Pain Features News
An elderly man presents to the emergency department with elbow and biceps pain after falling on the stairs.
Chronic low back pain (LBP) defined as persistent or fluctuating musculoskeletal pain of lower back and lumbar spine lasting >3 months.
Intravenous, patch lidocaine might be effective in treating, preventing chronic pain.
Co-prescribing naloxone and opioids in primary care is recommended for patients who have a high risk for opioid overdose.
Dysfunction of the endocrine system may lead to various neurologic manifestations, including headaches.
A woman has a myocardial infarction after her chest symptoms are misdiagnosed as acid reflux.
A young Caucasian woman presented with complaints of years regarding pain in her feet but did not know the cause.
Research has shown that use of suboxone and methadone, in conjunction with counseling, can be effective addiction treatment.
Ice is among alternative recommendations for treatment of chronic pain.
After 36 hours, a patient with a salivary duct stone shows limited improvement.
Slippery elm may be beneficial for patients with GI complaints.
Readers provide more suggestions for treating musculoskeletal pain.
Osteoarthritis is one of the most common problems encountered in primary care, and conservative treatment can improve patients' quality of life.
Which non-narcotic analgesics are best for treating musculoskeletal pain?
Although opioids are often prescribed for noncancer pain, a new review shows that they are no more effective than acetaminophen or NSAIDs.
An older patient with type 2 diabetes expresses concern about potential peripheral neuropathy.
For patients with severe osteoarthritis, dangling their legs can help with intra-articular injections.
Most pharmacies have a generic, affordable "caine" medication to relieve pain in wound care.
Headache is one of the most common complaints in outpatient practice. There are 10 things that clinicians need to know to help treat their patients with headache.
A patient overdoses when communication breaks down between clinicians.
Needle aponeurotomy and collagenase Clostridium histolyticum are both viable options for treating patients with Dupuytren disease.
A man with worsening pain in his right arm is diagnosed with reflex sympathetic dystrophy.
The benefits of CranioSacral Therapy may not outweigh the intensive training and medical costs associated with the treatment.
Due to the limited amount of high-quality human studies, craniosacral therapy should not be suggested as a first-line treatment.
Epidural injections of anesthetic without corticosteroids do not relieve the pain associated lumbar spinal stenosis.
A woman suffers cyclic pain after multiple abdominal and pelvic surgeries.
A man tells the orthopedics clinic staff about odd sensations in his hand a week after a car accident.
Incision and drainage on already infected skin structures can always be uncomfortable for the patient.
A clinician's opinions about a patient, noted in the patient's chart, become grounds for charges of defamation.
To minimize the risk of abuse and addiction, evidence-based prescribing practices must be used when treating acute and chronic pain with opioids.
Enlisting a parent's help can provide comfort without a scary needle or painful injection.
What treatments are recommended for pain from epiploic appendagitis?
When a magnet is placed on the skin, capillary walls relax, allowing for increased blood flow and oxygenation and removal of accumulated pain-producing prostaglandins.
A simple way to achieve oral cryotherapy to immediately relieve acutely painful symptoms.
Federal criminalization of this drug—most commonly used in the treatment of HIV, pain and glaucoma—has limited research into its effectiveness.
Does evidence support red wine for menstrual cramp prevention?
A strong dose of an opioid administered to a woman recovering from surgery causes permanent damage.
Hydromorphone for postoperative pain does not appear to increase delirium in elderly patients having hip fracture surgery.
A who takes acetaminophen for chronic neck and back pain awakens to a bloody nose and blood-soaked pillow. Could liver disease be to blame?
Reflexology uses subtle pressure on specific muscle areas of the feet or hands to stimulate blood flow and nerve impulses that then trigger the release of endorphins and retained toxins.
Rosmarinus officinalis is rich in iron, calcium and vitamin B6, and has been credited with improving cognition and memory.
Metastatic calcification of the left breast in a patient with renal failure raises suspicion.
The National Institutes of Health noted that there is enough scientific evidence of acupuncture's efficacy to warrant its use in certain clinical situations.
A growing body of evidence has linked the tart cherry to substantial anti-inflammatory benefits, including reduced arthritic and gout pain, and several cardiac benefits.
Can vitamin D deficiency play a role in post-fracture pain?
Failure to properly treat patients suffering legitimate chronic pain syndromes can result in a compounding of prescription pain-medication abuse.
These women experienced debilitating pain episodes that challenged even the most knowledgeable clinicians. You can learn from their case histories.
Medical hypnotherapy today is most commonly used for pain management, treatment of anxiety or psychosomatic illness, and treatment of behavioral disorders.
Ruling out pes planus can help avoid unnecessary prescriptions and referrals.
What treatment would you recommend for aborting a migraine in a patient with known coronary artery disease?
How do I know which radiologic tests to choose when evaluating abdominal pain?
A 55-year-old woman who had herpes zoster and takes morphine for post-herpetic neuralgia pain, no longer wants to be on heavy-duty pain medication. What are her alternatives?
Breast pain can be an frightening experience, but the primary-care provider can often allay the patient's fears and capably manage the condition.
