Pain Management

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.

Nov 15, 2008 Issue
Chronic Nonmalignant Pain in Primary Care [Article]

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.

May 1, 2007 Issue
Tramadol Relieves Neuropathic Pain [Cochrane for Clinicians]

Tramadol is an effective treatment for neuropathic pain. One out of four patients who take the medication achieves at least 50 percent pain relief.

Apr 15, 2007 Issue
Pramipexole (Mirapex) for Restless Legs Syndrome [STEPS]

Although many patients with RLS do not need pharmacologic therapy, pramipexole is one option for treating moderate to severe symptoms. As with other agents used to manage RLS, potentially serious adverse reactions are possible.

Apr 1, 2007 Issue
Are Opioids Effective in the Treatment of Neuropathic Pain? [Cochrane for Clinicians]

Eight to 60 days of opioid therapy for the treatment of neuropathic pain effectively reduces pain scores as measured by a visual analog scale. A lack of response to opioids in the first 24 hours should not be used to predict whether longer-term opioid therapy might be beneficial. There are no contro...

Dec 1, 2006 Issue
Opioids for Management of Breakthrough Pain in Cancer Patients [Cochrane for Clinicians]

Oral transmucosal fentanyl citrate (OTFC [Actiq]), a rapid-acting opioid, has been shown to be an effective treatment for breakthrough cancer pain. Other opioids, including immediate-release oral morphine (MSIR), also may be effective; however, evidence comparing these agents with OTFC is lacking.

Oct 15, 2006 Issue
Management of Common Opioid-Induced Adverse Effects [Article]

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. N...

Jul 1, 2006 Issue
Systemic Lidocaine or Mexiletine for Neuropathic Pain [Cochrane for Clinicians]

Intravenous lidocaine and oral mexiletine provide a modest reduction in neuropathic pain with no indication of serious adverse effects. However, safety data are limited because most studies were of relatively short duration and fewer than 400 patients have been studied in total for each drug. Intrav...

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