Net Guide: Chronic Pain

Pain Management, June 2010, Volume 3, Issue 4

A collection of links and resources from across the web focused on one specific condition. These resource range from useful websites to clinical trials.

(Type the link codes into our search function to visit the featured sites)

//The Educated Patient™

American Chronic Pain Association: Communication Tools

Patients can download useful pain-management tools at this site, which they can bring with them to the hospital, a doctor’s appointment, or use at home to keep track of their pain or treatment program. For example, the follow-up visit card allows a patient to keep track of tests that need to be administered before the next visit, treatments that need to be adhered to, and activities that should be done or avoided. Similarly, a quality of life scale can be downloaded through the site with which patients can rate their quality of life based on a number of factors. The site also contains a list of diseases associated with chronic pain, ranging from temporomandibular joint and muscle disorders to fibromyalgia. Visitors will also find a number of videos, including a “Consumer Guide to Pain Medication and Treatment;” and a collection of surveys on chronic pain.

Link Code: pm3421

Families and Chronic Pain

Caregivers can often feel overwhelmed from the process of providing support. Because a patient can benefit from the attitude and support of their caregivers, send your patient and their caregiver to this site to learn healthy techniques that will aid them both in managing chronic pain. “Families and Chronic Pain” covers the all-too-common communication issues, financial issues, and depression associated with managing chronic pain.

Link Code: pm3422

Power Over Your Pain

Updated regularly with news on the latest treatments, research, patient stories, and more, this site, provided by Saint Jude Medical Center, offers chronic pain sufferers the tools to take charge of their pain and try to better manage their symptoms. The site covers neurostimulation in detail as a mode of treating chronic pain and also offers videos and background information on different kinds of chronic pain, chronic pain solutions, pain treatment levels, and other topics. For those patients considering different treatment options, the site offers information on its ambassador program, which connects patients with “ambassadors”— chronic pain patients who can provide first-hand information about specific treatments.

Link Code: pm3423

//Medical Websites

Clinical Care Guidelines

Physicians looking to refresh their memory on chronic pain guidelines or read up on the latest updates should visit this site from the University of Michigan Health System. In the “Managing Patients with Chronic Non-Terminal Pain” section, visitors can access a pain guideline, which reviews diagnosis, treatment, guidelines for initial patient visits, items to look for when examining patients, and the common medications used to treat the condition. The section also offers tools for physicians, including downloadable documents that discuss the methods for and reasons behind altering opioid dosages.

Link Code: pm3411

Chronic Pain Communication Skills

This blog features a number of videos presented by Dr. Peter Mackenzie, Consultant in Anesthesia and Pain Management, and Dr. David Craig, Consultant Clinical Psychologist at the New Victoria Hospital, Glasgow. Four of these videos provide tips and advice on how physicians can successfully communicate with their patients. The videos also provide answers to questions such as: “What is the impact of chronic pain on the individual and society?” and “What are the effects of chronic pain on absence from work?”

Link Code: pm3412

//Online CME Pain Report #12 — Optimizing Chronic Pain Management in Elderly Persons: Integrating Pharmacokinetics & Pharmacodynamics

Credits: 1.00

Fee: Free

Expires: March 2012

Multimedia: None

This activity “reviews physiological changes in the older adult” and “common relevant age-related changes” and describes the pharmacologic agents that are commonly used to treat these conditions. Pain medications are compared and contrasted as well.

Link Code: pm3431

Strategies for Opioid Rotation: Decision Support in Chronic Pain Management

Credits: 1.00

Fee: Free

Expires: March 30, 2011

Multimedia: None

This activity reviews evidence for “effective opioid rotation strategies in patients with chronic pain” who are appropriate candidates for this treatment but have demonstrated “unacceptable adverse effects or ineffective analgesic responses.” The 2009 guidelines

developed by the American Pain Society and the American Academy of Pain Medicine are also analyzed.

