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Management of chronic pain

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https://www.readbyqxmd.com/read/28212145/assessing-and-managing-acute-pain-a-call-to-action
#1
Carla R Jungquist, April Hazard Vallerand, Corinna Sicoutris, Kyung N Kwon, Rosemary C Polomano
: Acute pain, which is usually sudden in onset and time limited, serves a biological protective function, warning the body of impending danger. However, while acute pain often resolves over time with normal healing, unrelieved acute pain can disrupt activities of daily living and transition to chronic pain. This article describes the effects of unrelieved acute pain on patients and clinical outcomes. The authors call on nurses to assess and manage acute pain in accordance with evidence-based guidelines, expert consensus reports, and position statements from professional nursing organizations in order to minimize the likelihood of its becoming chronic...
March 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28211797/effects-of-an-intervention-based-on-the-transtheoretical-model-on-back-muscle-endurance-physical-function-and-pain-in-rice-farmers-with-chronic-low-back-pain
#2
Thanakorn Thanawat, Nomjit Nualnetr
BACKGROUND: Chronic low back pain (LBP) can be managed by exercises which should be tailored to an individual's readiness to behavioral change. OBJECTIVE: To evaluate the effects of an intervention program based on the Transtheoretical Model of behavioral change (TTM) on back muscle endurance, physical function and pain in rice farmers with chronic LBP. METHODS: In a 32-week study, 126 rice farmers were allocated to the TTM (n= 62) and non-TTM (n= 64) groups...
February 3, 2017: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/28210742/clinics-in-diagnostic-imaging-174-l5-vertebral-superior-facet-osteoblastoma-ob
#3
Manickam Subramanian, Hong Chou, Kabilan Chokkappan, Wilfred Cg Peh
A 25-year-old man presented with chronic low back pain and occasional radiation to the right lower limb. Magnetic resonance imaging and computed tomography (CT) of the lumbar spine showed an osteolytic expansile lesion with a central sclerotic nidus in the right superior facet of the L5 vertebra and surrounding marrow oedema. The diagnosis of osteoblastoma was made based on imaging findings and confirmed after CT-guided biopsy. Radiofrequency ablation of the lesion was successfully performed. The patient tolerated the procedure well and showed symptomatic relief...
February 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28210404/infraorbital-nerve-decompression-for-infraorbital-neuralgia-causalgia-following-blowout-orbital-fractures-a-case-series
#4
Bijan Beigi, Mazda Beigi, Nuwan Niyadurupola, Manuel Saldana, Nabil El-Hindy, Deepak Gupta
The purpose of this study was to present the management of a series of patients referred with infraorbital nerve paraesthesia that developed after insignificant orbital floor fracture without diplopia or exophthalmos, and that did not require initial surgical repair. This is a retrospective interventional case series. The main outcome and measures were assessment of preoperative symptoms including neuralgia and sensory symptoms; review of periorbital computed tomography (CT) scans; and assessment of postoperative effects of surgery for infraorbital nerve decompression...
March 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/28206732/clinical-efficacy-and-safety-of-a-new-once-daily-1000-mg-suspension-versus-twice-daily-500-mg-tablets-of-micronized-purified-flavonoid-fraction-in-patients-with-symptomatic-chronic-venous-disorders-a-randomized-controlled-trial
#5
Patrick Carpentier, Debora Karetova, Harunarashid Hanafiah, Elisabeth Enriquez-Vega, Andrej Dzupina, Miso Sabovic, Lourdes Reina Gutierrez, Somboom Subwongcharoen, Hasan Tüzün, Arnaud Maggioli
BACKGROUND: Chronic venous disorders (CVD) is estimated to affect 30% to 50% of women and 10% to 30% of men. The most widely prescribed treatment for CVD worldwide is micronized purified flavonoid fraction 500 mg (MPFF). The aim of this clinical trial was to develop a new once daily 1000 mg oral suspension of MPFF. METHODS: In an international, randomized, double-blind, parallel-group study, symptomatic individuals classified CEAP C0s to C4s were randomized in either treatment arm and treated for 8 weeks...
February 15, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28205574/neuropathic-pain
#6
REVIEW
Luana Colloca, Taylor Ludman, Didier Bouhassira, Ralf Baron, Anthony H Dickenson, David Yarnitsky, Roy Freeman, Andrea Truini, Nadine Attal, Nanna B Finnerup, Christopher Eccleston, Eija Kalso, David L Bennett, Robert H Dworkin, Srinivasa N Raja
Neuropathic pain is caused by a lesion or disease of the somatosensory system, including peripheral fibres (Aβ, Aδ and C fibres) and central neurons, and affects 7-10% of the general population. Multiple causes of neuropathic pain have been described and its incidence is likely to increase owing to the ageing global population, increased incidence of diabetes mellitus and improved survival from cancer after chemotherapy. Indeed, imbalances between excitatory and inhibitory somatosensory signalling, alterations in ion channels and variability in the way that pain messages are modulated in the central nervous system all have been implicated in neuropathic pain...
