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 Information and education resources are described below for the benefit of healthcare providers to make available for their pain patients, as appropriate. Professional discretion in their distribution and application is advised. Pain Treatment Topics does not provide medical advice, diagnosis, or treatment (also see, Disclaimer below and Site Policies).
Researcher/Reviewer - Winnie Dawson, MA, RN, BSN; Reviewer/Editor - Stewart B. Leavitt, MA, PhD.
 Some of the resources listed below require purchase, as indicated, and reviews are providely only for the interest and convenience of website visitors. Pain Treatment Topics has no financial interest in these offerings and does not receive any compensation from their publishers or providers.
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 Recommended for ALL Patients...
How to Evaluate Health Information on the Internet
From: U.S. Food and Drug Administration; 2005; 3 pages.
 HTML document available online at: http://www.fda.gov/oc/opacom/evalhealthinfo.html (Access checked 11/6/08)
 Thousands of websites offer health information, some good and some bad. This document from the FDA offers essential guidance for identifying sources of information via the Internet that are most likely to be reliable and up-to-date. Access checked November 6, 2008.
NOTE: Pain-Topics.org has been designed to comply with all requirements for a trustworthy website specified in this official government document.
Patient Medication Wallet Card
From: Iowa Healthcare Collaborative, undated.
See this online at: http://www.ihconline.org/patients/patients.cfm (Access checked 11/6/08)
 This convenient document allows you to briefly list your vital personal medical history and to keep track of all of your medications. There are instructions at the website for folding the document down to a wallet-size card. It is a good idea to always bring this with you during visits to the doctor, hospital, dentist, clinic, and pharmacy.
There also is a 2-page reminder card that has tips about asking important questions when talking with healthcare providers and pharmacists about your medications. And, it has information about how you can be more safe when it comes to medications.
General Pain Resources
 Which Analgesics Work Best? What Do They Cost?
From: Consumer Reports Best Buy Drugs, 2005-2008.
 Selecting an appropriate analgesic (pain-reliever drug) can be difficult, especially when cost is a concern. The Consumers Union -- an independent, nonprofit organization and publisher of Consumer Reports -- offers guidance via their public education project, Consumer Reports Best Buy Drugs™. Funding comes primarily from educational grants and reviews are conducted by physicians and researchers. Access to all pages checked November 6, 2008.
The website page for each drug class below provides a brief summary of the pain-relieving benefits of the drugs and has a quick-reference tab for drug comparisons.
A small box on the right-hand side of the description has links to...
- Full Report -- ranging 15 to 23 pages -- includes a discussion of selection considerations in choosing appropriate analgesics for each patient, provides recommendations, and explains the efficacy, dosing, safety issues, and relative costs for each drug in the class.
- 2-Page Summaries -- in English and in Spanish – that include recommendations plus listings of generic and trade names along with dosing and cost information for drug comparison purposes.
> Opioid Drugs
For acute severe pain and sometimes longer-term moderate to severe pain. (2008)
See page: http://www.consumerreports.org/health/best-buy-drugs/opioids.htm
> Anticonvulsants
For fibromyalgia, neuropathies, and herpes zoster infections. (2007)
See page: http://www.consumerreports.org/health/best-buy-drugs/anticonvulsants.htm
> Triptans
For the treatment of migraine headaches. (2006)
See page: http://www.consumerreports.org/health/best-buy-drugs/triptan.htm
> Nonsteroidal anti-inflammatory Drugs
Most frequently used for osteoarthritis and mild to moderate pain. (2005)
See page: http://www.consumerreports.org/health/best-buy-drugs/nsaids.htm
Target Chronic Pain Notebook
From: American Pain Foundation; revised March 2008; 38 pages.
A Pain Treatment Topics affiliate organization.
 PDF available online at: http://www.painfoundation.org/Publications/TargetNotebook.pdf.
Additional notebook pages are available at: http://www.painfoundation.org/page.asp?file=Publications/Target.htm.
 A pain notebook is a valuable tool to help patients identify their pain patterns in relationship to their lifestyle (time, location, triggers, intensity, therapy results). The text stresses the overall health benefits of reducing pain levels and that reporting accurate symptoms can greatly improve communication with healthcare providers to help identify the best therapy. This notebook provides examples to show the patient how to chart pain by time and location, as well as the logging of activities or therapy used to relieve pain. Daily log pages are included so the patient can begin using the notebook immediately and additional blank log and worksheet pages are available at the website shown above. Access checked November 3, 2008.
Pain Resource Guide: Getting the Help You Need
From: American Pain Foundation; 2007; 27 pages. A Pain Treatment Topics affiliate organization.
PDF available at: http://www.painfoundation.org/Publications/PainResourceGuide2007.pdf
 This booklet is designed to help patients take charge of their pain care. It provides important information about pain, answers to common questions, and helpful tips for getting quality pain care. In easy-to-read fashion, the booklet discusses why pain management is important, how to find effective pain care and pain specialists, and methods used to assess and diagnose pain.
Also included are: important treatment goals and an overview of available treatment options; questions to ask healthcare providers; steps patients can use to reclaim their lives; and tips for overcoming fears and sharing concerns with loved ones. A glossary of "Common Pain Terms" can be useful in talking with the health care team, family, and friends about pain and pain management. Access checked November 6, 2008.
Pain Relievers: Understanding Your OTC Options
From: American Academy of Family Physicians; Updated December 2006; 4 pages.
See HTML article online at: http://familydoctor.org/x8389.xml.
