Assessment and Management of Chronic Pain. Assessment Algorithm.

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Source: Institute for Clinical Systems Improvement (ICSI). Assessment and management of chronic pain. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2008 July. 84 p. Assessment and Management of Chronic Pain Assessment Algorithm Patient has pain A = Annotation Critical first step: assessment *History and physical. *Key questions. *Pain and functional assessment tools. A Pain types and contributing factors are not mutually exclusive. Patients frequently do have more than one type of pain, as well as overlapping contributing factors. Determine biological mechanisms of pain. A Neuropathic pain *Peripheral (e.g., complex regional pain syndrome, HIV sensory neuropathy, metabolic disorders, phantom limb pain). *Central (e.g., Parkinson's disease, MS, myelopathies, poststroke pain). A Muscle pain *Fibromyalgia syndrome. *Myofascial pain syndrome. A Inflammatory pain *Inflammatory arthropathies (rheumatoid arthritis). *Infection. *Postoperative pain. *Tissue injury. Mechanical/compressive pain *Low back pain. *Neck pain. *Musculoskeletal pain - shoulders/elbow, etc. *Visceral pain. A Is pain chronic? A See ICSI Acute Pain guideline Is there a correctable cause of pain? Specialty involvement. A Other assessment *Work and disability issues. *Psychological and spiritual assessment. *Contributing factors and barriers. A To management algorithm - see next page All copyrights are reserved by the Institute for Clinical Systems Improvement, Inc.