When to consider 'mixed pain'? The right questions can make a difference!

This article outlines a methodical approach to clinical evaluation of patients presenting with acute, subacute or chronic pain, and to possibly identifying those who have mixed pain. The authors propose the use of nine simple key questions, which will provide the practicing clinician a framework for identifying the predominant pain mechanisms operating within the patient. A methodical, fairly rapid, and comprehensive assessment of a patient in chronic pain - particularly one suffering from pain with both nociceptive and neuropathic components - allows validation of their experience of chronic pain as a specific disease and, importantly, allows the institution of targeted treatment. PMID: 33012210 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - Category: Research Tags: Curr Med Res Opin Source Type: research

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by Chad D. Kollas MD, Terri A. Lewis PhD, Beverly Schechtman and Carrie Judy“I'm present. Uh … I do have a conflict. I receive funding to conduct reviews on opioids, and I'll be recusing myself after the um, director's, uh, um, um, uh … update.”- Dr. Roger Chou, Center for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control (NCIPC) Board of Scientific Counselors (BSC) Meeting Friday, July 16, 2021.IntroductionFor those familiar with the controversial relationship between the anti-opioid advocacy group, Physicians for Responsible Opioid Prescribing (PROP, recently...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: CDC judy kollas lewis opioid pain schechtman Source Type: blogs
Low back pain (LBP) is the leading cause of years lost to disability worldwide 104 with an economic burden comparable to cardiovascular disease, cancer, mental health, and autoimmune diseases 61. Up to 40% of people who experience an episode of acute LBP (defined as pain lasting less than six weeks)24,85 develop chronic pain (pain lasting longer than three months) 22,36, and interventions designed to prevent the development of chronic LBP during have not been effective 8,32,41,77,91.  A critical issue is the lack of robust mechanistic explanations for chronic LBP; in 85 – 95% of LBP cases 26,43,108, a pathoanato...
Source: The Journal of Pain - Category: Materials Science Authors: Source Type: research
CONCLUSION: Our study highlights regional differences between CNCP population phenotypes. Recognition of biomedical, psychological and socio-environmental factors affecting pain should be considered for patient stratification and rational approaches to treatment, as "one size treatment does not fit all".PMID:34410629 | DOI:10.1007/s40122-021-00301-9
Source: Pain Physician - Category: Anesthesiology Authors: Source Type: research
Conclusions: Increasing awareness of bone health issues in children will improve their recognition and treatment. Further research is needed on diagnosis, treatment, outcomes, and most importantly prevention of pediatric bone health diseases.
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Special Features Source Type: research
This article summarizes the top 20 research studies of 2020 identified as POEMs (patient-oriented evidence that matters), including the two most highly rated guidelines of the year on gout and chronic obstructive pulmonary disease (COPD). Regarding COVID-19, handwashing and social distancing through stay-at-home orders or quarantine measures are effective at slowing the spread of illness. Use of proper face masks (not gaiters or bandanas) is also effective at preventing trans- mission. This is important because the virus can infect others during the presymptomatic phase. Aspirin can no longer be recommended for the primary...
Source: American Family Physician - Category: Primary Care Authors: Source Type: research
ConclusionThe concurrent use of benzodiazepines and opioids was associated with an increased risk of fractures in older patients with chronic non-cancer pain. Therefore, patients continuously receiving benzodiazepines in whom opioids are newly initiated need careful monitoring, and such combined therapy should be limited to the shortest duration possible.
Source: Drugs and Aging - Category: Geriatrics Source Type: research
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