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Daniel Krashin, Natalia Murinova, Mark Sullivan
Health care in the USA faces a double challenge, the crisis of chronic pain and the crisis of opioid misuse and overdose. Patients have been prescribed opioids at high doses with unclear indications for long periods of time, putting them at high risk for morbidity and mortality. A significant proportion of these patients have comorbid psychiatric or substance use disorders complicating their pain conditions. The challenges to treating these patients adequately are discussed, along with potential solutions to these issues at the level of the individual provider, healthcare systems, and society...
December 2016: Current Pain and Headache Reports
Lia C C van der Maas, Albère Köke, Ruud J Bosscher, Jos W R Twisk, Thomas W J Janssen, Madelon Peters
BACKGROUND: The results of a recently performed randomized clinical trial showed that the effect of a multidisciplinary treatment of chronic pain patients on body awareness (BA), catastrophizing, and depression was improved by adding psychomotor therapy (PMT), an intervention targeting BA. No significant effects were found on quality of life and disability. The present follow-up study aimed to explore the relationship between improvements in BA and multidisciplinary chronic pain rehabilitation treatment outcome across treatment conditions and the possible mediating effect of BA between treatment conditions...
September 2016: Clinical Journal of Pain
Tomoko Tetsunaga, Tomonori Tetsunaga, Masato Tanaka, Keiichiro Nishida, Yoshitaka Takei, Toshifumi Ozaki
Background. The contribution of apathy, frequently recognized in individuals with neurodegenerative diseases, to chronic low back pain (LBP) remains unclear. Objectives. To investigate levels of apathy and clinical outcomes in patients with chronic LBP treated with tramadol-acetaminophen. Methods. A retrospective case-control study involving 73 patients with chronic LBP (23 male, 50 female; mean age 71 years) treated with tramadol-acetaminophen (n = 36) and celecoxib (n = 37) was performed. All patients were assessed using the self-reported questionnaires...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
Nalini Vadivelu, Leandro Lumermann, Richard Zhu, Gopal Kodumudi, Amir O Elhassan, Alan David Kaye
Drug addiction is present in a significant proportion of the population in the USA and worldwide. Drug addiction can occur with the abuse of many types of substances including cocaine, marijuana, stimulants, alcohol, opioids, and tranquilizers. There is a high likelihood that clinicians will encounter patients with substance abuse disorders on a regular basis with the prevalence of the use of illicit substances and the high rate of abuse of prescription drugs. The use of abuse deterrent formulations of prescription opioid agents, pill counts, and urine drug abuse screenings are all useful strategies...
May 2016: Current Pain and Headache Reports
Andreas Binder, Ralf Baron
BACKGROUND: Chronic neuropathic pain, including painful peripheral polyneuropathy and post-herpetic neuralgia, affects 6.9-10% of the general population. METHODS: In this article, we present current treatment recommendations on the basis of a selective review of the literature. RESULTS: Neuropathic pain does not respond consistently to classic non-opioid analgesic drugs and is better treated with co-analgesic, antidepressant, and anticonvulsant drugs and topical agents...
September 16, 2016: Deutsches Ärzteblatt International
David C Currow, Jane Phillips, Katherine Clark
No abstract text is available yet for this article.
October 3, 2016: Medical Journal of Australia
Akhila Reddy, Sriram Yennurajalingam, Suresh Reddy, Jimin Wu, Diane Liu, Rony Dev, Eduardo Bruera
CONTEXT: One-third of cancer patients require opioid rotation (OR) to treat uncontrolled pain or opioid-induced neurotoxicity. Although fentanyl is the most frequently rotated opioid in cancer patients, the accurate opioid rotation ratio (ORR) from transdermal fentanyl (TDF) to other so-called "strong" opioids is unknown. OBJECTIVES: We aimed to determine the ORR of TDF to strong opioids, as measured by morphine equivalent daily dose (MEDD). METHODS: We reviewed 2471 consecutive patient visits (938 patients) to our supportive care center for an OR from TDF to strong opioids...
