Pain research & management : the journal of the Canadian Pain Society = journal de la société canadienne pour le traitement de la douleur
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Undertreated pain is common among people who use illicit drugs (PWUD), and can often reflect the reluctance of health care providers to provide pain medication to individuals with substance use disorders. ⋯ The results of the present study suggest that the denial of pain medication is associated with the use of illicit drugs while hospitalized. These findings raise questions about how to appropriately manage addiction and pain among PWUD and indicate the potential role that harm reduction programs may play in hospital settings.
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Case Reports
Atypical nummular headache or circumscribed migraine: the utility of pressure algometry.
A peripheral mechanism has been proposed for nummular headache; however, there have been descriptions of atypical features resembling migraine. The authors describe a case in which algometry assessment facilitated the discrimination between atypical nummular headache and circumscribed migraine. A 21-year-old woman presented with a history of focal episodic pain in a circumscribed area on the left frontal region. ⋯ This result led the authors to introduce a more specific preventive therapy with topiramate, with significant relief. In conclusion, cartographic investigation of pressure pain sensitivity is a simple tool that can help to differentiate between nummular headache and migraine. Further confirmatory investigations are needed.
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Myofascial pain syndrome of the pelvic floor (MPSPF) is a common disease in the context of chronic pelvic pain (CPP); however, there is currently no gold-standard test to diagnose it. ⋯ TAA is a reliable diagnostic test to detect MPSPF. Further studies are needed to reproduce these results.
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Thousands of people treated in primary care are currently experiencing chronic pain (CP), for which management is often inadequate. In Quebec, nurses in family medicine groups (FMGs) play a key role in the management of chronic health problems. ⋯ FMG nurses are currently performing few activities in CP management. The nonrecognition of CP may explain this situation.
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Pain assessment is an immense challenge for clinicians, especially in the context of the intensive care unit, where the patient is often unable to communicate verbally. Several methods of pain assessment have been proposed to assess pain in this environment. These include both behavioural observation scales and evaluation of physiological measurements such as heart rate and blood pressure. Although numerous validation studies pertaining to behavioural observation scales have been published, several limitations associated with using these measures for pain assessment remain. Over the past few years, researchers have been interested in the use of the bispectral index monitoring system as a proxy for the evaluation of encephalography readings to assess the level of anesthesia and, potentially, analgesia. ⋯ Further studies are needed to clearly demonstrate the relationship between nociceptive stimuli and the bispectral index, as well as the specificity of the bispectral index in detecting pain.