Health

Once pain has occurred and efforts have been made to establish the cause and the type of pain (somatic versus neuropathic), the physician must assist the patient with establishing realistic goals. In acute pain, majority of the time, complete resolution of the condition should be anticipated.

Complete resolution may not be the case with chronic pain as may occur after a limb amputation, after a stroke, or with long-standing diabetes and the neuropathy associated with. In chronic pain, it may not be realistic to consider complete resolution of the pain. An individual who has suffered for many years should not live with the false hope of never being with pain. However, the individual should believe that the pain can be reduced and they should be able to improve their activities and quality of life.

The health care provider cannot change the level of desire and the level of commitment that the patient brings to rehabilitation. Only the individual can decide how much they are willing to commit to improving their condition, their pain, and their level of activity. The health care provider can assist with the adaptive tools to improve pain and function, but not with the motivation, commitment, and drive.

In all chronic pain states, inactivity is bad. To stay inactive will only make the situation worse and can render a dysfunctional limb useless. Rest is good, but only for twenty four hours, then graded activity is reinstituted to rehabilitate the injured part and medications are used to decrease the suffering so as to further enhance function. Medications should facilitate and not impede activity. If the individual becomes over-sedated or lethargic, then the medications are not achieving the intended goal and must be adjusted or replaced.