Chronic pain syndromes

Patients at risk for developing chronic pain, such as those in high-risk occupations, may benefit from the following:

• Instruction for physical therapy and occupational therapy to develop a general conditioning program

• Ergonomics

• Proper body mechanics (e.g., carrying, pushing, and lifting techniques)

• Pacing skills to reduce the risk for developing chronic pain.

Pre-emptive analgesia and effective postoperative pain control may also lessen the development of postprocedure chronic pain.

Vaccinations for the prevention of herpes zoster and its consequent postherpetic neuralgia are approved (unless otherwise contraindicated) for all people over 50 years of age, and for adults ages over 18 years who are at increased risk for herpes zoster because of immunodeficiency or immunosuppression caused by known disease or therapy.[34]Dooling KL, Guo A, Patel M, et al. Recommendations of the Advisory Committee on Immunization Practices for use of herpes zoster vaccines. MMWR Morb Mortal Wkly Rep. 2018 Jan 26;67(3):103-8. https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC5812314 http://www.ncbi.nlm.nih.gov/pubmed/29370152?tool=bestpractice.com [35]Anderson TC, Masters NB, Guo A, et al. Use of recombinant zoster vaccine in immunocompromised adults aged ≥19 years: recommendations of the Advisory Committee on Immunization Practices – United States, 2022. MMWR Morb Mortal Wkly Rep. 2022 Jan 21;71(3):80-4. https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8774159 http://www.ncbi.nlm.nih.gov/pubmed/35051134?tool=bestpractice.com Check local recommendations for the prevention of herpes zoster.

Patients should incorporate proper daily activity pacing, as well as incorporation of body mechanics (e.g., proper lifting and push-pull techniques), to avoid developing pain exacerbations.