to turn off the body’s alarm is not a substitute for finding the cause of the fire.”
  • 11.
  • 12.  
  • 13.
  • 14.
  • 15.  
  • 16. NSAIDs classes Meclofenamate Fenamates Ibuprofen, Naproxen, Oxaprosin Propionic Acids Nabumetone Napthylkanones Meloxicam, Piroxicam Enolic Acids Celecoxib Cox-2 Inhibitors Aspirin, Salsalate Carboxilic Acids Diclofenac, Sulindac, Indomethacin Acetic Acids Selected NSAID Class
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.