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What they Need to get Better Jay R. Skidmore, PhD Clinical Health - PowerPoint PPT Presentation

Mar 04, 2024 •280 likes •418 views

Incurable Chronic Pain Patients: What they Need to get Better Jay R. Skidmore, PhD Clinical Health Psychologist & Director Multidisciplinary Pain Management Program Northwest Return To Work Rehabilitation Center Audience Response Question

  1. Incurable Chronic Pain Patients: What they Need to get Better Jay R. Skidmore, PhD Clinical Health Psychologist & Director Multidisciplinary Pain Management Program Northwest Return To Work Rehabilitation Center

  2. Audience Response Question

  3. Audience Response Question SKIDMORE

  4. Audience Response Question SKIDMORE

  5. Typical Path to Chronic Pain • Onset of symptoms • Recurrent episodes • Seek medical help • Rx: Analgesics + • Rx: Search for dx • Physical therapies • Psychiatric referral • Scan for symptoms

  6. Biological Changes in Chronic Pain • Nociceptor sensitization • Activation of silent nociceptors • Chronic muscle tension and TPs • Chemical changes in spinal cord • Somatosensory changes in cortex

  7. PsychoSocial Changes in Chronic Pain • Postural and behavioral adaptations • Loss of confidence; postpone life goals • Remaining questions, & fears about dx • Decline in health habits & fitness levels • Self as patient: doctor shop, seek relief

  8. What Patients WANT • Validation of “real” injury, pain & suffering • Medical tests to find/prove injury and pain • Medical diagnosis (mechanical view pain) • Note: Psych factors imply pain isn’t “real” • Every conceivable medical treatment … • Eliminate pain; restore prior perfect life

  9. What Patients NEED • Validation of their injury, pain & suffering • Broader explanations of medical findings • Guidance to sensible medical treatments • Unhook from ineffective & palliative TXs • Come to accept some pain/SX as normal • Focus less on SX; more on health habits • Develop effective steps for rebuilding life

  10. A Logical Continuum for Medical Health Care • Get necessary DX tests, then d/c these • Use soft DX for musculoskeletal pathology • Short-term pain interventions (anesthetics) • Mid-term sensible meds, then d/c these • Refer for active physical therapy exercise • Integrate any psych care with med care • Refer to structured pain/rehab program • When does Best TX = No further TX?

  11. Pre Post Comparison True False True False

  12. Pre Post Comparison SKIDMORE True False True False

  13. Pre Post Comparison SKIDMORE False True False True

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