Pain

2018 ◽  
pp. 463-484
Author(s):  
Maria Flynn ◽  
Dave Mercer
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Assessment Tools ◽  
Acute Injury ◽  
Summary Table ◽  
Pain Medications ◽  
Key Features ◽  
The Individual ◽  
Chronic Pain Conditions ◽  
Dressing Change

It is widely recognized that the experience of pain is unique to the individual, which makes caring for people in pain a challenge. The general hospital nurse is most likely to see people in pain due to an acute injury, an episode of ill health, following surgery, or at a wound dressing change. People living with chronic pain conditions will most often be in the care of community nurses or specialist pain management teams. In both acute and chronic pain conditions, it is important that general nurses can accurately assess, monitor, and treat pain. This chapter identifies the key features of acute and chronic pain and describes pain assessment tools which are in widespread use. It outlines common pharmacological and non-pharmacological approaches to pain management, along with a summary table of frequently prescribed pain medications. Key considerations in nursing practice and decision-making are outlined.

Pain medicine

2014 ◽  
Author(s):  
Jeremy Prout ◽  
Tanya Jones ◽  
Daniel Martin
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Management Strategies ◽  
Multidisciplinary Management ◽  
Pain Medicine ◽  
Pain Pathways ◽  
Patient Groups ◽  
Chronic Pain Conditions ◽  
Sites Of Action ◽  
Specific Management

This chapter summarizes the assessment and management of acute and chronic pain for FRCA. Pain pathways and physiological consequences of pain are considered along with sites of action and the pharmacology of common analgesics. Assessment of pain for different patient groups and settings is explained. Pain management strategies, pharmacological, non-interventional and interventional techniques are described, including multidisciplinary management of chronic pain. Specific management of some common chronic pain conditions, such as trigeminal neuralgia, are discussed in more detail.

Neuropathic pain in patients with haemophilia, that is the question

2015 ◽  
Vol 35 (S 01) ◽  
pp. S5-S9 ◽  
Author(s):  
S. Krüger ◽  
T. Hilberg
Keyword(s):  
Rheumatoid Arthritis ◽  
Chronic Pain ◽  
Neuropathic Pain ◽  
Differential Diagnosis ◽  
Pain Management ◽  
Pain Mechanisms ◽  
Number Of Patients ◽  
Paindetect Questionnaire ◽  
Chronic Disorders ◽  
Chronic Pain Conditions

SummaryChronic pain caused by recurrent joint bleedings affects a large number of patients with haemophilia (PwH). The basis of this pain, nociceptive or neuropathic, has not been investigated so far. In other pain-related chronic disorders such as osteoarthritis or rheumatoid arthritis, initial studies showed nociceptive but also neuropathic pain features. 137 PwH and 33 controls (C) completed the painDETECT-questionnaire (pDq), which identifies neuropathic components in a person´s pain profile. Based on the pDq results, a neuropathic pain component is classified as positive, negative or unclear. A positive neuropathic pain component was found in nine PwH, but not in C. In 20 PwH an unclear pDq result was observed. In comparison to C the allocation of pDq results is statistically significant (p≤0.001). Despite various pDq results in PwH and C a similar appraisal pain quality, but on a different level, was determined. Summarising the results, there is a potential risk to misunderstand underlying pain mechanisms in PwH. In chronic pain conditions based on haemophilic arthopathy, a differential diagnosis seems to be unalterable for comprehensive and individualised pain management in PwH.

scholarly journals Multidisciplinary Pain Management for Pediatric Patients with Acute and Chronic Pain: A Foundational Treatment Approach When Prescribing Opioids

Children ◽  
2019 ◽  
Vol 6 (2) ◽  
pp. 33 ◽  
Author(s):  
Anava Wren ◽  
Alexandra Ross ◽  
Genevieve D’Souza ◽  
Christina Almgren ◽  
Amanda Feinstein ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Psychological Functioning ◽  
Pediatric Patients ◽  
Multidisciplinary Treatment ◽  
Evidence Base ◽  
Opioid Therapy ◽  
Management Approach ◽  
Chronic Pain Conditions ◽  
Multidisciplinary Pain Management

