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Home > Clinical Concepts

Clinical ConceptsThis section of Pain Treatment Topics brings together, analyzes, and discusses the various elements that play vital roles in effective clinical pain management. Included here are interviews and commentary, survey results, clinical tools, and other helpful resources. However, Pain Treatment Topics does not provide medical advice, diagnosis, or treatment recommendations for particular patients and professional discretion in the clinical application of these resources is advised. See also, Site Policies.

 

 

Register for e-NotificationsPlease register for e-Notifications to be alerted by e-mail of when this section is updated.

New = entry added or changed during latest update.

Pain-Topics Exclusive = exlusive offering from Pain Treatment Topics.

 

Making Sense of Pain Research [Series]

ResearchMaking sense of research for pain practice can be difficult, so articles in this section provide answers for practitioners and patients. Medical research can be a messy endeavor in which nothing is actually proved and no absolute, irrevocable truths are discovered. Healthcare professionals usually have had little if any specific training in evaluating research and this series helps to close the education gap, teaching how to understand and interpret the often mysterious and complex language of research to assess its validity.

 

See all details listings. View all details listings <Click Here> or select item below...

 

Pain-Topics Part 1: How to Make Practical Sense of Pain Research

Getting Started; Stewart B. Leavitt, MA, PhD; March 18, 2011.
See details>

 

Pain-Topics Part 2: Pain Research – All That Glitters is Not Gold

A Hierarchy of Evidence; Stewart B. Leavitt, MA, PhD; March 25, 2011. See details>

 

Pain-Topics Part 3: Validity, Reliability, & Bias in Pain Research

When Bad Things Happen to Good Research; Stewart B. Leavitt, MA, PhD; April 1, 2011. See details>

 

Pain-Topics Part 4: Pain Research – Insignificance of “Significance”

The Problem with P-Values; Stewart B. Leavitt, MA, PhD; April 15, 2011. See details>

 

Pain-Topics Part 5: Pain Research – Confidence in Confidence Intervals

Helping to Determine Clinical Significance; Stewart B. Leavitt, MA, PhD; May 1, 2011. See details>

 

Pain-Topics Part 6: Risks of Misinterpreting “Risk” in Pain Research

Understanding RR, RRR, ARR, & NNT; Stewart B. Leavitt, MA, PhD; May 20,2011. See details>

 

Pain-Topics Exclusive Part 7: At Odds with “Odds Ratios” in Pain Research

Beware of Odds Posing as Risks; Stewart B. Leavitt, MA, PhD; June 7, 2011. See details>

 

Pain-Topics Exclusive Part 8: The ‘Big Esses’ of Pain Research: SD, SEM, SMD

Precision, Accuracy, & Significance of Mean Values; Stewart B. Leavitt, MA, PhD; July 22, 2011. See details>

 

Pain-Topics Exclusive Part 9: Promises & Perils of Power in Pain Research

Why Size Really Does Matter; Stewart B. Leavitt, MA, PhD; August 10, 2011. See details>

 

NewPain-Topics Exclusive Part 10: Differences That Make A Difference

Interpreting Effect Sizes in Pain Research Data; Stewart B. Leavitt, MA, PhD; December 17, 2011. See details>

 

Pain-Topics Making Sense of Pain Research [Series MS Word Doc]

This Microsoft® Word® document file contains all UPDATES articles in the series to date for easy viewing and printing. Plus, all links in the document are active for easy access to additional resources.

See details and download doc file>

 

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Current Comments

Current CommentsThis section provides commentary on a variety of important subjects from experts in the pain management and/or addiction treatment fields. The viewpoints and opinions expressed are those of the authors, and do not necessarily reflect those of Pain Treatment Topics, our sponsors, or affiliate organizations.

 

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Updated Pain-Topics Exclusive Maximizing Safety with Methadone & Other Opioids

By: Lynn R. Webster, MD, FACPM, FASAM, with Beth Dove; Pain Treatment Topics, August 2011.  See details...>

 

Pain-Topics Exclusive The OIH Paradox: Can Opioids Make Pain Worse?

By: Peggy Compton, RN, PhD, Pain Treatment Topics, August 2008.

See details...>

 

Pain-Topics Exclusive Using Objective Signs of Severe Pain to Guide Opioid Prescribing

By: Forest Tennant, MD, DrPH, Pain Treatment Topics, June 2008.

See details...>

 

Pain-Topics Exclusive Opioid-Induced Sexual Dysfunction: Causes, Diagnosis, & Treatment

By: Stephen Colameco, MD, MEd, Pain Treatment Topics, April 2008.

See details...>

 

Pain-Topics Exclusive Should Opioid Abusers Be Discharged From Opioid-Analgesic Therapy?

By: Peggy Compton, RN, PhD, Pain Treatment Topics, January 2008.

See details...>

 

Howard Hughes & Pseudoaddiction [A saga of intractable pain.]

