INFORMATION FOR PROFESSIONALS

Pain Management Pocket Tools Policy Statement/Rulings
CME programs Complementary and Alternative Medicine in Pain Management Pain Resource Guide

New Policy Statements and Rulings

The Massachusetts Board of Registration in Nursing
The Massachusetts Board of Registration of Physician Assistants
The Massachusetts Board of Registration in Dentistry Advisory
The Massachusetts Board of Re
gistration in Pharmacy

Click on the above new rulings which affect  thousands of healthcare professional licensees across the state. These were created to insure patient access to appropriate, effective pain assessment and management.  The Massachusetts Division of Health Professions Licensure has taken the unprecedented milestone step of adopting all four Board policies in a seven- week period to focus attention on the hidden epidemic of pain which adversely affects thousands of Massachusetts citizens and has serious physiological, psychological, social and economic consequences.

The Massachusetts Pain Initiative has worked collaboratively with the Division of Health Professions Licensure to bring these policies to fruition and has developed a roll out plan in concert with the Boards.  The plan includes communication of the Rulings to licensees through professionals association newsletters, web sites and publications and continuing education training programs in pain management for healthcare professionals offered around the state taught by MassPI pain management professionals.

Mass PI is providing free educational sessions about the advisory rulings as well as current best practices related to pain assessment and management on June 30 at 6:00 to 7:30pm at Norwood Hospital. Click here for other scheduled sessions.

Tools for Screening for and Assessing Pain
Many published reliable and valid tools, including rating scales, diaries and comprehensive pain assessment tools exist. A variety of different tools may be used to identify and assess pain and/or behavior changes in individuals who are cognitively intact, people who are cognitively impaired, those who are acutely ill in intensive care and other health care settings. Guidelines for improving pain assessment and management recommend that organizations select specific tools to be used by all providers in the organization to screen for pain routinely and assess pain when pain is reported or suspected. The Pain Resource Center at the City of Hope Medical Center provides copies of many tools as well as information regarding selecting an appropriate tool. Access this resource at http://www.cityofhope.org

Continuing Education Programs for Licensees:
In support of 2009 Rulings on the Management of Pain from the Massachusetts Division of Health Professions Licensure, MassPI has created a list of on-line continuing education programs for licensees. Click here for a list of CE opportunities.

Pain Management Pocket Tools
MassPI Professional Education Council, along with national pain experts, have developed pocket tools for healthcare professionals. The first tool was printed in September 2004 and is periodically updated. View pdf here. You may request 5 tools mailed to you at no charge by emailing Virginia.Newell-Stokes@bhs.org. To receive more than five, the cost is $1 a tool. After purchasing 100, the cost per tool decreases significantly. See pricing information and how to order pocket tools by clicking here.

Pain Practice Change Program:
Through a Stratford Foundation grant, MassPI has been able to implement a practice change program in Massachusetts during 2003. Anne Marie Kelly, MassPI Professional Education Chair, organized the implementation of this project. Staff at the American Alliance of Cancer Pain Initiatives (AACPI) through a Robert Wood Johnson Foundation grant developed this exciting program.
The project, Institutionalizing Effective Pain Management Practices, has two purposes:
To encourage the growth of the state pain initiative
To improve pain management practices in small health care settings

Click here to view some general questions and answers to provide more information.

The Role of Complementary and Alternative
Medicine in Pain Management


NOTE: This article will provide an overview of complementary and alternative therapies. As with conventional therapies, MassPI cannot recommend specific treatments for pain. Patients should consult with their own health care professional and other practitioners about interventions that may be of benefit to them.

Both professionals and the lay public increasingly recognize the importance of “complementary” and “alternative” therapies in the role of pain management:
complementary therapies are used in addition to conventional treatments;
alternative therapies are generally used instead of conventional treatments.

Increasingly we are learning from the research that these therapies can be useful in providing evidence based best care to the whole person. The National Center for Complementary and Alternative Medicine (NCCAM) was established by Congressional mandate in October 1998. The Center's predecessor, the Office of Alternative Medicine, was established in 1992. The mission of NCCAM is to support rigorous research on complementary and alternative medicine (CAM), to train researchers in CAM, and to disseminate information to the public and professionals on which CAM modalities work, which do not, and why.

NCCAM recognizes 5 major domains of complementary and alternative medicine. These include Alternative Medical Systems, Mind-Body Interventions, Biologically-Based Treatments, Manipulative and Body-Based Methods, and Energy Therapies. Examples of a few of each of these categories are given below.

Alternative Medical Systems are complete systems of theory and practice that are independent of our conventional Western, biomedical approach to care. They are, however, complete systems of care, many of which also have their own scientific and evidence based practice. These systems include Ayurveda , Native American, Aboriginal, African, Middle-Eastern, Tibetan, Central and South American cultures, traditional Chinese medicine, Homeopathy, and Naturopathy.

Mind-Body Interventions are those that facilitate the mind’s ability to affect bodily functions and symptoms. Many, such as patient education and cognitive behavioral approaches are now considered “mainstream.” Other interventions in this domain include meditation, hypnosis, dance, music, art therapy, prayer and mental healing.

Biologically-Based Treatments are natural and biologically based interventions of care. Included in this domain are herbal treatments, special diets (such as those developed by Drs. Atkins, Ornish, Pritikin and Weil), orthomolecular therapies using mega doses of vitamins, magnesium, or melatonin, and individual biological therapies such as shark cartilage or laetrile.

Manipulative and Body-Based Methods are those interventions based on manipulation and/or movements of the body or spine including Chiropractic, osteopathic, and massage therapies.

Energy Therapies are
biofield therapies, which focus on energy fields within the body; and
electromagnetic therapies which focus on fields outside of the body.
These include but are not limited to Qi Gong, Bio-energy healing, Therapeutic Touch, Reiki, and Healing Touch.

The NCCAM Web site (nccam.nih.gov) is a rich resource of publications, information for researchers, answers to frequently asked questions about CAM, and links to other CAM-related resources. Databases located on the NCCAM Web site include:
CAM on PubMed, a subset of the National Library of Medicine's PubMed, which provides access to complementary and alternative medicine journal citations; and
CHID (the Combined Health Information Database), a reference tool to find patient education materials.
These resources can be useful to both the professional and the layperson seeking additional information about the use of CAM in pain management.

The NCCAM Clearinghouse is the public point of contact for scientifically based information on CAM and for information about NCCAM. For more information on CAM or NCCAM, contact:

NCCAM Clearinghouse
Toll-free: 1-888-644-6226
International: 301-519-3153
TTY (for deaf or hard-of-hearing callers): 1-866-464-3615

E-mail: info@nccam.nih.gov
Web site: nccam.nih.gov
Address: NCCAM Clearinghouse,
P.O. Box 7923
Gaithersburg MD 20898-7923

Fax: 1-866-464-3616
Fax-on-Demand Service: 1-888-644-6226

Information from NCCAM Website, NCCAM Publication No. D158
June 2002, retrieved August 11, 2003.

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Click here for a Pain Resource Guide