The Medical clinics of North America
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Med. Clin. North Am. · Jan 2016
ReviewManaging Chronic Pain in Special Populations with Emphasis on Pediatric, Geriatric, and Drug Abuser Populations.
In the adult population chronic pain can lead to loss of productivity and earning potential, and decreased quality of life. There are distinct groups with increased vulnerability for the emergence of chronic pain. ⋯ Within the pediatric, geriatric, and drug abuser populations, chronic pain represents a significant health issue. This article focuses on known anatomic, physiologic, and genetic mechanisms underlying chronic pain in these populations, and highlights the need for a multimodal approach from multiple health care professionals for management of chronic pain in those with the most risk.
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Med. Clin. North Am. · Jan 2016
ReviewBiopsychosocial Approach to Assessing and Managing Patients with Chronic Pain.
Chronic pain affects nearly one-third of the American population. Chronic pain can lead to a variety of problems for a pain sufferer, including developing secondary medical problems, depression, functional and vocational disability, opioid abuse and suicide. ⋯ Most patients with chronic pain are managed by primary care clinicians who are typically ill prepared to effectively and efficiently manage these cases. A biopsychosocial approach to evaluate and treat chronic pain is clinically and economically efficacious, but unique delivery systems are required to meet the challenge of access to specialty care.
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Med. Clin. North Am. · Jan 2016
ReviewChronic Pain Management: An Overview of Taxonomy, Conditions Commonly Encountered, and Assessment.
Chronic pain has multiple mechanisms that result in pain amplification and maintenance, including central and peripheral sensitization and altered modulation of pain perception. Assessment of pain requires comprehensive assessment of symptoms and signs, suspected pain mechanisms, and the patient's biopsychosocial context. Multiple validated measures exist for the assessment of pain symptoms, pain-related disability, psychological impact of pain, and candidacy for opioid management.
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Low back pain is an extremely common presenting complaint that occurs in upward of 80% of persons. Treatment of an acute episode of back pain includes relative rest, activity modification, nonsteroidal anti-inflammatories, and physical therapy. ⋯ Clinicians' ability to diagnose the exact pathologic source of these symptoms is severely limited, making a cure unlikely. Treatment of these patients should be supportive, the goal being to improve pain and function.