Pain

Though a diagnosis can be made from a single plain X-ray film, multiple views are often recommended, especially when the anatomy is so small that it is difficult to visualize a fracture.

The US Food and Drug Administration (FDA) has approved Xiaflex (collagenase clostridium histolyticum) as the first non-surgical treatment for Peyronie's disease.

Primary prevention measures for upper GI bleeding should include NSAIDs, antiplatelet therapy, and anticoagulants appropriately, while secondary preventive measures should include testing and treating H. pylori and using long-term PPIs when appropriate.

Will the approval of Zohydro benefit patients and physicians by providing another option for pain relief for patients with legitimate chronic pain needs, or will it spark a new wave of abuse, misuse, and diversion?

Study results show patients with the disorder report a sever burden of illness, with high rates of hospital and emergency room visits and significant negative impact on activities of daily living.

Study shows that somatization and low job security are independently associated with low back pain prevalence.

Mary Lynn McPherson, PharmD, BCPS, CPE, FASPE, shows healthcare professionals how to apply an equianalgesic opioid dosing chart to 12 complicated patient cases requiring an opioid switch.

Even when it's administered in a low-dose form that resists gastric acid and prevents tablet dissolution in the stomach, aspirin therapy causes peptic ulcer and increases the risk of 30-day mortality resulting from gastrointestinal (GI) disorder progression.

Recognizing that melatonin secretion from the gastrointestinal (GI) tract improves abdominal pain in irritable bowel syndrome (IBS) but decreases with age, Polish researchers from the Medical University of Lodz aimed to define the effect of administering melatonin in postmenopausal women with different predominating IBS symptoms.

A high-potency probiotic supplement that mimics the effect of morphine in the gut may reduce the development of visceral pain in irritable bowel syndrome (IBS).

Treating postherpetic neuralgia patients with the oral opioid agonist tramadol may significantly reduce moderate to severe nerve pain.

Achieving safe, effective pain control for inpatients can challenge even experienced clinicians. Components of successful pain control include avoiding pain crises while still steering clear of respiratory depression, being confident with equianalgesic calculations, and transitioning to the outpatient setting.

While past studies suggest variability in physicians' chronic pain treatment decisions based on patients' sex and race, few have considered the degree of providers' self-insight into the influence of such demographics on their treatment decisions.

The TIRF REMS Access program is designed to streamline the prescribing process and ensure appropriate patients are safely provided with TIRF products, but it may be preventing patients from accessing needed medications.

Results from a small study indicate patients with difficult-to-treat diabetic peripheral neuropathy (DPN) may benefit from therapy with tanezumab, a humanized monoclonal antibody against nerve growth factor.

Declaring that the benefits of the original formulation of OxyContin no longer outweigh the risks of misuse and abuse, the FDA announced it would not approve any applications for non-tamper resistant formulations of the drug, a decision that could have far-reaching implications for all makers of opioid medications.

Understanding and addressing these disorders can improve the patient's mental health as well as their chronic pain and other comorbid conditions. Incorporating cognitive behavioral therapy and mindfulness-based cognitive therapy into the management of chronic pain has been shown to improve pain outcomes.

Researchers successfully treated a patient with refractory complex regional pain syndrome by inducing a coma with ketamine and dexmedetomidine.

Several studies recently have looked at the relationship between irritable bowel syndrome and increased pain sensitivity.

Though original results of the five-year Spine Patient Outcomes Research Trial (SPORT) determined surgically-treated spinal stenosis (SpS) patients showed significant advantage in body pain and physical function after two years than their nonsurgically-treated counterparts, a subgroup analysis published in the Feb. 15 issue of Spine found patients who received epidural steroid injections (ESI) in the SPORT study exhibited a worse outcome through four years' follow-up, regardless of surgical or nonsurgical treatment.

The push to provide better pain care and ensure adequate analgesia for patients living with chronic pain led to liberalized opioid prescription practices that have been accompanied by a massive increase in the abuse, misuse, and diversion of prescription opioids. Efforts to combat this include technological remedies such as "abuse-deterrent" formulations of opioids and educational approaches such as the REMS program approved by the FDA in 2012.

"Urine drug testing (UDT) has become a widely utilized tool across many specialties. Although it was traditionally used more by pain specialists due to concerns over prescription drug abuse, diversion, and misuse, it has become something that family physicians and non-pain specialists rely on more than ever..." A Q&A with Joshua Gunn, PhD