By: Forest Tennant, MD, DrPH. By permission from Practical Pain Management. 2007(Jul/Aug);7(6).  See details...>

 

Pain-Topics Exclusive Chronic Pain Conundrums in Primary-Care Practice

By: Penelope P. Ziegler, MD, FASAM, Pain Treatment Topics, July 2007.  See details...>

 

Pain-Topics Exclusive Overcoming Opiophobia & Doing Opioids Right

By: Forest Tennant, MD, DrPH; Pain Treatment Topics, May 2007.

See details...>

 

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INNOVATIONS in Pain Treatment

Innovations in Pain TxUnderstandings of pain and its clinical management are constantly changing. Resources in this section report on new clinical treatments for pain as well as new applications of existing therapies. Pharmacologic and nonpharmacologic treatments are explored and, when possible, recommendations for their application in daily clinical practice are provided. These topics would be of interest and importance for all healthcare providers and their patients.

 

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Pain-Topics Exclusive Opioid Antagonists, Naloxone & Naltrexone — Aids for Pain Management

By: Stewart B. Leavitt, MA, PhD, Pain Treatment Topics, March 2009.

Opioid Antagonists in Pain Management [Journal Article]

By: Stewart B. Leavitt, MA, PhD, Practical Pain Management, 2009(April);9(3):10-21.

See details for both articles...>

 

Vitamin D for Chronic Pain [Journal Article]

By: Stewart B. Leavitt, MA, PhD, Practical Pain Management, 2008(Jul/Aug);8(6):24-42. See details...>

 

Pain-Topics Exclusive VITAMIN D – A 'New' Therapy for Chronic Pain

By: Stewart B. Leavitt, MA, PhD, Pain Treatment Topics, June 2008.

Vitamin D – A Neglected ‘Analgesic’ for Musculoskeletal Pain
     > Practitioner Briefing (7-pages)
     > Full Report (50-pages)
     > Evidence Update: Vitamin D for Pain

Vitamin D: A Champion of Pain Relief
     > Patient Brochure (6-pages)

See details on all documents...>

 

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Overview - Pain Management & Treatment

Pain ManagementDocuments in this section examine pain mechanisms and diagnosis, barriers to effective management, and treatment strategies and planning. Various treatment modalities may be considered, including: pharmacologic, non-pharmacotherapies, surgery, and other interventions. In some cases, criteria for measuring successful outcomes and patient monitoring practices are presented.

 

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ACPA Guide to Pain Medications & Treatment - 2011

From: American Chronic Pain Association (ACPA); updated 2011.

See details...>

 

Current Treatments In the Management of Diabetic Peripheral Neuropathic Pain 2009

By: Louis Kuritzky, MD, George P. Samraj, MD, Charles E. Argoff, MD. Pain Medicine News. 2009(Aug);7(8). See details…>

 

Which Analgesics Work Best? What Do They Cost?

From: Consumer Reports Best Buy Drugs, 2005-2008. See details...>
  > Opioid Drugs (acute and chronic pain)
  > Anticonvulsants (fibromyalgia, neuropathy, herpes zoster)
  > Triptans (migraine)
  > NSAIDs (nonsteroidal anti-inflammatory drugs)
  > Laxatives (drug-related constipation)

 

Antidepressant Agents for the Treatment of Chronic Pain and Depression

By: Michael W. Jann, PharmD and Julian H. Slade, PharmD. Posted at Medscape, 2008 [from Pharmacotherapy. 2007;27(11):1571-1587].

See details...>

 

Pain Management: The Online Series

From: American Medical Association; 2007.  See details...>

 

Translating Science Into the Art of Acute Pain Management

By: Sharon M. Gordon, DDS, MPH, PhD. Compendium. 2007(May).

See details...>

 

The PainEDU.org Manual: A Pocket Guide to Pain Management

By: Lynette A. Menefee Pujol, PhD, Nathaniel P. Katz, MD, Kevin L. Zacharoff, MD; from Inflexxion, Inc.; 2007 (3rd ed.).  See details...>

 

Neuropathic Pain: A Practical Guide for the Clinician

By: Gilron I, Watson CPN, Cahill CM, et al. Canadian Medical Association Journal; 2006(Aug). See details...>

 

PAIN: Current Understanding of Assessment,
Management, and Treatments

From: American Pain Society; June 2006.  See details...>

 

See More... For more specific information, also see the Pain Disorders sections:

<Click Here>

 

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Pain & Disability Assessment Tools

Assessment ToolsPain scales and checklists offered in this section are useful for clinically assessing how intensely patients are feeling pain and for monitoring the effectiveness of treatments at different points in time. These essential tools for pain management practice are variously designed for different age groups, as well as individuals who do not speak English and/or cannot verbalize responses.

