Patient perspectives from the multi-disciplinary chronic pain clinic: a qualitative study

Aim: The chronic pain clinic (CPC) is a multi-disciplinary program that incorporates pharmacological and non-pharmacological methods, including First Nations healing strategies, to manage pain, improve functioning and reduce opioid misuse among patients with chronic pain in Regina, Canada. Materials & methods: The care experiences of ten current clients were explored using a narrative interview approach. Results: The CPC provides high-quality and safe care for effective chronic pain management. Clients noted pain reduction and improvements in sleep, mobility, functionality, and mood. First Nation clients emphasized the importance of traditional healing strategies. Conclusion: This unique comprehensive multi-modal approach which incorporates First Nations healing strategies is effective in supporting the unique needs of local clients.

Ureterocele as a cause of chronic intractable abdominal pain

A ureterocele is a submucosal, cystic dilation of the terminal ureter, either congenital or acquired, as it enters the bladder. It is a rare clinical entity that can be entirely asymptomatic and present as an incidental finding or can manifest in the form of distressing symptoms such as unremitting abdominal pain, haematuria, obstructive uropathy, to name a few. The authors present a case of abdominal pain in a 43-year-old woman who was presumptively attributed to various clinical entities and was finally referred to the chronic pain clinic. The patient underwent numerous diagnostic tests, psychological evaluations and therapeutic interventions, including surgeries, over the years that failed to mitigate her symptoms until urologic imaging reported intravesical ureterocele as the underlying disorder. The case report entails the diagnostic challenge faced by the authors along with the clinical characteristics of ureterocele.

Pain, mental health, and health care utilization of military Veterans compared to civilians in a chronic pain clinic

LAY SUMMARY More than 40% of Canadian Veterans live with chronic pain. Chronic pain is often combined with mental health issues as well as the challenges of isolation and deconditioning. This study examined if there were differences in characteristics and type of care received between Veterans and civilians (people with no military service background) seeking care at a chronic pain clinic. The two groups of individuals with chronic pain were quite similar in pain outcomes, physical function, and mental health. Veterans visited chiropractors, massage therapists, physiotherapists, and psychologists more often than civilians. Although Veterans received this extra care and support, they were almost three times more likely to have thoughts of suicide. It was concluded that Veterans with chronic pain would greatly benefit in participating in an interdisciplinary pain care program tailored to Veteran-specific needs.

Bioethical correctness of integrative medicine in the treatment of chronic pain in the historical perspective

A reflection on progress in medicine – bioethics appeared in the 1970s. „Principless of biomedical ethics” – the monograph by Tom Beachamp and James Childress – was to change the concept of ethical evaluation of new possibilities of diagnostic and therapy and making decisions in medicine. In the 70’s there was also the development of chronic pain management. A pioneering concept of multidisciplinary management of a patient suffering from chronic pain by John Bonica is a part of the process of implementing four bioethical principles. The idea of integrative medicine – combining the methods resulting from the scientific and technical progress of Western medicine with the methods of traditional Eastern medicine has enabled the implementation of beneficience, nonmaleficence, autonomy, and justice. This article will present facts related to the Bonica’s concept in the first chronic pain clinic created in Poland in the 1970s.

Barriers to Outpatient Pediatric Chronic Pain Clinic Participation Among Referred Patients

Initial clinic evaluation among referred patients and factors limiting treatment initiation are not well characterized. We conducted a retrospective review of referrals to our outpatient pain clinic to identify intake visits and factors associated with treatment initiation among adolescents with chronic pain. We identified adolescents aged 13 to 18 years at the time of referral to clinic (2010-2016). Factors associated with completion of visits were evaluated using logistic regression. Patients who completed visits more frequently had private insurance than public or no insurance ( P = .053). The most common reasons for caregiver decision not to attend the pain clinic included use of another pain clinic, that services were not wanted or no longer needed, and that their child was undergoing further testing. The current study demonstrated that patients with head pain were more likely to complete an intake visit, while there was a trend showing that lack of private insurance decreased this likelihood.