Strategy For Management Of Chronic Pain Research Articles

Complementary and alternative medicine therapies for chronic pain.

Pain afflflicts over 50 million people in the US, with 30.7% US adults suffering with chronic pain. Despite advances in therapies, many patients will continue to deal with ongoing symptoms that are not fully addressed by the best conventional medicine has to offer them. The patients frequently turn to therapies outside the usual purview of conventional medicine (herbs, acupuncture, meditation, etc.) called complementary and alternative medicine (CAM). Academic and governmental groups are also starting to incorporate CAM recommendations into chronic pain management strategies. Thus, for any physician who care for patients with chronic pain, having some familiarity with these therapies-including risks and benefits-will be key to helping guide patients in making evidence-based, well informed decisions about whether or not to use such therapies. On the other hand, if a CAM therapy has evidence of both safety and efficacy then not making it available to a patient who is suffering does not meet the need of the patient. We summarize the current evidence of a wide variety of CAM modalities that have potential for helping patients with chronic pain in this article. The triad of chronic pain symptoms, ready access to information on the internet, and growing patient empowerment suggest that CAM therapies will remain a consistent part of the healthcare of patients dealing with chronic pain.

Intrathecal Therapy for Cancer-Related Pain.

Objective. The increasing incidence of cancer survivorship has shifted treatment of cancer-related pain from short-term analgesia to long-term chronic pain management. As a result, alternatives to oral analgesics, such as intrathecal therapy, may be beneficial for patients with cancer-related pain. The authors review the use of intrathecal therapy in the management of cancer-related pain. Methods. The Medline database was searched for English-language articles that included “ziconotide” or “morphine” AND (“cancer” OR “malignant”) AND “intrathecal” in title or abstract. Available abstracts from scientific congresses in the areas of neuromodulation and oncology were also reviewed. Results. Intrathecal therapy provides pain relief with reduced systemic concerns in patients with cancer-related pain. Patients should undergo multidisciplinary evaluation and, in most cases, drug trialing before intrathecal pump implantation. Morphine, an opioid (µ-opioid receptor antagonist), and ziconotide, a nonopioid (selective N-type calcium channel inhibitor), are both approved for intrathecal analgesia; however, tolerance and safety concerns may deter the use of intrathecal morphine. Ziconotide has also shown efficacy for reduction of cancer-related pain; however, proper dosing and titration must be used to prevent adverse events. There is little information available on use of intrathecal therapies specifically in cancer survivors. Conclusions. Treatment of cancer-related pain has shifted toward chronic pain management strategies, especially among cancer survivors. Intrathecal therapy provides an alternate route of administration of chronic pain medications (e.g., morphine and ziconotide) for cancer patients with and without active disease, although additional research is needed to support effectiveness in cancer survivors.

Strategies for Managing Chronic Pain: Case of a Skilled Orthopaedic Physician and Mini-Review

Epidemiological surveys have recently revealed a high prevalence of chronic musculoskeletal pain in Japan; however, 30% of the patients in the survey were not satisfied with their pain treatment. This indicates that standard strategies in the management of chronic pain are poorly shared among physicians in Japan. Herein we report a case of a patient with intractable chronic pain who is a skilled orthopaedic physician. A 43-year-old man who was a skilled orthopaedic surgeon presented at our center complaining of severe buttock pain especially around the right hip region for more than three years. At begging of pain onset, he was diagnosed with femoacetabular impingement syndrome (FAI) with labral tear. Despite biophysical interventions including twice surgeries and alternative conservative treatment, his pain persisted, and he occasionally had to take a day off work due to the severe pain. Therefore we had to evaluate his pathological condition using a multidimensional approach based on a biopsychosocial model. We had provided him with cognitive behavioral therapy (CBT) approach, and simultaneously suggestion for short leaving from work. Three months after the start of CBT training, his disabilities had begun to improve. About six months later, he could continue to do his work. Finally, 19 months have passed since we started implementing the CBT approach; he has regained both his previous work-life balance and his health, although the pain has not completely subsided. In conclusion, we think it is important for physicians treating chronic pain to learn the management strategies for chronic pain and to re-consider their management policy when conventional biomedical interventions were not succeeded, even in cases where medication and surgical intervention are warranted.

