Pain medicine : the official journal of the American Academy of Pain Medicine
-
Pain syndromes are prevalent among older individuals and generally increase in incidence as the population ages. Yet, pain often is undertreated in older patients, sometimes due to difficulties in assessing pain intensity and the effectiveness of treatment in the context of age-related cognitive impairment and physiologic changes. As a result, older patients with chronic pain conditions are more likely to experience greater functional limitations and decreased quality of life due to these and other barriers to appropriate care. This article discusses the epidemiology, assessment, and management of pain in older adults, and reviews special issues in the treatment of this population, such as adverse effects due to changes in drug metabolism and drug-drug interactions.
-
Randomized Controlled Trial
A single-blind placebo run-in study of venlafaxine XR for activity-limiting osteoarthritis pain.
Osteoarthritis pain is a significant problem for our aging population. Non-steroidal anti-inflammatory drugs and opioids are effective treatments, but have significant adverse effects, so there is a need for alternative treatments. Selective norepinephrine-serotonin reuptake inhibitor antidepressants may provide a new treatment option for osteoarthritis pain. ⋯ Venlafaxine significantly reduced pain intensity on the BPI and marginally improved self-reported function. Venlafaxine should be investigated further in a larger randomized trial for the treatment of osteoarthritis pain.
-
To determine the long-term response to serial sacroiliac joint (SIJ) corticosteroid injections. Design. Retrospective practice audit. ⋯ SIJ corticosteroid injections appear to be an effective palliative treatment for selected patients with SIJ pain. Most patients whose pain is responsive to SIJ steroid injections improved sufficiently and remained well after 1 to 3 injections, but some required frequent injections on a long-term basis.
-
Chronic nonmalignant pain (CNMP) is both a prevalent and a costly health problem in our society. Pain rehabilitation programs have been shown to provide cost-effective treatment. A treatment goal for some rehabilitation programs is reduction in the use of pain-related medication. Medication costs savings from pain rehabilitation programs have not been analyzed in previous studies. ⋯ Patients benefited from significant medication cost savings at the completion of the 3-week outpatient pain rehabilitation program and maintained significant savings after 6 months. This study adds to the current literature on the economic value of comprehensive pain rehabilitation programs.
-
To demonstrate the efficacy and safety of the addition of bupivacaine in restoring pain control and improving quality of life and activity level in patients with chronic nonmalignant pain refractory to intrathecal opioids. ⋯ The addition of intrathecal bupivacaine restores pain control, improves activity level, quality of life, and mental health in this patient group.