The last several decades have seen a marked increase in both the recognition and treatment of
chronic pain. Unfortunately, patients frequently misunderstand both the nature of
pain and the best practices for its treatment. Because primary care physicians treat the majority of
chronic pain, they are ideally situated to provide evidence-based
pain care. The majority of the medical evidence supports a biopsychosocial model of
pain that integrates physical, emotional, social, and cultural variables. The goal of this primer is to assist primary care physicians in their understanding of
pain, evaluation of the
chronic pain patient, and ability to direct evidence-based care. This article will discuss the role of physical rehabilitation,
pain psychology,
pharmacotherapy, and procedural interventions in the treatment of
chronic pain. Given the current epidemic of drug-related deaths, particular emphasis is placed on the alternatives to
opioid therapy. Unfortunately, death is not the only significant complication from
opioid therapy, and this article discusses many of the most common side effects. This article provides general guidelines on the most appropriate utilization of
opioids with emphasis on the recent Centers for Disease Control and Prevention guidelines, risk stratification, and patient monitoring. Finally, the article concludes with the critical role that a
pain medicine specialist can play in the management of patients with
chronic pain.