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Pain management in severe chronic pain

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https://www.readbyqxmd.com/read/28220381/pharmacological-management-of-people-living-with-end-stage-chronic-obstructive-pulmonary-disease
#1
Victoria Dalgliesh, Hilary Pinnock
Supportive care and pharmacological treatment can improve the quality of life of people with end-stage chronic obstructive pulmonary disease (COPD) who cope on a daily basis with substantial physical, psychological, social and spiritual morbidity. Smoking cessation is the only intervention that reduces the rate of progression of COPD, but evidence-based drug treatments and non-pharmacological strategies can relieve symptoms and reduce the impact of exacerbations. People with severe COPD live with increasingly troublesome breathlessness and other symptoms such as fatigue, pain, sputum production and weight loss...
February 21, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28216196/hypericum-perforatum-st-john-s-wort-beyond-depression-a-therapeutic-perspective-for-pain-conditions
#2
REVIEW
Nicoletta Galeotti
ETHNOPHARMACOLOGICAL RELEVANCE: Hypericum perforatum L. (Hypericaceae), popularly called St. John's wort (SJW), has a rich historical background being one of the oldest used and most extensively investigated medicinal herbs. Many bioactivities and applications of SJW are listed in popular and in scientific literature, including antibacterial, antiviral, anti-inflammatory. In the last three decades many studies focused on the antidepressant activity of SJW extracts. However, several studies in recent years also described the antinociceptive and analgesic properties of SJW that validate the traditional uses of the plant in pain conditions...
February 12, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28213817/breakthrough-cancer-pain-and-rational-drug-use
#3
Juan Manuel Núñez Olarte
Recent data indicate that there are large disparities in the use of opioid analgesics to control breakthrough cancer pain (BTcP) in Europe and worldwide. While it is clear that affordability is a key factor, it is certainly not the only one, and other factors, such as cultural differences and overall awareness, are undoubtedly responsible. More work remains to be done to overcome barriers in the use of these medications when warranted. When prescribing a medication for BTcP, it must be considered that its time profile is different from chronic persistent pain...
February 18, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
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
#4
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/28186946/gabapentinoids-for-chronic-low-back-pain-a-protocol-for-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#5
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/28186390/pain-management-in-the-ehlers-danlos-syndromes
#6
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/28183576/the-benefits-of-ultrasound-guided-continuous-sensory-nerve-blockade-in-the-setting-of-burn-injury-a-case-report-of-bilateral-continuous-superficial-peroneal-nerve-blockade-in-a-patient-with-severe-sleep-apnea
#7
Vladislav Shick, Evan E Lebovitz, Emerson Conrad
The management of pain after burn injuries is a clinical challenge magnified in patients with significant comorbidities. Presently, burn pain is treated via a wide variety of modalities, including systemic pharmacotherapy and regional analgesia. Although the latter can provide effective pain control in patients with burn injuries, it is relatively underused. Furthermore, the development of ultrasound guidance has allowed for novel approaches and sparing of motor nerve blockade with preference toward sensory-specific analgesia that has not been possible previously...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183561/audit-of-postoperative-pain-management-after-open-thoracotomy-and-the-incidence-of-chronic-postthoracotomy-pain-in-more-than-500-patients-at-a-tertiary-center
#8
G Niraj, A Kelkar, Vipul Kaushik, Yee Tang, Danny Fleet, Frances Tait, Theresa Mcmillan, Sridhar Rathinam
STUDY OBJECTIVE: To evaluate the quality of postoperative pain relief during the first 3 days after surgery and to evaluate with the incidence of persistent pain at 6 months after surgery. DESIGN: Retrospective single-center audit. SETTING: University hospital. PATIENTS: Five hundred four patients who underwent thoracotomy. INTERVENTIONS: Review of patient records, questionnaire, and telephone review...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28182123/long-term-safety-and-analgesic-efficacy-of-buprenorphine-buccal-film-in-patients-with-moderate-to-severe-chronic-pain-requiring-around-the-clock-opioids
#9
Martin Hale, Veronica Urdaneta, M Todd Kirby, Qinfang Xiang, Richard Rauck
BACKGROUND: This open-label, single-arm study was conducted to evaluate the long-term safety and efficacy of a novel buprenorphine formulation, buprenorphine buccal film, in the treatment of moderate-to-severe chronic pain requiring around-the-clock opioids. METHODS: The primary purpose of this study was to evaluate the long-term safety and tolerability of buprenorphine buccal film. Five hundred and six patients who completed previous studies with buprenorphine buccal film (n=445; rollover patients) or were recruited de novo for this study (n=61) were enrolled in this study...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28176463/severe-chronic-norovirus-diarrheal-disease-in-transplant-recipients-clinical-features-of-an-under-recognized-syndrome
#10
Robin K Avery, Bonnie E Lonze, Edward S Kraus, Kieren A Marr, Robert A Montgomery
BACKGROUND: Norovirus (NV) infection has been reported as a cause of severe chronic diarrhea in transplant recipients, but this entity remains under-recognized in clinical practice, leading to diagnostic delays. Transplant clinicians should become familiar with this syndrome in order to facilitate early detection and management. METHODS: Demographic, clinical, and outcomes variables were summarized from a series of transplant recipients with positive stool NV reverse transcription polymerase chain reaction (RT-PCR) assays at Johns Hopkins in 2013-2014...
