Characteristics of patients with chronic pain accessing treatment with medical cannabis in Washington State

2018 ◽  
Vol 5 (5) ◽  
pp. 257 ◽  
Author(s):  
Sunil K. Aggarwal, PhD, MD Candidate ◽  
Gregory T. Carter, MD, MS ◽  
Mark D. Sullivan, MD, PhD ◽  
Craig ZumBrunnen, PhD ◽  
Richard Morrill, PhD ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Myofascial Pain ◽  
Visceral Pain ◽  
Pain Syndrome ◽  
Pain Clinic ◽  
Phantom Pain ◽  
Medical Cannabis ◽  
Treatment Access ◽  
Common Diagnosis ◽  
Cord Injury

Objectives: This study was conducted to better understand the characteristics of chronic pain patients seeking treatment with medicinal cannabis (MC).Design: Retrospective chart reviews of 139 patients (87 males, median age 47 years; 52 females, median age 48 years); all were legally qualified for MC use in Washington State.Setting: Regional pain clinic staffed by university faculty.Participants: Inclusion criteria: age 18 years and older; having legally accessed MC treatment, with valid documentation in their medical records. All data were de-identified.Main Outcome Measures: Records were scored for multiple indicators, including time since initial MC authorization, qualifying condition(s), McGill Pain score, functional status, use of other analgesic modalities, including opioids, and patterns of use over time.Results: Of 139 patients, 15 (11 percent) had prior authorizations for MC before seeking care in this clinic. The sample contained 236.4 patientyears of authorized MC use. Time of authorized use ranged from 11 days to 8.31 years (median of 1.12 years). Most patients were male (63 percent) yet female patients averaged 0.18 years longer authorized use. There were no other gender-specific trends or factors. Most patients (n = 123, 88 percent) had more than one pain syndrome present. Myofascial pain syndrome was the most common diagnosis (n = 114, 82 percent), followed by neuropathic pain (n = 89, 64 percent), discogenic back pain (n = 72, 51.7 percent), and osteoarthritis (n = 37, 26.6 percent). Other diagnoses included diabetic neuropathy, central pain syndrome, phantom pain, spinal cord injury, fibromyalgia, rheumatoid arthritis, HIV neuropathy, visceral pain, and malignant pain. In 51 (37 percent) patients, there were documented instances of major hurdles related to accessing MC, including prior physicians unwilling to authorize use, legal problems related to MC use, and difficulties in finding an affordable and consistent supply of MC.Conclusions: Data indicate that males and females access MC at approximately the same rate, with similar median authorization times. Although the majority of patient records documented significant symptom alleviation with MC, major treatment access and delivery barriers remain.

scholarly journals Classification of Chronic Pain at a Multidisciplinary Pain Rehabilitation Clinic

1998 ◽  
Vol 3 (1) ◽  
pp. 13-22 ◽  
Author(s):  
Jan Lidbeck ◽  
Gertie IM Hautkamp ◽  
Ritva A Ceder ◽  
Urban LO Näslund
Keyword(s):  
Chronic Pain ◽  
Musculoskeletal Pain ◽  
Myofascial Pain ◽  
Pain Syndrome ◽  
Pain Clinic ◽  
Psychological Pain ◽  
Pain Syndromes ◽  
Epidemiological Surveys ◽  
Clinical Diagnoses ◽  
Chronic Pain Syndromes

