Chronic pain is at epidemic levels and has become the highest-cost condition in health care. This course uses evidence-based science with creative and experiential learning to better understand chronic pain conditions and how they can be prevented through self-management in our cognitive, behavioral, physical, emotional, spiritual, social, and environmental realms. The goal of this course is to blend creative, experiential, and evidence-based teaching strategies to help participants understand chronic pain conditions and how a human systems approach can be applied to self-management strategies to reduce risk factors, enhance protective factors, and prevent chronic pain. There are four major objectives to the course; 1. Describe the prevalence, personal impact, and health care dilemma associated with chronic pain. 2. Recognize the clinical characteristics and underlying etiology of several common pain conditions and the peripheral, central, and genetic mechanisms of chronic pain 3. Based on the literature associated with risk and protective factors in the seven realms of our lives, learn specific strategies in each realm that can be employed daily to prevent chronic pain and enhance wellness. 4. Appreciate the value of a human systems approach to health care and how it can provide a basis for integrative, interdisciplinary, and individualized care to preventing pain and enhancing wellness. CONTINUING EDUCATION CREDIT OPTION Accreditation Statement: University of Minnesota, Interprofessional Continuing Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. American Medical Association (AMA) The University of Minnesota, Interprofessional Continuing Education designates this enduring material for a maximum of 24.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. American Nurses Credentialing Center (ANCC) This activity is awarded up to 24.0 ANCC contact hours. Other Health Care Professionals Other health care professionals who participate in this CE activity may submit this certificate statement of participation to their appropriate accrediting organizations or state boards for consideration of credit. The participant is responsible for determining whether this activity meets the requirements for acceptable continuing education. Registration and disclosure information is available here at http://z.umn.edu/chronicpain and pay the additional fee. Then, email your Coursera certificate statement of completion to cme@umn.edu.
7 Take-home Messages about Chronic Pain
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Do curso por University of Minnesota
Preventing Chronic Pain: A Human Systems Approach
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Implementing Transformative Care (Week 10)
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Dr. James Fricton, DDS, MSProfessor and Pain Specialist
University of Minnesota, HealthPartners Institute, and Minnesota Head and Neck Pain Clinic
Hi, welcome back.
This is the final part of the module on
transformative care which is at the end of the course.
So I wanted to really give you a few suggestions that I
try to pay attention to when I work with patients with chronic pain.
And you can take or leave some of these suggestions, but they, to me, they have
been very helpful over the years to not
only convey a positive atmosphere within my clinical setting.
but, more importantly, to really put me in a good mood.
To understand how important and helpful it is
to work with the patient as closely as possible.
So these are some of the my keys to success in
working in prevention to chronic pain as well as managing chronic pain.
One of the most important things I learned was I always look where you're going.
I always have developed a treatment plan based on the problem list.
And I try to implement that treatment plan.
Often can be complex with patients with multiple contributing factors.
And we need to really make sure that we are going in the right direction.
In addition I try to avoid finding myself in awkward situations,
If I didn't really explain things adequately, or if a patient
was confused, they went back to their referring doctor and were
confused and complained because they didn't
really understand what was going on.
So I really tried to lay out the decision making
and shared decision making to do with the patient together.
I do encourage the patient to get involved in peer
group as well as company or home wellness activities, whether
it's yoga together, exercises, because that energy, that positive energy
you convey to the patient can spread to their lifestyle.
Also, and all of that will work together to really enhance the patient's outcome.
I also really make sure that I focus on
getting the good advice from my team members, when needed.
I don't have the expertise in all of these areas
and I greatly appreciate and respect my colleagues and their opinions.
As long as we have a consistent paradigm in care, which is not always easy but we
generally work together over a period of time
and will convey the same message to the patients.
But we'll train them on different things.
And some patients can be quite complicated.
It's important not to let the situation confuse you by
developing a treatment plan for each patient as I mentioned earlier.
And that course over, over time, that, that, care that we provide.
Really is focused on developing a long-term relationship with the patient.
And so when there are positive and negatives and ups and downs that,
that patient trusts me to work with the person and in helping accomplish that.
And you'll find that even with your own self-management program
that you need to figure out what works, what doesn't work.
