Articles: pain-management.
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Prescription opioid tapering has increased significantly over the last decade. Evidence suggests that tapering too quickly or without appropriate support may unintentionally harm patients. The aim of this analysis was to understand patients' experiences with opioid tapering, including support received or not received for pain control or mental health. ⋯ Patient-centered approaches to tapering include reaching out to monitor how patients are doing, involving patients in decision-making, supporting mental health changes, and allowing for flexibility in the tapering pace. PERSPECTIVE: Patients tapering prescription opioids desire more provider-initiated communication including checking in about pain, setting expectations for withdrawal and mental health-related changes, and providing support for mental health. Patients preferred opportunities to share decisions about taper speed and to have flexibility with pausing the taper as needed.
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The aim of our meta-analysis was to systematically assess the enduring effectiveness and safety of high-frequency spinal stimulation (HF-SCS) in the management of chronic pain. ⋯ The findings from our comprehensive review and meta-analysis offer encouraging data about the prolonged efficacy and safety of HF-SCS in chronic pain management on some but not all outcomes. Recognizing the constraints of the existing evidence is crucial. Additional clinical trials, meticulously planned and stringent, are essential to bolster the current body of evidence and reach more conclusive findings.
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A multidisciplinary approach is the gold standard in the management of persistent pain and is current practice in tertiary pain clinics. However, such approaches seem to be a rarity in primary care, although pain is the most common reason for visiting a primary care physician. A comprehensive systematic review was conducted to explore whether studies on multidisciplinary management programs for persistent pain exist in primary care. ⋯ Persistent pain is a growing challenge to the health care system, and most patients are treated in primary care. The biopsychosocial concept is the basis for the multidisciplinary management of pain. The review revealed that studies about treatment interventions for persistent pain patients are scarce. Existing studies were heterogeneous in terms of intervention characteristics, population, outcome variables, and study methodology. There is an urgent need for further studies on systematic multidisciplinary treatment protocols for managing persistent pain in primary care.
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Despite pharmacological treatments for osteoarthritis (OA), more individuals are choosing medical cannabis for OA symptom management and for mitigating opioid prescriptions for OA. This systematic review examines the global evidence of medical cannabis use on OA pain and function. ⋯ CRD42022354026.
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Curr Pain Headache Rep · Jul 2024
ReviewCannabinoids for Acute Pain Management: Approaches and Rationale.
Acute pain management remains a challenge and postoperative pain is often undermanaged despite many available treatment options, also including cannabinoids. ⋯ In the light of the opioid epidemic, there has been growing interest in alternative care bundles for pain management, including cannabinoids as potential treatment to decrease opioid prescribing. Despite the lack of solid evidence on the efficacy of cannabinoids, their use among patients with pain, including those using opioids, is currently increasing. This use is supported by data suggesting that cannabinoids could potentially contribute to a better pain management and to a reduction in opioid doses while maintaining effective analgesia with minimum side effects. The scientific basis for supporting the use of cannabis is extensive, although it does not necessarily translate into relevant clinical outcomes. The use of cannabinoids in acute pain did not always consistently show statistically significant results in improving acute pain. Large randomized, controlled trials evaluating diverse cannabis extracts are needed in different clinical pain populations to determine safety and efficacy.