February 16, 2017: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/28204956/centrally-targeted-pharmacotherapy-for-chronic-abdominal-pain-understanding-and-management
#7
Hans Törnblom, Douglas A Drossman
Chronic abdominal pain has a widespread impact on the individual and the society. Identifying and explaining mechanisms of importance for the pain experience within a biopsychosocial context are central in order to select treatment that has a chance for symptom reduction. With current knowledge of brain-gut interactions, chronic abdominal pain, which mostly appears in functional gastrointestinal disorders, to a large extent involves pain mechanisms residing within the brain. As such, the use of centrally targeted pharmacotherapy as an effective treatment option is obvious in a selected number of patients...
February 16, 2017: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/28204786/application-of-a-value-model-for-the-prevention-and-management-of-chronic-musculoskeletal-pain-by-physical-therapists
#8
Trevor A Lentz, Jeffrey S Harman, Nicole M Marlow, Steven Z George
No abstract text is available yet for this article.
February 16, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28203370/abdominal-adhesions-a-practical-review-of-an-often-overlooked-entity
#9
REVIEW
N Tabibian, E Swehli, A Boyd, A Umbreen, J H Tabibian
Formation of intra-abdominal adhesions is a common consequence of abdomino-pelvic surgery, radiation therapy, and inflammatory processes. In a small but clinically significant proportion of patients, adhesive disease may develop, wherein adhesions lead to a variety of chronic symptoms such as abdominal distension, pain, nausea, and abnormal bowel movement pattern which can be daily, intermittent, or episodic. Due to the chronic and troublesome nature of these symptoms, adhesive disease may be life-altering in many patients, particularly when not recognized and appropriately addressed, as is the case not infrequently...
March 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28201840/clinical-response-to-dorsal-duct-drainage-via-the-minor-papilla-in-refractory-obstructing-chronic-calcific-pancreatitis
#10
Chang-Il Kwon, Mark A Gromski, Stuart Sherman, Ihab I El Hajj, Jeffrey J Easler, James Watkins, Lee McHenry, Glen A Lehman, Evan L Fogel
Background and study aims Complete stone removal from the main pancreatic duct might not be achieved in all patients with obstructive chronic calcific pancreatitis. We report our results for endoscopic dorsal pancreatic duct (DPD) bypass of obstructing stones in the ventral pancreatic duct (VPD). Patients and methods 16 patients with obstructive chronic calcific pancreatitis were treated with a DPD bypass. Clinical success was defined as significant pain relief and no hospital admissions for pain management during the ongoing treatment period...
February 15, 2017: Endoscopy
https://www.readbyqxmd.com/read/28196019/pancreatoscopy-directed-electrohydraulic-lithotripsy-for-pancreatic-ductal-stones-in-painful-chronic-pancreatitis-using-spyglass
#11
Noor L H Bekkali, Sam Murray, Gavin J Johnson, Steven Bandula, Zahir Amin, Michael H Chapman, Stephen P Pereira, George J M Webster
OBJECTIVE: Painful chronic pancreatitis is often associated with main duct obstruction due to stones. Approaches to management are challenging, including surgery, extracorporeal shock wave lithotripsy, or endoscopic approaches. Here, we report our experience of pancreatoscopy + electrohydraulic lithotripsy (EHL) for pancreatic duct (PD) stones using SpyGlass. METHODS: We retrospectively audited the use of SpyGlass (Legacy and DS) + EHL. Indication, procedural details, and clinical outcomes were assessed...
February 14, 2017: Pancreas
https://www.readbyqxmd.com/read/28195861/perioperative-management-of-a-patient-with-an-intrathecal-drug-delivery-device-infusing-ziconotide-a-case-report
#12
Sephalie Patel, Osama Hafez, Wade J Sexton, David A Edwards
Intrathecal ziconotide is used for the treatment of chronic pain and is delivered by an implanted drug delivery device. Anesthesiologists should be familiar with the perioperative management of the pump as well as the potential adverse events related to continued ziconotide infusion during general anesthesia. A case is presented demonstrating the perioperative management of an intrathecal drug delivery device infusing ziconotide in a patient presenting for radical cystectomy with pelvic lymphadenectomy and ileal conduit diversion...
February 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28195608/proximal-hamstring-tendinosis-and-partial-ruptures
#13
Ashley N Startzman, Oliver Fowler, Dominic Carreira
Proximal hamstring tendinosis and partial hamstring origin ruptures are painful conditions of the proximal thigh and hip that may occur in the acute, chronic, or acute on chronic setting. Few publications exist related to their diagnosis and management. This systematic review discusses the incidence, treatment, and prognosis of proximal hamstring tendinosis and partial hamstring ruptures. Conservative treatment measures include nonsteroidal anti-inflammatory drugs, physical therapy, rest, and ice. If these measures fail, platelet-rich plasma or shockwave therapy may be considered...
