Pain Management

Jul 15, 2013 Issue
Epidural Steroids for Sciatica Minimally Effective in the Short Term [POEMs]

Epidural corticosteroid treatment produces a small and not clinically relevant decrease in leg pain and disability in the short term in patients with sciatica; any difference is gone after one year.

Jun 1, 2013 Issue
Pharmacologic Therapy for Acute Pain [Article]

The approach to patients with acute pain begins by identifying the underlying cause and a disease-specific treatment. The first-line pharmacologic agent for the symptomatic treatment of mild to moderate pain is acetaminophen or a nonsteroidal anti-inflammatory drug (NSAID). The choice between these...

Jan 1, 2013 Issue
Caffeine as an Analgesic Adjuvant for Acute Pain in Adults [Cochrane for Clinicians]

Overall, there appears to be a small but clinically significant benefit to adding caffeine to analgesic therapy for various types of acute pain. More research is needed to determine the optimal dosing.

Oct 1, 2012 Issue
Opioid Abuse and Pain Management [Editorials]

Chronic nonmalignant pain affects a significant number of Americans. Concurrent with the increased need for pain management is a considerable increase in the use of prescription pain relievers for nonmedical purposes. Nonmedical use of prescription pain relievers is now the second most common form o...

Aug 1, 2012 Issue
Epidural Analgesia for Labor Pain [Cochrane for Clinicians]

Compared with other types of analgesia or no analgesia, epidurals offered better pain relief, but were associated with a longer second stage of labor and increased risk of instrumental vaginal delivery, maternal fever, and oxytocin (Pitocin) administration. There were no statistically significant di...

Aug 1, 2012 Issue
Rational Use of Opioids for Management of Chronic Nonterminal Pain [Article]

Opioid prescribing for chronic nonterminal pain has increased in recent years, although evidence for its long-term effectiveness is weak and its potential for harm is significant. Nonmedical use of prescription opioids, diversion, and overdose deaths have also increased sharply, sparking concern abo...

May 1, 2012 Issue
Tapentadol (Nucynta) for Treatment of Pain [STEPS]

Tapentadol is a DEA schedule II opioid medication with a safety profile, duration of action, frequency of dosing, and analgesic effect similar to those of other oral narcotics, although it is more expensive. At low doses, immediate-release tapentadol is better tolerated than oxycodone in terms of ga...

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.

Jul 1, 2010 Issue
Opioid Therapy for Chronic Noncancer Pain [Cochrane for Clinicians]

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.

Dec 15, 2009 Issue
NSAID Prescribing Precautions [Article]

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...

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