June 2016: Journal of Pain and Symptom Management
Marc A Schuckit
This article provides an overview of the current treatment of opioid-related conditions, including treatments provided by general practitioners and by specialists in substance-use disorders. The recent dramatic increase in misuse of prescription analgesics, the easy accessibility of opioids such as..
July 28, 2016: New England Journal of Medicine
Daniel Feingold, Itay Goor-Aryeh, Silviu Bril, Yael Delayahu, Shaul Lev-Ran
OBJECTIVE: To assess prevalence rates and correlates of problematic use of prescription opioids and medicinal cannabis (MC) among patients receiving treatment for chronic pain. DESIGN: Cross-sectional study. SETTING: Two leading pain clinics in Israel. SUBJECTS: Our sample included 888 individuals receiving treatment for chronic pain, of whom 99.4% received treatment with prescription opioids or MC. METHODS: Problematic use of prescription opioids and MC was assessed using DSM-IV criteria, Portenoy's Criteria (PC), and the Current Opioid Misuse Measure (COMM) questionnaire...
June 26, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
H G Kress, E D Koch, H Kosturski, A Steup, K Karcher, C Dogan, M Etropolski, M Eerdekens
BACKGROUND: A recent randomized-withdrawal, active- and placebo-controlled, double-blind phase 3 study showed that tapentadol prolonged release (PR) was effective and well tolerated for managing moderate to severe, chronic malignant tumour-related pain in patients who were opioid naive or dissatisfied with current treatment (Pain Physician, 2014, 17, 329-343). This post hoc, subgroup analysis evaluated the efficacy and tolerability of tapentadol PR in patients who previously received and were dissatisfied with tramadol for any reason and who had a pain intensity ≥5 (11-point numerical rating scale) before converting directly to tapentadol PR...
October 2016: European Journal of Pain: EJP
Sebastian Straube, Sheena Derry, Carmen Straube, R Andrew Moore
BACKGROUND: This review is an update of a previously published review in the Cochrane Database of Systematic Reviews (Issue 1, 2010) on 'Vitamin D for the treatment of chronic painful conditions in adults'.Vitamin D is produced in the skin after exposure to sunlight and can be obtained through food. Vitamin D deficiency has been linked with a range of conditions, including chronic pain. Observational and circumstantial evidence suggests that there may be a role for vitamin D deficiency in the aetiology of chronic painful conditions...
May 6, 2015: Cochrane Database of Systematic Reviews
Lisa Ronan, Aaron F Alexander-Bloch, Konrad Wagstyl, Sadaf Farooqi, Carol Brayne, Lorraine K Tyler, Paul C Fletcher
Common mechanisms in aging and obesity are hypothesized to increase susceptibility to neurodegeneration, however, direct evidence in support of this hypothesis is lacking. We therefore performed a cross-sectional analysis of magnetic resonance image-based brain structure on a population-based cohort of healthy adults. Study participants were originally part of the Cambridge Centre for Ageing and Neuroscience (Cam-CAN) and included 527 individuals aged 20-87 years. Cortical reconstruction techniques were used to generate measures of whole-brain cerebral white-matter volume, cortical thickness, and surface area...
November 2016: Neurobiology of Aging
M Seretny, L A Colvin
Vascular disease covers a wide range of conditions, including arterial, venous, and lymphatic disorders, with many of these being more common in the elderly. As the population ages, the incidence of vascular disease will increase, with a consequent increase in the requirement to manage both acute and chronic pain in this patient population. Pain management can be complex, as there are often multiple co-morbidities to be considered. An understanding of the underlying pain mechanisms is helpful in the logical direction of treatment, particularly in chronic pain states, such as phantom limb pain or complex regional pain syndrome...
September 2016: British Journal of Anaesthesia
Centers For Disease Control And Prevention Public Health Service U S Department Of Health And Human Services
Improving the way opioids are prescribed through clinical practice guidelines can ensure patients have access to safer, more effective chronic pain treatment while reducing the number of people who misuse, abuse, or overdose from these drugs. The Centers for Disease Control and Prevention (CDC) developed and published the Guideline for Prescribing Opioids for Chronic Pain to provide recommendations for the prescribing of opioid pain medication for patients 18 and older in primary care settings. Recommendations focus on the use of opioids in treating chronic pain (pain lasting longer than 3 months or past the time of normal tissue healing) outside of active cancer treatment, palliative care, and end-of-life care...