OBJECTIVE: To make a detailed diagnostic analysis of patients with chronic pain syndromes, including classification according to the International Association for the Study of Pain (IASP).DESIGN: Descriptive study of consecutive referrals during a two-year period.SETTING: A multidisciplinary out-patient pain clinic focused on occupational rehabilitation.SUBJECTS: A total of 309 chronic pain patients.METHODS: After a standardized multimodal physical and psychological examination, the chronic pain syndrome of each patient was assigned one or more clinical diagnoses; assigned to an etiological pain category (nociceptive pain, non-nociceptive including idiopathic pain, and psychological pain); and coded diagnostically according to IASP taxonomy.RESULTS: In all, 397 clinical diagnoses were made (ie, a mean of 1.3 diagnoses per patient). A large majority (87%) received a diagnosis of myalgia. Myofascial pain (trigger point syndrome) was diagnosed in two-thirds of the patients and was the most frequent clinical pain syndrome. A total of 51.8% of the pain syndromes were categorized as nociceptive, 43.0% as idiopathic and less than 1% as pain of psychological origin. Classification using the IASP system yielded a very high proportion of nociceptive, musculoskeletal pain syndromes of high intensity, with widespread pain and/or pain located in the neck/shoulder/arm region, and of dysfunctional etiology.CONCLUSIONS: Musculoskeletal pain was very common in this series, and myofascial pain syndromes were the most frequent specific pain disorders. However, myofascial pain had generally gone unrecognized by the referring physician. In contrast to findings of other studies, the incidence of low back pain and of primary psychological pain was low. Comparison of the results with those of Swedish epidemiological surveys showed the frequencies of the diagnoses in this series to be representative of chronic pain syndromes in the Swedish general population.

scholarly journals Myofascial pain syndrome and SARS-CoV-2: a case series

2021 ◽  
Author(s):  
Jaldhi Patel ◽  
Saba Javed
Keyword(s):  
Chronic Pain ◽  
Myofascial Pain ◽  
Case Series ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Pain Clinic ◽  
History Of ◽  
The Relationship

SARS-CoV-2 is a novel virus that has caused a plethora of dysfunctions and changes in the human body. Our goal in this case study series was to demonstrate the relationship that coronavirus has had in newly diagnosing patients with myofascial pain syndrome (MFPS). Medical records were obtained from a pain clinic that demonstrated the effects of this virus on patients who developed MFPS between March 2020 and December 2020. Chart reviews were performed and demonstrated patients who had a history of chronic pain had subsequent episodes of worsening exacerbations of pain, more specifically trigger points, after being diagnosed with coronavirus. MFPS and SARS-CoV-2 are proposed to be correlated amongst chronic pain patients. Potential pathological mechanisms include coronavirus-induced hypoxic muscle dysfunctions as well as psychological stress triggering pain receptors, leading to myofascial pain syndrome.

scholarly journals Millon Behavioral Health Inventory Scores of Patients With Chronic Pain Associated with Myofascial Pain Syndrome

Pain Medicine ◽  
2001 ◽  
Vol 2 (4) ◽  
pp. 328-335 ◽  
Author(s):  
David A. Fishbain ◽  
Deborah Turner ◽  
Hubert L. Rosomoff ◽  
Renee Steele Rosomoff
Keyword(s):  
Chronic Pain ◽  
Behavioral Health ◽  
Myofascial Pain ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Millon Behavioral Health Inventory

Chronic pain associated with malignant neoplasm. Modern terms and classification

2021 ◽  
Vol 22 (1) ◽  
pp. 146-151
Author(s):  
V. V. Khinovker ◽  
◽  
A. P. Spasova ◽  
V. A. Koryachkin ◽  
D. V. Zabolotskiy ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Radiation Therapy ◽  
Visceral Pain ◽  
International Association ◽  
Malignant Neoplasm ◽  
Pain Syndrome ◽  
International Classification Of Diseases ◽  
Malignant Neoplasms ◽  
Common Symptom

According to 2019 data, the incidence of cancer in Russia increases by 1.5% annually, 8.5 million people die from malignant neoplasms. Pain is the most common symptom when diagnosed with a malignant neoplasm. In the final stage of the disease, about 66% of patients experience pain, and in most cases the intensity of pain syndrome is regarded as moderate to severe pain. In the international classification of diseases 11 revisions (μb-11), the diagnosis of chronic pain is supposed to be reflected in a separate section. The aim of the review was to present a modern classification of chronic pain associated with malignancy. The search for publications has been carried out by two independent researchers since 01.2010. until 12.2020. in the databases PubMed, MEDLINE, EMBASE, Cochrane, as well as the International Association for the Study of Pain. The International Association for the Study of Pain has established a special group, which, in close collaboration with WHO representatives, has developed a new classification of chronic pain. Chronic pain caused by malignancy: chronic visceral pain caused by malignancy; chronic bone pain caused by malignancy; chronic neuropathic pain caused by malignancy; other chronic pain caused by malignancy. Chronic pain due to treatment of malignant neoplasm: chronic pain caused by drug treatment of malignant neoplasm Chronic polyneuropathy due to chemotherapy; chronic pain caused by radiation therapy of malignant neoplasm; chronic neuropathy due to radiation therapy; Chronic pain caused by surgical treatment of malignant neoplasm. Other chronic pain caused by treatment of malignant neoplasm. Thus, the inclusion in the MKB-11 of a separate classification of chronic pain associated with malignancy will lead to the correct formulation of the diagnosis, which will contribute to individualized treatment (antitumor therapy, surgery), psychological support, the involvement of algologists (intervention methods of therapy), intensified research on the prevention and treatment of pain syndromes, as well as standardization of chronic assessment of pain.

