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首页> 外文期刊>Open Journal of Urology >Strategies for Managing Chronic Pain: Case of a Skilled Orthopaedic Physician and Mini-Review
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Strategies for Managing Chronic Pain: Case of a Skilled Orthopaedic Physician and Mini-Review

机译：慢性疼痛的治疗策略：骨科医师和小型复习案例

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Epidemiological surveys have recently revealed a high prevalence of chronic musculoskeletal pain in Japan; however, 30% of the patients in the survey were not satisfied with their pain treatment. This indicates that standard strategies in the management of chronic pain are poorly shared among physicians in Japan. Herein we report a case of a patient with intractable chronic pain who is a skilled orthopaedic physician. A 43-year-old man who was a skilled orthopaedic surgeon presented at our center complaining of severe buttock pain especially around the right hip region for more than three years. At begging of pain onset, he was diagnosed with femoacetabular impingement syndrome (FAI) with labral tear. Despite biophysical interventions including twice surgeries and alternative conservative treatment, his pain persisted, and he occasionally had to take a day off work due to the severe pain. Therefore we had to evaluate his pathological condition using a multidimensional approach based on a biopsychosocial model. We had provided him with cognitive behavioral therapy (CBT) approach, and simultaneously suggestion for short leaving from work. Three months after the start of CBT training, his disabilities had begun to improve. About six months later, he could continue to do his work. Finally, 19 months have passed since we started implementing the CBT approach; he has regained both his previous work-life balance and his health, although the pain has not completely subsided. In conclusion, we think it is important for physicians treating chronic pain to learn the management strategies for chronic pain and to re-consider their management policy when conventional biomedical interventions were not succeeded, even in cases where medication and surgical intervention are warranted.
机译：流行病学调查最近显示，日本的慢性肌肉骨骼疼痛普遍存在。但是，接受调查的患者中有30％对疼痛治疗不满意。这表明在日本，医生在治疗慢性疼痛方面的标准策略很少。本文中，我们报告了一位熟练的骨科医师患有顽固性慢性疼痛的患者。一位43岁的男子是一位熟练的整形外科医生，在我们中心就诊，他抱怨臀部严重疼痛，尤其是在右髋区域周围，已有三年多了。乞讨疼痛发作时，他被诊断出患有唇裂的女性髋臼撞击综合征（FAI）。尽管进行了包括两次外科手术和替代性保守治疗在内的生物物理干预，但他的疼痛仍然存在，由于剧烈的疼痛，他偶尔不得不休假一天。因此，我们必须使用基于生物心理社会模型的多维方法来评估他的病理状况。我们为他提供了认知行为疗法（CBT）的方法，同时建议他短暂休假。开始接受CBT训练三个月后，他的残疾状况开始好转。大约六个月后，他可以继续工作。最终，自我们开始实施CBT方法以来已经过去了19个月;尽管疼痛尚未完全缓解，但他已经恢复了以前的工作与生活平衡。总之，我们认为对于治疗慢性疼痛的医生来说，了解慢性疼痛的治疗策略并在常规生物医学干预措施未获得成功的情况下重新考虑其治疗策略非常重要，即使在需要药物和手术干预的情况下也是如此。

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