The use of povidine-iodine in wound care is controversial. Several experimental studies have demonstrated concerns regarding its safety and effect on wound healing.
Chronic inflammation can lead to a calcaneal spur at the base of the heel bone.
Willow bark contains the chemical salicin, which is the precursor to aspirin.The active salicin in white willow bark acts primarily as both an analgesic and an antipyretic. The actual mechanism of action of salicin is very similar to that of modern prescription medications in the cyclo-oxygenase-1 and 2 (COX-1, COX-2) pathways.
How should a clinician treat a patient with recurring migraines, that also has a history of drug seeking behavior?
This painful disease greatly impacts the daily lives of those who suffer from it. Diagnosis, treatment, and lifestyle modification can ease long-term effects
What are the side effects of fentanyl?
Neuropathy is one of the most common diabetic comorbidities — affecting about 60% to 70% of patients. Managing glucose levels is the most direct way to prevent nerve damage and alleviate pain.
Nothing offered more than temporary relief for the aching, constant pain, which was unaccompanied by other symptoms.
What do you recommend to speed healing or to treat the pain of costochondritis?
Nurse commits to dedicating more time to free clinics.
Early experience in the medical ICU helped a nurse choose the appropriate test.
Many sources of chest pain have nothing to do with the heart. Whether the pain is cardiac or noncardiac in nature dictates the next steps.
The antiseizure medication tiagabine (Gabitril) has been used off-label to manage neuropathic pain, either diabetic or spinal in nature.
When is it appropriate to refer patients to a pain clinic?
Do the benefits now outweigh the risks of using lidocaine with epinephrine in digital blocks?
Patient treated despite EKG results devoid of Q waves, ST depression or elevation.
Ms. L, 34 years old and para 1 gravida 2, presented to the emergency room one evening following a four-day battle with "the flu." She became concerned after experiencing increasing pain in her left flank and pelvic area. On questioning, she recounted being constipated and very nauseated.
Misconceptions surround the use of opioids for chronic pain. For optimal management, clinicians and patients need to be armed with the facts.
What is the best way to differentiate between a patient who has legitimate back pain and someone who is looking for a drug prescription or workers' compensation?
A randomized trial of 66 patients with fibromyalgia suggests that Tai Chi might be helpful for both pain and sleep disturbance symptoms.
Four weeks after the accident, the patient was still in severe pain and reported urinary frequency.
Are there any nonpharmacologic treatment measures that have been effective in managing pain associated with sickle-cell disease?
Should all patients with fibromyalgia undergo sleep studies?
Combining these agents may compound GI complications. New guidelines help primary-care clinicians identify and protect patients most at risk.
Mr. C, 58 years old, presented for a routine primary-care appointment with the complaint of "right arm pain" of two months' duration. He rated the severity of his pain as a 10/10 and described it as gradual in onset from the shoulder down. The pain was keeping him awake at night. He had had no correlative injury except for a rotator cuff tear and repair 20 years ago.
In order to meet diagnostic criteria for generalized anxiety disorder, a patient must worry excessively about everyday problems for at least six months.
Your main challenge is to pinpoint the true cause and limit invasive interventions. A leading rheumatologist tells how to achieve these goals.
A review of the diagnosis, treatment, and testing of carpal tunnel syndrome.
If an insurance company hires you to evaluate disability claims, are you functioning as its agent or as the patient's clinician?
Not all knee complaints require orthopedic referral. This review of basic testing and exam techniques will help you arrive at an accurate diagnosis.
Coalition of Pain Experts Offers Guidance on Measures to Prevent Misuse and Abuse of Pain Medications
An ad hoc coalition of leading pain specialists and representatives from key clinical and patient advocacy organizations convened in November 2008 to address the growing problem of misuse and abuse of pain medications.
A faulty dermal patch causes a fatal overdose, but if she didn't prescribe it, why is this NP in court?
Learn which pain complaints call for medication management only and which are more time-intensive and require multimodal regimens.
Education, self-management, and pharmacologic as well as nonpharmacologic therapies take center stage in this latest, jointly issued guideline.
Clinicians may be able to help patients with chronic back pain overcome discomfort by employing a self-care program known as the Alexander technique...
A systematic review of seven randomized placebo-controlled trials evaluated the...
Some risk factors are unavoidable, but adjusting your patient's diet and addressing comorbidities can prevent excruciating episodes.
Adding etanercept (Enbrel) to methotrexate therapy for early rheumatoid arthritis (RA) resulted in...
Given the minimal risk associated with approved medications, newly released guidelines recommend expanding treatment approaches.
Mr. R, age 54, was a diabetic, moderately overweight construction worker. One day he tripped at a job site, falling heavily on his right hip. Despite the pain, he finished his shift, then he went home, took an ibuprofen tablet, and went to bed. When he awoke in agony at...
Her discomfort could have been from inevitable arthritis, but there were signs of a different diagnosis.
Two months after moving to the United States from Egypt, 67-year-old Mr. A presented to the emergency department with moderate shortness of breath that worsened on...