Journeys with Chronic Pain: Acquiring Stigma along the Way

2010 ◽  
pp. 43-54
Keyword(s):  
Chronic Pain ◽  
The Way

The Psychology of Opioid Tapering

2021 ◽  
pp. 231-250
Author(s):  
Daniel M. Doleys ◽  
Nicholas D. Doleys
Keyword(s):  
Chronic Pain ◽  
Physical System ◽  
Evidence Based ◽  
Double Pendulum ◽  
The Future ◽  
Opioid Tapering ◽  
The Individual ◽  
Evidence Based Guidelines ◽  
Existing Data ◽  
The Way

The pendulum has swung; in this case, it may be a double pendulum. The double pendulum is a pendulum hanging from a pendulum. It is a simple physical system used in physics to demonstrate mathematical chaos. When the motion of its tip is monitored, it appears very predictable at the outset, but soon reveals a very chaotic and unpredictable pattern. It is very difficult to know where the tip of the double pendulum will be at any given time in the future. This seems to describe the course of the use of opioids, especially for the treatment of chronic pain. Once, all but ignored, then heralded, and then demonized. At every step of the way, pundits will argue the incompleteness, absence, or misinterpretation of existing data. It is important to understand the psychological environment is which the opioid tapering movement occurs and to carefully consider the process in the context of the individual patient. Simply instituting another set of presumptive evidence-based guidelines could have unforeseen, and potentially tragic, consequences for the patient.

Proof of concept

2018 ◽  
Author(s):  
Victoria Tidman
Keyword(s):  
Chronic Pain ◽  
Opioid Receptors ◽  
Epidural Morphine ◽  
Direct Action ◽  
Case Series ◽  
Substantia Gelatinosa ◽  
Proof Of Concept ◽  
Small Case Series ◽  
The Way

The landmark paper discussed in this chapter is ‘Epidural morphine in treatment of pain’, published by Behar et al. in 1979. A small case series in the seventies first highlighted the use of epidural morphine for pain. It consists of only ten patients who were all administered 2 mg of morphine epidurally. Patients suffering from both acute and chronic pain had a significant reduction in the level of pain within 2–3 minutes, and this lasted 6–24 hours. The authors went on to postulate that morphine produced its effect by a direct action on the specific opioid receptors in the substantia gelatinosa. Although morphine is rarely used epidurally, this paper paved the way for the use of epidural opioids in many different pain conditions.

scholarly journals Why anesthesiologists need to care about the way chronic pain is managed

2013 ◽  
Vol 61 (2) ◽  
pp. 95-100 ◽  
Author(s):  
Alexander J. Clark ◽  
Christopher C. Spanswick
Keyword(s):  
Chronic Pain ◽  
The Way

scholarly journals Anesthesia and Ehlers-Danlos Syndrome (EDS)

2018 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Chronic Pain ◽  
Connective Tissue ◽  
Connective Tissue Disease ◽  
Local Anesthetics ◽  
Peripheral Nerves ◽  
Ehlers Danlos Syndrome ◽  
Hemorrhagic Risk ◽  
Danlos Syndrome ◽  
The Way ◽  
Lack Of Knowledge

Ehlers-Danlos syndrome is not or poorly known to doctors, anesthetists and surgeons. This lack of knowledge exposes patients to therapeutic accidents that can be prevented. This inherited connective tissue disease, which combines tissue fragility with a major proprioception disorder, causes very paradoxical reactions with local anesthetics such as xylocaine. Very often, it is ineffective as anesthetic while it sometimes has a spectacular and immediate effect on chronic pain and proprioceptive disorders. Hemorrhagic risk in this disease is considerable and underestimated imposing caution in the way such patients are treated. Lack of protection of peripheral nerves and hypermobility increase risks in positional paralysis thus necessitating positioning precautions during anesthesia.

The Painful Truth

2016 ◽  
Author(s):  
Lynn Webster
Keyword(s):  
Chronic Pain ◽  
American Academy ◽  
Positive Attitude ◽  
Cultural Transformation ◽  
Social Implications ◽  
Medical Professionals ◽  
Pain Medicine ◽  
Societal Level ◽  
The Way

The Painful Truth describes the personal and social implications of living with chronic pain and paints a picture of how society can do a better job of helping people who are in pain. In Part 1, the author-a former president of the American Academy of Pain Medicine-tells in-depth stories about some of his patients, using each story to focus on a key issue that frequently surfaces in the lives of people who have pain. The value of a positive attitude, the way that pain combines with other things going on in a person’s life, the reality of prejudice, the risk of becoming addicted to opioids, the power of love, the possibility of leveraging faith for healing, the burden and necessity of caregiving, and the need to be active in managing and making decisions for one’s own life-these are issues that come out in the stories. In Part 2, Webster talks about the issue of pain on a societal level. He faces head-on the thorny decisions involved in the use of opioids to treat chronic pain. Finally he argues that we need a cultural transformation to increase the acceptance of people who are in pain and to mobilize society’s resources to find cures for pain and make them available to all who need them. The Painful Truth, while intended for laypeople, is also helpful to medical professionals and policymakers.

scholarly journals Teamwork in chronic pain management and the way forward in low and middle-income countries

2021 ◽  
Vol 25 (2) ◽  
Author(s):  
Ali Sarfraz Siddiqui ◽  
Usman Bashir
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Adult Population ◽  
Developed Countries ◽  
Chronic Pain Management ◽  
Middle Income ◽  
Low Resource ◽  
Middle Income Countries ◽  
Low And Middle Income ◽  
The Way

Assessment and management of patients with chronic pain is a challenging task due to its complex multidimensional nature and biopsychosocial impact. It requires a collaborative effort by an interdisciplinary team. Evidence showed that in low and middle-income countries (LMICs), 33% patients among general adult population, and 56% of general elderly population, suffer from chronic painful conditions.  Women are more likely to report chronic pain than men. In this narrative review, we attempted to search published literature to know the status of assessment and management of patients with chronic pain in low resource countries and to know the most appropriate chronic pain management strategies used in developed countries. We used broad electronic database (January 2010- December 2020) through common search engines. Lack of trained pain physicians and staffs, lack of interest, empathy and lack of integrated multidisciplinary approach are some of the barriers to achieve teamwork in chronic pain management. Authors strongly recommend the need of further research in this area, improvement in training programs for physicians and nursing staff for proper pain assessment and management of patients with chronic pain in low resource countries. Key words: Chronic pain management; Teamwork; Low resource; Multidisciplinary team; Interdisciplinary approach; Low and middle-income countries Citation: Siddiqui AS, Usman B. Teamwork in chronic pain management and the way forward in low and middle-income countries. Anaesth pain intensive care 2021;25(2):229-235. DOI: 10.35975/apic.v25i2.1477 Received: 18 January 2021, Reviewed: 20 January, 10 February 2021, Accepted: 9 March 2021

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