The ACPA and Stanford Resource Guide to Chronic Pain Management
The ACPA believes that people with chronic pain benefit from being well informed about their medications. This knowledge may relieve the fears that can interfere with receiving maximum benefits from medications. The ACPA Resource Guide to Chronic Pain Management is not meant to serve as medical advice for your condition or regarding your medication needs. Remember that the best source of information about your health and medication needs is from an open dialogue with your treating doctor.
An Integrated Guide to Medical, Intervention, Behavioral, Pharmacologic and Rehabilitation Therapies
Preface
Since 1980, the American Chronic Pain Association (ACPA), a non-profit, tax exempt organization, has offered a support system for people with chronic pain through education in pain management skills and self-help group activities. To learn more about the ACPA and how to become a member, please visit our web site at the American Chronic Pain Association or call the National Office at 916-632-0922.
The Stanford University Division of Pain Medicine (henceforth referred to as Stanford Pain Medicine) merges the triple mission of clinical care, education, and research to advance the frontier of pain management and for those dealing with acute or chronic pain problems. The focus of Stanford Pain Medicine is the treatment of the entire person with pain to enable them to live their fullest life, education of the next generation of pain physicians and healthcare leaders, and the pursuit of cutting-edge research to translate into safe and effective therapies for the person in pain.
The history of this Resource Guide started in 2000 as The ACPA Medication Supplement. Dr. Edward Covington authored the first version, a job that was taken over by Dr. Steven Feinberg thereafter with yearly updates.
In 2020, Penney Cowan (ACPA Founder) and Dr. Sean Mackey (Division Chief, Stanford Pain Medicine) partnered to further advance the Resource Guide to Chronic Pain Management. Dr. Mackey had long respected the work of the ACPA whose mission and philosophy aligned closely with that of Stanford Pain Medicine. Furthermore, he and Penny Cowen had worked collaboratively on many projects to advance pain education, care, and research – including the development of the National Pain Strategy. They both felt the time was right to bring in the faculty and resources of Stanford Pain Medicine to further update the Resource Guide with the most up-to-date information. In the future, the ACPA and Stanford Pain Medicine will be working collaboratively to make the Resource Guide available in multiple electronic sources and more integrated into health care environments. While the Resource Guide will be refreshed and advanced, the underlying “person-centric” philosophy will remain the same.
Both the ACPA and Stanford Pain Medicine advocates a multi-modal strategy for addressing chronic pain. The ACPA focuses on pain management skills and self-help strategies that individuals can use in conjunction with modalities discussed with and approved by their health care professionals. Stanford Pain Medicine applies six broad categories of therapies (1) medications, (2) interventional procedures, (3) psychological/behavioral approaches, (4) physical rehabilitative approaches, (5) complementary and integrative medicine approaches, and (6) self-help strategies. These are all applied in a person centric manner to improve the health and well-being of the person in pain.
Both the ACPA and Stanford Pain Medicine considers the use of medication and other treatments to be a matter for individuals to determine in conjunction with their health care professionals. The ACPA or Stanford Pain Medicine take no position on medical treatment choices. Thus, information the ACPA and Stanford Pain Medicine provides in this resource guide about medical care is educational and informative only. The information in the Resource Guide does not replace medical advice, diagnosis, or treatment from a health professional. We encourage you to speak with your health-care professional about your personal health-care questions and care. Furthermore, The ACPA Resource Guide to Chronic Pain Management combines practical clinical experience and the most recent scientific information presented in an easy-to-read format for consumers and professionals. Input comes from many sources, including from individuals, from industry sources, some of which support the ACPA with grants. Similarly, Stanford Pain Medicine receives grant support from several federal sources (e.g., NIH, PCORI, FDA) as well as philanthropy. Some of the Stanford Pain Medicine faculty who contributed to this Resource Guide receive research support from industry. Individual contributors will disclose such industry funding where appropriate. Dr. Feinberg, Senior Author and Editor, receives no funds from industry. Dr. Mackey, Senior Author and Editor, receives no funds from industry. Both Drs. Feinberg and Mackey welcome input regarding any recommended changes, additions, or deletions.
Editors, Contributors & Reviewers
Senior Editors
This resource guide is the culmination of many years of effort and over 100 contributors. Those listed below have contributed to the 2021 edition. Space (and our record keeping) does not permit us to list every contributor and their contributions over the years.
The Stanford University Division of Pain Medicine (henceforth referred to as Stanford Pain Medicine) merges the triple mission of clinical care, education, and research to advance the frontier of pain management and for those dealing with acute or chronic pain problems. The focus of Stanford Pain Medicine is the treatment of the entire person with pain to enable them to live their fullest life, education of the next generation of pain physicians and healthcare leaders, and the pursuit of cutting-edge research to translate into safe and effective therapies for the person in pain.
The history of this Resource Guide started in 2000 as The ACPA Medication Supplement. Dr. Edward Covington authored the first version, a job that was taken over by Dr. Steven Feinberg thereafter with yearly updates.
In 2020, Penney Cowan (ACPA Founder) and Dr. Sean Mackey (Division Chief, Stanford Pain Medicine) partnered to further advance the Resource Guide to Chronic Pain Management. Dr. Mackey had long respected the work of the ACPA whose mission and philosophy aligned closely with that of Stanford Pain Medicine. Furthermore, he and Penny Cowen had worked collaboratively on many projects to advance pain education, care, and research – including the development of the National Pain Strategy. They both felt the time was right to bring in the faculty and resources of Stanford Pain Medicine to further update the Resource Guide with the most up-to-date information. In the future, the ACPA and Stanford Pain Medicine will be working collaboratively to make the Resource Guide available in multiple electronic sources and more integrated into health care environments. While the Resource Guide will be refreshed and advanced, the underlying “person-centric” philosophy will remain the same.