And how can you, can man, manage that success and positive outcome.
And I always try to make sure that everybody is nice.
I mean, I'm nice to the patient.
That I'm respectful.
That I don't assume or convey that the patient's
problem is in their head or that they're drug seekers.
Everybody needs to be confirmed with regard
to their physical problem and to explain all
the different problems to them in as nice a way as you can is very important.
And of course recovery does take time so I try to avoid feeling rushed.
A patient obviously wants to get out of pain if they can as quickly as they can.
But I explain to them, it's going to take six months and
it's a process that is similar to healing a broken bone.
Muscles and joints don't heal over night and it just takes some
time.
And I, as I mentioned throughout the entire course that one
of the most important things is to really treat the whole patient.
And that way you have the best chance of improving the condition and
having a very successful and happy patient at the end of the process.
And sometimes you'll identify contributing factors later on
in the process that you didn't identify early on.
So I constantly reassess and try to understand that whole patient.
And not only the patient, but their family also, as this cartoon says.
Under our holistic approach, Mr Wynder, we do not only, we
do not only treat your symptoms but we also treat your dog.
So, it's really about the person and their
own environment around them and particularly, their family.
And we convey this, and I mentioned this over and over again.
80% of a patients success is based on what
they do, and not what the health professional does.
But we need to do our 20%, and we need to
train the patient on what they need to do for their 80%.
So we educate, we engage, we empower the patients.
And we recognize that each patient is unique.
There's no two treatment plans that are the same.
Everybody has their individual characteristics and we really
need to understand what they are and address those.
We also use a lot of common sense.
And common sense just means that we're down to earth, we're practical.
We don't expect the patient to do 100% of everything we tell them to do.
We realize that people are going to ta, pick and choose, and
take whatever treatment or intervention seems to work best and apply that.
So, we use a lot of common sense as we go through this process.
And we encourage the patients to spend time.
Reflecting, being introspective to daydream everyday, because
that's where the insight comes from, from looking inside.
Understanding where they are and to really move forward with regard to.
What they want to achieve and define their
purpose, to give them the hope that they need.
And these issues are dealt with primarily introspectively.
So they need to spend some time alone.
There was an interesting recent study showing that mothers, for instance,
have approximately, on the average, 11 minutes a day by themselves.
Well it's just, not much time to be by themselves to really understand
what's going on in their lives and in, in, ins, and inside themselves.
And so we recommend spending at least a half hour a day by yourself.
relaxing, calming, and daydreaming, if you can.
And this is probably one of the most important suggestions.
You have to be kind to your muscles and joints.
Don't abuse them.
And they, they will be kind to you.
So when they, when a person has pain, there's a reason for that pain.
You need to identify what that reason is.
What the risk factors.
And then enhance the protective factors so that it doesn't contribute to pain.
So, the most important thing is just don't injure yourself.
Minimize any future injuries.
And then each person is unique, and we see beauty
in each person and compliment them as, as needed, and so.
It really helps set up a very positive relationship with the patient.
And of course, I've tried being too serious although I know this
is an online course and sometimes it's difficult to make you smile.
And I want to make sure I cover the material, but very
importantly is you've gotta have fun every day working with patients.
And and that way, you can really sustain enjoyment
with working with people over a period of time.
And then finally, your relationship with the patient
is really the most powerful treatment you have.
As I mentioned about placebo, it is the
most powerful treatment that we have, regardless of whether
you give them medication, surgery, physical therapy, cognitive behavioral
therapy, it is your relationship that's the most important.
So my recommendation is always give your patients the
best that you have because it's all about your energy.
So I appreciate you taking this course, listening to
each of these modules, And I have a number
of other modules for you to listen to, some
other integrative care specialists who focus on pain also.
And so we have recorded some brief interviews
with them, and if you want to hear from
other people and what their perspective is on
prevention of chronic pain, I'd appreciate you listening.
So, thank you very much and I really want to end with that quote
that I started with and it's, divine is the task of relieving pain.
So thank you very much for your participation, and
I hope you've, this information and knowledge carries with
you for the rest of your life, both personally
and if you're a health professional, with your patients.
Thank you.
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