Selecting the appropriate pain medication to alleviate an injured worker’s pain symptoms can be difficult for treating physicians and claims managers. Injured workers can be frustrated, and even harmed, when a physician takes a “trial and error” approach to identifying the right medication or combination of medication to control their pain symptoms. Treating physicians and claims managers who adhere to some fundamental pain medication guidelines can help improve the quality of care and clinical outcomes for the injured worker.

Pain Medication Guidelines:

• Medication must be applied as part of a comprehensive rehabilitation plan.
• Avoid prescribing medications in a “blind” fashion. Medication is more effective when physicians understand the specific pain symptoms they are targeting.
• Remember to identify the dynamics you are trying to improve: set biological, psychosocial, and functional goals.
• Understand the specific action of the prescribed medication: for example, if an anti-inflammatory is being prescribed, is there evidence of inflammation?

Guard against trial-and-error approaches to pain management.

Components of a Rehabilitation Plan

A successful rehabilitation plan employs several components designed to address multiple levels of patient health. As mentioned before, it is critical to apply pain medication within the context of a comprehensive rehabilitation plan. Such a plan may include therapeutic exercise, physical therapy, behavior and dietary modifications, other medications, as well as psychological therapy and counseling.

When you observe that a patient is not meeting recovery benchmarks, it may be necessary to reevaluate the rehabilitation plan. Here are some signs that a reconfiguration of treatment protocol might be necessary:

• Lack of measurable therapeutic gains
• Side effects needing further intervention (e.g. anti-ulcer drugs, stimulants, anti-emetics)
• Medical complications (e.g. gastrointestinal malaise, emergency room visits, cardiovascular problems, and falls or other injuries)

Adhering to a comprehensive care plan can make the difference between the injured worker developing chronic pain or being released to return to work.

For more information on managing pain, prescribing pain medication within the context of a rehabilitation plan and general medical case management, follow Paradigm Outcomes on LinkedIn, Twitter, and Facebook. You can also visit our website.