Articles: chronic-pain.
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Clinical rehabilitation · Apr 2012
Randomized Controlled TrialEfficacy of perceptive rehabilitation in the treatment of chronic nonspecific low back pain through a new tool: a randomized clinical study.
To evaluate the efficacy of a perceptive rehabilitative approach, based on a new device, with regard to pain and disability in patients with chronic nonspecific low back pain. ⋯ Perceptive rehabilitation has immediate positive effects on pain. Back School reduces disabilities at follow-up.
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Review
Current considerations for the treatment of severe chronic pain: the potential for tapentadol.
Studies suggest that around 20% of adults in Europe experience chronic pain, which not only has a considerable impact on their quality of life but also imposes a substantial economic burden on society. More than one-third of these people feel that their pain is inadequately managed. A range of analgesic drugs is currently available, but recent guidelines recommend that NSAIDs and COX-2 inhibitors should be prescribed cautiously. ⋯ In clinical trials in patients with chronic pain, the efficacy of tapentadol was similar to that of oxycodone, but it produced significantly fewer gastrointestinal side-effects and treatment discontinuations. Pain relief remained stable throughout a 1-year safety study. Thus, tapentadol could possibly overcome some of the limitations of currently available analgesics for the treatment of chronic pain.
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Curr Pain Headache Rep · Apr 2012
ReviewComplex [corrected] regional pain syndrome: what specialized rehabilitation services do patients require?
Complex [corrected] regional pain syndrome (CRPS) is a complex disorder, the optimal treatment of which requires an interdisciplinary approach encompassing medical, interventional, psychological, and rehabilitation services that emphasize the role of physical and occupational therapies. The central focus of treatment is the restoration of function, utilizing a systematic, coordinated, and progressive set of therapeutic strategies. The poorly delineated pathophysiology and variable course of CRPS suggest that individualized strategies are required for optimal management, but also mean that carefully controlled trials of physiotherapy are difficult to conduct. This article presents a brief review of the nature and pathophysiology of CRPS, the medical and psychological approaches that have been found to be effective, and a review of the current trends in rehabilitation.
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Editorial
New proposals for the International Classification of Diseases-11 revision of pain diagnoses.
The representation of pain diagnoses in current classification systems like International Classification of Diseases (ICD)-10 and Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV does not adequately reflect the state of the art of pain research, and does not sufficiently support the clinical management and research programs for pain conditions. Moreover, there is an urgent need to harmonize classification of pain syndromes of special expert groups (eg, International Classification of Headache Disorders) and general classification systems (eg, ICD-11, DSM-V). Therefore, this paper summarizes new developments, and proposals for pain diagnoses in revised classification systems. A qualitative review of the literature concerning new proposals for classification of pain syndromes that are based on consensus groups was conducted. Selected proposals of national and international pain societies that are based on consensual processes are presented. These proposals can be condensed to be used in ICD-11 classification. The benefits of considering multidimensional and transdiagnostic processes for the classification process are also outlined. The manuscript provides options how to transform current pain-specific classification proposals to the revision of ICD-11. ⋯ Pain research and expertise must be more visible in the ICD-11 revision process. A general category for pain diagnoses as well as specific pain diagnoses under existing categories of organ-specific sections are needed.
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Curr Pain Headache Rep · Apr 2012
ReviewHealth economics of interdisciplinary rehabilitation for chronic pain: does it support or invalidate the outcomes research of these programs?
Interdisciplinary rehabilitation has been shown to be effective for treatment of patients suffering from chronic nonmalignant pain with respect to activity level, pain intensity, function, or days of sick leave. However, effects in clinical outcome do not necessarily imply a superiority of the intervention from an economic point of view. ⋯ Recent publications add interesting information to the current discussion; these studies cover the long-term development of sickness absence post-intervention and the cost effectiveness of workplace interventions, as well as a collaborative intervention in primary care. Much research has been done, and tendencies of effectiveness are visible, but there is still a long way to go to understand the economic implications of interdisciplinary rehabilitation from the perspectives of society, the health insurers, and the patients.