June 2016: Journal of Pain & Palliative Care Pharmacotherapy
Keith L Jackson, John G Devine
Study Design Literature review. Objective The aim of this literature review is to examine the effects of obesity on postoperative complications and functional outcomes after spine surgery. Methods A review of the relevant literature examining the effects of obesity and spine surgery was conducted using PubMed, Google Scholar, and Cochrane databases. Results Obesity contributes to disk degeneration and low back pain and potentially increases the risk of developing operative pathology. Obese patients undergoing spine surgery have a higher risk of developing postoperative complications, particularly surgical site infection and venous thromboembolism...
June 2016: Global Spine Journal
Katharine S Baker, Nellie Georgiou-Karistianis, Stephen J Gibson, Melita J Giummarra
OBJECTIVES: Cognitive functioning is commonly disrupted in people living with chronic pain, yet it is an aspect of pain that is often not routinely assessed in pain management settings, and there is a paucity of research on treatments or strategies to alleviate the problem. The purpose of this review is to outline recent research on cognitive deficits seen in chronic pain, to give an overview of the mechanisms involved, advocate cognitive functioning as an important target for treatment in pain populations, and discuss ways in which it may be assessed and potentially remediated...
July 29, 2016: Clinical Journal of Pain
Katherine A Mifflin, Bradley J Kerr
Most autoimmune diseases are associated with pathological pain development. Autoimmune diseases with pathological pain include complex regional pain syndrome, rheumatoid arthritis, and Guillian-Barré syndrome to name a few. The present Review explores research linking the immune system to the development of pathological pain in autoimmune diseases. Pathological pain has been linked to T-cell activation and the release of cytokines from activated microglia in the dorsal horn of the spinal cord. New research on the role of autoantibodies in autoimmunity has generated insights into potential mechanisms of pain associated with autoimmune disease...
June 2017: Journal of Neuroscience Research
Arianne P Verhagen, Aron Downie, Nahid Popal, Chris Maher, Bart W Koes
OBJECTIVE: The purpose of this study was to identify and descriptively compare the red flags endorsed in guidelines for the detection of serious pathology in patients presenting with low back pain to primary care. METHOD: We searched databases, the World Wide Web and contacted experts aiming to find the multidisciplinary clinical guideline in low back pain in primary care, and selected the most recent one per country. We extracted data on the number and type of red flags for identifying patients with higher likelihood of serious pathology...
September 2016: European Spine Journal
David A Provenzano, Joseph R Williams, Gaye Jarzabek, Leonard A DeRiggi, Thomas F Scott
OBJECTIVE: To report a case with two years follow-up of neuropathic pain and functional limitations associated with multiple sclerosis (MS) effectively treated with an MRI conditional spinal cord stimulator (SCS) system that allowed for spinal imaging. To present a comprehensive literature review of spinal cord stimulator utilization in the treatment of multiple sclerosis. DESIGN: Case report and literature review. INTERVENTION: Treatment was a spinal cord stimulation implant after successful trial...
June 2016: Neuromodulation: Journal of the International Neuromodulation Society
Mei Gao, Damoon Rejaei, Hong Liu
After nearly half a century on the market, ketamine still occupies a unique corner in the medical armamentarium of anesthesiologists or clinicians treating pain. Over the last two decades, much research has been conducted highlighting the drug's mechanisms of action, specifically those of its enantiomers. Nowadays, ketamine is also being utilized for pediatric pain control in emergency department, with its anti-hyperalgesic and anti-inflammatory effects being revealed in acute and chronic pain management. Recently, new insights have been gained on ketamine's potential anti-depressive and antisuicidal effects...
July 2016: Acta Pharmacologica Sinica
2016-03-30 14:22:55
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