 There is much confusion regarding the use of pain relievers, and products that are readily available over-the-counter are no exception. This brief, easy-to-read article can provide a patient with some basic guidelines when selecting non-prescription pain medications. It includes information on the types of pain that are relieved by each type of medication and, more importantly, lists the type of health conditions that should preclude a patient from taking acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs). The article includes a link to a 2-page paper that describes the health effects of drug-drug interactions for selected pain relievers and other common over-the-counter products. In addition, a link is provided for a 5-page paper that lists the active ingredients for each over-the-counter product to help reduce the possibility of unknowingly taking more medication than intended. Access to all sites was checked November 6, 2008.
"Drug Interactions Chart" PDF is available at:
http://familydoctor.org/PreBuilt/otc_drugdruginteractionschart.pdf.
"Know What's in the Medicines You Take" PDF is available at:
http://familydoctor.org/PreBuilt/otc_knowingredientschart.pdf.
In light of recent results of a study published in the October 2006 issue of JAMA, these websites could be exceptionally important to patients who are 65 years and older. The study results, based on a national surveillance of emergency room visits, showed that more than 3% of the visits were due to the adverse effects of nonsteroidal anti-inflammatory drugs alone. In addition, people aged 65 and older were reported as being more than twice as likely to experience an adverse event. (Study reference: Budnitz DS, Pollock DA, Weidenbach KN, et al. National surveillance of emergency department visits for outpatient adverse drug events. JAMA. 2006(Oct);296(15):1858-1866).
Treatment Options: A Guide for People Living with Pain
From: American Pain Foundation; 2006; 84 pages. A Pain Treatment Topics affiliate organization.
Website PDF available at: http://www.painfoundation.org/Publications/TreatmentOptions2006.pdf (2.4MB).
 This booklet from APF -- Treatment Options: A Guide for People Living with Pain -- is an important resource for patients of all ages. Written and reviewed by leading pain specialists, the 8 chapters in this guide provide credible, comprehensive information about pain treatment medications, psychosocial interventions, complementary approaches, rehabilitation therapies, surgical interventions, and more. It can be a useful adjunct in preparing patients and their families for meaningful discussions with their healthcare providers regarding strategies for dealing with pain conditions of all types. Access checked November 4, 2008.
Anesthesia & Me© Checklist
From: American Society of Anesthesiologists; 2005; 1 page.
 PDF available online for download at:
http://www.asahq.org/patientEducation/Anes%20&%20Me%20Checklist.pdf
 This brief patient handout serves two purposes: 1) it provides a few paragraphs of basic information on the role of the anesthesiologist in surgery, and 2) contains a health checklist for any person to complete. The checklist covers personal information about the individual, including a history of allergies, endocrine system disorders, cardiovascular disease or compromises of the immune system. The checklist can be quickly completed, folded, and stored in the patient's wallet for use prior to scheduled surgery or in the event of emergency surgery. Access checked November 6, 2008.
Discussion Guide to Talk to Your Healthcare Provider About Your Pain Relief Needs
From: Making Sense of Pain Relief; 2005; 2 pages.
Website PDF available online for download at:
http://www.makingsenseofpainrelief.org/information/DiscussionGuide.pdf.
 This guide answers 8 questions about pain medications and risk. The main focus is on the use of NSAIDs following the 2005 FDA request that drug companies re-write labels to warn of potential cardiovascular risks. Lists of factors known to increase the risk of gastrointestinal or cardiac problems in patients taking NSAIDs are provided. Most importantly, the answers provided here will help patients generate their own talking points with healthcare professionals who are providing guidance on how to balance safety and pain relief. Access checked November 6, 2008.
Options for Managing Pain
From: Making Sense of Pain Relief; 2005; 15 pages.
PDF available online at: http://www.makingsenseofpainrelief.org/information/ConsumerGuide.pdf.
Also available online in separate HTML pages (by topic) at:
http://www.makingsenseofpainrelief.org/managingpain/default.asp.
 Chronic pain can require the long-term use of potent medications and some patients would like to become better informed of their pain management options. This consumer guide provides credible online resources to assist your patient in researching topics related to pain treatment from reliable, patient-friendly sources.
Contents include suggestions to help ensure good communication during the appointment with a healthcare provider. This booklet includes sources that allow a patient to learn more about specific drugs and their side effects, including a link to the FDA site for current information on the risks of taking Cox-2 inhibitors and NSAIDs. Useful resources for patient questions on the topics of drug tolerance and dependency or addiction are also offered. In addition, it offers sites for the patient to learn more about non-drug steps that they can take to help them gain more control over their pain.
Making Sense of Pain Relief™ is a public education program of the American Chronic Pain Association, The American Pain Foundation, and the National Pain Foundation with support from Pfizer, Inc. Access checked November 6, 2008.
Pain Information Library
From: American Pain Foundation; provides multiple links to APF pain management topics.
A Pain Treatment Topics affiliate organization.
HTML article available online at: http://www.painfoundation.org/page.asp?file=Library/Index.htm.
Pain management is complex because there are many pathological causes as well as emotional and cultural factors that influence pain perception and experience. The Pain Information Library was developed to help patients find answers and support for a myriad of pain conditions. Printable articles are available on Arthritis, Back Pain, Cancer Pain, Complex Regional Pain Syndrome, Fibromyalgia, Headaches, Musculoskeletal Pain, Neuropathic Pain, and Reflex Sympathetic Dystrophy. In addition, the site includes resources for finding patient advocacy groups, getting psychosocial support, and coping with financial issues.
A section titled 'Questions & Answers About Pain' provides answers to approximately 30 questions on various pain topics from addiction to trigger point injections, with valuable information on many medical and psychotherapy treatments in between. Techniques for describing pain to healthcare practitioners (see Pain Assessment) and writing in a pain log (see Keeping a Pain Diary) can be very helpful to patients who have trouble describing their symptoms; these tools can be found under the 'Pain & Pain Management' section. For the interested patient, the 'Complementary & Alternative Medicine' section contains credible information on herbs as well as physical approaches to pain and stress management. Access checked November 6, 2008.
