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Pain & Pain Management


Comorbid Depression, Chronic Pain, and Disability in Primary Care

Psychosomatic Medicine 68:262-268 (2006) © 2006 American Psychosomatic Society. Conclusions: Chronic pain is common among those with MDD. Comorbid MDD and disabling chronic pain are associated with greater clinical burden than MDD alone.

Pain Management Health Center

Chronic pain affects an estimated 86 million American adults to some degree. Here you'll find the latest information on chronic pain treatments, as well as natural ways to manage your chronic pain. Plus, get help daily in our online support group.

Management of Chronic Low Back Pain

US Pharm. 2008;33(5):34-43. Summary: Pharmacists can continue to play a critical role in the management of CLBP due to their accessibility and frequent contact with patients in the community. With proper education, patients with CLBP can manage their pain more effectively in an effort to decrease the significant societal burden resulting in costly medical bills and lost productivity. Increased awareness of current guidelines for pharmacologic as well as nonpharmacologic therapy will help to provide effective management of CLBP. In addition, the implementation of pharmacist-directed pain clinics may provide more effective patient care through regular monitoring and titration of analgesics in an effort to help patients meet reasonable pain-specific goals. Future considerations for the management of CLBP include the evaluation of combination pharmacologic agents as well as additional research to assess decision tools or methods for tailoring therapy.

Holistic assessment of pain and chronic wounds

Maureen Benbow discusses the need for holistic assessment of pain in patients with chronic wounds. Maureen Benbow MSc, BA, HERC, RGN is a Senior Lecturer, University of Chester. Article accepted for publication: December 2005

Methadone Treatment for Pain States

Methadone is a synthetic opioid with potent analgesic effects. Although it is associated commonly with the treatment of opioid addiction, it may be prescribed by licensed family physicians for analgesia. Methadone's unique pharmacokinetics and pharmacodynamics make it a valuable option in the management of cancer pain and other chronic pain, including neuropathic pain states. It may be an appropriate replacement for opioids when side effects have limited further dosage escalation. Metabolism of and response to methadone varies with each patient. Transition to methadone and dosage titration should be completed slowly and with frequent monitoring. Conversion should be based on the current daily oral morphine equivalent dosage. After starting methadone therapy or increasing the dosage, systemic toxicity may not become apparent for several days. Some medications alter the absorption or metabolism of methadone, and their concurrent use may require dosing adjustments. Methadone is less expensive than other sustained-release opioid formulations. Am Fam Physician 2005;71:1353-8. Copyright© 2005 American Academy of Family Physicians

Methadone Treatment for Pain States

April 1, 2005 - American Family Physician

Management of Pain in Acute Illness

US Pharm. 2008;33(5):HS-4-HS-9. Conclusion: The selection of analgesics in the acute-care setting requires a careful consideration of the coexisting disease states and the potential for interaction between drug and disease. Care should be taken to ensure that the changes occurring during an acute illness do not compromise the safety of the selected analgesic and that the selected analgesic does not promote the severity of the illness.

Consequences of Persistent Pain

US Pharm. 2008;33(5):28-30. Conclusion: Clinical manifestations of persistent pain are usually multifactorial. Pharmacists should develop an understanding of the nature of persistent pain with regard to its consequences and ultimate potential to cause physical impairment, psychologic disability, and social withdrawal. By integrating this knowledge with appropriate pharmaceutical recommendations and ongoing pain assessment, individualized medication regimens for persistent pain may be achieved.

Measuring troublesomeness of chronic pain by location

BMC Musculoskeletal Disorders 2006, 7:34 doi:10.1186/1471-2474-7-34. Conclusions: The troublesomeness grid is well completed and appears to be an appropriate tool to assess the comparative severity of pain in different body regions.

Antidepressants for the Treatment of Neuropathic Pain


The Healing Touch


Reflex Sympathetic Dystrophy (RSD) Syndrome Association

The Reflex Sympathetic Dystrophy Syndrome Association was founded in 1984 to promote public and professional awareness of Reflex Sympathetic Dystrophy Syndrome (RSD or RSDS), also known as Complex Regional Pain Syndrome (CRPS I).

Healing Touch International

Healing Touch is a holistic energy therapy that emphasizes compassionate, heart-centered care in which the Healing Touch provider and client are equal partners in facilitating health and healing. Healing Touch providers use gentle, non-invasive touch to influence and support the human energy system within and surrounding the body. The goal of Healing Touch is to restore harmony, energy and balance within the human energy system. This goal supports the client's self-healing process of becoming whole in body, mind, emotion and spirit. The Merriam-Webster dictionary lists the primary definition of "Healing" as "to make or become healthy, sound, or whole". Healing Touch complements conventional health care and is also used in collaboration with other approaches to health and healing.

New Research Findings in Chronic Pain: An Expert Interview With Frederick W. Burgess, MD, PhD

The American Academy of Pain Medicine 23rd Annual Meeting took place from February 7 to 10, 2007 in New Orleans, Louisiana. During this meeting, new information about the diagnosis and treatment of pain disorders was presented. Marni Kelman, MSc, Medscape Neurology & Neurosurgery Editorial Director, discussed results presented at this year's meeting and their implications with Frederick W. Burgess, MD, PhD, Clinical Associate Professor of Surgery (Anesthesiology), Brown University, The Warren Alpert Medical School, Providence, Rhode Island; Attending Anesthesiologist, Rhode Island Hospital, Providence, Rhode Island.

Improving State Pain Policies

CA Cancer J Clin 2007; 57:341-353.

The Healing Power of Hypnosis

The latest research shows that it eases pain, speeds healing, increases fertility, even fights cancer.

Management of Common Opioid-Induced Adverse Effects

Am Fam Physician 2006;74:1347-54. Copyright © 2006 American Academy of Family Physicians. Opioid analgesics are useful agents for treating pain of various etiologies; however, adverse effects are potential limitations to their use. Strategies to minimize adverse effects of opioids include dose reduction, symptomatic management, opioid rotation, and changing the route of administration. Nausea occurs in approximately 25 percent of patients; prophylactic measures may not be required. Patients who do develop nausea will require antiemetic treatment with an antipsychotic, prokinetic agent, or serotonin antagonist. Understanding the mechanism for opioid-induced nausea will aid in the selection of appropriate agents. Constipation is considered an expected side effect with chronic opioid use. Physicians should minimize the development of constipation using prophylactic measures. Monotherapy with stool softeners often is not effective; a stool softener combined with a stimulant laxative is preferred. Sedation and cognitive changes occur with initiation of therapy or dose escalation. Underlying disease states or other centrally acting medications often will compound the opioid's adverse effects. Minimizing unnecessary medications and judicious use of stimulants and antipsychotics are used to manage the central nervous system side effects. Pruritus may develop, but it is generally not considered an allergic reaction. Antihistamines are the preferred management option should pharmacotherapy treatment be required.

Pain Control: What Works Best?

US Pharm. 2006;5:8.

Pain is unpleasant, but a vital clue to what's wrong

February 17, 2007. PAIN is a great motivator. Unsurprisingly, it's one of the main reasons people present to a doctor, and a powerful reminder to continue therapy. If elevated blood pressure, sugar or cholesterol caused pain, far fewer people would neglect to take their controlling medication.

For Grace

For Grace is a nonprofit organization passionately devoted to raising awareness of Reflex Sympathetic Dystrophy and the plight of women in pain.

Prevalence of Americans Suffering from Pain

US Pharm. 2006;5:11.





 

 

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