February 13, 2017: Orthopedics
https://www.readbyqxmd.com/read/28194391/simultaneous-bilateral-patellar-tendon-rupture
#14
Diogo Lino Moura, José Pedro Marques, Francisco Manuel Lucas, Fernando Pereira Fonseca
Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a short immobilization period and intensive rehabilitation program...
January 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28191300/a-case-report-of-neisseria-mucosa-peritonitis-in-a-chronic-ambulatory-peritoneal-dialysis-patient
#15
Alan Awdisho, Maria Bermudez
Peritonitis is a leading complication of chronic ambulatory peritoneal dialysis. However, very rarely does Neisseria mucosa cause peritonitis. We describe an unusual case of N. mucosa peritonitis in a chronic ambulatory peritoneal dialysis patient. A 28-year-old Hispanic male presents with diffuse abdominal pain exacerbated during draining of the peritoneal fluid. Peritoneal fluid examination was remarkable for leukocytosis and gramnegative diplococci. Bacterial cultures were positive for N. mucosa growth. The patient was treated with ciprofloxacin with preservation of the dialysis catheter...
December 31, 2016: Infectious Disease Reports
https://www.readbyqxmd.com/read/28190896/yoga-and-other-meditative-movement-therapies-to-reduce-chronic-pain
#16
Allison Achilefu, Kunal Joshi, Megan Meier, Laine H McCarthy
CLINICAL QUESTION: In adults with chronic pain, do yoga and other meditative movement therapies to improvement in chronic pain symptoms? ANSWER: Yes. However, in each of the studies reviewed, yoga classes were included as part of the pain management regime, sometimes alone and sometimes in tandem with DVDs or audiotapes. We feel that no exercise therapy program should be undertaken without professional coaching from certified, registered and qualified instructors...
January 2017: Journal of the Oklahoma State Medical Association
https://www.readbyqxmd.com/read/28186946/gabapentinoids-for-chronic-low-back-pain-a-protocol-for-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#17
Harsha Shanthanna, Ian Gilron, Lehana Thabane, Philip J Devereaux, Mohit Bhandari, Rizq AlAmri, Manikandan Rajarathinam, Sriganesh Kamath
INTRODUCTION: Chronic low back pain (CLBP) is a common condition and causes significant pain, distress and disability across the world. It is multifactorial in aetiology and is challenging to manage. Although the underlying mechanism of pain is predominantly non-specific, many argue that there is a substantial neuropathic pain element. Neuropathic pain is more severe, with significant disability. Gabapentinoids, including gabapentin and pregabalin, have proven efficacy in some neuropathic pain conditions...
November 10, 2016: BMJ Open
https://www.readbyqxmd.com/read/28186393/chronic-fatigue-in-ehlers-danlos-syndrome-hypermobile-type
#18
Alan Hakim, Inge De Wandele, Chris O'Callaghan, Alan Pocinki, Peter Rowe
Chronic fatigue is an important contributor to impaired health-related quality of life in Ehlers-Danlos syndrome. There is overlap in the symptoms and findings of EDS and chronic fatigue syndrome. A proportion of those with CFS likely have EDS that has not been identified. The evaluation of chronic fatigue in EDS needs to include a careful clinical examination and laboratory testing to exclude common causes of fatigue including anemia, hypothyroidisim, and chronic infection, as well as dysfunction of major physiological or organ systems...
February 10, 2017: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
https://www.readbyqxmd.com/read/28186390/pain-management-in-the-ehlers-danlos-syndromes
#19
Pradeep Chopra, Brad Tinkle, Claude Hamonet, Isabelle Brock, Anne Gompel, Antonio Bulbena, Clair Francomano
Chronic pain in the Ehlers-Danlos syndromes (EDS) is common and may be severe. According to one study, nearly 90% of patients report some form of chronic pain. Pain, which is often one of the first symptoms to occur, may be widespread or localized to one region such as an arm or a leg. Studies on treatment modalities are few and insufficient to guide management. The following is a discussion of the evidence regarding the underlying mechanisms of pain in EDS. The causes of pain in this condition are multifactorial and include joint subluxations and dislocations, previous surgery, muscle weakness, proprioceptive disorders, and vertebral instability...
February 10, 2017: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
https://www.readbyqxmd.com/read/28185319/gabapentenoids-in-pain-management-in-urological-chronic-pelvic-pain-syndrome-gabapentin-or-pregabalin
#20
Mayank Mohan Agarwal, Mudelin Elsi Sy
AIMS: To compare efficacy of gabapentin and pregabalin in patients with urological chronic pelvic-pain syndrome (UCPPS). METHODS: Design-retrospective, setting-urology outpatient services of a secondary-care private hospital, inclusion criteria-men 18-50 years, presenting with pelvic pain (lower abdomen, groin, scrotum, perineum, low-back, hip) with or without lower urinary tract symptoms for at least 3 months duration. Hospital database was searched using keywords for neuropathic pain (ICD9-729...
February 10, 2017: Neurourology and Urodynamics
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