NIH Pain Consortium — Pain Information Index
From: National Institutes of Health; provides multiple links to NIH pain management topics.
See HTML options online at: http://painconsortium.nih.gov/pain_index.html.
 This NIH website provides an A-Z listing of pain-related conditions as well as treatments and topics related to the management of pain. The list is comprehensive and many topic headings contain multiple links to information sources from various institutes under the NIH umbrella. Subjects range from disease conditions (e.g. Arthritis, Back Pain, Carpal Tunnel Syndrome, Diabetic Neuropathy, Gout, Herpes Zoster, Juvenile Rheumatoid Arthritis, Psoriasis, Trigeminal Neuralgia) to treatment options, including a few that address complementary and alternative medicine issues. Many of the information pieces are in fact-sheet format, but some contain photos (e.g. Shingles) or videos (e.g. Acupuncture for Osteoarthritis of the Knee). The site is easy to navigate and pleasantly devoid of distracting advertising banners. Access checked November 6, 2008.
The National Pain Foundation: My Pain
From: National Pain Foundation; provides multiple links to pain management topics.
See HTML document at website: http://www.nationalpainfoundation.org/MyPain/default.asp.
 The goal of this website is patient education and it offers 9 sections on different pain conditions plus a link to clinical trial information. The pain conditions presented include: Arthritis, Back and Neck Pain, Cancer Pain, Complex Regional Pain Syndrome (CRPS), Fibromyalgia, Headache, and Pelvic Pain. In addition, a discussion of concerns over potential addiction and recommendations for a patient's mental health care are presented. The articles are written in an easy-to-read style and, frequently, use examples to help illustrate concepts.
By registering for a free logon, the patient can use the online pain inventory and pain journal tools. The link entitled 'Treatment Options' near the bottom of the page links the viewer to treatment for the 9 pain conditions listed above, including medical and complementary therapies, as well as explanations of other treatments, like physical therapy or surgery, for specific conditions. Classes of drugs are explained and standard medications are categorized by condition from the mildest to most potent forms of therapy. Access checked November 6, 2008.
Two-page Summaries of Common Medical Conditions (with Questionnaires)
From: Taylor MicroTechnology, Inc (TMT); 2006; 41 pages.
Website PDF available at:
http://www.masterdocs.com/PDF/2-Page_Medical_Summaries_for_20_Common_Symptoms_and_Diseases.pdf.
This guide contains summaries of 20 medical conditions, half of which relate to common pain conditions. The summaries are highly condensed versions of review articles provided by the National Institutes of Health. The 10 pain-related topics include: Headache, Low Back Pain and Sciatica, Knee Pain, Shoulder Pain, Hip Pain, Toothache, Chest Pain, Jaw Pain and Temporomandibular Joint Disorder (TMJ), Peripheral Neuropathy, and Wrist/Carpal Tunnel Problems. Each summary includes potential causes, symptom differentiation, and standard diagnostic and treatment methods. Most summaries provide a helpful anatomical drawing relevant to the site of pain.
Questionnaires for the 10 conditions listed above are available under the 'Questionnaires' tab on the Taylor MicroTechnology home website, see: http://www.masterdocs.com/pain.htm.
These questionnaires, plus two surveys that can aid in the identification of chronic pain types, ask specific questions that will help a patient define the pain in terms of intensity, duration, location, and precipitating factors. Descriptions of pain symptoms are designed to make it easy for a patient to create a document that will provide the most accurate portrayal of their pain. The final step of the questionnaire includes an optional easy-to-use drawing pad that allows a patient to mark specific regions of pain on a body outline. Most questionnaires will take 10 to 20 minutes to complete and the results can be printed so the patient can take a copy to their healthcare provider.
Taylor MicroTechnology, Inc. (TMT), is a nonprofit organization with 22 years experience in the design of medical diagnostic systems as well as the design and administration of clinical research studies. Access checked November 6, 2008.
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Acute Pain
Practical Tips for Preventing a Sickle Cell Crisis [Pain]
From: American Academy of Family Physicians; Updated 2007; 2 pages.
PDF available here for download: http://familydoctor.org/online/famdocen/home/common/blood/550.html.
 A painful sickle cell crisis can occur when sickled red blood cells accumulate and stop the passage of blood flow through narrow blood vessels. Because there are many causes of an acute pain attack and patients can take steps to reduce the frequency of attacks, this article provides self-care techniques and prevention tips for patients with sickle cell disease. Available in Spanish language also. Access checked November 6, 2008.
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Alternative & Complementary Therapy
Vitamin D: A Champion of Pain Relief
 By: Stewart B. Leavitt, MA, PhD, Pain Treatment Topics, June 2008.
Download PDF: http://pain-topics.org/pdf/vitamind-brochure.pdf (200 KB, 6-pages)
Chronic pain – often involving muscles, bones, and joints – is a common problem leading patients to seek medical care. Overcoming these problems may be as simple, safe, and inexpensive as an extra dose of vitamin D each day.
This 6-page brochure explains in easy-to-understand language what vitamin D is and how it works. In also describes how inadequate vitamin D intake may play a role in aches and pains, as well as the benefits of vitamin D supplementation for relieving these symptoms.
Pain Control — How to Use Imagery
From: National Cancer Institute; January 2008; 2 pages.
Available in HTML online at: http://www.cancer.gov/cancertopics/paincontrol/page14.
