How do we determine treatment success in chronic pain ?

We determine treatment efficacy from seven perspectives, most of which can be reviewed in a standard office visit. We focus on functionality.

First, progress towards your personal goal, such as a tolerable air travel, an increase in walking endurence, or an ability to concentrate well enough to read a novel or play more with your grandchild or child.

Second, improve physical, psychological, and social function.

Third, your family members view your functional status, pain levels, and mood and medication side effects.

Fourth, your sleep quality, energy level, appetite, and libido.

Fifth, your self-rated pain scales.  
 
To document your pain inventory, rate the following (1= no interference, 10= maximum interference):
To what degree has pain interfered with-
Your sleep:                      1   2   3   4   5   6   7   8   9   10
General activities:             1   2   3   4   5   6   7   8   9   10
Mood :                            1   2   3   4   5   6   7   8   9   10
Walking ability:                1   2   3   4   5   6   7   8   9   10
Normal work:                  1   2   3   4   5   6   7   8   9   10
Relationship with others :  1   2   3   4   5   6   7   8   9   10
Enjoyment of Life:            1   2   3   4   5   6   7   8   9   10
 
When you come back for a follow up visit, we will ask you about the above questions. A good way to ensure that your medications are indeed working is to focus on your improvements in functionality. With "before and after" functional scales, you will be able to recognize whether  your pain is alleviating.
At each visit, we want to know side effects such as nausea, sexual problem or constipation. We  will ask you specifically about the frequency and severity of these problem.