The focus in chronic pain assessment differs from the evaluation of acute pain, which assumes a specific underlying injury or disease that treatment will cure. Begin chronic pain assessment with the history and physical examination. Important components of the initial evaluation are summarized in Table 3 and are detailed below.

All prescription sleeping pills have risks, especially for people with certain medical conditions, including liver or kidney disease, and for older adults. Always talk with your health care provider before trying a new treatment for insomnia.

The strong evidence for the contribution of psychosocial factors in pain experience, particularly in explaining disability attributed to pain, has led to the development of multidisciplinary pain rehabilitation programs (MPRPs) that simultaneously address physical, psychological, and functional aspects of chronic pain disorders.

Watch for side effects. If you feel sleepy or dizzy during the day or if you experience any other side effects that bother you, talk to your health care provider.

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If you regularly have trouble either falling or staying asleep — a condition called insomnia — make an appointment with your health care provider. Treatment depends on what's causing your insomnia.

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NSAIDs may also increase risk for exacerbations of hypertension, heart failure, and chronic kidney disease. NSAID use in patients with heart disease or its risk factors increases the overall risk of heart attack or stroke.

Counseling and behavioral therapy are also available through many of the smoking programs to aid in dealing with urges and stress. Mobile apps and helplines also exist that offer encouragement and advice on the practical things you need to do.”

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Pain quality. A detailed account of pain quality may help identify potential types/sources of pain. Musculoskeletal or myofascial pain is often described as aching, throbbing or tight.

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The feeling of pain and the emotional, physical, and social impact of pain are interrelated, but can be separated for treatment purposes. Therefore, problems with functioning related to pain can be addressed even if pain is not targeted directly and remains unchanged.

If PRN medication is required ≥ 3×/day → inadequate analgesia likely; review the regular medication Additionally, concurrent treatment with adjuvant drugs