 Imagery can be a useful technique to achieve more effective pain management. Complementary therapies can be added to pharmacotherapy and oftentimes reduce the medication dosage needed to adequately manage pain. This report is part of an NCI booklet on cancer pain management and includes instructions in the use of imagery and breathing exercises to achieve relaxation. Access checked November 6, 2008.
Copies of the complete booklet, entitled 'Pain Control: Support for People With Cancer', is available at no charge from NCI and may be ordered by telephoning 800-422-6237. Access checked November 5, 2008.
Meditation for Health Purposes
From: National Center for Complementary and Alternative Medicine (NCCAM); reviewed 2007; 6 pages.
Website PDF available at: http://nccam.nih.gov/health/meditation/meditation.pdf
Also available online at: http://nccam.nih.gov/health/meditation/.
 Studies have shown that meditation can promote pain relief and reduce other symptoms that can aggravate pain, such as anxiety, depression, and insomnia. Several types of meditation, including the main elements of all meditative practices, are discussed. A brief look at the theories on how meditation affects the body and the specific topics of recent NCCAM scientific studies are included. Access checked November 3, 2008.
Selecting a CAM Practitioner
From: National Center for Complementary and Alternative Medicine (NCCAM); revised 2007; 6 pages.
PDF available here for download: http://nccam.nih.gov/health/practitioner/D346.pdf
Also available online at: http://nccam.nih.gov/health/practitioner/index.htm.
The selection of a complementary or alternative medicine (CAM) practitioner can be confusing and intimidating. This fact sheet offers some key considerations for the patient who is interested in finding and selecting an appropriate CAM therapist. Guidance for the patient regarding the kinds of questions to ask during the initial visit are included. Access checked November 6, 2008.
Pediatric Pain: Psychological Factors Related to Chronic Pain in Children and Adolescents
From: National Pain Foundation; revised August 2005; 7 pages.
See HTML article online at: http://www.nationalpainfoundation.org/MyTreatment/articles/Pediatric_General_Pain.asp.
 Psychological therapy can be an integral component in the treatment of chronic pain in children. This article explains that pain is a physical and psychological experience so it can be beneficial to evaluate the child's feelings related to the pain. Feelings of frustration, anger, and anxiety can exacerbate chronic pain and compound the challenges of treatment. Therapeutic approaches such as biofeedback, self-hypnosis, guided imagery, relaxation, and cognitive interventions are discussed as treatment for headache and chronic pain syndromes. Integrating psychological therapy can help the child to feel some measure of control over symptoms. Access checked November 6, 2008.
Using Complementary Therapy to Relieve Pain
From: National Pain Foundation; revised August 2005; 7 pages.
See HTML article online at: http://www.nationalpainfoundation.org/MyTreatment/News_Complementary.asp.
The use of complementary therapy continues to increase in patients experiencing chronic pain. A complementary approach is frequently used in combination with pharmacotherapy to enhance pain relief while reducing the overall consumption of drugs. This article provides a basic description of 9 different types of complementary therapy and would be a helpful handout for a patient who is interested in learning more about complementary treatment options. In addition to recommendations on choosing a practitioner, the article explains the rationale behind using the following types of therapy: acupuncture, biofeedback, chiropractic manipulation, guided imagery, herbal medicine, hypnosis, naturopathic medicine, relaxation techniques, and yoga. Access checked November 6, 2008.
Get the Facts: Acupuncture
From: National Center for Complementary and Alternative Medicine (NCCAM); revised December 2004; 8 pages.
Website PDF available at: http://nccam.nih.gov/health/acupuncture/acupuncture.pdf
Also available online at: http://nccam.nih.gov/health/acupuncture/.
 This data sheet from NCCAM provides an overview of acupuncture, including a brief history and a statement about the growth of the practice in the United States. Evidence of the safety and effectiveness of acupuncture is explained and theories on why it can be effective for pain management are proposed. Tips for finding a licensed practitioner and a glossary of terms used in the practice are included. Access checked November 6, 2008.
What You Should Know About Herbal and Dietary Supplement Use and Anesthesia
From: American Society of Anesthesiologists; 2003; 2 pages.
Website PDF available at: http://www.asahq.org/patientEducation/herbPatient.pdf
 Based on the fact that nearly one third of surgical patients use at least one herbal supplement regularly, the American Society of Anesthesiologists created a brochure to communicate the message that failure to disclose such information before surgery can be have dangerous consequences. Oftentimes, patients unknowingly consider herbs and supplements as natural and, therefore, safe. While the brochure provides specific data on the potential side effects or interactions for 15 supplements, patients are also urged to inform surgeons and anesthesiologists of any vitamin, nutritional supplement, or herbal medicine use before surgery. Access checked November 6, 2008.
Relaxation Exercise
From: StopPain.org, Beth Israel University Hospital; undated; 15-minute audio with slides
Play audio-visual exercise at: http://www.healingchronicpain.org/content/relax/default.asp.
Relaxation exercises have been shown to reduce pain, anxiety, and depression. This audio-visual program uses visualization and breathing as the basis for relaxation and offers basic instruction for patients who are new to this type of relaxation exercise. The visualization component offers options for three different slide formats: sky, water, and trees. The slides change continually as the speaker gently instructs the user on techniques for focusing on mental images that soothe and comfort and, therefore, relax and aid the release of physical discomforts. This is a useful tool that is instructive and one that can be used repeatedly. Access checked November 6, 2008.
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Arthritis Pain (Osteoarthritis & Rheumatoid)
American College of Rheumatology Patient Education Fact Sheets
From: American College of Rheumatology (ACR); 2004-2008; 2-4 pages each.
