OMNI homes participate in workshop to learn about neuropathic pain
Presentation provides OMNI team members with insight into identifying, treating neuropathic pain
Monday May 12, 2008 -- Deron Hamel
PETERBOROUGH, Ont. - Representatives from six OMNI homes recently participated in a workshop to gain insight into ways to identify and treat neuropathic pain in residents living in long-term care.

Staff members from Frost Manor, Streamway Villa, Burnbrae Gardens, Springdale Country Manor, Pleasant Meadow Manor and Riverview Manor met with team members from other long-term care providers within the Four Counties Palliative Care Network at the May 8 meeting held at the Rock Haven Motor Hotel in Peterborough.

Keynote speaker Dr. Howard Burke spoke to the approximately 40 attendees about methods of identifying and medicating neuropathic pain.

Neuropathic pain refers to pain caused by tissue injury resulting in damaged nerves. Common causes of neuropathic pain include diabetes, amputation, shingles and back, leg or hip problems.

Burke, chief of the family medicine program at Lakeridge Health Corporation in Bowmanville and a palliative care consultant, says neuropathic pain is a concern throughout the health-care sector.

In fact, about 25 to 50 per cent of individuals with diabetes will develop diabetic neuropathy at some point, notes Burke.

Burke’s message to network members was that neuropathic pain is unique to other types of pain and that there is “a wide variety of medications that can be used to treat it.”

He adds that caregivers in long-term care need to be aware of the symptoms of neuropathic pain. Additionally, he says front-line staff members should know about medications used to treat neuropathic pain.

“The caregivers are the ones that see the (residents) the absolute most, as opposed to a physician who maybe sees them for five minutes once a week or less,” says Burke. “It’s the caregivers who are going to see the pain and hear the suffering, and can alert the rest of the medical team to what is really going on and get appropriate treatment for the person so they are not suffering.”

The challenge, Burke says, is trying to identify neuropathic pain. To counter this, he recommends caregivers ask residents experiencing pain the following questions:

• Does the pain have one or more of the following characteristics:

Burning?

Painful cold?

Electric shocks?

• Is the pain associated with any of the following symptoms in the same area?

Tingling?

Pins and needles?

Numbness?

Itching?

• Is the pain in the area where the physical examination may reveal any of the following characteristics?

Hypoesthesia to touch?

Hypoesthesia to pinprick?

• In the painful area can the pain be caused or increased by brushing?

If the answer is “yes” to four or more of the above areas, the person is likely suffering from neuropathic pain.

Lori Myserscough, director of care at Frost Manor in Lindsay, says she found the presentation to be insightful, adding it was beneficial to the group that Burke relayed information in an easy-to-understand, non-clinical manner.

“Dr. Burke spoke to the group on a level that everyone understood, considering the group is comprised of PSWs (personal support workers), RPNs (registered practical nurses), RNs (registered nurses), pharmacists, etc.,” she says. “It was a well-organized and well-presented program that shed light on an ever-increasing problem in our aging population.”

The Four Counties Palliative Care Network holds five workshops annually to discuss best practices in palliative care in long-term care homes. The network consists of representatives from long-term care homes in Peterborough, Haliburton, Northumberland counties and the City of Kawartha Lakes.

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