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Chronic Pain: Care Instructions

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Chronic pain is pain that lasts a long time (months or even years) and may or may not have a clear cause. It is different from acute pain, which usually does have a clear cause like an injury or illness and gets better over time. Chronic pain:

  • Lasts over time but may vary from day to day.
  • Does not go away despite efforts to end it.
  • May disrupt your sleep and lead to fatigue.
  • May cause depression or anxiety.
  • May make your muscles tense, causing more pain.
  • Can disrupt your work, hobbies, home life, and relationships with friends and family.

Chronic pain is a very real condition. It is not just in your head. Treatment can help and usually includes several methods used together, such as medicines, physical therapy, exercise, and other treatments. Learning how to relax and changing negative thought patterns can also help you cope.

Chronic pain is complex. Taking an active role in your treatment will help you better manage your pain. Tell your doctor if you have trouble dealing with your pain. You may have to try several things before you find what works best for you.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It s also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Pace yourself. Break up large jobs into smaller tasks. Save harder tasks for days when you have less pain, or go back and forth between hard tasks and easier ones. Take rest breaks.
  • Relax, and reduce stress. Relaxation techniques such as deep breathing or meditation can help.
  • Keep moving. Gentle, daily exercise can help reduce pain over the long run. Try low- or no-impact exercises such as walking, swimming, and stationary biking. Do stretches to stay flexible.
  • Try heat, cold packs, and massage.
  • Get enough sleep. Chronic pain can make you tired and drain your energy. Talk with your doctor if you have trouble sleeping because of pain.
  • Think positive. Your thoughts can affect your pain level. Do things that you enjoy to distract yourself when you have pain instead of focusing on the pain. See a movie, read a book, listen to music, or spend time with a friend.
  • If you think you are depressed, talk to your doctor about treatment.
  • Keep a daily pain diary. Record how your moods, thoughts, sleep patterns, activities, and medicine affect your pain. You may find that your pain is worse during or after certain activities or when you are feeling a certain emotion. Having a record of your pain can help you and your doctor find the best ways to treat your pain.
  • Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.

Reducing constipation caused by pain medicine

  • Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fiber.
  • Drink plenty of fluids, enough so that your urine is light yellow or clear like water. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
  • If your doctor recommends it, get more exercise. Walking is a good choice. Bit by bit, increase the amount you walk every day. Try for at least 30 minutes on most days of the week.
  • Schedule time each day for a bowel movement. A daily routine may help. Take your time and do not strain when having a bowel movement.

When should you call for help?

Call your doctor now or seek immediate medical care if:

  • Your pain gets worse or is out of control.
  • You feel down or blue, or you do not enjoy things like you once did. You may be depressed, which is common in people with chronic pain. Depression can be treated.
  • You have vomiting or cramps for more than 2 hours.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You cannot sleep because of pain.
  • You are very worried or anxious about your pain.
  • You have trouble taking your pain medicine.
  • You have any concerns about your pain medicine.
  • You have trouble with bowel movements, such as:
    • No bowel movement in 3 days.
    • Blood in the anal area, in your stool, or on the toilet paper.
    • Diarrhea for more than 24 hours.

Care instructions adapted under license by Neuromuscular Spine & Joint Center. This care instruction is for use with your licensed healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Kopp Medical LLC, DBA Neurmomuscular Spine & Joint Center disclaims any warranty or liability for your use of this information.

Learning About Opiates

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Introduction

Opiates are medicines used to relieve moderate to severe pain. They may be used for a short time for pain, such as after surgery. Or they may be used for long-term pain. They don’t cure a health problem. But they help you manage the pain.

Opiates relieve pain by changing the way your body feels pain and the way you feel about pain.

Sometimes opiates are used for people who can’t take other pain medicines. They may be prescribed if you have heart, kidney, or liver problems. For instance, you may take an opiate instead of nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs include ibuprofen (Advil, Motrin) and naproxen (Aleve).

Opiates are powerful medicines. You may need to take extra steps to stay safe.

Examples

Opiates or other medicines that contain them include:

  • Codeine (Tylenol 3).
  • Hydrocodone (Norco).
  • Oxycodone (OxyContin, Percocet).

Safety tips

Taking too much (overdose) of an opiate can cause death. To avoid an overdose:

  • Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. You will get more details on the specific medicines your doctor prescribes.
  • Do not break, crush, or chew a pill. Do not cut or tear a patch.
  • Do not drink alcohol. Do not take recreational or illegal drugs.
  • Do not drive or operate machinery until the medicine effects are gone. Wait until you can think clearly.
  • Keep your medicine away from children and pets. Store it in a safe and secure place.
  • Call your doctor if you miss a dose of your medicine and aren’t sure what to do. Do not double your dose.
  • Check with your doctor or pharmacist before you use any other medicines. This includes over-the-counter medicines. Make sure your doctor knows all of the medicines, vitamins, herbal products, and supplements you take. Taking some medicines together can cause problems.
  • Talk to your doctor about a naloxone rescue kit. A kit can help you, and even save your life, if you take too much of an opiate.

