The Chronic Pain Patient in the Emergency Department

Pain presentations are very common in the emergency department (ED), of which an estimated 12-16 % of total ED visits are from patients with chronic pain-related complaints (McLeod and Nelson in Australas Emerg Nurs J 16: 30-36, 2013). The ED physician frequently has few tools to manage chronic pain patients, and is often times limited to pharmacological means of alleviating the patient's suffering. For chronic pain patients, the ED only represents a fraction of their total longitudinal care. This article presents the scope of chronic pain, evaluation issues of the chronic pain patient, barriers to effective management, targeted pharmacotherapy suggestions, patient assessment strategies, prescribing guidelines, and other outpatient modalities used for treatment of chronic pain. The goal of this article is to improve the reader's understanding of the issues surrounding the chronic pain patient and improve the care of these patients.