1. In a patient presenting with acute pain provide analgesia while seeking a diagnosis.
  2. When assessing a patient with pain take a detailed history to recognize clinical patterns (diagnostic discerning characteristics) to inform diagnosis (e.g., neuropathic, vascular, muscular, visceral pain).
  3. In a patient presenting with pain without a clear diagnosis:
    • Include life-threatening conditions in your differential diagnosis
    • Investigate appropriately and in a timely manner
  4. When there is a concern about drug-seeking behaviour in a patient with pain:
    • Maintain your therapeutic relationship (e.g., be empathic, avoid stereotyping, manage frustration)
    • Do not attribute the presentation to drug-seeking without first considering an appropriately broad differential diagnosis
  5. When treating pain with narcotics:
    • Dose appropriately considering narcotic naïveté and renal function
    • Consider addiction risk
    • Consider variable and potentially dangerous metabolic responses (e.g., codeine, especially in pregnant and breastfeeding women; sudden removal of a painful stimulus)
  6. In a patient whose pain is not resolving or following the anticipated course, regularly re-evaluate (e.g., diagnosis, complications, medication choices, drug diversion).
  7. When prescribing medication for pain inform the patient not to use over-the-counter products that contain the same drug or drugs from the same class (e.g., acetaminophen, NSAIDs)
  8. When treating a patient with pain appropriately use non-pharmacologic treatments and self-management strategies to control pain and optimize function.
  9. In a patient where acute pain has become chronic:
    • Recognize the transition
    • Readdress the treatment plan and your patient’s expectations appropriately