There are several goals in the practice of PM.
Two obvious goals are:
- Reduce or limit dependency on medications for pain control
- Avoid addiction to pain medications
A primary tenet of PM is that a patient should not expect to be pain-free. Clinicians will ask patients what their expectations are for their pain control and will counsel them and explain that living pain-free is not a realistic goal. Few, it any, of us live pain-free. Instead, the goal of PM is to maximize a patient's quality of life; to get the patient to a place where he/she can function despite pain.
Opiates are not the only tools available to the PM clinician. Counseling, group therapy, physical therapy, exercise, encouraging positive behaviors, acupuncture, and even hypnosis can be tried. The PM clinician is concerned with getting the patient to a lower pain level using the lowest possible dose of a drug, or no drug at all.
PM can usually only reduce subjective pain around 30%. Thus, it's important for patients to have realistic expectations. When using drugs to lower pain the obvious goals of producing as few side effects as possible and having a daily plan to manage acute pain and flare-ups are important as well.
Patients are often prescribed one opiate and are told to increase the dose temporarily, only if pain flares up.