Current pain and headache reports
-
Most patients with cancer pain achieve good analgesia using traditional analgesics and adjuvant medications; however, an important minority of patients (2% to 5%) suffers from severe and refractory cancer pain. For these individuals, spinal analgesics (intrathecal or epidural) provide significant hope for pain relief over months or years of treatment to help improve quality of life. ⋯ A variety of opioids, local anesthetics, clonidine, ketamine, and other analgesics are available for the spinal route of administration and should be titrated to clinical effect or intolerable side effect. This article discusses the appropriate selection of patients for spinal analgesics, reviews current recommended infusion systems and current spinal analgesics, discusses possible complications, and includes practical suggestions for patient management.
-
High-altitude headache (HAH) is an important public health problem because many of the millions of visitors to locations high above sea level get significant headaches each year. Headache is the most common symptom of acute exposure to high altitude. ⋯ This article describes the clinical picture of AMS and CMS. The clinical characteristics of HAH are presented, its pathophysiology is discussed, and the acute and preventive treatment options are reviewed.
-
Curr Pain Headache Rep · Aug 2007
Review Case ReportsAdvances in radiation therapy for oncologic pain.
Pain is a feared component of cancer for a patient. The patient's prior experience with cancer pain will affect how he or she deals with ongoing and acute onset new pain. ⋯ New technologies are rapidly becoming available that will allow more specific and accurate targeting, while limiting the dose that is received by normal tissues and thus minimizing the potential for tissue toxicity. How new techniques and technologies are incorporated into the management of cancer pain will require a better understanding of the disease process being treated.
-
Pharmacologic treatment of pain does not always meet patients' needs and may produce difficult side effects. Complementary therapies, which are safe, noninvasive, and generally considered to be relatively free of toxicity, may be used adjunctively with standard pain management techniques to improve outcome and reduce the need for prescription medication. Approaches such as acupuncture, massage therapy, mind-body interventions, and music therapy effectively reduce pain, enhance quality of life, and provide patients with the opportunity to participate in their own care. Such therapies have an important role in modern pain management.
-
Curr Pain Headache Rep · Aug 2007
ReviewAssessment tools for the evaluation of pain in the oncology patient.
The control of cancer pain is an essential goal in the care of patients with cancer. Inadequate pain assessment by health care providers is a major risk factor for undertreatment of pain. Repeated and accurate pain assessment is required for optimal pain management. ⋯ In addition to measuring pain intensity, it is important to determine the impact of pain on patients' function, mood, and quality of life. Developmental issues must be considered when assessing the pain of children and elderly individuals with cancer. Novel technologies may be used to improve accurate and timely pain measurement.