Link Code: pm3432


Drug Treatment of Chronicintermittent Abdominal Cramping and Pain: A Multi-national Survey on Usage and Attitudes Journal: Alimentary Pharmacology & Therapeutics (May 2010)

Authors: Mueller-Lissner S, Quigley E, Helfrich I, Schaefer E

Purpose: The authors sought to examine data on the treatment of abdominal cramping and pain across countries to form comparisons.

Results: A multi-national survey was conducted in the USA, Mexico, Brazil, Argentina, Germany, Belgium, Italy, and the UK. There were 1,717 participants who were “interviewed on various aspects of drug treatment of their complaints.” Results demonstrated that those “from the Americas used more medication (about 90%) than those from Europe (about 70%).” Mostly, over-the-counter remedies were used rather than prescription drugs (except in Mexico). Further results showed, “The majority of people afflicted by abdominal cramping and pain use medication and take them on demand. Consequently, rapid onset of action is mentioned as most important. Antispasmodics are the class most frequently used with considerable variation from country to country.”

Link Code: pm3451

Methadone: Does Stigma Play a Role as a Barrier to Treatment of Chronic Pain?

Journal: Pain Physician (May 2010)

Authors: Shah S, Diwan S

Purpose: To explore the benefits of “methadone as an analgesic in the relief of chronic neuropathic pain.”

Results: The team surveyed 124 pain physicians from “private practice, university settings, and community hospitals” to determine their methadone prescribing practices. Results showed that “The majority of survey responders (90%) prescribed methadone in their pain practice, but on a very limited basis; 59% state <20% of their patients are on methadone.” The authors found the fact that “many clinicians do not prescribe methadone as a primary analgesic” to be of interest. They concluded that one reason this may be so “is due to the social stigma of its use in treatment of heroin addicts.” “The role of stigma

as a barrier to adequate treatment of chronic pain among pain physicians prescribing practices is a fundamental, yet unexplored issue.”

Link Code: pm3452

//Clinical Trials

A Telephone Feedback System for Prevention of Chronic Pain Relapse

Study Type: Interventional

Age/Gender Requirement: 18 years+ (male/female)

Sponsor: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Purpose: The study is designed to determine if a “telephone-based self-monitoring

and skills review program with personalized therapist feedback following group CST for chronic pain can reduce and prevent relapse of the pain, physical disability, and psychological distress experienced by patients with chronic pain of the muscles and bone.”

Link Code: pm3461

Pharma Focus

Celebrex (Celecoxib)

The Educated Patient™

Celebrex (Celecoxib Capsules)

Direct your patients to this site to review the risks and benefits of taking Celebrex, as well as safety tips and vital information, such as what to do if he or she misses a dose and what might indicate that he or she may have taken too much of the medication. In the frequently asked questions section, patients will find answers to commonly asked questions like, “Do all NSAIDs have the same warnings for serious stomach and intestine side effects?” The “Working with Your Doctor” section provides patients with tips on questions they should ask their doctors and how to manage their pain symptoms.

Link Code: pm3425

Clinical Trials

The Effects of Celecoxib or Naproxen on Blood Pressure in Pediatric Subjects

Study Type: Interventional Age/Gender requirement: 2-18 years (male/female)

Sponsor: Pfizer

Purpose: This multicenter, active-controlled trial will “evaluate the effects of celecoxib (Celebrex) or Naproxen on blood pressure in pediatric subjects with juvenile idiopathic arthritis.”

Link Code: pm3464

Celecoxib as a Post-tonsillectomy Pain Medication

Study Type: Interventional

Age/Gender requirement: 18 years+ (male/female)

Sponsor: University of Iowa

Purpose: This study will test the hypothesis “that celecoxib effectively reduces pain after a tonsillectomy and reduces post-operative narcotic use.” Patients will receive either celecoxib or placebo, and all participants will “receive the standard post-operative pain medications.”

Link Code: pm3465