Opioid therapy is the cornerstone of treatment for acute procedural and postoperative pain and is regularly prescribed for severe and debilitating chronic pain conditions. Although beneficial for many patients, opioid therapy may have side effects, limited efficacy, and potential negative outcomes. Multidisciplinary pain management treatments incorporating pharmacological and integrative non-pharmacological therapies have been shown to be effective in acute and chronic pain management for pediatric populations. A multidisciplinary approach can also benefit psychological functioning and quality of life, and may have the potential to reduce reliance on opioids. The aims of this paper are to: (1) provide a brief overview of a multidisciplinary pain management approach for pediatric patients with acute and chronic pain, (2) highlight the mechanisms of action and evidence base of commonly utilized integrative non-pharmacological therapies in pediatric multidisciplinary pain management, and (3) explore the opioid sparing effects of multidisciplinary treatment for pediatric pain.

scholarly journals Acute and chronic pain: a narrative review of the literature

2012 ◽  
Vol 25 (spe1) ◽  
pp. 150-154 ◽  
Author(s):  
Ana Maria Calil Sallum ◽  
Dayse Maioli Garcia ◽  
Mariana Sanches
Keyword(s):  
Chronic Pain ◽  
Customer Satisfaction ◽  
Pain Measurement ◽  
Rating Scales ◽  
Signs And Symptoms ◽  
Narrative Review ◽  
Assessment Tools ◽  
Review Of The Literature ◽  
Chronic Pain Conditions ◽  
At Home

The study objectives were to identify the organic, emotional and psychic prevalent consequences in patients with acute and chronic pain and punctuate the main assessment tools for these pains. A narrative review of the literature was conducted using descriptors related to pain measurement, signs and symptoms, totalizing 184 articles. The electronic databases MEDLINE and LILACS were searched from January 2000 to December 2010. The review pointed out a series of conclusive studies about the organic repercussions more frequent in acute and chronic pain conditions and the use of different rating scales for both situations. It is believed that these findings could be of great values for health teams, could contribute with a better practice and with customer satisfaction in the hospital scenario and at home.

Understanding transdermal buprenorphine and a practical guide to its use for chronic cancer and non-cancer pain management

2019 ◽  
Vol 15 (2) ◽  
pp. 147-158 ◽  
Author(s):  
Tony O’Brien, MB, FRCPI ◽  
Jin Seok Ahn, MD ◽  
Richard Chye, MBBS, FRACP, FFPMANZCA, FAChPM ◽  
Brian Le, MBBS (Hons), MPH, FRACP, FAChPM ◽  
Henry Lu, MD, DABPN, DPBPM ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Neuropathic Pain ◽  
Pain Management ◽  
Cancer Pain ◽  
Chronic Pain Management ◽  
Cancer Pain Management ◽  
Appropriate Use ◽  
Chronic Pain Conditions ◽  
Favorable Safety ◽  
Practical Recommendations

Transdermal buprenorphine (TDB) has demonstrated effectiveness in treating a range of chronic pain conditions, including cancer pain, nociceptive pain, and neuropathic pain and has a favorable safety profile. Worldwide, clinical experience of its use is relatively limited. There is considerable misunderstanding about the pharmacology, mechanism of action, and safety of buprenorphine. There is also limited guidance on the appropriate use of TDB for chronic pain management. This article presents an overview of TDB and also provides practical recommendations for its use as part of a multifaceted strategy in chronic cancer and non-cancer pain.

Pediatrics: Scoliosis Repair

2019 ◽  
pp. 334-344
Author(s):  
Jenna Sobey ◽  
Carrie Menser
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Pediatric Patients ◽  
Anesthetic Management ◽  
Balanced Approach ◽  
Successful Recovery ◽  
Chronic Postsurgical Pain ◽  
Key Factor ◽  
Perioperative Pain Management ◽  
Chronic Pain Conditions

