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Latest Pain-Topics News/Research UPDATES
New Guidelines for Treating Knee OA
More than 27 million persons in the United States alone have osteoarthritis (OA), with the knee being most commonly affected. What can be done? The AAOS (American Academy of Orthopaedic Surgeons) recently issued updated treatment guidelines that should be of interest to healthcare providers and patients. Learn more>
A Doctor’s View of Patients with Chronic Disease
As scary and frustrating as it can be to have a chronic disease, especially chronic pain, it is often equally frightening and concerning for the providers who care for such patients. One practitioner offers his viewpoints on what it is like to care for patients with chronic disorders and offers some helpful and practical advice to follow. Read letter>
Other Recent Pain-Topics UPDATES of Interest...
> More Bad News About NSAIDs Reported
> Weather Does Not Affect Fibromyalgia, Study Finds
> Does Long-Term Rehab for Chronic Pain Help?
> June 2013 – Pain Product Announcements & Warnings
> Opioid Ties to Hormonal Upsets Studied
> Injections for Low-Back Pain Disparaged
See Table of Contents for ALL UPDATES>
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NEW Pain Treatment Guidelines/Reports
Tests to Assess Physical Function in Hip or Knee Osteoarthritis
From: Osteoarthritis Research Soc. Intl. (OARSI), 2013
Evidence-based guidelines recommend 5 different performance-based tests to assess physical function, strength, agility, and balance in persons aged 40+ diagnosed with hip and/or knee osteoarthritis (OA). Verbal instructions for patient implementation, score sheets, and a normal value range table are included. See details here>
Guideline on the Treatment of Knee Osteoarthritis (OA)
From: Amer. Acad. of Orthopaedic Surgeons (AAOS); updated 2013.
Based on an extensive evidence review, 18 statements provide guidance for knee OA treatments that are less invasive than surgical knee replacement. Relatively few treatments have strong recommendations, while glucosamine/chondroitin, acupuncture, and hyaluronic acid injections, among others, are shunned. Access guideline here>
Recent Resources for Patients
Headaches and Complementary Approaches
Fact sheet reviews definitions and characteristics of the most common types of headache. Complementary approaches for headache therapy are discussed, including relaxation training, biofeedback, acupuncture, Tai Chi, cognitive-behavioral therapy, massage (including craniosacral therapy), spinal manipulation, and diet supplementation. See details>
U.S. FDA - Patient Network Website
Interactive website provides education on how medications and medical devices move from the drawing board to the marketplace. Also helps patients determine whether medical products are safe and effective, and encourages them to become involved by contributing their ideas and concerns about the development and regulation of these products. See details>
Opioid Rx & Safety
Drug-Drug Interactions Apps: Methadone & Buprenorphine
Special apps for iPhones, iPads, and Android devices, as well as online use with any computer, provide info on risks of drug-drug interactions between either methadone or buprenorphine and 120 commonly Rx'd drugs. See details>
What to Know About the U.S. FDA’s ER/LA-Opioid REMS
Website on U.S. FDA Risk Evaluation and Mitigation Strategy, or REMS, for Extended Release (ER) and Long-Acting (LA) opioid analgesics. See details>
NEW Focus on CRPS/RSD
History, Diagnosis & Treatment of CRPS/RSD
This 2 part article briefly reviews the history of complex regional pain syndrome (CRPS) — also known as reflex sympathetic dystrophy (RSD) — and physiologic mechanisms for its confusing symptoms. Diagnostic considerations and treatments are discussed, including pharmacotherapy, interventional modalities, and psychotherapy. See details here>
Treatment of CRPS/RSD in Adults: A Systematic Review
This review examines randomized controlled trials (RCTs) to identify successful therapeutic interventions for complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (RSD). Studies showing strong evidence for physiotherapy, drug therapy, and interventional treatments are described, as well as 15 treatments for which there is a lack of evidence. See details>
NEW in Pain Disorders
Management of Chronic Pain in the Elderly
Article provides guidance for a more age-specific approach to the assessment and management of geriatric chronic pain. Discusses physiologic changes in aging by specific body system and their impact on the pharmacodynamics and pharmacokinetics of commonly-used analgesics. The use of multiple modalities in an individualized patient care plan is emphasized. See details>
Adverse Effects of Analgesics for OA in Geriatrics
Systematic review assesses analgesic commonly used in elder adults for osteoarthritis (OA), including acetaminophen, NSAIDs, and opioids. Pharmacokinetics and pharmacodynamics of each are discussed along with adverse event data. Benefits and risks of each drug class for elderly patients are considered. See details>
NEW in Clinical Concepts
Chronic Pain is Like…
The Clinical Use of Analogy and Metaphor in the Treatment of Chronic Pain
