Objectives. Provide a framework for comprehensive pain evaluation and individualized multimodal treatment. Improve quality of life and function in patients experiencing pain, while reducing the morbidity and mortality associated with pain treatments, particularly opioid analgesics.

Read how psychological symptoms can accompany thyroid disorders and possible treatment and management options

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.

Although not completely understood, the pathophysiology is thought to involve the following two mechanisms:

The following information pertains to adults. See “Pain management in children” for pediatric recommendations.

Many patients are aware that methadone is often associated with opioid addiction therapy. Patients may need additional counseling that methadone is an effective analgesic, not merely a treatment for opioid addiction.

Occasionally opioids may have less risk than other pain management medications. Examples include patients vulnerable to gastrointestinal bleeding for whom NSAIDs are contraindicated and patients experiencing cognitive effects from membrane stabilizers.

Pain location. Pain drawings are frequently used for patients to identify the location of pain. A drawing on more info an anatomical outline can provide a quick impression of the breadth and character of the presenting pain complaint.

Chronic peripheral pain disorders can be a significant driver to the sensitization of central nociceptive neurons Usually continues even after the initial injury has healed

Monitor for respiratory depression in the first 72 hours after initiating or increasing the opioid dose.

Pain diary: regular documentation of the pain intensity to identify peaks and triggers; enables treatment optimization

If you become hyperthyroid because of too much thyroid hormone, the increased activity of your body cells or body organs may lead, for example, to a quickening of your heart rate or increased activity of your intestine so that you have frequent bowel motions or even diarrhoea.

A full discussion of the diagnosis and management of opioid use disorder is beyond the scope of this guideline. However, monitor patients for signs and symptoms of this disorder.

Your doctor will be able to get a good idea about the activity of your thyroid gland by listening to your symptoms, asking you some questions, and by examining your neck. However, by taking a small sample of your blood he or she can assess exactly how well your thyroid is working.