This chapter discusses scoliosis repair, one of the most common major orthopedic surgeries performed in pediatric patients. Adolescent idiopathic scoliosis is the most common form and affects 1% to 3% of children and adolescents between the ages of 10 and 16. The anesthetic management of these patients can be challenging due to potential physiologic derangements that may be present. Adequate perioperative pain management is crucial, given the potential for significant postoperative and chronic pain conditions following repair. The rate of chronic postsurgical pain following scoliosis repair in pediatric patients averages about 20%. A balanced approach to analgesic management is best utilized to optimize pain relief while limiting side effects. Proper preparation for the perioperative experience, including setting expectations and planning for pain management, is a key factor in a successful recovery.

scholarly journals Support for osteopathic manipulative treatment inclusion in chronic pain management guidelines: a narrative review

2021 ◽  
Vol 121 (3) ◽  
pp. 307-317
Author(s):  
Megan Franzetti ◽  
Emily Dries ◽  
Brady Stevens ◽  
Lisa Berkowitz ◽  
Sheldon C. Yao
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Functional Status ◽  
Secondary Outcome ◽  
Osteopathic Manipulative Treatment ◽  
Chronic Pain Management ◽  
Medication Usage ◽  
Management Guidelines ◽  
Comparator Group ◽  
Chronic Pain Conditions

Abstract Context Osteopathic manipulative treatment (OMT) is used to treat chronic pain conditions. However, few guidelines focusing on chronic pain management include recommendations for OMT. Objectives To evaluate previous literature on the use of OMT for improving chronic pain. Methods A literature search was conducted on MEDLINE/PubMed and ScienceDirect on August 26–27, 2019, using the terms “osteopathic,” “chronic,” and “pain,” yielding a total of 312 MEDLINE/PubMed articles and 515 ScienceDirect articles. Eligibility criteria required that studies investigate pain, functional status, or medication usage through an experimental design, focusing on human subjects with chronic pain who had various forms of OMT administered by osteopathically trained individuals in which the comparator group received no intervention, a sham or placebo, or conventional care. Three authors independently performed literature searches and methodically settled disagreements over article selection. Results In the 22 articles included in our study that examined OMT use in chronic pain conditions, we evaluated primary outcomes of pain (22; 100%) and functional status (20; 90.9%), and the secondary outcome of medication usage (3; 13.6%). The majority of articles showed that OMT resulted in a significant decrease in pain levels as compared to baseline pain levels or the control group (20; 90.9%) and that OMT resulted in an improvement in functional status (17; 77.3%). In articles that did not find a significant difference in pain (2; 9.1%) or functional status (3; 13.6%), there were overall outcomes improvements noted. All articles that investigated medication usage (3; 13.6%) showed that OMT was effective in decreasing patients’ medication usage. Our study was limited by its small sample size and multimodal comparator group exclusion. Conclusions OMT provides an evidence-based management option to reduce pain levels, improve functional status, and decrease medication usage in chronic pain conditions, especially low back pain (LBP). Pain management guidelines should include OMT as a resource to alleviate chronic pain.

scholarly journals Intravenous Infusions in Chronic Pain Management

2013 ◽  
Vol 3;16 (3;5) ◽  
pp. 231-249
Author(s):  
Boleslav Kosharskyy
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
The United States ◽  
Treatment Modalities ◽  
Sufficient Evidence ◽  
Chronic Pain Management ◽  
Intravenous Infusions ◽  
Regional Pain Syndromes ◽  
Complex Regional Pain Syndromes ◽  
Chronic Pain Conditions

In the United States, millions of Americans are affected by chronic pain, which adds heavily to national rates of morbidity, mortality, and disability, with an ever-increasing prevalence. According to a 2011 report titled Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research by the Institute of Medicine of the National Academies, pain not only exacts its toll on people’s lives but also on the economy with an estimated annual economic cost of at least $560 - 635 billion in health care costs and the cost of lost productivity attributed to chronic pain. Intravenous infusions of certain pharmacologic agents have been known to provide substantial pain relief in patients with various chronic painful conditions. Some of these infusions are better, and although not necessarily the first therapeutic choice, have been widely used and extensively studied. The others show promise, however are in need of further investigations. This article will focus on non-opiate intravenous infusions that have been utilized for chronic painful disorders such as fibromyalgia, neuropathic pain, phantom limb pain, post-herpetic neuralgia, complex regional pain syndromes (CRPS), diabetic neuropathy, and central pain related to stroke or spinal cord injuries. The management of patients with chronic pain conditions is challenging and continues to evolve as new treatment modalities are explored and tested. The following intravenous infusions used to treat the aforementioned chronic pain conditions will be reviewed: lidocaine, ketamine, phentolamine, dexmedetomidine, and bisphosphonates. This overview is intended to familiarize the practitioner with the variety of infusions for patients with chronic pain. It will not, however, be able to provide guidelines for their use due to the lack of sufficient evidence. Key words: Intravenous infusions in chronic pain management, bisphosphonates, phentolamine, ketamine, lidocaine, Dexmedetomidine, chronic pain

