Evidence-based position paper on Physical and Rehabilitation Medicine professional practice for persons with acute and chronic pain. The European PRM position (UEMS PRM Section).
Gabor Fazekas, Filipe Antunes, Stefano Negrini, Nikolaos Barotsis, Susanne R Schwarzkopf, Andreas Winkelmann, Enrique Varela Donoso, Nicolas Christodoulou
Author Information
Gabor Fazekas: National Institute for Medical Rehabilitation, Budapest, Hungary - fazekas123@t-online.hu.
Filipe Antunes: PRM Department/Chronic Pain Unit, Hospital de Braga, Braga, Portugal.
Stefano Negrini: Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Nikolaos Barotsis: Department of Rehabilitation, Patras University Hospital, Rion, Greece.
Susanne R Schwarzkopf: Physical and Rehabilitation Medicine, Paracelsus Medical University (PMU), General Hospital Nuremberg, Nuremberg, Germany.
Andreas Winkelmann: Department of Orthopedic Surgery, Physical Medicine and Rehabilitation Medical Centre, University of Munich, Munich, Germany.
Enrique Varela Donoso: Department of Physical and Rehabilitation Medicine, Complutense University, Madrid, Spain.
Nicolas Christodoulou: Medical School, European University Cyprus, Nicosia, Cyprus.
BACKGROUND: pain is a frequent complaint from patients undergoing rehabilitation. It can be a major problem and can lead to several activity limitations and participation restrictions. For this reason, when the Professional Practice Committee (PPC) of the Physical and Rehabilitation Medicine (PRM) Section of the European Union of Medical Specialists (UEMS) decided to prepare evidence-based practice position papers (EBPPs) on the most relevant fields of PRM, a paper on the role of the PRM specialist on pain conditions was also included. The goals of this paper are to provide recommendations on the PRM physician's role in pain management; how to address this major problem and what is the best evidence-based approach for the PRM physician in acute and chronic pain conditions. This paper follows the methodology defined by the Professional Practice Committee of the UEMS-PRM Section. METHODS: A systematic literature search in PubMed was carried out and the results obtained from filtered papers were subjected to four Delphi rounds. RESULTS: Fifteen recommendations were obtained from the Consensus Process and systematic review and were approved by all of the delegates of the UEMS-PRM Section. It is recommended that PRM physicians focus on pain as a primary aim of their interventions, in whatever field they are applying their competencies. It is also recommended that the approach to pain focuses either on reducing the symptoms and improving functioning/reducing disability or recurrences and improving the health condition in the long term avoiding chronicity. CONCLUSIONS: Every PRM specialist encounters the problem of pain and some specialize in this field and their role is greater than that of the regular PRM doctor. Based on the evidence available, it is reasonable to determine the role of the physiatrist in managing pain.
