Pain

Achieving safe, effective pain control for inpatients can challenge even experienced clinicians. Components of successful pain control include avoiding pain crises while still steering clear of respiratory depression, being confident with equianalgesic calculations, and transitioning to the outpatient setting.

While it's important for nutrition and an integral part of patients' lives, food also plays a role in functional gastrointestinal disorders such as irritable bowel syndrome (IBS).

Although several reliable and valid pain assessment tools for cognitively intact and impaired geriatric patients are currently available, clinical evidence emphasized by Keela Herr, PhD, RN, FAAN, AGSF, co-director of the John A. Hartford Center for Geriatric Nursing Excellence at the University of Iowa College of Nursing, suggests those scales are not consistently administered throughout practice settings.

Phase III study results show patients with chronic non-cancer pain and opioid-induced constipation (OIC) experienced improvements in spontaneous bowel movement frequency and other symptoms of OIC.

While past studies suggest variability in physicians' chronic pain treatment decisions based on patients' sex and race, few have considered the degree of providers' self-insight into the influence of such demographics on their treatment decisions.

A literature review of randomized controlled trials and open-label studies of six months or longer duration finds good evidence that opioid therapy improves pain scores, with weaker evidence for its long-term effect on functional status.

Though the total National Institutes of Health (NIH) budget has stayed flat over the past several years, chronic pain research has enjoyed an expanded slice of the federal funding pie, as dollars committed to that portion of science grew from $279 million in 2008 to $396 million in 2012.

In light of issues concerning opioid misuse running parallel to the tenfold increase of prescription opioid use over the past 20 years, a team of researchers have developed an ongoing study examining results of a pilot program aimed at reducing patients' use of pain medications.

Only half of all patients who report experiencing symptoms that would fulfill migraine diagnostic criteria have received a formal migraine diagnosis from a physician.

The TIRF REMS Access program is designed to streamline the prescribing process and ensure appropriate patients are safely provided with TIRF products, but it may be preventing patients from accessing needed medications.

Results from a small study indicate patients with difficult-to-treat diabetic peripheral neuropathy (DPN) may benefit from therapy with tanezumab, a humanized monoclonal antibody against nerve growth factor.

Jennifer Erensen, associate director of health policy at Purdue Pharma L.P., discusses the clinical study "Review of opioid conversion recommendations from select clinical practice guidelines: all are not equal," presented at the 32nd Annual Scientific Meeting of the American Pain Society.

Analysis of claims data finds patients often receive starting doses of Butrans that do not follow published recommendations, with more than one-third of patients receiving initial doses that are too low.

According to the Administration on Aging, patients older than 65 are expected to account for approximately 19 percent of the U.S. population by 2030, compared to 12.9 percent today.

Though the third edition of the International Classification of Headache Disorders (ICHD-III) proposes to label aura in non-hemiplegic migraine that lasts longer than one hour but shorter than one week as probable migraine with aura - or probable complex migraine - a group of researchers from Italy, Switzerland, Germany, and California decided to analyze clinical studies to determine whether or not that timeframe aligns with the typical duration of migraine aura.

Declaring that the benefits of the original formulation of OxyContin no longer outweigh the risks of misuse and abuse, the FDA announced it would not approve any applications for non-tamper resistant formulations of the drug, a decision that could have far-reaching implications for all makers of opioid medications.

Pharmacist and runner Jay Sochoka, BSPharm, RPh, reflects on his experiences competing in the Boston Marathon and shares his thoughts on the tragedy that occurred at this year's race.

Understanding and addressing these disorders can improve the patient's mental health as well as their chronic pain and other comorbid conditions. Incorporating cognitive behavioral therapy and mindfulness-based cognitive therapy into the management of chronic pain has been shown to improve pain outcomes.

Pain is a common side effect of cancer that can be caused by the disease itself, treatment, and other factors. Greater awareness of the causes and types of cancer pain, knowledge of available treatments, and willingness to consult pain specialists are the keys to providing effective cancer pain management.

Pain has been associated with a number of conditions, including addiction, depression, and anxiety. Greater awareness of concurrent comorbid conditions and the options available to treat them produces better outcomes in chronic pain patients.

Pain is a product of the brain and the experiences of pain can be shaped by mood, cognition, anxiety, fear, genetics, and other individual differences. Currently, pain is measured subjectively but an objective measure of pain may improve the diagnosis and management of patients with chronic pain.

New implantable technologies such as spinal cord stimulation and peripheral nerve stimulation have shown great potential to improve the management of patients with chronic pain.

Chronic pain is a difficult condition to diagnose and manage, especially since most diagnostic measures are subjective and treatment varies from patient to patient. A key to diagnosing and treating chronic pain is to have a strong understanding of the different diagnostic tools and treatment options available.

A poster session at the 2013 AAPM annual meeting highlighted research on the role of central sensitization in chronic pain, the use of microwave ablation to treat refractory pain in patients with soft tissue tumors, a possible treatment for opioid-induced hyperalgesia, and the psychosocial effects of opioid treatment in patients with sickle-cell anemia.

Trial design and other factors can conspire to produce false positive or false negative results, which complicates not only the search for more effective pain treatments but also the safe and effective use of pain medications in practice.

The authors of three award-winning posters shared results and insights at the 2013 AAPM Annual Meeting.

While digital medicine and neuromodulation have gathered enough clinical evidence to treat chronic pain, Timothy R. Deer, MD, president and CEO of St. Francis Hospital's Center for Pain Relief, in Charleston, WV, said regenerative therapies like platelet-rich plasma, stem cells and biologics are lagging years behind in the testing realm with a long road to go.

There are several tools and resources available to pain practitioners who want to use their patient data to conduct a clinical trial.

The advent of accountable care organizations, bundled payments, and other reforms under the Affordable Care Act has steered the focus of health care delivery from quantity to quality, but where exactly do pain medicine providers fit into the new value-based care model, and how can it benefit their patients?

From full-motion video demonstrations of orthopedic clinical tests to suites of disease activity score calculators, these apps for Google and Apple mobile devices provide rheumatologists with useful and easy-to-access information at crucial moments in diagnosis and treatment.