Management of patients with chronic pain in acute and perioperative medicine : An interdisciplinary challenge.

[Management of patients with chronic pain in acute and perioperative medicine : An interdisciplinary challenge]. Anaesthesist. 2020 Jan 13;: Authors: Erlenwein J, Pfingsten M, Hüppe M, Seeger D, Kästner A, Graner R, Petzke F Abstract Chronic pain is a frequent comorbidity of patients in hospitals and has an influence on the clinical course and the duration of hospitalization. There is a need to have a better understanding of chronic pain as a comorbidity and it should be considered to a greater extent in understanding diseases, in treatment concepts and hospital structures to ensure a resource-oriented and high-quality care. This begins on admission by identifying pre-existing pain and related risk factors with the medical history and taking these into account in the treatment regimen. A multimodal treatment approach that involves medicinal, educational, psychological and physiotherapeutic expertise is required in these patients. A unimodal approach in the treatment is not effective. A pain physician should be involved in the treatment team as early as possible. Furthermore, psychological joint supervision should be available for these patients as several studies have demonstrated positive perioperative effects of psychological approaches on the treatment in this patient group. PMID: 31932857 [PubMed - as supplied by publisher]
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research

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Alert: rant ahead. Early in my career working in persistent pain management, it was thought that “chronic pain is chronic pain is chronic pain” and pretty much anything that helped one person would help the next. Over time we’ve learned a lot more about persistent pain: the mechanisms differ a lot between neuropathic mechanisms and nociplastic mechanisms. Even within these groups, the mechanisms are very different. We’ve also learned a lot more about the psychosocial variables that are associated with prolonged disability and distress when pain persists. Some of the earliest work by Turk and coll...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Chronic pain Groupwork Interdisciplinary teams Pain conditions Research Science in practice Source Type: blogs
Publication date: Available online 2 July 2019Source: Anaesthesia &Intensive Care MedicineAuthor(s): Judith SemmonsAbstractThe role of physiotherapy in managing chronic pain is challenging. A multidisciplinary approach incorporating several specialities within the pain clinic is recommended. Treatment primarily focuses on the biopsychosocial model: part of the clinician's skill is to decide which part or parts of this biopsychosocial model influence the patient's pain. Key physiotherapy treatments are described: education, patient empowerment and promoting exercise and function. Patients often fear exercise as without ...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
Conclusions: Acupuncture therapy seems effective for motor function, pain relief and activities of daily living in stroke patients with mild SHS, when it is used in combination with rehabilitation. The low certainty of evidence downgrades our confidence in making recommendations to clinical practice. Introduction Shoulder-hand syndrome (SHS) is a common condition among people who have had a stroke, with its reported prevalence ranging from 12% to 49% (1, 2). The main symptoms of SHS include pain, hyperalgesia, joint swelling and limitations in range of motion (ROM) (3). Post-stroke SHS is also named type I complex ...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
We examined the expression of TRPV1 in peripheral tissue and DRG neurons of CPIP model rats and we studied whether CPIP model could induce peripheral sensitization of TRPV1 channel and enhance DRG neuron excitability. Then we examined the therapeutic effects of locally applied TRPV1 specific antagonist AMG9810 on pain responses of CPIP model rats. Lastly, we explored the effects of AMG9810 on DRG neuron hyperexcitability and spinal glial activation induced by CPIP. Our results demonstrate that TRPV1 plays an important role in mediating the behavioral hypersensitivity of CPIP model rats via promoting peripheral nociceptor a...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
AbstractPurpose of ReviewThe purpose of this chapter is to provide a review and expert opinion supporting pharmacological treatments for insomnia in children and adolescents with chronic pain conditions.Recent FindingsInsomnia as an independent disorder is defined as dissatisfaction with sleep quantity or quality, clinically significant distress or impairment in daytime functioning, and a specific time pattern of occurrence. Independent of the pathological context, insomnia is more frequent in adolescents than in children. The impact of insomnia on pediatric patients is quite profound, especially on those affected by chron...
Source: Current Anesthesiology Reports - Category: Anesthesiology Source Type: research
As a shadowing medical student in family medicine clinics in Toronto, I’d seen patients with chronic pain of a neurogenic origin and always felt heartbroken. I’d looked on in helplessness as we consoled the patients and offered them physi...
Source: Medgadget - Category: Medical Devices Authors: Tags: Anesthesiology Exclusive Pain Management Rehab Source Type: blogs
Bioness, a Valencia, California medical device/rehabilitation company, recently received approval from Health Canada for its StimRouter device, an implantable peripheral nerve stimulator designed to reduce chronic pain. We spoke with Mark Geiger, the...
Source: Medgadget - Category: Medical Devices Authors: Tags: Anesthesiology Exclusive Neurosurgery Pain Management Source Type: blogs
Abstract Frozen shoulder is a painful debilitating condition which can be diagnosed clinically. It is a condition of chronic inflammation and proliferative fibrosis resulting in painful limitation of shoulder movements with classical clinical signs. Diabetic patients are more likely to develop the disease and more likely to require operative management. Diabetic frozen shoulder is a difficult condition to manage, and the clinician must strike a balance between improving range of movement and treating pain, but not over-treating what is an essentially self-resolving condition. Treatment options principally include physiothe...
Source: European Journal of Orthopaedic Surgery and Traumatology - Category: Orthopaedics Source Type: research
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Source: Scandinavian Journal of Pain - Category: Anesthesiology Source Type: research
Conclusions: Currently available immersive virtual reality technology with myolectric and motion tracking control may represent a possible therapy option for treatment-resistant phantom limb pain. Keywords: virtual reality, phantom limb pain, rehabilitation, amputation, therapy, pain Innov Clin Neurosci. 2017;14(7–8):3–7 Phantom limb pain (PLP), the sensation of pain in an absent limb, is a frequent complication after amputation, with reported prevalence rates ranging from 40 to 85 percent.1,2 While the exact mechanism of PLP remains to be elucidated, peripheral and central neural factors are thought to contrib...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Case Report Current Issue amputation pain phantom limb pain rehabilitation therapy virtual reality Source Type: research
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