Physical medicine and rehabilitation clinics of North America
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Phys Med Rehabil Clin N Am · Aug 2015
ReviewGuideline for Prescribing Opioids to Treat Pain in Injured Workers.
Recently, there has been a dramatic increase in the use of opioids to treat chronic noncancer pain. Opioids are also being prescribed in stronger potencies and larger doses for musculoskeletal injuries. ⋯ The risk of dependence and addiction is much more common than previously thought. This guideline provides recommendations for prudent opioid prescribing and addresses issues critical to the care and rehabilitation of injured workers.
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Phys Med Rehabil Clin N Am · Aug 2015
ReviewWork-Related Complex Regional Pain Syndrome: Diagnosis and Treatment.
Complex regional pain syndrome can be a debilitating disorder, which, in its earliest stages, can be prevented by aggressive rehabilitation based on reactivation. It is critical to follow international criteria on making the diagnosis; overdiagnosis can lead to inappropriate interventions and further disability. ⋯ This article presents a phased approach to treatment that suggests movements of nonresponders quickly to more integrated levels of care. Some commonly used invasive interventions, such as sympathectomy and spinal cord stimulation, have not been proved effective; these unproven and potentially harmful therapies should be avoided.