Painâ€"it is the most common complaint presented to physicians. Yet pain is subjectiveâ€"it cannot be measured directly and is difficult to validate. Evaluating claims based on pain poses major problems for the Social Security Administration (SSA) and other disability insurers. This volume covers the epidemiology and physiology of pain; psychosocial contributions to pain and illness behavior; promising ways of assessing and measuring chronic pain and dysfunction; clinical aspects of prevention, diagnosis, treatment, and rehabilitation; and how the SSA's benefit structure and administrative procedures may affect pain complaints.
Chronic pain costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the Institute of Medicine (IOM) in examining pain as a public health problem. In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America. To reach the vast multitude of people with various types of pain, the nation must adopt a population-level prevention and management strategy. The IOM recommends that HHS develop a comprehensive plan with specific goals, actions, and timeframes. Better data are needed to help shape efforts, especially on the groups of people currently underdiagnosed and undertreated, and the IOM encourages federal and state agencies and private organizations to accelerate the collection of data on pain incidence, prevalence, and treatments. Because pain varies from patient to patient, healthcare providers should increasingly aim at tailoring pain care to each person's experience, and self-management of pain should be promoted. In addition, because there are major gaps in knowledge about pain across health care and society alike, the IOM recommends that federal agencies and other stakeholders redesign education programs to bridge these gaps. Pain is a major driver for visits to physicians, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority.
Highlights major new accomplishments in such areas as the neurobiology of pain, age-related psychological and cognitive differences in pain perception, and the assessment of pain in cognitively intact and cognitively impaired older persons. Treatments such as oral analgesics, physical therapy techniques, cognitive-behavioral therapy, complementary and alternative medicine applications, and multidisciplinary pain management clinics are discussed, as are low back pain, neuropathic pain, postoperative pain, and end-of-life issues.
Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
Pain is both a symptom and a disease. It manifests in multiple forms and its treatment is complex. Physical, social, economic, and emotional consequences of pain can impair an individual's overall health, well-being, productivity, and relationships in myriad ways. The impact of pain at a population level is vast and, while estimates differ, the Centers for Disease Control and Prevention reported that 50 million U.S. adults are living in pain. In terms of pain's global impact, estimates suggest the problem affects approximately 1 in 5 adults across the world, with nearly 1 in 10 adults newly diagnosed with chronic pain each year. In recent years, the issues surrounding the complexity of pain management have contributed to increased demand for alternative strategies for treating pain. One such strategy is to expand use of topical pain medicationsâ€"medications applied to intact skin. This nonoral route of administration for pain medication has the potential benefit, in theory, of local activity and fewer systemic side effects. Compounding is an age-old pharmaceutical practice of combining, mixing, or adjusting ingredients to create a tailored medication to meet the needs of a patient. The aim of compounding, historically, has been to provide patients with access to therapeutic alternatives that are safe and effective, especially for people with clinical needs that cannot otherwise be met by commercially available FDA-approved drugs. Compounded Topical Pain Creams explores issues regarding the safety and effectiveness of the ingredients in these pain creams. This report analyzes the available scientific data relating to the ingredients used in compounded topical pain creams and offers recommendations regarding the treatment of patients.
This comprehensive text is the definitive academic pain medicine resource for medical students, residents and fellows. Acting as both an introduction and continued reference for various levels of training, this guide provides practitioners with up-to-date academic standards. In order to comprehensively meet the need for such a contemporary text—treatment options, types of pain management, and variables affecting specific conditions are thoroughly examined across 48 chapters. Categories of pain conditions include orofacial, neuropathic, visceral, neck, acute, muscle and myofascial, chronic urogenital and pelvic, acute, and regional. Written by renowned experts in the field, each chapter is supplemented with high-quality color figures, tables and images that provide the reader with a fully immersive educational experience. Academic Pain Medicine: A Practical Guide to Rotations, Fellowship, and Beyond is an unprecedented contribution to the literature that addresses the wide-spread requisite for a practical guide to pain medicine within the academic environment.
This definitive clinical reference comprehensively reviews the most advanced methods for assessing the person in pain. The field's leading authorities present essential information and tools for evaluating psychosocial, behavioral, situational, and medical factors in patients' subjective experience, functional impairment, and response to treatment. Empirically supported instruments and procedures are detailed, including self-report measures, observational techniques, psychophysiological measures, and more. Best-practice recommendations are provided for assessing the most prevalent pain syndromes and for working with children, older adults, and people with communication difficulties. The book also weighs in on the limitations of existing methods and identifies key directions for future research.
The second edition of Chronic Pain now covers a vast scientific and clinical arena, with the scientific background and therapeutic options much expanded. In common with the other titles comprising Clinical Pain Management, the volume gathers together the available evidence-based information in a reader-friendly format without unnecessary detail, and is divided into three parts. The broad coverage under Part One encompasses basic science, including applied physiology, genetics and epidemiology, through societal aspects of chronic pain and disability, to patient assessment, diagnostic procedures and outcome measures. Part Two considers the different therapies available, including pharmacological, psychological, behavioural, interventional and alternative. In Part Three specific and non-specific pain syndromes and their management are described, including pain in neurological disease, in HIV and AIDS patients, and after surgery or spinal cord injury, regional pain in the head, face, neck, back, joints, chest, abdomen and pelvis, and issues related to pain in children, the elderly and in association with substance misuse.
Chronic Abdominal Pain is a comprehensive resource focused on the management of chronic abdominal pain. Chapters begin with an overview of pain generation, adaptive mechanisms and various diagnostic approaches. A complete range of novel, conservative, minimally invasive and surgical therapeutic options and their proper selection are then discussed along with evidence-based and practical clinical aspects of patient care. Authored by a team of world-renowned physicians and researchers, this definitive guide provides novel algorithms for contemporary treatment of chronic abdominal pain, giving pain medicine clinicians and practitioners the knowledge needed to assess and treat patients with abdominal pain.