Approach to Neuropathic Pain

2021 ◽  
Vol 41 (06) ◽  
pp. 744-759
Author(s):  
Ashwin Malhotra ◽  
Joshua Weaver
Keyword(s):  
Neuropathic Pain ◽  
Systematic Approach ◽  
Signs And Symptoms ◽  
Primary Care Providers ◽  
Care Providers ◽  
Laboratory Investigations ◽  
Interventional Therapies ◽  
Somatosensory Nervous System ◽  
Underlying Pathology ◽  
Symptomatic Control

AbstractNeuropathic pain is a common chief complaint encountered by neurologists and primary care providers. It is caused by disorders involving the somatosensory nervous system. The clinical evaluation of neuropathic pain is challenging and requires a multifaceted systematic approach with an emphasis on a thorough history and physical examination to identify characteristic signs and symptoms. Ancillary laboratory investigations, targeted imaging, and electrodiagnostic studies further help identify underlying etiologies to guide specific treatments. Management of neuropathic pain encompasses treating the underlying pathology as well as symptomatic control with nonpharmacological, pharmacological, and interventional therapies. Here, we present an approach to help evaluate patients with neuropathic pain.

Pregabalin for the treatment of neuropathic pain: a narrative review for primary care providers

2017 ◽  
Vol 33 (8) ◽  
pp. 1353-1359 ◽  
Author(s):  
Yvonne D’Arcy ◽  
Bill McCarberg ◽  
Bruce Parsons ◽  
Regina Behar ◽  
Andrew Thorpe ◽  
...  
Keyword(s):  
Primary Care ◽  
Neuropathic Pain ◽  
Primary Care Providers ◽  
Narrative Review ◽  
Care Providers

scholarly journals A Systems-Wide Approach for Early Detection and Management of Dementia in Primary Care

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 346-346
Author(s):  
Annette Fitzpatrick ◽  
Basia Belza
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Providers ◽  
Signs And Symptoms ◽  
Primary Care Providers ◽  
Population Increase ◽  
Community Advisory Board ◽  
Care Practice ◽  
Care Providers ◽  
Cognitive Changes

Abstract Dementia is frequently unrecognized and under-reported by health care providers. The needs of an aging population increase the burden on an already over-worked primary care system that is often without the appropriate training, resources, and reimbursement to address the growing number of people with cognitive decline in the US. In this symposium we present a systems-wide approach within University of Washington (UW) Primary Care to increase awareness of early signs and symptoms, detection of cognitive impairment, and support of providers, patients and caregivers that will ultimately improve outcomes of care. This quality improvement (QI) program integrates stakeholder-selected components of the GSA KAER (Kickstart-Assess-Evaluate and Refer) Model and Toolkit (2020 Edition), developed by the Gerontological Society of America (GSA), into primary care practice. We describe content and logistics of a continuing education intervention for primary care providers and clinical staff to increase skills for evaluation and management of dementia. Working with UW clinic managers and information technology (IT), we have developed a pragmatic system for streamlining operations and documenting care utilizing newly developed interdisciplinary workflows and electronic health record order sets. Using input from our Community Advisory Board, we explain development of a web-based resource directory to be used in-clinic and at home to support providers, staff, patients, families, and caregivers across cognitive changes. Strategies presented here are aimed to help other health care systems initiate steps to integrate KAER and other tools into a practical QI program for improving detection and management of dementia through support of primary care.

Neuropathic pain: a narrative review of etiology, assessment, diagnosis, and treatment for primary care providers

2017 ◽  
Vol 33 (8) ◽  
pp. 1361-1369 ◽  
Author(s):  
Bill McCarberg ◽  
Yvonne D’Arcy ◽  
Bruce Parsons ◽  
Alesia Sadosky ◽  
Andrew Thorpe ◽  
...  
Keyword(s):  
Primary Care ◽  
Neuropathic Pain ◽  
Primary Care Providers ◽  
Narrative Review ◽  
Diagnosis And Treatment ◽  
Care Providers

scholarly journals The Rehabilitation of Oncological Patients Presenting Neuropathies

2014 ◽  
Vol 87 (2) ◽  
pp. 67-72
Author(s):  
Elena Claudia Micu ◽  
Laszlo Irsay
Keyword(s):  
Nervous System ◽  
Neuropathic Pain ◽  
Peripheral Neuropathy ◽  
International Association ◽  
Treatment Options ◽  
Signs And Symptoms ◽  
Morbidity Rate ◽  
Oncological Patients ◽  
Somatosensory Nervous System

