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Aug 15, 2010 Issue
ICSI Releases Guideline on Chronic Pain Assessment and Management [Practice Guidelines]
The Institute for Clinical Systems Improvement (ICSI) released a guideline on the assessment and management of chronic pain in adults and physiologically mature adolescents 16 to 18 years of age.
Weak evidence suggests that opioids reduce chronic noncancer pain in some highly selected patients, although the effects on quality of life and functional status are unclear.1 Many patients will discontinue opioids because of adverse effects or inadequate pain relief.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used, but have risks associated with their use, including significant upper gastrointestinal tract bleeding. Older persons, persons taking anticoagulants, and persons with a history of upper gastrointestinal tract bleeding associated with NS...
The American Pain Society and American Academy of Pain Medicine recently released a guideline for the use of opioids in patients with chronic noncancer pain. Chronic opioid therapy is controversial because of the potential for adverse effects and abuse.
Acupuncture is increasingly used as an alternative or complementary therapy for the treatment of pain. It is well tolerated, with a low risk of serious adverse effects. Traditional and modern acupuncture techniques may result in reported improvement in pain patterns. Research on acupuncture has had ...
This case encapsulates many of the significant challenges in providing care for patients with chronic noncancer pain.
May 1, 2009 Issue
Nonmalignant Chronic Pain: Taking the Time to Treat [Curbside Consultation]
Nonmalignant chronic pain is a common, yet challenging, health problem.1 Numerous factors over the past decade have put primary care physicians in a central role in the management of this pain.
A systematic approach to chronic nonmalignant pain includes a comprehensive evaluation; a treatment plan determined by the diagnosis and mechanisms underlying the pain; patient education; and realistic goal setting. The main goal of treatment is to improve quality of life while decreasing pain. An i...
Dec 1, 2007 Issue
Patient-Controlled Analgesia for Postoperative Pain [Cochrane for Clinicians]
Patient-controlled opioid analgesia is safe and provides a statistically significant improvement in analgesia in postoperative patients, but the clinical significance of the improvement is marginal.
Oct 1, 2007 Issue
Opioid Analgesia During Evaluation of Acute Abdominal Pain [Cochrane for Clinicians]
Providing early opioid analgesia to patients presenting with acute abdominal pain does not affect or delay management decisions, but it lessens pain intensity as rated by the patient.