Literature review of pain management for people with chronic pain.

Multimodal approaches toward relieving pain, patients' participation, and improving self-efficacy are important for chronic pain management. The aims of this review were to identify possible options of nursing strategies for pain management in individuals with chronic pain and to determine the effectiveness of these strategies for pain relief/pain-related problems; therefore, nurses and researchers could consider and/or adopt multimodal chronic pain management strategies. A Systematic Integrated Literature Review was conducted. Published work related to pain management in individuals with chronic pain was identified by searching databases and reviewed. Among the studies reviewed, we identified 35 studies that focused on pain management strategies. In 10 studies, interventions such as integrated and multidisciplinary pain management programs were associated with significant decreases in pain intensity. However, they reported that the long-term effectiveness of pain relief was not satisfactory. Individuals with chronic pain reported that strategies including pharmacotherapy, physical activity, social support from friends and family, acupuncture, heating, rest, diets, or life-style changes helped them to effectively manage their pain. We identified possible options of pain management strategies and explored effectiveness of chronic pain interventions. The long-term effects of pain relief interventions and social support for individuals with chronic pain require further investigation.

Chronic pain management strategies used by low-income overweight Latinos

The objective of this study is to examine the strategies used to manage chronic pain from the perspective of the individual in group interviews. Sixteen low-income overweight Latino adults participated in two group interviews facilitated by a trained moderator who inquired about the type of chronic pain suffered by participants, followed by more specific questions about pain management. Interviews were audio-recorded, transcribed verbatim (Spanish), back-translated into English, and analyzed using thematic analysis. Participants' pain varied in type, location, and intensity. Participants discussed pain-related changes in activities and social life, and difficulties with health care providers, and as a result, we discovered five major themes: pain-related life alterations, enduring the pain, trying different strategies, emotional suffering, and encounters with health care system/providers. Findings indicated that there are opportunities for providers to improve care for low-income overweight Latinos with chronic pain by listening respectfully to how pain alters their daily lives and assisting them in feasible self-management strategies.

The need for a national strategy for chronic pain management in Ireland

Chronic pain is defined as pain on a daily basis for more than six months. It affects 13% of the Irish population. Despite its prevalence and the impact on patient's quality of life there is no national strategy for this problem. To determine the need for a national strategy for chronic pain in Ireland. The cost of low back pain (LBP) (common chronic pain condition), the level of education and research and current chronic pain clinic resources were investigated. The cost of LBP in Ireland is enormous: disability payments from the Department of Social and Family Affairs amounted to euros 348 million and insurance payments cost euros 10.5 million. The number of teaching hours timetabled for pain education in the schools of Medicine, Physiotherapy, Dentistry, Nursing and Psychology in Ireland's six universities varied significantly (e.g. 11.5-72 hrs in nursing). Research grants awarded from state organisations were limited to one over a four-year period. No current chronic pain clinics comply with recommended International Association for the Study of Pain (IASP) guidelines. A national strategy is needed to reduce costs, standardise teaching and increase pain clinic resources to maximise patient care.

Chronic Pain Management in the Workplace

1. Occupational health nurses often have the opportunity and knowledge to assist clients with chronic pain management and help them progress toward a more active and fulfilling lifestyle. 2. Proper pain management is considered one of the major concerns of modern health care. Health providers continue to search for ways to explain, predict, and cure the misery caused by chronic pain. 3. Chronic pain management is a multifacted condition of both mind and body and is heavily influenced by environmental factors such a family, cultural norms, and job expectations. 4. Current chronic pain management strategies focus on the whole person, not just the painful symptoms experienced by the individual.

Management strategies for chronic pain.

Management strategies for chronic pain.