See the list of fact sheets (organized alphabetically by disease or condition) at: http://www.rheumatology.org/public/factsheets/diseases_and_conditions/index.asp.
 The American College of Rheumatology and the Association of Rheumatology Health Professionals have developed about 40 information sheets on rheumatic diseases and conditions. These include carpal tunnel syndrome, fibromyalgia, back pain, neck pain, tendonitis/bursitis, the many types of arthritis, and many others.
Each fact sheet describes the condition, the diagnostic process, an overview of treatment, and also provides information on locating caregivers who treat patients for the disorder. Some topics are related to one specific aspect of a disorder; several fact sheets are written in both English and Spanish languages. Access checked November 13, 2008.
Choosing Pain Medicine for Osteoarthritis: A Guide for Consumers
From: U.S. Agency for Healthcare Research and Quality; January 2007; 10 pages.
PDF available here for download: Pain_Meds_Osteoarth_Pts.pdf
 This booklet helps consumers -- patients and their caregivers -- work with their doctors or nurses in choosing pain-relief medications for osteoarthritis. It is based on a detailed review of 350 research reports on this subject. The guide describes the different kinds of pain relievers and gives information about the trade-offs between pain relief, risks of problems, and the price of the medications. Access checked November 6, 2008.
Take Control With Exercise
From: The Arthritis Foundation; 2006; 60-minute audio-visual exercise program.
 See the Arthritis Foundation website for DVD ordering information:
http://afstore.arthritis.org/AFConsumerStore/SearchProductAction.do?_$action=Search &text=Take%20Control.
This audio-visual program demonstrates a variety of exercises that can benefit people with varying levels of disability due to arthritis. The program includes strengthening and range-of motion exercises as well as a relaxation component. The DVD can be purchased for US$19.95 by calling the Arthritis Foundation at 800-283-7800 or by visiting the website listed above. A Pain-Topics.org review of this program is provided under the Education/CME Locator, Resource Review section. See: http://www.pain-Topics.org/education_CME_locator/indexbkrv.php#top.
Access to all checked November 6, 2008.
Managing Arthritis Pain — Hot and Cold Treatments
From: University of Washington Medicine; 2005; 2 pages.
See HTML article online at: http://www.orthop.washington.edu/uw/livingwith/tabID__3376/ItemID__96/....
Patients are frequently confused about the use of heat or cold packs for pain relief. This information sheet provides tips on how to use both effectively, including the rationale behind using one or the other. The article includes safety tips when using heat or cold therapy. Access checked November 6, 2008.
Handout on Health: Rheumatoid Arthritis
From: National Institute of Arthritis and Musculoskeletal and Skin Diseases; revised May 2004; 48 pages.
Website PDF available at: http://www.niams.nih.gov/Health_Info/Rheumatic_Disease/rheumatoid_arthritis_hoh.pdf.
Also available online at: http://www.niams.nih.gov/Health_Info/Rheumatic_Disease/default.asp .
 The pain and inflammation associated with Rheumatoid Arthritis, an autoimmune disease, are manifested differently from one patient to another. This booklet describes these differences and is helpful for patients, as well as family members and friends. The symptoms and progression patterns of the disease are presented in an easy to understand manner. The exact causes of rheumatoid arthritis are unknown, but this booklet presents what is currently known about the factors that could play a part in this immune disorder. Treatment can be a multi-faceted combination of medical care and self-care. A list of commonly used prescription drugs for rheumatic diseases, including each drug's benefits and potential side effects, is presented in a convenient table. This booklet encourages the patient to monitor lifestyle behaviors to ensure adequate rest, appropriate levels of activity, a nutritious diet, and low stress levels. A section on alternative and complementary therapies suggests that patients first discuss any therapy they are considering with their doctor.
Copies of this booklet are available at no charge from NIAMS and may be ordered at the website noted above. Access checked November 6, 2008.
Questions and Answers About Arthritis and Exercise
From: National Institute of Arthritis and Musculoskeletal and Skin Diseases; 2001; 4 pages.
See HTML article online at: http://www.pueblo.gsa.gov/cic_text/health/qa-arthex/arthex.htm.
 Arthritis pain can discourage patients from getting much-needed exercise. This handout provides general information on the importance of regular exercise for people with arthritis and describes three different types of exercise: range-of-motion, muscle strengthening, and aerobic. Recommendations for starting an exercise program include tips on how to incorporate pain relief techniques into the exercise regimen. Access checked November 6, 2008.
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Cancer Pain
Pain Control: A Guide for People with Cancer & Their Families
From: American Cancer Society (ACS), latest revision November 2008; 31 pages.
HTML document available online at: http://www.cancer.org/docroot/MIT/content/MIT_7_2x_
Pain_Control_A_Guide_for_People_with_Cancer_and_Their_Families.asp
 Pain can present many challenges for a cancer patient and family members. This easy-to-read document explains the types and origins of pain associated with cancer, and the obstacles that can interfere with its treatment. A list of sample questions about the pain experience are provided as an aid to a patient's preparation for an appointment with their healthcare provider. The need for pain assessment is explained. Alternative treatments, non-opioid drugs, and weak and strong opioids are defined using specific examples. The concept of adjuvant analgesics — specifically, antidepressants, anticonvulsants, steroids, and topical anesthetics — are explained. Techniques for scheduling medications and managing side effects are offered. Various other therapies, as well as the importance of psychosocial and emotional support, are discussed and a useful glossary of terms is provided. Access checked December 30, 2008.
Pain (PDQ®)
From: National Cancer Institute; revised July 2008; 9 pages.
Available online in HTML at: http://www.cancer.gov/cancertopics/pdq/supportivecare/pain/patient/allpages.
