Management of chronic pain with epidural steroids.

Perioperative nurses need to be aware of the multiple treatment modalities associated with chronic back problems. Patients who undergo back surgeries often have been and may continue to be pain therapy patients. In addition, many conditions other than back problems are treated in pain clinics. Perioperative nurses may be in a position to refer patients for pain therapy and are encouraged to do so. Patients may look to nurses for guidance when making decisions about using pain therapy clinics. Pain management programs vary from small single-discipline or modality clinics to large multidisciplinary centers. Regardless of the type of clinic, team members should place a strong emphasis on assessing patients' physical, mental, and psychosocial statuses so that coherent treatment plans can be developed. Patients should be encouraged to participate in all decision making because they have much of the responsibility for their treatment. Patients also should be cautioned not to expect miracles but to look for significant improvement and the opportunity to lead more effective and satisfying lives with minimal pain.