Pain management
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Neuropathic pain affects 6-8% of the general adult population. It is reported by 27% of chronic pain patients and 40% of cancer patients, yet there is no standardized diagnostic test for neuropathic pain. ⋯ Over the past decade these neuropathic pain screening tools have been validated in a wide range of pain populations, as well as translated into many languages, to discriminate between neuropathic and non-neuropathic pain. We describe here the five most commonly used neuropathic pain screening tools and discuss current assessment guidelines, the use of screening tools in novel clinical contexts and their potential use in personalized therapy.
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A recent revision in the definition of neuropathic pain has highlighted this condition as a distinct disease entity. More accurate search for a lesion in the somatosensory nervous system as the pain-generating mechanism will help target the treatment by pharmacological agents. A multidisciplinary approach is recommended, with pharmacotherapy supplemented by psychological therapy and physical rehabilitation, and appropriate interventional treatment for selected refractory cases.
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To evaluate the effectiveness and safety of transdermal buprenorphine (BTDS) in the treatment of post-traumatic pain in a working population. ⋯ BTDS is an effective and safe alternative for the treatment of patients with severe post-traumatic pain, reducing the intensity of pain and improving functional capacity and quality of sleep.
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Use of experimental pain is vital for addressing research questions that would otherwise be impossible to examine in the real world. Experimental induction of pain in children is highly scrutinized given the potential for harm and lack of direct benefit to a vulnerable population. ⋯ It addresses practical implementation and ethical issues, as well as the advantages and disadvantages offered by each task. The incredible potential for future research is discussed given the array of experimental pain modalities now available to pediatric researchers.
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Psychological approaches to chronic pain have produced significant success and are widely accepted. Yet it can be difficult for those outside the field to understand the many different variables, processes and methods that are a part of these approaches. ⋯ This integration could be helped by an appropriately designed and appropriately organizing theoretical model. It is suggested that what is called the psychological flexibility model could provide such a point of integration.