February 7, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28167178/chronic-pain-in-a-patient-with-ehlers-danlos-syndrome-hypermobility-type-the-role-of-myofascial-trigger-point-injections
#11
Saipriya Tewari, Rajashree Madabushi, Anil Agarwal, Sujeet K Gautam, Sandeep Khuba
Chronic widespread musculoskeletal pain is a cardinal symptom in hypermobility type of Ehler Danlos Syndrome (EDS type III). The management of pain in EDS, however, has not been studied in depth. A 30 year old female, known case of EDS, presented to the pain clinic with complaints of severe upper back pain for 6 months. Physical examination of the back revealed two myofascial trigger points over the left rhomboids and the left erector spinae. Local anaesthetic trigger point injections were given at these points, followed by stretching exercises under analgesic cover for the first week...
January 2017: Journal of Bodywork and Movement Therapies
https://www.readbyqxmd.com/read/28164407/volatility-and-change-in-chronic-pain-severity-predict-outcomes-of-treatment-for-prescription-opioid-addiction
#12
Matthew J Worley, Keith G Heinzerling, Steven Shoptaw, Walter Ling
BACKGROUND AND AIMS: Buprenorphine-naloxone (BUP-NLX) can be used to manage prescription opioid addiction among persons with chronic pain, but post-treatment relapse is common and difficult to predict. This study estimated whether changes in pain over time and pain volatility during BUP-NLX maintenance would predict opioid use during the taper BUP-NLX taper. DESIGN: Secondary analysis of a multisite clinical trial for prescription opioid addiction, using data obtained during a 12-week BUP-NLX stabilization and 4-week BUP-NLX taper...
February 5, 2017: Addiction
https://www.readbyqxmd.com/read/28160759/five-herbs-plus-thiamine-reduce-pain-and-improve-functional-mobility-in-patients-with-pain-a-pilot-study
#13
Robert Hedaya
: Context • Five herbs-Urtica dioica (stinging nettle), Boswellia serrata, Equisetum arvense, Allium sativum, and Apium graveolens-have been demonstrated to have activity at several anti-inflammatory pathways and have analgesic properties that are effective in treating chronic musculoskeletal pain. Objectives • The study intended to evaluate the clinical efficacy of a proprietary blend of U dioica, B serrata, E arvense, A sativum, A graveolens, and thiamine (vitamin B1), or "the blend," in the treatment of chronic musculoskeletal pain...
January 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/28159390/sickle-cell-disease
#14
REVIEW
Russell E Ware, Mariane de Montalembert, Léon Tshilolo, Miguel R Abboud
Sickle cell disease is a common and life-threatening haematological disorder that affects millions of people worldwide. Abnormal sickle-shaped erythrocytes disrupt blood flow in small vessels, and this vaso-occlusion leads to distal tissue ischaemia and inflammation, with symptoms defining the acute painful sickle-cell crisis. Repeated sickling and ongoing haemolytic anaemia, even when subclinical, lead to parenchymal injury and chronic organ damage, causing substantial morbidity and early mortality. Currently available treatments are limited to transfusions and hydroxycarbamide, although stem cell transplantation might be a potentially curative therapy...
