A New Paradigm: Prevention of Central Sensitization in Pain Management through Minimizing Opioid Exposure

Current exacerbations of chronic pain cannot be understood in isolation from how past incidents impact pain and its experience. Patients who frequent the Emergency Room or hospital for a pain crisis or intensification of their pain without new findings on X-rays or scans are often seen as ‘drug seekers.’ Yet, to the patient the pain is agonizing, and the suffering real. It is this type of patient that prompted an ongoing improvement project in our local hospital, our Multiple Visit Patient Complex Care Program. The goal was to determine the similarities between this type of ‘complex’ patient—who frequents the hospital despite no new radiographic change—and other patients. Understanding this ‘complex’ pattern in terms of central intractable pain can change the trajectory of treatment. Results of our program described here reveal that a better understanding of central pain and central sensitization can result in better patient care