Tag Archives: chronic pain

Opioid Task Force, Recent Studies, and CDC Opioid Recommendations

The North Carolina Industrial Commission recently joined many other states (i.e. Massachusetts) in tackling the issue of opioids in the workers’ compensation cases by creating a Workers’ Compensation Opioid Task Force. The goal of the task force is to “study and recommend solutions for the problems arising from the intersection of the opioid epidemic and related issues in workers’ compensation claims.” According to the Chair, “[o]pioid misuse and addiction are a major public health crisis in this state.” 

As of last June, a study by the Workers’ Compensation Research Institute (WCRI) noted “noticeable decreases in the amount of opioids prescribed per workers’ compensation claim.” From 2012 – 2014, “the amount of opioids received by injured workers decreased.” In particular, there were “significant reductions in the range of 20 to 31 percent” in Maryland, Massachusetts, Michigan, Oklahoma, North Carolina, and Texas. 

Additionally last March, the Centers for Disease Control and Prevention (CDC) issued new recommendations for prescribing opioid medications for chronic pain “in response to an epidemic of prescription opioid overdose, which CDC says has been fueled by a quadrupling of sales of opioids since 1999.” 

Currently, the CDC’s recommendations for prescribing opioids for chronic pain outside of active cancer, palliative, and end-of-life care will likely follow these steps:

1.  Non-medication therapy / non-opioid will be preferred for chronic pain.

2.  Before starting opioid therapy for chronic pain, clinicians should establish treatment goals and consider how therapy will be discontinued if benefits do not outweigh risks.

3.  Before starting and periodically during opioid therapy, clinicians should discuss with patients known risks and realistic benefits of opioid therapy. 

Help for Chronic Pain Patients

According to a recent news article by Rachel Noble Benner, a mental health counselor, chronic pain is defined as pain that lasts longer than three months. It affects more than 100 million sufferers in the United States alone, and for those who suffer from chronic pain caused by an illness or injury it may seem as if there is no end in sight to their misery.

Chronic pain is not merely one symptom or a limited experience like acute pain; it is usually accompanied by depression, fatigue, changes in appetite and trouble sleeping. It can hold sufferers back from wanting to socialize with family and friends, and it reduces their quality-of-life.

Chronic pain requires treatment by physicians using a holistic approach in order to relieve symptoms. Physical therapists should be able to reactivate injured muscles and retune a hyper-excited nervous system; exercise will help recover a patient’s nervous system by re-teaching nerves the difference between normal and harmful sensations, and counseling on a regular basis should help establish strengths, manage depression and anxiety, and develop relaxation techniques.

 

Original post in the Washington Post by Rachel Noble Benner

Reposted in News & Observer 1/20/15 http://bit.ly/1J3vquV

 

 

Coach K’s struggle with chronic pain

Duke Basketball Coach Mike Krzyzewski

Duke Basketball Coach Mike Krzyzewski has struggled with back pain

If you are a fan of college basketball, you probably know the accomplishments of Coach Mike Krzyzewski, who has led Duke University’s men’s basketball program for 35 years, including 4 national championships. What you might not know is that Coach K struggled with chronic back pain that culminated in a personal crisis twenty years ago, and a recent news article by Barry Jones for the News & Observer tells the story.

Coach K had back surgery for a ruptured disk in October of 1994 and was so eager to return to work that he didn’t take the necessary time to recover and he returned to work too soon. As his wife, Mickie, recounted, “Getting well was worse for him than being sick because he felt he had deserted his men.” She even had to give him an ultimatum: skip practice and see the doctor or don’t come home. In fact, his struggle got so bad that he decided to resign. Luckily, the athletic director convinced Coach K to take a leave of absence instead. “One of the things we’ve learned is the emotional toll that chronic pain takes. It just completely changes everything,” said Mickie.

Chronic pain can be devastating, physically and emotionally, and if it can take down Mike Krzyzewski and his family, imagine what it can do to the average working person. Employers, physicians and the injured employee should follow his eventual lead: listen to your body and get proper rest; don’t return to work sooner than you should; and don’t try to be superman.