January 31, 2017: Lancet
https://www.readbyqxmd.com/read/28158160/ultrasound-guided-block-of-the-suprascapular-nerve-in-breast-cancer-survivors-with-limited-shoulder-motion-case-series
#15
Sibel Caglar Okur, Ozden Ozyemisci-Taskiran, Yasemin Pekindogan, Murat Mert, Nil Syiner Caglar
BACKGROUND: Suprascapular nerve block is performed in the management of chronic shoulder pain and frozen shoulder. OBJECTIVE: To investigate the effects of ultrasound-guided suprascapular nerve block in restoration of shoulder motion in breast cancer survivors. STUDY DESIGN: A cohort study. SETTING: A training and research hospital, outpatient setting. METHODS: A total of 18 breast cancer survivors with limited shoulder motion, pain, and difficulty in positioning the upper extremity for radiation treatment following surgery were enrolled in this study...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28157442/a-nationally-scaled-telebehavioral-health-program-for-chronic-pain-characteristics-goals-and-psychological-outcomes
#16
Heidi Mochari-Greenberger, Aimee Peters, Lee Vue, Reena L Pande
BACKGROUND: Millions of U.S. adults suffer from chronic pain with a high prevalence of comorbid mental health issues. Telehealth-delivered behavioral therapy for chronic pain has been evaluated in the research setting. The purpose of this study was 1) to describe a nationally scaled, standardized, telebehavioral therapy program for patients with chronic pain and behavioral comorbidities, and 2) evaluate characteristics, goals, and psychosocial outcomes among program participants. MATERIALS AND METHODS: This was mixed-methods retrospective cohort analysis among consecutive program graduates (mean age 53y; 24% male)...
February 3, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28149454/splint-assisted-disc-plication-surgery
#17
Omar Sheikh, Greg Logan, Deepak Komath, Patrick Grossman, Peter Ayliffe
Chronic disc displacement may lead to long-term pain. Temporomandibular joint surgery is reserved for those patients whose symptoms remain severe despite conservative treatment. We looked at the of effect of modified meniscopexy on patients with chronic disc displacement without reduction who did not respond to non-surgical pain management treatment. In this retrospective study a total of 59 joints was treated and all patients except one underwent splint assisted bilateral meniscopexy: this patient had splint assisted unilateral meniscopexy...
July 2016: Annali di Stomatologia
https://www.readbyqxmd.com/read/28146334/dementia-and-co-occurring-chronic-conditions-a-systematic-literature-review-to-identify-what-is-known-and-where-are-the-gaps-in-the-evidence
#18
REVIEW
Mark B Snowden, Lesley E Steinman, Lucinda L Bryant, Monique M Cherrier, Kurt J Greenlund, Katherine H Leith, Cari Levy, Rebecca G Logsdon, Catherine Copeland, Mia Vogel, Lynda A Anderson, David C Atkins, Janice F Bell, Annette L Fitzpatrick
OBJECTIVE: The challenges posed by people living with multiple chronic conditions are unique for people with dementia and other significant cognitive impairment. There have been recent calls to action to review the existing literature on co-occurring chronic conditions and dementia in order to better understand the effect of cognitive impairment on disease management, mobility, and mortality. METHODS: This systematic literature review searched PubMed databases through 2011 (updated in 2016) using key constructs of older adults, moderate-to-severe cognitive impairment (both diagnosed and undiagnosed dementia), and chronic conditions...
February 1, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28144159/anterior-cutaneous-nerve-entrapment-syndrome-management-challenges
#19
REVIEW
Eleni Chrona, Georgia Kostopanagiotou, Dimitrios Damigos, Chrysanthi Batistaki
Anterior cutaneous nerve entrapment syndrome (ACNES) is a commonly underdiagnosed and undertreated chronic state of pain. This syndrome is characterized by the entrapment of the cutaneous branches of the lower thoracoabdominal intercostal nerves at the lateral border of the rectus abdominis muscle, which causes severe, often refractory, chronic pain. This narrative review aims to identify the possible therapeutic strategies for the management of the syndrome. Seventeen studies about ACNES therapy were reviewed; of them, 15 were case-control studies, case series, or case reports, and two were randomized controlled trials...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28135743/-alcohol-injection-in-a-patient-with-chronic-orbital-pain-after-enucleation-a-case-report-and-review-of-the-literature
#20
M P Schittkowski
A case is presented of a 54-year old patient who had been treated 10 months previously with enucleation for a painful blind eye. This led to severe and chronic pain in the orbital region that did not respond to conventional pain management. However, a single 1.5 ml injection of 96 % ethanol led to almost complete resolution of pain for the follow-up period of 6 months. Orbital pain after enucleation or evisceration may originate from the implant itself, the prosthesis, the socket or the sinuses. Taking a careful medical history and an examination, including orbital scans, are necessary to decide on the correct differential diagnosis...
January 2017: Klinische Monatsblätter Für Augenheilkunde
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