🌉 𝐁𝐫𝐢𝐝𝐠𝐢𝐧𝐠 𝐏𝐚𝐢𝐧, 𝐍𝐨𝐭 𝐉𝐮𝐬𝐭 𝐓𝐫𝐞𝐚𝐭𝐢𝐧𝐠 𝐈𝐭: 𝐓𝐡𝐞 𝐌𝐢𝐬𝐬𝐞𝐝 𝐋𝐢𝐧𝐤 𝐢𝐧 𝐓𝐫𝐚𝐧𝐬𝐢𝐭𝐢𝐨𝐧𝐚𝐥 𝐏𝐚𝐢𝐧 𝐂𝐚𝐫𝐞 #TransitionalPain #BeyondTheBlock #PainContinuum #MedTwitter #ChronicPainPrevention #RAInsights #RegionalAnesthesia #PainMedicine #AcuteToChronic #PainPathways #MultimodalAnalgesia #TPS #PainTrajectory #GrayZonesInRA #GrayAreasInRA 𝐆𝐑𝐀𝐘 𝐙𝐎𝐍𝐄𝐒 𝐢𝐧 𝐑𝐀 ➤ Transitional Pain Services (TPS) were never meant to be a formality. ➤ They were designed as a continuum of care, preventing the silent drift from acute pain to chronic suffering. ➤ Yet, what we often witness is the rise of Transitional Pain Syndromes - where pain lingers, evolves, and embeds itself into the patient’s life. ➤ Regional anesthesia is excellent for blocking pain, but not always for modulating long-term pain trajectories. Whats going 𝐖𝐑𝐎𝐍𝐆? 👇 🔵 👤 𝐏𝐀𝐓𝐈𝐄𝐍𝐓 𝐅𝐀𝐂𝐓𝐎𝐑𝐒 - 𝐓𝐡𝐞 𝐈𝐠𝐧𝐨𝐫𝐞𝐝 𝐅𝐨𝐮𝐧𝐝𝐚𝐭𝐢𝐨𝐧 🔹Pre-existing chronic pain, opioid tolerance, anxiety, catastrophizing, poor compliance. 🔹These are not side notes, they are primary drivers. 🔹Ignoring them is like treating symptoms while fueling the disease. 🔴 🔪 𝐒𝐔𝐑𝐆𝐈𝐂𝐀𝐋 𝐃𝐄𝐂𝐈𝐒𝐈𝐎𝐍𝐒 - 𝐔𝐧𝐢𝐧𝐭𝐞𝐧𝐝𝐞𝐝 𝐇𝐚𝐫𝐦 🔸 Abrupt stoppage of essential medications (antidepressants, anticonvulsants, baseline opioids) disrupts neurochemical balance. 🔸In trying to “simplify,” we often complicate recovery. ⚫ 💉 𝐀𝐍𝐄𝐒𝐓𝐇𝐄𝐒𝐈𝐎𝐋𝐎𝐆𝐘 𝐆𝐀𝐏𝐒 - 𝐀𝐜𝐮𝐭𝐞 𝐋𝐞𝐧𝐬, 𝐂𝐡𝐫𝐨𝐧𝐢𝐜 𝐂𝐨𝐧𝐬𝐞𝐪𝐮𝐞𝐧𝐜𝐞𝐬 ◾Brilliant at managing immediate pain, yet often limited by a 24-hour VAS mindset. ◾Pain relief is celebrated early, while long-term pain evolution goes untracked. 🟣 🧠 𝐊𝐍𝐎𝐖𝐋𝐄𝐃𝐆𝐄 𝐃𝐄𝐅𝐈𝐂𝐈𝐓- 𝐏𝐚𝐢𝐧 𝐈𝐬 𝐍𝐨𝐭 𝐎𝐧𝐞-𝐃𝐢𝐦𝐞𝐧𝐬𝐢𝐨𝐧𝐚𝐥 🔹 Nociceptive ≠ Neuropathic ≠ Nociplastic. 🔹Without understanding pain pathways and phenotypes, we end up applying uniform solutions to diverse problems. 💠 🎯 𝐒𝐇𝐎𝐑𝐓-𝐓𝐄𝐑𝐌 𝐆𝐎𝐀𝐋𝐒 - 𝐓𝐡𝐞 𝐁𝐢𝐠𝐠𝐞𝐬𝐭 𝐓𝐫𝐚𝐩 🔹 A low VAS score at 24 hours is not success - it’s just a snapshot. 🔹 True success lies in functional recovery, prevention of central sensitization, and avoiding chronicity. 🔘 📚 𝐅𝐑𝐀𝐆𝐌𝐄𝐍𝐓𝐄𝐃 𝐋𝐈𝐓𝐄𝐑𝐀𝐓𝐔𝐑𝐄 - 𝐌𝐢𝐬𝐥𝐞𝐚𝐝𝐢𝐧𝐠 𝐒𝐢𝐦𝐩𝐥𝐢𝐜𝐢𝐭𝐲 ➜ Short, procedure-focused, and outcome-limited studies create half-knowledge. ➜ This leads to miscommunication, inconsistent practices, and silo-based decision-making. ✳️ 🤝 𝐋𝐀𝐂𝐊 𝐎𝐅 𝐈𝐍𝐓𝐄𝐆𝐑𝐀𝐓𝐈𝐎𝐍 - 𝐓𝐡𝐞 𝐂𝐨𝐫𝐞 𝐅𝐚𝐢𝐥𝐮𝐫𝐞 ✅ Surgeons, anesthesiologists, and pain physicians often work in parallel, not in sync. ✅ TPS fails when care is episodic instead of continuous. ⚪ 🚀 𝐓𝐡𝐞 𝐖𝐚𝐲 𝐅𝐨𝐫𝐰𝐚𝐫𝐝 ✔️ Shift from Pain Scores → Pain Trajectories ✔️ Shift from Protocol → Personalization ✔️ Shift from Acute Relief → Long-Term Recovery ✔️ Shift from Isolated Care → Integrated TPS Model 🔥 𝐅𝐈𝐍𝐀𝐋 𝐓𝐀𝐊𝐄𝐀𝐖𝐀𝐘𝐒 👉 Pain is not a 24-hour event. It is a biological journey, influenced by neural plasticity, psychology, and perioperative decisions. 👉 If we continue to measure success in hours, we will continue to create suffering for months… even years. 👉 Transitional Pain Care is not about crossing the bridge quickly - it’s about making sure the patient never falls off it. 👉 Even a “perfect block” can fail the patient if: ▫️ TPS is absent ▫️ Baseline meds are stopped ▫️ Pain phenotype is misunderstood 👉 Move from: “Did my block work?” To: “Did my intervention alter the patient’s pain journey?” 👉 RA may start the story… but transitional pain care decides the ending.