 Effective cancer pain management begins with assessment and this article includes a good tip list for the patient to use when describing pain to healthcare professionals, including their emotional and behavioral responses. The WHO 3-step approach to pain management and the various classes of analgesic drugs are discussed briefly. This guide encourages patients to consider noninvasive physical and psychological interventions as an adjunct to drug therapy, and also provides instructions for 4 common relaxation techniques. The issues involved in assessing and treating older patients are summarized nicely. This HTML text contains web links to other PDQ summaries for managing medication side effects, nausea and gastrointestinal complications, nutritional concerns, and sexuality and reproductive issues.
Copies of this booklet are available at no charge from NCI and may be ordered by telephoning 800-422-6237. Access checked November 3, 2008.
Pain Control — Other Ways to Control Pain
From: National Cancer Institute (NCI); 2008; 4 pages.
Available online in HTML at: http://www.cancer.gov/cancertopics/paincontrol/page8.
Nondrug therapy can provide effective pain management as a stand-alone treatment or in concert with pharmacotherapy. Complementary therapies can oftentimes reduce the medication dosage needed to adequately manage pain. This report is part of an NCI booklet on cancer pain management and includes information on 13 different pain relieving techniques. Some techniques are explained in detail (relaxation, deep breathing, imagery) while other treatment modalities are simply described (Tai Chi, yoga, Reiki). Special precautions are suggested for any treatments that require advanced knowledge.
Copies of the complete booklet, entitled 'Pain Control: Support for People With Cancer', is available at no charge from NCI and may be ordered by telephoning 800-422-6237. Access checked November 5, 2008.
Controlling Cancer Pain: What You Need to Know to Get Relief
From: CancerCare.org; 2005; 20 pages.
Website PDF available at: http://www.cancercare.org/pdf/booklets/ccc_controlling_pain.pdf.
Cancer pain can be caused by tumor growth, physiological changes to adjacent tissues, or as a side effect of cancer treatments. This booklet provides tips that can help the patient effectively describe their pain to clinicians and encourages the use of a pain diary. A basic discussion of pain medications includes an explanation of the benefits of various types of adjunct medications; additionally, breakthrough pain is defined and treatment options are reviewed. Techniques for managing the side effects of opioid drugs—nausea, constipation, excessive drowsiness—are offered for patients who need the benefits of opioid pain relief. This easy-to-read booklet provides a concise overview for the patient who wants to understand the basics of pain management. Access checked November 6, 2008.
Pain Management (Blood Cancer)
From: The Leukemia & Lymphoma Society; October 2005; 14 pages.
Website PDF available at: http://www.leukemia-lymphoma.org/attachments/National/br_1130788384.pdf.
Also online in HTML at: http://www.leukemia-lymphoma.org/all_mat_toc.adp?item_id=104411&cat_id=1214.
 In this patient booklet, the types of pain related to blood cancers (leukemia, lymphoma, and myeloma) are described and the patient is reassured that the pain can usually be managed by oral medications. The descriptions of the differences between acute, chronic, and breakthrough pain are easy to understand. This handout makes suggestions on how to prepare for good communication with healthcare staff and supplies a list of words to use to effectively describe pain. A list of questions is provided that can be useful for patients when asking their physician about medication use to treat their pain. The tools for patient use that are provided include the 1) numerical pain rating scale, 2) the FACES pain scale, and 3) a pain diary sheet that can be copied and used repeatedly. Access checked November 6, 2008.
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Chronic & Intractable Pain
ACPA Medications & Chronic Pain Supplement 2008
From: American Chronic Pain Association (ACPA); updated 2008; 52 pages.
PDF available online at: http://www.theacpa.org/documents/ACPA%20Meds%202008%20Final.pdf
 This annual supplement is of value for both patients and practitioners. It is consistent with the ACPA's philosophy that patient knowledge is important and states "the ACPA believes that people with chronic pain benefit from being well informed about their medications." This pain medication supplement is reviewed each year to provide current information on drugs as well as potential side effects. The ACPA strongly advises patients to find out why medications have been prescribed for them and to help reduce confusion by learning to identify their pills by sight. The suggestion is made to take all medication containers to a first visit with a new physician. In addition, the concept of using a medication for an "off-label" use is described and the discussion of over-the-counter medications includes a reminder to look at the label to become aware of all active ingredients before taking a new formulation.
Descriptions of indications and the pros and cons of non-opioid analgesics are conveniently provided in a table. A list of the trade names of commonly used opioid medications precedes an easy to understand explanation of the issues related to tolerance, physiological impairment, dependence, addiction, and withdrawal. A checklist can help a patient work with their physician to determine if opioid use is appropriate for their overall health. Uses of antidepressants, anticonvulsants, sedatives, muscle relaxants, and topical analgesics in pain management are discussed to help patients understand why each can be useful. This booklet can be printed or used online; it has many links within the text to additional website resources. Access checked November 3, 2008.
My Pain Management
From: Leonard Schanfield Research Institute (LSRI) at CJE Senior Life; 2008.
Go to website at: http://www.mypainmanagement.net (Free registration is required.)
My Pain Management is a website that is most appropriate for people who are experiencing chronic pain. The site provides a variety of exercises for managing pain, which are not intended to be specific to a particular condition or cause of pain. Since the symptoms of pain can vary and pain is a very personal experience, everyone will have different ways of handling their pain. This website was developed and tested by the Leonard Schanfield Research Institute (LSRI) at CJE Senior Life in Chicago, IL, and it was demonstrated as being helpful for persons of all ages suffering from chronic pain conditions.
So You’ve Got Chronic Pain… What’s Next?
By: Mark R. Collen and Steven Feinberg, MD. From: PainExhibit.com; 2008.