The International Association for the Study of Pain (IASP 2011) defines neuropathic pain as “the pain caused by an injury or disease of the somatosensory portion of the nervous system”. The central neuropathic pain is defined as “the pain caused by an injury or disease of the central somatosensory central nervous system”, whereas the peripheral neuropathic pain is defined as “the pain caused by an injury or disease of the peripheral somatosensory nervous system”. The peripheral neuropathy describes any affection of the peripheral nervous system. The etiology is vast, there being a number of over 100 possible causes, which causes the global morbidity rate to reach approximately 2.4%. The chronic nature of the pain superposes the everyday routine and leads to the high intake of medication for pain alleviation. The number of cases of neuroplasia has always increased today. This disturbing diagnosis which can potentiate the signs and symptoms of peripheral neuropathy as well as reduce and limit the treatment options associated with neuropathies. The treatment presupposes a multidisciplinary approach, while the solution to prevent complications involves the control of risk factors and pathophysiological treatment.  Chemotherapy-induced peripheral neuropathy (CPIN) is a significant disabling symptom that is tightly connected to the administration of neurotoxic cytostatic agents used for the treatment of neoplasia. CPIN compromises the quality of life and produces pain or discomfort. I have sought to produce a presentation of the medicated and physical-kinetic treatment options that have proved their effectiveness during clinical studies or random trials and can be applied to cancer patients presenting with symptoms associated with peripheral neuropathy, namely with neuropathic pain, and support it with arguments

Craniofacial Screening Profile: Quick Screening for Congenital Malformations

1992 ◽  
Vol 29 (1) ◽  
pp. 87-91
Author(s):  
Gale Norman Coston ◽  
Rona B. Sayetta ◽  
Harold I. Friedman ◽  
Martin C. Weinrich ◽  
Caroline A. Macera ◽  
...  
Keyword(s):  
Young Children ◽  
Training Program ◽  
Congenital Malformations ◽  
Systematic Approach ◽  
Signs And Symptoms ◽  
First Grade ◽  
Early Age ◽  
Correct Identification ◽  
Care Providers ◽  
Brief Training

The correct identification of syndromes and other congenital malformations at an early age is critical for the child, family and care providers. Most specialists who conduct large screenings of young children are not adequately trained to recognize signs and symptoms that should lead to appropriate referral to the clinical geneticist and/or diagnostic team. A systematic approach for recognizing important signs is presented here; a Craniofacial Screening Profile. Following a brief training program, the Profile was validated by 39 speech-language pathologists in screening 3,539 kindergarten and first grade children. The results were excellent (specificity was 99.6%), demonstrating that with limited training, specialists can effectively screen for important signs and symptoms of a major group of syndromes and other congenital malformations.

The Perspective of Older Men With Depression on Suicide and Its Prevention in Primary Care

Crisis ◽  
2018 ◽  
Vol 39 (5) ◽  
pp. 397-405 ◽  
Author(s):  
Steven Vannoy ◽  
Mijung Park ◽  
Meredith R. Maroney ◽  
Jürgen Unützer ◽  
Ester Carolina Apesoa-Varano ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Socioeconomic Status ◽  
Thematic Analysis ◽  
Older Men ◽  
Primary Care Providers ◽  
Depression Treatment ◽  
Care Providers ◽  
Low Socioeconomic ◽  
Self Image ◽  
The Impact

Abstract. Background: Suicide rates in older men are higher than in the general population, yet their utilization of mental health services is lower. Aims: This study aimed to describe: (a) what primary care providers (PCPs) can do to prevent late-life suicide, and (b) older men's attitudes toward discussing suicide with a PCP. Method: Thematic analysis of interviews focused on depression and suicide with 77 depressed, low-socioeconomic status, older men of Mexican origin, or US-born non-Hispanic whites recruited from primary care. Results: Several themes inhibiting suicide emerged: it is a problematic solution, due to religious prohibition, conflicts with self-image, the impact on others; and, lack of means/capacity. Three approaches to preventing suicide emerged: talking with them about depression, talking about the impact of their suicide on others, and encouraging them to be active. The vast majority, 98%, were open to such conversations. An unexpected theme spontaneously arose: "What prevents men from acting on suicidal thoughts?" Conclusion: Suicide is rarely discussed in primary care encounters in the context of depression treatment. Our study suggests that older men are likely to be open to discussing suicide with their PCP. We have identified several pragmatic approaches to assist clinicians in reducing older men's distress and preventing suicide.

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