A Review of Myofascial Pain and Fibromyalgia – Factors that Promote Their Persistence

2005 ◽  
Vol 23 (3) ◽  
pp. 121-134 ◽  
Author(s):  
Robert D Gerwin
Keyword(s):  
Muscle Pain ◽  
Myofascial Pain ◽  
Visceral Pain ◽  
Treatment Plan ◽  
Specific Treatment ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Difficult Problem ◽  
Chronic Muscle Pain

Chronic muscle pain (myalgia) is a common problem throughout the world. Seemingly simple, it is actually a difficult problem for the clinician interested in determining the aetiology of the pain, as well as in managing the pain. The two common muscle pain conditions are fibromyalgia and myofascial pain syndrome. Fibromyalgia is a chronic, widespread muscle tenderness syndrome, associated with central sensitisation. It is often accompanied by chronic sleep disturbance and fatigue, visceral pain syndromes like irritable bowel syndrome and interstitial cystitis. Myofascial pain syndrome is an overuse or muscle stress syndrome characterised by the presence of trigger points in muscle. The problem these syndromes pose lies not in making the diagnosis of muscle pain. Rather, it is the need to identify the underlying cause(s) of persistent or chronic muscle pain in order to develop a specific treatment plan. Chronic myalgia may not improve until the underlying precipitating or perpetuating factor(s) are themselves managed. Precipitating or perpetuating causes of chronic myalgia include structural or mechanical causes like scoliosis, localised joint hypomobility, or generalised or local joint laxity; and metabolic factors like depleted tissue iron stores, hypothyroidism or Vitamin D deficiency. Sometimes, correction of an underlying cause of myalgia is all that is needed to resolve the condition.

Therapeutic Effect of Acupuncture for Chronic Pain

1977 ◽  
Vol 05 (01) ◽  
pp. 45-61 ◽  
Author(s):  
Gregory S. Chen ◽  
Yeou-Cheng Hwang
Keyword(s):  
Chronic Pain ◽  
Acupuncture Treatment ◽  
Pain Syndrome ◽  
Pain Clinic ◽  
Previous Surgery ◽  
Male And Female ◽  
The Past ◽  
Good General Health ◽  
Better Than

The purpose of this report concerned with the activities of the acupuncture clinic at UAB during the past 2 years and 3 months, is to objectively assess the role of acupuncture in the treatment of various pain disorders for which conventional pain relieving methods had failed to yield satisfactory results. In carefully analyzing the data provided by the patients through completed questionnaires, an attempt was made to look at the results obtained as unbiased as possible and to determine whether it is justified to continue the acupuncture activities at UAB or terminate them. From the data presented it appears that acupuncture helped in more than 50 percent of the patients by either completely or partially controlling the suffering from painful disorders. Patients helped by acupuncture received 8.55 treatments on the average, while patients not helped by acupuncture only recieved 4.75 treatments. There is little difference between the male and female patients as to the response to acupuncture. However, we noticed that the younger the patient and the shorter the duration of their problems, the better the response. Patients who had not had surgery to treat the pain syndrome responded better than those who had previous surgery. Patients with backache who had previously had laminectomy showed better response to acupuncture than the patients who had spinal fusion. It appears that good general health plays an important role in favorably responding to acupuncture treatment. It is apparent from this survey that acupuncture may be a valuable extension of a conventional pain clinic and an alternative in patients who are desperate in their desire to get relief from pain which they failed to obtain from other methods.

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