See details online at: http://painexhibit.com/brochure.html
(Free copies of the brochure can be requested at this site.)
 The intent of this brochure is to help manage expectations of the patient with chronic pain and to provide tested and true strategies for living a high-quality life with such pain. The brochure was developed over a three-year period and tested at 25 clinics nationwide. Feedback from both clinicians and patients was integral in its creation.
The writer, Mark R. Collen, is himself a person with long-standing chronic pain, and the creator/manager of the Pain Exhibit at PainExhibit.com. He also serves on the editorial board of the Journal of Pain and Palliative Care Pharmacotherapy. Many of the very expressive creative artworks from the Pain Exhibit are incorporated into the brochure.
The brochure was edited by Steven Feinberg, MD, a professor at Stanford University, and a physiatrist and pain specialist in private practice in Palo Alto, California. He also serves as on the board of directors of the American Chronic Pain Association. Access checked November 6, 2008.
Intractable Pain Patient's Handbook for Survival
By: Forest Tennant, MD, DrPH; from Pain Treatment Topics, 2007, 36 pages.
PDF available here for download: IntractablePainSurvival.pdf (459 KB)
 This first-of-its-kind handbook, exclusively available from Pain Treatment Topics, is specifically for persons with intractable pain, or IP. This is pain more serious than typical chronic pain conditions; such as arthritis, headaches, back pain, bunions, and others. IP involves severe and often disabling pain that never stops; and, it can also harm heart function, hormonal balance, and other body systems if undertreated.
According to the author -- Dr. Forest Tennant, who has more than 30 years experience as an IP-treatment specialist -- IP afflicts a small percentage of persons with chronic pain. Consequently, many healthcare providers do not know how to effectively treat IP, which requires a customized treatment plan often involving a combination of strong medications. This unique handbook takes a no-nonsense approach, explaining in everyday language how to communicate with healthcare providers, insurance companies, family, and others to receive proper care. Dr. Tennant also offers advice on medication options and safety, diet and weight control, how to adopt a positive attitude, and many other helpful suggestions for not only surviving IP but improving one's quality of daily living with this chronic and severe condition. Access checked November 6, 2008.
Managing Chronic Pain: A Guide for Patients [Booklet + DVD]
From: PainBalance.org, 2007.
See ordering information at: http://www.painbalance.org/opioid/pages/product.aspx?id=123
(Free registration is required to order. Item is available and shipped at no charge.)
 This noncommercial 31-page booklet and 30-minute video program on DVD for patients and their caregivers describe the complexities of managing chronic pain. The program discusses the nature of pain and goals of pain-relieving therapies, pain medications and their safe use, alternative approaches to pain relief, and how to work with the healthcare team. The video program features commentary by leading pain physicians, messages from patients, and special narration by television and film star Donna Mills, herself a chronic pain sufferer. Most important, the program conveys a message of hope that relief from chronic pain can be within any patient’s reach. Access checked November 6, 2008.
Surviving a Loved One's Chronic Pain
By: David Kannerstein, PhD and Sarah M. Whitman, MD; from Practical Pain Management; 2007; 4 pages.
PDF available here for download: LovedOnesChronicPain.pdf
This article is suggested as a handout for patients' families, friends, or caretakers to help them understand what patients in chronic pain are going through. It provides guidance for understanding chronic pain and its treatment, and how to best communicate with and provide support to the patient. It recognizes that dealing with severe, ongoing pain can be overwhelming for both patients and those who care for them and/or about them. Access checked November 6, 2008.
Mistakes Made by Chronic Pain Patients
A patient guide for avoiding pitfalls and becoming part of their pain management team to restore a better quality of life.
By: Ron Lechnyr, PhD, DSW and Terry Lechnyr, PhD, LCSW; from Practical Pain Management; 2007; 3 pages.
PDF available here: http://pain-topics.org/pdf/mistakes-by-chronic-pain-patients.pdf (56 KB)
 Entering the world of chronic pain is a confusing and difficult process for patients, as well as their caregivers. Often they do not understand the basics of pain management approaches to long-term care. However, helping patients to become aware of various potential problems and mistakes ahead of time, will allow them to respond differently and learn how to become part of the pain management team.
This guide is intended for healthcare providers to give to patients, and their caregivers, at the start of treatment for any chronic pain problem. Knowledge is power and it can help reduce what may appear to healthcare providers as 'treatment resistance' on the part of patients or their loved ones.
Five Steps to Control Chronic Pain
From: COVIDIEN/Mallinckrodt; 2002; 8 pages. A Pain Treatment Topics sponsor.
PDF available here for download: ControlChronicPain-5-Steps.pdf (480 KB)
There are many steps to help alleviate chronic pain, ranging from doctor-prescribed medications to more unconventional methods. This brochure provides a number of ideas to assist patients in controlling and minimizing persistent pain and associated suffering.
The 5 steps briefly covered in the brochure include: 1) relaxation and meditation, 2) humor and positive thinking, 3) sleep and exercise, 4) diet and nutrition, and 5) medication. There also is a list of several resources where more thorough discussions of these topics and specific recommendations can be found. Access checked November 6, 2008.
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Fibromyalgia
Fibromyalgia
From: Mayo Clinic; Updated February 2008; 8 pages.
See HTML article online at: http://www.mayoclinic.com/health/fibromyalgia/DS00079.
