Navigating Life with Chronic Pain

Robert A. Lavin, MD, MS is Assistant Professor in Department of Neurology at the University of Maryland School of Medicine and Director of Chronic Pain Management at VA Maryland Health Care Services in Baltimore, MD. Sara Clayton, PhD is the Director of Pain Psychology at VA Maryland Health Care Services at a member of the Department of Neurology at the Baltimore VAMC in Baltimore, MD. Lindsay Zilliox, MD is part of the Department of Neurology at the University of Maryland School of Medicine in Baltimore, MD.

Table of Contents 1.Understanding Chronic Pain How the Brain Interprets Pain How the Brain Modifies Pain What is the Difference between Acute and Chronic Pain, and Why Does It Matter? Will My Chronic Pain Improve? You Are Not Alone 2. Different Types of Chronic Pain The Nervous System What is Nerve Pain? Arthritis Pain Myofascial Pain Fibromyalgia Back Pain Headaches 3. What You Might Expect During a Doctor's Appointment Why Do I Need to Complete All of These Forms? Talking with Your Doctor About Chronic Pain Diagnostic Tests That Your Doctor May Request Injections 4. Taking Control of Your Life Inactivity Loss of Flexibility Exercise as a Prescription Other Problems Caused by Immobility Making the Most of Things Feeling Better The Unseen Enemy: Depression, Anxiety, PTSD, Sleep Disturbances 5. Behavioral Approaches What is the Biopsychosocial Model of Pain? The Pain Experience Cognitive Behavioral Therapy Meditation and Mindfulness Acceptance and Commitment Therapy Hypnosis Exercise Biofeedback 6. Lifestyle Modifications What is the Role of Exercise and Nutrition? What are Complementary and Alternative (CAM) Treatments? What are Orthotic and Assistive Devices? What are Environmental Modifications? 7. Non-opioid Pain Medications Medications - Why They Don't Always Work and How to Use Them Safely Commonly Prescribed Pain Medications and Common Side Effects Acetaminophen, Nonsteroidal Anti-inflammatory Drugs (NSAIDs), Antidepressants, Antiepileptics, Muscle Relaxants Medical Marijuana 8. Opioid Pain Medications So Why Do Opioids Work for Pain? Why are Opioids So Controversial? Commonly Prescribed Opioid Medications: Indications and Common Side Effects Confusing Concepts: Dependence, Addiction, Withdrawal, Tolerance, and Hyperalgesia When to Call Your Doctor 9. Injections, Implants, and Surgery - Benefits and Limitations Why Spine Surgery May Not Fix the Pain Problem Why Can't They Cut Out the Pain? Spinal Fusion Surgeries Other Surgical Limitations Why Can't I have an Injection? What Should I Expect from Interventional Procedures? What are the Risks of Injections? 10. Pain and Your Significant Others Social interactions and Communication Intimacy Caregiver Burnout Appendix: Practical Patient/Caregiver Aids Appendix: Resources List