Physician-Delivered Pain Neuroscience Education for Opioid Tapering: A Case Report

Vikas Agarwal, Adriaan Louw and Emilio J. Puentedura
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Vikas Agarwal: Department of Internal Medicine, Mosaic Life Care, St. Joseph, MO 64506, USA
Adriaan Louw: Pain Science Division, Evidence in Motion, San Antonio, TX 78247, USA
Emilio J. Puentedura: Robbins College of Health and Human Sciences, Baylor University, Waco, TX 76798, USA

IJERPH, 2020, vol. 17, issue 9, 1-11

Abstract: We describe the case of a 75-year-old female with chronic low back pain (CLBP), on opioids for more than 15 years. She presented with an acute episode of nausea, vomiting, abdominal pain, and shortness of breath. After a complete work-up, it was concluded that her presenting symptoms were likely due to her high levels of CLBP and high dose opioids. At the time of intervention, her opioid dosage was between 50–90 MME (Morphine milligram equivalent) (Norco 8 × 7.5 mg/day + Fentanyl 12 mcg patch). She was subsequently seen by the physician for seven outpatient internal medicine appointments over nine months and received Pain Neuroscience Education (PNE) in conjunction with monitored tapering of opioids and other medication associated with her CLBP. This case report demonstrates how a physician might deliver PNE as a viable nonpharmacological treatment option for the tapering of long-term opioids for chronic pain.

Keywords: chronic pain; pain neuroscience education; opioid; opioid epidemic; opioid tapering (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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