Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Mar 2015
CommentTime to declare victory and unite pain and palliative medicine.
The value and importance of improved communication and collaboration among pain management and palliative care clinicians is presented. The commentator uses the case report in this issue of the journal on the use of indwelling catheters for continuous interscalene blocks in cancer pain management as an example of why these two medical subspecialties need improved collaboration and integration.
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Over the last few decades, advances have been made in the understanding of myofascial pain syndromes (MPSs). In spite of its high prevalence in the society, it is not a commonly established diagnosis. MPS is said to be the great imitator. This article puts some light on the various clinical presentations of the syndrome, on the various tools to reach to a diagnosis for commencing the treatment and on the treatment modalities that have been used so far.
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J Pain Palliat Care Pharmacother · Mar 2015
Case ReportsManagement of severe pain due to lumbar disk protrusion.
Lumbar intervertebral disk protrusion can cause excruciating pain in severe cases, which can be exacerbated by activity such as sitting down and straining at stool. Acute sciatica due to disk rupture will improve within 1 to 3 months. ⋯ Severe cases can require opioid analgesia, however people taking opioids for pain relief frequently present with opioid-induced bowel dysfunction. The use of transforaminal steroid injections is a controversial issue and repeat steroid injections should be considered in light of the risk-benefit profile of the individual patient.
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J Pain Palliat Care Pharmacother · Mar 2015
Temporomandibular disorders, headaches and chronic pain.
Temporomandibular disorders (TMDs) are a major cause of non-dental orofacial pain with a suggested prevalence of 3% to 5% in the general population. TMDs present as unilateral or bilateral pain centered round the pre-auricular area and can be associated with clicking and limitation in jaw movements. It is important to ascertain if there are other comorbid factors such as headaches, widespread chronic pain and mood changes. A biopsychosocial approach is crucial with a careful explanation and self-care techniques encouraged.