Treatment Guidelines

VA/DoD Guideline for Chronic Pain

Management of Opioid Therapy for Chronic Pain [PDF]

E-mail PDF

The Management of Opioid Therapy for Chronic Pain Working Group. VA/DoD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain. Version 2.0, 2010. Department of Veterans Affairs, Department of Defense. “Equianalgesic and Conversion Doses for Patients Previously Receiving Other Opioids”, pages 134-136.

QUALIFYING STATEMENTS

The Department of Veterans Affairs (VA) and the Department of Defense (DoD) guidelines are based on the best information available at the time of publication. They are designed to provide information and assist in decision-making. They are not intended to define a standard of care and should not be construed as one. Also, they should not be interpreted as prescribing an exclusive course of management.

Variations in practice will inevitably and appropriately occur when providers take into account the needs of individual patients, available resources, and limitations unique to an institution or type of practice. Every healthcare professional making use of these guidelines is responsible for evaluating the appropriateness of applying them in any particular clinical situation.

Chronic Noncancer Pain

Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain; recommendations of a multidisciplinary, expert panel from the American Pain Society and the American Academy of Pain Medicine.

http://www.jpain.org/article/S1526-5900(08)00831-6/fulltext

Chou R, Fanciullo GJ, Fine PG, et al. Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain.  (APS/AAPM) The Journal of Pain 2009(Feb); 10(2):113-230.

Condition Specific Guidance

Arthritis Pain

Guidelines for Medical Management of Osteoarthritis of the Hip and Knee from the American College of Rheumatology.

Recommendations for the Use of Nonpharmacologic and Pharmacologic Therapies in Osteoarthritis of the Hand, Hip, and Knee.pdf

American College of Rheumatology Subcommittee on Osteoarthritis Guidelines. Recommendations for the medical management of osteoarthritis of the the hip and knee. May 2000.

Low Back Pain

Clinical Practice Guidelines from the American College of Physicians and the American Pain Society.

http://annals.org/article.aspx?articleid=736950

Chou, R., Qaseem, A., Snow, V., et. al. Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society. Annals of Internal Medicine. 2007, 147(7):478-491

Migraine Headaches

Summarizes evidence-based treatment of migraine headache.

http://www.neurology.org/content/55/6/754.full.pdf

Silberstein, S.D.. Practice Parameter: Evidence-based guidelines for migraine headache (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology and the European Federation of Neurological Societies. Neurology 2000; 55; 754.

Trigeminal Neuralgia

An evidence-based review of diagnostic evaluation and treatment of trigeminal neuralgia.

http://www.aan.com/Guidelines/Home/GetGuidelineContent/301

Gronseth, G., Cruccu, G., Alksne, J., et. al. Practice Parameter: The diagnostic evaluation and treatment of trigeminal neuralgia (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology and the European Federation of Neurological Societies. Neurology 2008; 71; 1183-1190.

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