Abandoned Practices for Chronic Pain???

A lawyer asked me a couple thought-provoking questions: Lawyer: "Doctor, is there a professional consensus on the use of opioids for chronic pain?" Me: "No." Lawyer: "Doctor, has the field of pain management abandoned using opioids for treating chronic pain?" Me: "No." So, it got me thinking. What have we abandoned? How will we ever know that there is a consensus about the appropriate use of a modality based upon evidence? Everything (chiro, acupuncture, opioids, PT, psych, etc)... Abandoned Practices for Chronic Pain???
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Source Type: forums

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(University of Massachusetts at Amherst) A major shift in practice by the VA means that therapies such as meditation and yoga are being offered to VA patients as non-drug approaches for pain management, says Elizabeth Evans of UMass Amherst, who studied their use by gender among veterans with chronic musculoskeletal pain.
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news
Conclusions: Acupuncture is feasible and safe as an adjunct treatment for chronic CD, and might be associated with subjective symptomatic benefits. PMID: 30147821 [PubMed]
Source: Acupuncture in Medicine - Category: Complementary Medicine Authors: Tags: Med Acupunct Source Type: research
Publication date: May–June 2018Source: EXPLORE, Volume 14, Issue 3Author(s): Heather Tick, Arya Nielsen, Kenneth R. Pelletier, Robert Bonakdar, Samantha Simmons, Ronald Glick, Emily Ratner, Russell L. Lemmon, Peter Wayne, Veronica Zador, The Pain Task Force of the Academic Consortium for Integrative Medicine and HealthABSTRACTMedical pain management is in crisis; from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addiction, diversion and overdose deaths. The rising costs of pain care and managing adverse effects of that care have prompted action ...
Source: EXPLORE: The Journal of Science and Healing - Category: Complementary Medicine Source Type: research
Abstract BACKGROUND: Warm needle acupuncture (WNA) is commonly used in primary osteoporosis (OP) management in China. The evidence of its effectiveness needs to be systematically reviewed. OBJECTIVE: The aim of the meta-analysis was to evaluate whether using WNA alone or combined with conventional medicine benefits primary OP. METHODS: PubMed, Embase, the Cochrane Central Register, Medline, China National Knowledge Infrastructure, Wanfang and VIP databases were searched from their inception through30 June 2016. RCTs applying WNA independently or as an adjunct to conventional medicine, compared with conve...
Source: Acupuncture in Medicine : journal of the British Medical Acupuncture Society - Category: Complementary Medicine Authors: Tags: Acupunct Med Source Type: research
Publication date: May–June 2018Source: EXPLORE, Volume 14, Issue 3Author(s): Heather Tick, Arya Nielsen, Kenneth R. Pelletier, Robert Bonakdar, Samantha Simmons, Ronald Glick, Emily Ratner, Russell L. Lemmon, Peter Wayne, Veronica Zador, The Pain Task Force of the Academic Consortium for Integrative Medicine and HealthABSTRACTMedical pain management is in crisis; from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addiction, diversion and overdose deaths. The rising costs of pain care and managing adverse effects of that care have prompted action ...
Source: EXPLORE: The Journal of Science and Healing - Category: Complementary Medicine Source Type: research
AbstractObjectiveThe aim of this study was to provide an overview of the recommendations regarding the diagnosis and treatment contained in current clinical practice guidelines for patients with non-specific low back pain in primary care. We also aimed to examine how recommendations have changed since our last overview in 2010.MethodThe searches for clinical practice guidelines were performed for the period from 2008 to 2017 in electronic databases. Guidelines including information regarding either the diagnosis or treatment of non-specific low back pain, and targeted at a multidisciplinary audience in the primary care set...
Source: European Spine Journal - Category: Orthopaedics Source Type: research
AbstractPurpose of ReviewChronic wounds are increasing in prevalence and are often associated with significant pain, which can have a major impact on quality of life. Safe and effective pain management can be challenging, an unfortunate reality that is highlighted by the ongoing opioid crisis. This review aims to provide an evidence-based framework for pharmacologic and non-pharmacologic pain management in patients with chronic wounds.Recent FindingsAs reflected in the new CDC guidelines, no study has shown that long-term opioid use mitigates chronic pain. Non-pharmacologic therapies, including virtual reality and acupunct...
Source: Current Dermatology Reports - Category: Dermatology Source Type: research
AbstractThe prefrontal cortex (PFC) is not only important in executive functions, but also pain processing. The latter is dependent on its connections to other areas of the cerebral neocortex, hippocampus, periaqueductal gray (PAG), thalamus, amygdala, and basal nuclei. Changes in neurotransmitters, gene expression, glial cells, and neuroinflammation occur in the PFC during acute and chronic pain, that result in alterations to its structure, activity, and connectivity. The medial PFC (mPFC) could serve dual, opposing roles in pain: (1) it mediates antinociceptive effects, due to its connections with other cortical areas, a...
Source: Molecular Neurobiology - Category: Neurology Source Type: research
CONCLUSIONS: Based on the findings of moderate quality evidence, this review found that some non-pharmacological interventions such as acupuncture and extracorporeal shockwave therapy are likely to result in a decrease in prostatitis symptoms and may not be associated with a greater incidence of adverse event. The QoE for most other comparisons was predominantly low. Future clinical trials should include a full report of their methods including adequate masking, consistent assessment of all patient-important outcomes including potential treatment-related adverse events and appropriate sample sizes. PMID: 29757454 [Pub...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Publication date: Available online 1 March 2018 Source:EXPLORE Author(s): Heather Tick, Arya Nielsen, Kenneth R. Pelletier, Robert Bonakdar, Samantha Simmons, Ronald Glick, Emily Ratner, Russell L. Lemmon, Peter Wayne, Veronica Zador Consortium Pain Taskforce White Paper Summary Evidence-based Nonpharmacologic Strategies for Comprehensive Pain Care Supplementary information can be found in the online version at https://doi.org/10.1016/j.explore.2018.02.001. Medical pain management is in crisis; from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addict...
Source: EXPLORE: The Journal of Science and Healing - Category: Complementary Medicine Source Type: research
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