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The Journal of the American Board of Family Practice 17:S1-S12 (2004)
© 2004 American Board of Family Practice

Article

Pain Management by the Family Physician: The Family Practice Pain Education Project

Edward T. Bope, MD, Alan B. Douglass, MD, Alan Gibovsky, MD, Tanya Jones, MD, Laeth Nasir, MBBS, Trish Palmer, MD, Sunil Panchal, MD, Francine Rainone, PhD, DO, Peter Rives, MD, Knox Todd, MD and James D. Toombs, MD

Riverside Family Practice Residency Program, Riverside Methodist Hospital, Columbus, OH (ETB)
Middlesex Hospital Family Practice Residency, University of Connecticut School of Medicine, Farmington (AD)
Departments of Medicine and Public Health, Weill Medical College, Cornell University, New York, NY (AG)
Department of Family Medicine, Morehouse School of Medicine, Atlanta, GA (TJ)
Department of Family Medicine, University of Nebraska at Omaha (LN)
Pisacano Leadership Foundation and the Department of Family and Preventive Medicine, University of Utah, Salt Lake City (TP)
H. Lee Moffitt Cancer Center, University of South Florida, Tampa (SP)
Department of Family Medicine, Montefiore Medical Center, Bronx, NY (FR)
Pain Care Institute, Owensboro, KY (PR)
Pain Medicine and Emergency Medicine Initiative, Rollins School of Public Health, Emory University, Atlanta, GA (KT)
Department of Anesthesia, University of Iowa Hospitals & Clinics, Iowa City (JDT)

Correspondence: Address correspondence to Edward T. Bope, MD, Program Director, Riverside Family Practice Residency Program, Riverside Methodist Hospital, 697 Thomas Lane, Columbus, OH 43214 (e-mail: bopee{at}ohiohealth.com)

Pain is a common complaint of patients who visit a family physician, and its appropriate management is a medical mandate. The fundamental principles for pain management are: placing the patient at the center of care; adequately assessing and quantifying pain; treating pain adequately; maximizing function; accounting for culture and gender differences; identifying red and yellow flags early; understanding and differentiating tolerance, dependence and addiction; minimizing side effects; and being familiar with and using CAM therapies when good evidence of efficacy exists. The pharmacologic management of pain requires thorough knowledge of nonsteroidal anti-inflammatory drugs, cyclo-oxygenase-2–specific inhibitors, and opioids. A table of equianalgesic dosages is useful because patients may need to move from one opioid to another. Accompanying this article are papers discussing 5 common pain disorders seen by family physicians, including: neck pain, low back pain, joint pain, pelvic pain, and cancer/end of life pain. The family physician who learns these principles of pain management and the algorithms for these common pain disorders can serve patients well.






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Copyright © 2004 by the American Board of Family Medicine.