Thrilled to see our work published in @RAPMOnline! Building a transitional pain service is both complex and rewarding. Honored to collaborate with such an incredible team. Thanks @EMARIANOMD @ESchwenkMD @TobiHunterDNP @KyleHarrisonMD @VAPaloAlto @stanfordanes! #TransitionalPain

@200UB313 teaching us about the pelvic pain in pregnant women which is not given enough attention but is a serious problem which needs addressing urgently. A very passionate talk @DaraEsra @ESRA_Society #transitionalpain services need to be set up for these patients

Calling all Pain Nurses interested in Transitional Pain and Service Development!! Come and join our free workshop available to Pain Nurse Network members!! #Painnurse #transitionalpain #qualityimprovement @RNPainNet

Cash-strapped Pakistan gets $7 billion loan from IMF, Finance Minister says will face 'transitional pain' newsboxer.com/blog/blogdesc/… #cashtrapped #PakistanGovt #IMF #transitionalpain #IMFLoan

The post-op pain experience varies for each patient. However, incorporating a multimodal approach that involves #cryoNB can play a crucial role in minimizing #TransitionalPain and facilitating the recovery process. ​ Learn more at bit.ly/transitionalpain

I am pleased to share with you our new publication; addressing a very important and emerging topic (Transitional Pain Medicine). @vafisalmasi @DrOttestad @DrSeanMackey @StanfordPain @stanfordanes Enjoy! sciencedirect.com/.../pii/S1…... #painmanagement #chronicpain #TransitionalPain

Saphenous nerve block @ mid-thigh remains an important tool in diagnosing & treating ▶️persistent post-surgical pain ➡️ s/p Ankle Surgery ⏩ s/p Knee Surgery/Replacement #postsurgicalpain #transitionalpain #orthopedics #chronicpain @ASPSP_Pain

I am thrilled to share with you my new lecture on “Transitional Pain Medicine”! In this lecture, I will take you over the rational and potential of this new field, as well as my personal vision. Enjoy: youtu.be/XYml45jr_GE #TransitionalPain #CPSP #PPSP #ChronicPain

Thank you @DrKimBaylessNP for all what you do for the pain community #TransitionalPain @ASRA_Society

I have a manuscript coming soon in this topic – stay tuned. @kaohesham @Vafisalmasi @DrOttestad @NarouzeMD @EMARIANOMD @Drhaclarke #TransitionalPain #CPSP #PPSP #ChronicPain #AcutePain #PainPhysician

Are you attending #STS2023? Don't miss Nathalie Cote, our TPS physiotherapist, speaking about "Non-Pharmaceutical Approaches to Pain Management" on Jan 21st. More info here: cdmcd.co/rMkJMB #TransitionalPain #ChronicPain

Put this in your calendars! @Drhaclarke 👇#transitionalpain #postsurgicalpain

Improving perioperative care to prevent chronic post-surgical #pain. Don’t miss @Drhaclarke at the @a2cps_pain Journal Club on Jan 26 to learn more. Register here: surveymonkey.com/r/VPYRM72 #transitionalpain

I had a great time giving a talk about nerve blocks to our new #acutepain and #transitionalpain nurses while we created medication vial ornaments 🎄

Check out our publication! We adapted a #ChronicPain questionnaire for the #TransitionalPain setting through #pediatric patient & family feedback. Grateful for this team! @DrLisaIsaac @JenniferTyrre14 @lallooc @rachelgoren @SKAnesthesia #PatientEngagement doi.org/10.1186/s41687-022-0…

@DrKimBaylessNP reviews the benefits of the #transitionalpain service and the need for #opioid stewardship. #APPRNSIG @ASRA_Society

New from @RAPMOnline: Making a business plan for a transitional pain service in the U.S. ow.ly/FdM450FywvV #TransitionalPain #Regionalanesthesa #Pain #ChronicPain @NarouzeMD @RodneyGabrielMD @kaohesham @KyleHarrisonMD @EMARIANOMD @dr_rajgupta @ESchwenkMD

It is normal to experience pain after surgery, but what happens when it is months, years post surgery and still experiencing #pain? Wish there was services like this when I had my 1st shoulder surgery. Check it out #TransitionalPain services

What can patients expect at the #transitionalpain service? Find out more about our approach to patient care on our website: transitionalpainservice.ca/f…