scholarly journals Moving towards a molecular understanding of pain management

2018 ◽  
Vol 87 (1) ◽  
pp. 49-51
Author(s):  
Logan Van Nynatten ◽  
Shafaz Veettil
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Molecular Medicine ◽  
Prescription Opioids ◽  
Pharmaceutical Treatment ◽  
Pharmacological Interventions ◽  
Drug Effectiveness ◽  
Pain Medications ◽  
Great Pressure ◽  
Promising Avenue

The management of chronic pain remains a challenging area in the practise of medicine. As our population ages, the incidence and prevalence of those living with chronic pain continues to increase. Hence, there is need for methods that promote optimal pain management. One promising avenue is that of “personalized and molecular pain management”. Indeed, a variety of genetic and molecular factors have been shown to impact metabolism of narcotics, limiting drug effectiveness. Furthermore, the prominence of polypharmacy can complicate the action of pain medications. Additional laboratory and diagnostic tests may be of benefit for risk stratifying patients at high risk of abusing pain medications from those at lower risk. Combining this with physician worry of worsening the opioid addiction crisis in North America via prescribing narcotics, there remains great pressure on physicians to limit their use of narcotics. Unfortunately, this may result in patients who are suitable candidates for prescription opioids receiving inadequate pharmaceutical treatment to complement non-pharmacological interventions. Moving forward, the implementation of molecular medicine approaches to pain management may provide unique solutions to these challenges.

Chronic pain experience and pain management in persons with spinal cord injury in Nepal

2018 ◽  
Vol 18 (2) ◽  
pp. 195-201
Author(s):  
Sagun Thapa ◽  
Luppana Kitrungrote ◽  
Jintana Damkliang
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Chronic Pain ◽  
Pain Management ◽  
Community Context ◽  
Cross Sectional ◽  
Data Set ◽  
Pain Experience ◽  
Pain Medications ◽  
Cord Injury

Abstract Background and aims: Chronic pain is the frequent and significantly challenging complications in persons with spinal cord injury (SCI). Socio-cultural background may lead people perceive and manage pain differently. The study aims to describe the chronic pain experience and pain management of SCI persons in Nepal. Methods: A descriptive cross sectional study was conducted among purposively selected sample of 120 SCI persons with chronic pain living in the eight districts of Bagmati Zone of Nepal. The data were collected using the International Spinal Cord Injury Pain Basic Data Set Version 2 (ISCIPBDS-2) and Open-ended Pain Management Questionnaire. The data were analyzed using descriptive statistics and content analysis method. Results: The back (n=84), lower legs/feet (n=63) and buttocks/hips (n=51) was found as the common pain locations. In common, the onset of pain was found within the first 6 month of the injury. Overall pain intensity and pain interference were found to be at the moderate level. The SCI persons used pain medications and non-pharmacological pain management. Ibuprofen was the commonly used pain medication and commonly used non-pharmacological pain management methods included physical support (e.g. massage, exercise), relaxation (e.g. distraction, substance abuse), coping (e.g. acceptance, praying), and traditional herbs. Conclusions: SCI persons had chronic pain experience which interfered with their daily living. They used pain medications and non-pharmacological pain management methods based on their beliefs, knowledge, and community resources in Nepal. Implications: This study provides some evidence to help the team of rehabilitation professional to plan and help SCI persons with chronic pain. Based on these findings, chronic pain management intervention for SCI persons should be developed and supported continuously from hospital to home based community context of Nepal.

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