Both the ACPA and Stanford Pain Medicine advocates a multi-modal strategy for addressing chronic pain. The ACPA focuses on pain management skills and self-help strategies that individuals can use in conjunction with modalities discussed with and approved by their health care professionals. Stanford Pain Medicine applies six broad categories of therapies (1) medications, (2) interventional procedures, (3) psychological/behavioral approaches, (4) physical rehabilitative approaches, (5) complementary and integrative medicine approaches, and (6) self-help strategies. These are all applied in a person centric manner to improve the health and well-being of the person in pain.
Both the ACPA and Stanford Pain Medicine considers the use of medication and other treatments to be a matter for individuals to determine in conjunction with their health care professionals. The ACPA or Stanford Pain Medicine take no position on medical treatment choices. Thus, information the ACPA and Stanford Pain Medicine provides in this resource guide about medical care is educational and informative only. The information in the Resource Guide does not replace medical advice, diagnosis, or treatment from a health professional. We encourage you to speak with your health-care professional about your personal health-care questions and care. Furthermore, The ACPA Resource Guide to Chronic Pain Management combines practical clinical experience and the most recent scientific information presented in an easy-to-read format for consumers and professionals. Input comes from many sources, including from individuals, from industry sources, some of which support the ACPA with grants. Similarly, Stanford Pain Medicine receives grant support from several federal sources (e.g., NIH, PCORI, FDA) as well as philanthropy. Some of the Stanford Pain Medicine faculty who contributed to this Resource Guide receive research support from industry. Individual contributors will disclose such industry funding where appropriate. Dr. Feinberg, Senior Author and Editor, receives no funds from industry. Dr. Mackey, Senior Author and Editor, receives no funds from industry. Both Drs. Feinberg and Mackey welcome input regarding any recommended changes, additions, or deletions.
Editors, Contributors & Reviewers
Senior Editors
- Steven Feinberg, MD, MS, MPH – practicing pain medicine physician in Palo Alto, California, and Adjunct Clinical Professor, Division of Pain Medicine, Stanford University School of Medicine.
- Sean Mackey, MD, PhD – Redlich Professor and Chief, Division of Pain Medicine, Stanford University School of Medicine
This resource guide is the culmination of many years of effort and over 100 contributors. Those listed below have contributed to the 2021 edition. Space (and our record keeping) does not permit us to list every contributor and their contributions over the years.
- Meredith Barad, MD, Clinical Associate Professor, Division of Pain Medicine, Stanford University School of Medicine
- Mandy Conrad, PhD, Pain Psychology Fellow in Anesthesiology, Perioperative and Pain Medicine, Division of Pain Medicine, Stanford University School of Medicine
- Corinne Cooley, DPT, OCS, TPS, Stanford Health Care, Division of Pain Medicine, Stanford University School of Medicine
- Xiaoxiao 'Catherine' Guo, MD, Pain Medicine Fellow in Anesthesiology, Perioperative and Pain Medicine, Division of Pain Medicine, Stanford University School of Medicine
- Nicholas Karayannis, MPT, PhD, Assistant Professor, Division of Physical Therapy, Ohio University College of Health Sciences and Professions
- Heather Poupore-King, PhD, Clinical Associate Professor, Division of Pain Medicine, Stanford University School of Medicine
- Albert Kwon, MD, Clinical Assistant Professor, Division of Pain Medicine, Stanford University School of Medicine
- Michael Leong, MD, Clinical Professor, Division of Pain Medicine, Stanford University School of Medicine
- Chen Der (Jason) Low, MSN, NP, Stanford Health Care, Division of Pain Medicine, Stanford University School of Medicine
- Theresa Mallick-Searle, MS, PMGT-BC, ANP-BC, Stanford Health Care, Division of Pain Medicine, Stanford University School of Medicine
- Gabriel Schonwald, MD FASAM, Adjunct Clinical Assistant Professor, Division of Pain Medicine, Stanford University School of Medicine
- Aric Steinmann, MD, Fellow in Anesthesiology, Perioperative and Pain Medicine, Division of Pain Medicine, Stanford University School of Medicine
- Karen Suggerman, LCSW, Stanford Health Care, Division of Pain Medicine, Stanford University School of Medicine
- Abdullah Terkawi, MD, Fellow in Anesthesiology, Perioperative and Pain Medicine, Division of Pain Medicine, Stanford University School of Medicine
- Richard Trimble, BS, Medical Student, Division of Pain Medicine, Stanford University School of Medicine
- Carolyn Wright, MD, Resident in Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine
Most Recent Updates
Introduction
Glossary of Terms
Overview of Chronic Pain and its Treatment
What Does Successful Pain Treatment Look Like?
Pain Definitions and Types
Pain in Special Populations
Pelvic Pain
Major Interventions for Pain
Functional Restoration Approaches and Programs
Self-Directed Group and Self-Management
Active Interventions
Nutrition
Complementary, ALTERNATIVE & Integrative Medicine (CAM)
ACUPUNCTURE AND Acupressure
Physical MODALITIES - Noninvasive Interventions
Invasive Interventions
Medication Information
Medication Types for the Treatment of Pain
Not Recommended for Chronic Pain
Tapering/Weaning Off Pain Medications (Including Opoiods)
Self-Medication: Alcohol, Tobacco, Marijuana, and Illicit Substances
Internet Pain-Management Resources