Side effects

Common side effects include:

  • Constipation.
  • Feeling dizzy or lightheaded. You may feel like you might faint.
  • Feeling sleepy.
  • Nausea or vomiting.

You may have other side effects or reactions. Check the information that comes with your medicine.

What to know about taking this medicine

  • Your body gets used to opiates if you take them all the time. You could have withdrawal symptoms when you stop taking them. Symptoms include nausea, sweating, chills, diarrhea, anxiety, and shaking. But you can avoid these symptoms if you slowly stop taking the medicine as your doctor tells you to.
  • You have a small chance of addiction if you take opiates as prescribed. Your risk is a bit higher if you have abused drugs in the past.
  • Some opiates have acetaminophen in them. Check the labels on all the other medicines you take. This includes over-the-counter drugs. Many medicines have acetaminophen. Do not take others with acetaminophen in them unless your doctor has told you to. Taking too much acetaminophen can be harmful. Talk to your doctor or pharmacist if you have questions about this.
  • Be sure you know how to safely get rid of any leftover medicine. Talk to your doctor or pharmacist about how to do this. Ask for written instructions.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have symptoms of a severe allergic reaction. These may include:
    • Sudden raised, red areas (hives) all over your body.
    • Swelling of the throat, mouth, lips, or tongue.
    • Trouble breathing.
    • Passing out (losing consciousness). Or you may feel very lightheaded or suddenly feel weak, confused, or restless.
  • You have signs of an overdose. These include:
    • Cold, clammy skin.
    • Confusion.
    • Severe nervousness or restlessness.
    • Severe dizziness, drowsiness, or weakness.
    • Slow breathing.
    • Seizures.

Call your doctor now or seek immediate medical care if:

  • You have symptoms of an allergic reaction, such as:
    • A rash or hives (raised, red areas on the skin).
    • Itching.
    • Swelling.
    • Belly pain, nausea, or vomiting.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • Your medicine is not helping with the pain.
  • You are having side effects, such as constipation.

Care instructions adapted under license by Neuromuscular Spine & Joint Center. This care instruction is for use with your licensed healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Kopp Medical LLC, DBA Neurmomuscular Spine & Joint Center disclaims any warranty or liability for your use of this information.

Starting a Weight Loss Plan: Care Instructions

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If you are thinking about losing weight, it can be hard to know where to start. Your doctor can help you set up a weight loss plan that best meets your needs. You may want to take a class on nutrition or exercise, or join a weight loss support group. If you have questions about how to make changes to your eating or exercise habits, ask your doctor about seeing a registered dietitian or an exercise specialist.

It can be a big challenge to lose weight. But you do not have to make huge changes at once. Make small changes, and stick with them. When those changes become habit, add a few more changes.

If you do not think you are ready to make changes right now, try to pick a date in the future. Make an appointment to see your doctor to discuss whether the time is right for you to start a plan.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It s also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Set realistic goals. Many people expect to lose much more weight than is likely. A weight loss of 5% to 10% of your body weight may be enough to improve your health.
  • Get family and friends involved to provide support. Talk to them about why you are trying to lose weight, and ask them to help. They can help by participating in exercise and having meals with you, even if they may be eating something different.
  • Find what works best for you. If you do not have time or do not like to cook, a program that offers meal replacement bars or shakes may be better for you. Or if you like to prepare meals, finding a plan that includes daily menus and recipes may be best.
  • Ask your doctor about other health professionals who can help you achieve your weight loss goals.
    • A dietitian can help you make healthy changes in your diet.
    • An exercise specialist or personal trainer can help you develop a safe and effective exercise program.
    • A counselor or psychiatrist can help you cope with issues such as depression, anxiety, or family problems that can make it hard to focus on weight loss.
  • Consider joining a support group for people who are trying to lose weight. Your doctor can suggest groups in your area.

Care instructions adapted under license by Neuromuscular Spine & Joint Center. This care instruction is for use with your licensed healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Kopp Medical LLC, DBA Neurmomuscular Spine & Joint Center disclaims any warranty or liability for your use of this information.

Learning About Safe Use of Long-Acting Opiates

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Introduction

Long-acting opiates relieve moderate to severe long-term pain. They are also called extended-release opiates. Opiates relieve pain by changing the way your body feels pain. They don’t cure a health problem. They help you manage the pain.

If you take a lot of short-acting pain medicine, your doctor may give you long-acting opiates. They help you avoid the ups and downs in pain relief that you may have with short-acting medicine.

Opiates are powerful. When taken on schedule and as your doctor prescribes, they work well and are safe. But even with proper use, opiates can cause tolerance and overdose, physical dependence, addiction, or death.

Examples

  • Fentanyl patch (Duragesic)
  • Methadone (Dolophine)
  • Morphine (Kadian)
  • Oxycodone controlled-release (OxyContin)

Safety tips

To avoid taking too much (overdose):

  • Take your medicines exactly as prescribed. Do not take extra doses. Even one extra dose can be dangerous. Taking too much of these medicines can cause death.
  • Call your doctor if you miss a dose of your medicine and aren’t sure what to do. Do not double your dose.
  • Do not break, crush, or chew a pill. Do not cut or tear a patch.