 

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Pain-Assessment & Monitoring Tools

From: Partners Against Pain®. Reviewed July 2011. See details…>

> Pain Assessment Scales
> Patient-Assessment Forms
> Clinical Follow-up Forms
> Pain Diaries & Reporting Forms for Patients
> Drug Abuse Screening / Aberrant Behaviors Assessment

 

NewPain Assessment in the Patient Unable to Self-Report

From: American Society for Pain Management Nursing [Pain Management Nursing. 2011(Dec);12(4):230-250].  See details...>

 

Verbal Descriptor Scale (Pain Thermometer)

From: GeriatricPain.org; Center for Nursing Excellence in Long-Term Care. Reviewed July 2011. See details…>

 

New Developments in the Diagnosis of Fibromyalgia Syndrome: Say Goodbye to Tender Points?

By: Wilke WS. Cleveland Clinic J Med. 2009:76(6):345-352.
See details…>

 

Tools for Assessing Neuropathic Pain

By: Giorgio Cruccu, Andrea Truini; PLoS Medicine; 2009;6(4).
See details...>

 

DASH – Disabilities of the Arm, Shoulder, & Hand

From: Institute for Work & Health (IWH). Reviewed December 2008.

See details...>

 

Assessing Obstructive Sleep Apnea Potential, Which May Affect Opioid Risk (Snore Score)

From: American Sleep Apnea Association. 2007. See details...>

 

Pain Intensity Scales Used by the National Institutes of Health

From: NIH Pain Consortium. Reviewed 2007. See details...>

 

Pain Rating Scales For Children

From: Texas Children's Cancer Center. See details...>

 

Faces Scales for the Self-Report of Pain Intensity
(Multi-Language)

Selected websites provide scripts for use with faces pain rating scales in a wide variety of languages. See details...>

 

Multi-Language NUMERICAL Pain Rating Scales

Two websites provide options for downloading a Numerical pain rating scale in 18 languages. See details...>

 

The Assessment of Pain in Older People

From: Royal College of Physicians of London. October 2007.
See details...>

 

Assessing Pain in Older Adults With Dementia

From: John A. Hartford Institute for Geriatric Nursing and the Alzheimer's Association. Revised 2007.  See details...>

 

Neuropathic Pain Scale

From: PainEdu.com. 2006.  See details...>

 

Pain, Suffering, and Spiritual Assessment

From: City of Hope. 2006.  See details...>

 

Pain Drawing

From: American Academy of Physical Medicine and Rehabilitation. 2001. See details...>

 

Migraine Disability Assessment Test (MIDAS)

From: Varied sources: 2 adult versions, 1 pediatric version. See details...>

 

Aberdeen Low Back Pain Scale

From: Provided by the Centre for Evidence Based Physiotherapy in the Netherlands; developed by researchers from the University of Aberdeen and the Aberdeen Royal Infirmary of Scotland. 1994. See details...>

 

Dallas Pain Questionnaire

From: Osteoarthritis Research Society International; Colorado Rehabilitation & Occupational Medicine. See details...>

 

Sheehan Disability Scale

From: Center for Quality Assessment & Improvement in Mental Health. See details...>

 

Psychosocial Pain Assessment

From: City of Hope.  See details...>

 

Brief Pain Inventory (BPI)

From: MD Anderson Cancer Center.  See details...>

 

Neck Pain Disability Index Questionnaire

From: Osteoarthritis Research Society International. See details...>

 

Special Clinical Tools for Assessing Opioid Risks

Opioid RiskApart from tools for evaluating pain, other properly validated and applied tools can help in assessing current or potential risks of drug abuse, misuse, addiction, or diversion associated with prescribed opioid analgesics.
Go to opioid risk assessment tools …>

 

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Disclaimer

Pain Treatment Topics and its associates do not endorse any medications, products, services, or treatments described, mentioned, or discussed in any of the sources referenced. Nor are any representations made concerning efficacy, appropriateness, or suitability of any such medications, products, services, or treatments.

In view of the possibility of human error or advances in medical knowledge, Pain Treatment Topics and its associates do not warrant the information contained in the above contents is in every respect accurate or complete, and we are not responsible nor liable for any errors or omissions made by the original sources or for results obtained from the use of this information. Also see, Site Policies.

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Affiliates

Click logos for info.
 

American Academy of Pain Management
American Academy
of Pain Management


American Association for the Treatment of Opioid Dependence

American Association
for the Treatment of
Opioid Dependence


American Chronic Pain Association

American Chronic Pain
Association


American College of Apothecaries

American College
of Apothecaries


American Pain Foundation

American Pain
Foundation


American Society of Pain Educators

American Society of
Pain Educators


European Opiate Addition Treatment Association

European Opiate
Addiction Treatment
Association


NfmCPA

National Fibromyalgia &
Chronic Pain Association


National Fibromyalgia Association

National Fibromyalgia
Association


Reflex Sympathetic Dystrophy Syndrome Association

Reflex Sympathetic
Dystrophy Syndrome
Association


TNA-The Facial Pain Association

TNA-The Facial Pain
Association


US Pain Foundation

U.S. Pain Foundation

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