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.

Regular exercise. Start small, gradually increase to at least 150 minutes/week at moderate intensity. Adjust this goal to the individual’s status.

Acupuncture. Acupuncture in traditional Chinese medicine uses the insertion of needles into specific areas to manipulate anatomical energetic meridians. The nature of the psychological effect continues to be debated, but efficacy has been established for many chronic pain conditions.

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

In some cases, the cause is not immediately obvious, but the category of pain is. For example, burning pain starting in the neck and radiating into the fingers could be associated with acute cervical radiculopathy or may evolve to reveal zoster.

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Marijuana. Evidence regarding benefits and harms is currently insufficient to recommend using “medical” marijuana for chronic pain. Some data support cannabidiol (CBD) alone as being relatively safe.

Acute pain A warning signal indicating actual or potential tissue damage that triggers a protective reaction

Fentanyl testing. Fentanyl is a synthetic opioid and its metabolites are often missed in urine drug screens. GC/MS or LCMS are relatively good at detecting it and are reasonable confirmatory tests.

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Coffee is one of the most widely researched drinks for liver health, says Cherkaoui. “When consumed in moderation, it has been shown to help lower liver enzyme levels and protect liver cells thanks to its rich antioxidant profile,” she adds.

Non-pharmacologic therapy get more info and non-opioid pharmacologic therapy are preferred for the treatment of chronic pain.11 There is insufficient evidence to support the use of long-term opioid use for chronic pain. Opioids carry substantial risks of harm.