The authors provide information from research studies to support the use of metaphors as an effective way to increase patients’ understandings of the biology of chronic pain. Multiple analogies are offered for explaining persistent pain, factors that influence an individual's interpretation of pain, and the rationale and benefits of a multidisciplinary approach to pain management. See details here>
RECENT Continuing Education (CME) Postings
Mind, Body, Spirit Solutions: An Integrative Approach to Fibromyalgia
This educational activity reviews pharmacologic therapies, as well as potential benefits in symptom reduction by adding complementary therapies like acupuncture, bodywork, and mind-body approaches. Emphasis is on designing therapy according to the personal needs of individual patients. See details>
Opioid Analgesics: Recognizing Risks of Abuse and Misuse
Activity reviews basic principles of chronic pain assessment and treatment, and considerations when prescribing or rotating opioids. Differences between addiction and physical dependence are explained, along with discussions of tools and approaches for effective opioid risk management. See details>
NEW in Non-Opioid Therapies
Role of Glucosamine in the Treatment for Osteoarthritis
Controversial review of research concludes that glucosamine sulfate can reduce symptoms of osteoarthritis; however, differences in glucosamine product quality and dosing affect outcomes. See details>
NEW Books to Note
Stories of Hope
Living in Serenity with Chronic Pain and Chronic Illness
From: Chronic Pain Anonymous; 2012.
This book was written by members of the Chronic Pain Anonymous, or CPA, 12-Step fellowship to help explain how the tools and principles of the program can serve as catalysts for emotional, mental, and spiritual transformation. Readers discover how it is possible to live in happiness and contentment, one day at a time, regardless of the nature of their chronic pain or illness. See review>
Understanding and Treating the Complex Patient
From: IASP Press, Giamberardino and Jensen, eds.; 2012.
In the 23 chapters of this expansive and well-illustrated text, the editors have carefully assembled a collection of evidence-based articles examining the nature, modalities of diagnosis, and treatment of complex clinical situations involving multiple concurrent diseases that variously influence patients’ experience of pain. See review>
Pain & Disability Assessment Tools
Pain Catastrophizing Scale
Questionnaires for adults, spouses, and children assess catastrophic thinking as it relates to a patient’s experiences of helplessness and magnification of pain. Full instructions for administration are provided and the instrument is available in multiple languages. See details>
Spanish Versions of Opioid-Risk Assessment Tools Available
Now available in Spanish: SOAPP-R and COMM. See details>
SPECIAL: Managing Overdose Risks
OD Prevention & Naloxone Manual
Guidance is provided for developing and managing an Overdose Prevention and Education Program, with or without the use of a take-home naloxone component. These programs can be easily integrated into existing medical practices or clinical settings . See details>
Naloxone for At-Home Opioid OD Rescue
A new website and a short video tell everything you -- and your patients -- need to know about the use of naloxone at home to reverse opioid overdose . Access resources here>
Making Sense of Pain Research [Series]
Improving pain practice requires better research. However, healthcare professionals, and certainly patients, usually have had little specific training in evaluating research. This UPDATES series on “Making Sense of Pain Research” helps to close the education gap, teaching readers how to understand and interpret the often mysterious and complex language of research to assess its quality and validity. See listings>
Help for Safely Using Opioid Pain Relievers
Extensive, REMS-compliant, educational activity for patients and their caregivers focusing on the proper and safe use of opioid pain relievers. Provides an understanding of opioids and their risks. Vital instruction is provided on recognizing opioid problems and on being prepared for emergencies. Go to Opioids911.org>
June is Migraine & Headache
Although 47% of adults experience headache annually, and 37 million persons are diagnosed with migraine in the USA alone, these disorders are still poorly recognized and often inadequately treated. June has been set aside as the month to come forward, to “show purple” in building awareness of these often debilitating disorders, to remove the stigma, and to push for more and better treatments. Further information is available at the National Headache Foundation [here] and the American Pain Society [here].
IASP Global Year Against VISCERAL PAIN
The International Association for the Study of Pain (IASP) has launched its Global Year Against Visceral Pain initiative, bringing worldwide attention to pain that originates in or near the internal organs of the body. Visceral pain is the number one reason for patients to seek medical attention. The 12‐month campaign offers education for healthcare professionals, government leaders, and the public. See more info in our Newsroom>
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Thank you, for visiting, and we hope to see you here often.
Stewart B. Leavitt, MA, PhD, Executive Director