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When I Control the Pain, I Control My Life: Opioids and Opioid-Containing Analgesic Medication in the Management of Chronic Intractable Pain
Published in Michael S. Margoles, Richard Weiner, Chronic PAIN, 2019
“Chronic pain syndrome”* is usually presented as a clinical problem with subjective pain complaints, but has no organic basis. This is routinely considered an emotional problem, and the conclusion is that opioids are not given for emotional problems.
Life Care Planning for People with Chronic Pain*
Published in Roger O. Weed, Debra E. Berens, Life Care Planning and Case Management Handbook, 2018
Significant pain can be experienced as a result of a multitude of medical problems. Chronic pain syndrome refers to pain that lasts more than 6 months, worsens with time, and is associated with major comorbidities, especially psychological (McMahon & Koltzenburg, 2006). Multidisciplinary therapy is often required. The Institute of Medicine (IOM) recently estimated that more than 110 million adults, over one third of the population of the United States, experience some form of chronic pain, with the symptom of pain being the most common reason for people to consult a primary care physician. It has an associated annual economic cost of $560 to $635 billion, and is a leading cause of disability worldwide (Institute of Medicine Committee on Advancing Pain Research Care and Education Board on Health Sciences Policy, 2011; Vos et al., 2012).
Chapter Twelve
Published in Eugene Fukumoto, Advanced ICD-10 for Physicians Including Worker’s Compensation and Personal Injury, 2017
Chronic pain syndrome is a different type of chronic pain (neuropathic pain) with biochemical changes that are triggered in the body. This type of pain affects all aspects of life, including the formation of psychological problems that require both medical treatment and counseling.
A post-market, randomized, controlled, prospective study evaluating intrathecal pain medication versus conventional medical management in the non-cancer, refractory, chronic pain population (PROSPER)
Published in Expert Review of Medical Devices, 2022
Jason E. Pope, Navdeep Jassal, Dawood Sayed, Denis Patterson, Gladstone McDowell, Anjum Bux, Phillip Lim, Eric Chang, Ali Nairizi, Samuel Grodofsky, Timothy R Deer
For comparison of primary endpoint analysis, global pain score was performed across all time points, with IDDS with improvement (Table 4). A subgroup analysis was performed to better qualify differences among the treatment groups, based on diagnosis and time. For group analysis of the primary diagnosis, the patients in both cohorts were placed in one of two groupings: Chronic Pain and Related Syndromes and the Failed Back and Related Syndromes, as defined by the diagnoses of idiopathic progressive neuropathy, chronic pain due to trauma, chronic pain Syndrome, Complex Regional Pain Syndrome, and lumbar spondylosis, spondylosis with radiculopathy, intervertebral disc disorders other intervertebral disc degeneration, lumbar and lumbosacral radiculopathy, osteoporosis, post-laminectomy syndrome and wedge compression fracture lumbar, respectively. This was for both groups, within the CMM arm, there are no benefit differentiation. For the IDDS, there was significant benefit differentiation statistically indicating that the patient experienced substantial pain relief (0.0431) (Table 5). This was analyzed at 3 months due to rescue analysis, with continuation across all time points, demonstrating early patient benefit with employment of intrathecal therapy, as compared to CMM, for both the Chronic Pain and Related Syndromes and the Failed Back and Related Syndromes groups.
Delayed onset serotonin syndrome in the setting of polypharmacy
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
Roshan Acharya, Smita Kafle, Sijan Basnet, DilliRam Poudel, Sushil Ghimire
The population of patients who enters 65 years of age group is increasing everyday not only in the USA but globally. This age group usually has chronic medical conditions for which they are dependent on daily medicines from which they experience substantial side-effects also. To counteract the side-effects, another medicine is introduced quickly leading to polypharmacy [8]. One study revealed that polypharmacy tripled in 10 years in the Spanish population [9]. A study revealed that chronic pain syndrome, arthritis, insomnia, depression are common medical conditions for which this age group takes medicines such as anticholinergics, sedatives, anti-psychotics, and anti-depressants that are commonly associated with SS [8]. Chronic pain affects up to one-fifth of the population and depression is the third global burden disease and treatment is usually medicines that belong to tricyclic antidepressants, selective serotonin reuptake inhibitors selective norepinephrine reuptake inhibitors, and monoamine oxidase inhibitor [10]. As mentioned earlier, anti-depressants, anti-emetics, opioids, muscle relaxants, over the counter cough medications can have interactions that can lead to serotonin syndrome [11]. As generally witnessed hospitalized patients are on one or more than one such medicines for chronic medical conditions.
Employee experience of workplace supervisor contact and support during long-term sickness absence
Published in Disability and Rehabilitation, 2019
Nicholas J. Buys, John Selander, Jing Sun
Supportive contact with the worker during the recovery and return to work process is particularly important. A people oriented culture at the workplace is associated with lower disability incidence and duration [11–13]. Environmental factors associated with a positive return to work outcome include stakeholder participation in the return to work process, which involves communication between the supervisor and employee, the worker and the workplace and the healthcare provider and the workplace. A supportive workplace culture and climate, including early communication with workers on sickness absence, empathic responses to injury, a supportive work environment and involvement of workers in decision making are associated with effective disability management programs [14,15]. Workplace support from supervisors and coworkers is also predictive of less disability among workers with chronic pain syndrome [16]. Employees view supervisors as critical in preventing disability through actions such as a people-oriented leadership style, supportive and regular contact with absent workers and involving workers in collaborative problem solving [16].