To use these medicines safely:

  • Call your doctor if you think you are having a problem with your medicine. You will get more details on the specific medicines your doctor prescribes.
  • Do not drink alcohol or take illegal drugs.
  • Do not drive or operate machinery until you can think clearly. Opiates may affect your judgment and decision making. Talk with your doctor about when it is safe to drive.
  • Keep your medicine in a safe and secure place. Keep it away from children and pets.
  • Check with your doctor or pharmacist before you use any other medicines. This includes over-the-counter medicines.
    • Make sure your doctor knows all of the medicines, vitamins, herbal products, and supplements you take.
    • Do not take opiates with other medicines that make you sleepy or relaxed. Taking both can be dangerous.
  • Talk to your doctor about a naloxone rescue kit. A kit can help you, and even save your life, if you take too much of an opiate.

Possible side effects

All medicines have side effects. But many people don’t feel the side effects, or they are able to deal with them. You may:

  • Feel confused or have a hard time thinking clearly.
  • Be constipated.
  • Feel faint, dizzy, or lightheaded.
  • Feel drowsy.
  • Feel sick to your stomach or vomit.
  • Have an allergic reaction.

What to know about taking this medicine

  • When you take an opiate regularly, your body gets used to it. This can lead to tolerance and physical dependence. These are not the same as addiction.
    • Tolerance means that, over time, you may need to take more of the drug to keep getting the same amount of pain relief. The danger is that tolerance greatly increases your risk of overdose, breathing emergencies, and death.
    • If you are physically dependent on an opiate, you may have withdrawal symptoms when you stop taking it. These include nausea, sweating, chills, diarrhea, and shaking. You can avoid these symptoms if you gradually stop taking the opiate over a set period of time. Your doctor can help you.
    • Addiction is a chronic illness that makes you crave a substance, such as a drug or alcohol. When you are addicted to a substance, you have a hard time stopping yourself from using it even when you can see it causes harm.
  • You have a small risk of addiction when you take opiates. Your risk is greater if you have a history of substance use problems. Others who are more at risk for addiction are teenagers, older adults, people who have depression, and those who take high doses of medicine.
  • Ask for written instructions from your doctor or pharmacist about how to safely get rid of any medicine that’s left over.
  • Call your doctor if the dose you are taking doesn’t control your pain.

Care instructions adapted under license by Neuromuscular Spine & Joint Center. This care instruction is for use with your licensed healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Kopp Medical LLC, DBA Neurmomuscular Spine & Joint Center disclaims any warranty or liability for your use of this information.

Safe Use of Opiate Pain Medicine: Care Instructions

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Your Care Instructions

Pain is your body’s way of warning you that something is wrong. Pain feels different for everybody. Only you can describe your pain.

A doctor can suggest or prescribe many types of medicines for pain. These range from nonprescription medicines like acetaminophen (Tylenol) to powerful medicines called opiates.

Opiates work well to relieve pain. But they also can cause problems, especially if they are taken too often or in too large a dose. They can interact with other medicines, or they may make it hard for you to do your job or to think clearly. They can even cause death. For these reasons, doctors are very careful about how they prescribe opiates.

The doctor carefully considered what pain medicine is right for you. You may not have received opiate pain medicine if your doctor was concerned about drug interactions or your safety, or if he or she had other concerns.

It is best to have one doctor or clinic treat your pain. This way you will get the pain medicine that will help you the most, and a doctor will be able to watch for any problems that the medicine might cause.

The doctor has checked you carefully, but problems can develop later. If you notice any problems or new symptoms, get medical treatment right away.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Try other ways to reduce pain:
    • Relax, and reduce stress. Relaxation techniques such as deep breathing or meditation can help.
    • Keep moving. Gentle, daily exercise can help reduce pain over the long run. Try low- or no-impact exercises such as walking, swimming, and stationary biking. Do stretches to stay flexible.
    • Try heat, cold packs, and massage.
    • Get enough sleep. Pain can make you tired and drain your energy. Talk with your doctor if you have trouble sleeping because of pain.
    • Think positive. Your thoughts can affect your pain level. Do things that you enjoy to distract yourself when you have pain instead of focusing on the pain. See a movie, read a book, listen to music, or spend time with a friend.
  • If the doctor gave you a prescription medicine, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.

When should you call for help?

Call your doctor now or seek immediate medical care if:

  • You have a new kind of pain.
  • You have new symptoms, such as a fever or rash, along with the pain.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You think you might be using too much pain medicine, and you need help to use less or stop.
  • Your pain gets worse.
  • You would like a referral to a doctor or clinic that specializes in pain management.

Care instructions adapted under license by Neuromuscular Spine & Joint Center. This care instruction is for use with your licensed healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Kopp Medical LLC, DBA Neurmomuscular Spine & Joint Center disclaims any warranty or liability for your use of this information.