 Authors at Mayo Clinic address some of the frustrations related to diagnosis, risk factors, and various chronic symptoms of fibromyalgia syndrome. This information resource explains the American College of Rheumatology classification criteria for diagnosis and includes a diagram of the common locations of physical pain and tenderness. A discussion of treatment includes information on effective drugs as well as techniques for self-care. The section on medications includes the benefits of using analgesics, antidepressants, muscle relaxants, and Lyrica®, an anti-convulsant recently FDA-approved for the treatment of fibromyalgia. Complementary therapies that have shown some evidence for effectiveness in the relief of fibromyalgia symptoms are discussed. Access checked November 6, 2008.
What is Fibromyalgia? Fast Facts: An Easy-to-Read Series of Publications for the Public
From: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); Updated August 2007; 3 pages.
English-language PDF available at: http://www.niams.nih.gov/health_info/Fibromyalgia/fibromyalgia_ff.pdf.
Spanish-language PDF available at: http://www.niams.nih.gov/Portal_En_Espanol/Informacion_de_Salud/Fibromialgia/fibromyalgia_ff_espanol.pdf.
 These factsheets on fibromyalgia syndrome provide a brief, easy-to-read overview of the common symptoms, contributing factors, and treatments known to provide some symptom relief. The handout emphasizes that a team approach to professional diagnosis and treatment is common. Lyrica®, the drug recently approved for the treatment of fibromyalgia is mentioned. The factsheet is ideal for patients who are in the diagnostic process and others who are unfamiliar with fibromyalgia syndrome. Access checked November 6, 2008.
Fibromyalgia Factsheet
From: American College of Rheumatology (ACR); Updated 2006; 4 pages.
See HTML article online at: http://www.rheumatology.org/public/factsheets/diseases_and_conditions/fibromyalgia.asp?aud=pat.
This factsheet provides an overview of fibromyalgia syndrome, from definition to treatment. Because fibromyalgia symptoms can vary from patient to patient, the full range of potential symptoms are listed, and a graphic depiction of the common "tender points" associated with fibromyalgia pain is provided. Medications for symptom relief, complementary beneficial therapies, and techniques for improving the daily quality of life are all reviewed. The rationale for utilizing the diagnostic expertise of a rheumatologist is explained. Access checked November 6, 2008.
Questions and Answers About Fibromyalgia
From: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); Updated June 2004; 32 pages.
See HTML article online at: http://www.niams.nih.gov/Health_Info/Fibromyalgia/default.asp.
Website PDF available at: http://www.niams.nih.gov/Health_Info/Fibromyalgia/fibromyalgia_qa.pdf.
Fibromyalgia syndrome, a common disorder of unknown etiology, is characterized by widespread chronic pain which is frequently accompanied by multiple symptoms — like fatigue, sleep disturbances, headaches, irritable bowel syndrome, and memory problems — that can reduce the quality of life. This booklet describes current scientific knowledge related to possible causes of the syndrome, best diagnostic practices, and the most effective forms of therapy. Additional topics include behavioral changes that a patient can initiate to minimize the impact of fibromyalgia, as well as tips for improving sleep. The final section provides an overview of the current research being conducted to learn more about the disorder. The booklet is ideal for newly-diagnosed patients, as well as family members, friends, and others who would like to learn more about fibromyalgia syndrome.
Copies of this booklet are available at no charge from NIAMS and may be ordered at the website noted above. Access checked November 6, 2008.
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Headache
Migraine Headache
From: National Women's Health Information Center; 2008; 9 pages.
Website PDF available at: http://www.4woman.gov/faq/migraine.pdf.
Also available online in HTML at: http://www.4woman.gov/faq/migraine.htm.
 This booklet uses a 'Frequently Asked Questions' format and provides answers to 17 questions. The topics covered include the causes of a migraine, the types of migraines, headache as it relates to a woman's menstrual cycle, migraines in pregnancy, and treatments. Topics on treatment include medications as well as an emphasis on modifying lifestyle factors. The writers encourage women to keep a headache diary to try to learn more about what triggers headache episodes.
The National Women's Health Information Center is a service of the Office on Women's Health (OWH) in the US Department of Health and Human Services. The OWH provides valuable information on many Women's Health Topics at http://www.4woman.gov. Access checked November 3, 2008.
Patient Headache Diary Information
Pain journals or diaries are valuable tools to help patients identify patterns in the timing and intensity of headaches. A diary can also help a patient to notice foods, lifestyle factors, or environmental changes that trigger headaches. These tools are a valuable asset in the assessment process and there are three different forms available for patients to print and use at home. Remind your patient to bring their completed diary pages to their next appointment.
Access to following sites was checked November 6, 2008.
From: American Academy of Neurology
A 1-page Trigger Tracker that provides a list of possible headache triggers plus tips on how to keep notes in a headache diary is available at:
http://www.aan.com/globals/axon/assets/2359.pdf.
 From: National Headache Foundation
Two single-page handouts — a 1-page diary "how-to" sheet for keeping a useful diary plus a printable diary form to record all aspects of headache episodes — are available at:
http://www.headaches.org/For_Professionals/Headache_Diary.
From: University of California Berkeley Health Services
A 2-page handout on Migraine Triggers that covers lifestyle and environmental triggers in addition to a full page of common food triggers is available at:
http://www.uhs.berkeley.edu/home/healthtopics/pdf/triggers.pdf.
A 1-page printable patient diary (2 forms per page) for notations of all aspects of headache episodes that includes a space for treatment notes is available at:
http://www.uhs.berkeley.edu/home/healthtopics/pdf/diary.pdf.
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Musculoskeletal Pain (Back, Neck, & Joint)
Back Pain
Information From Your Family Doctor. Low Back Pain
From: American Academy of Family Physicians (AAFP); 2007; 3 pages
See HTML article online at: http://www.aafp.org/afp/20070415/1190ph.html.
This question-and-answer sheet from the American Family Physician provides a good summary of the basic issues related to low back pain. In addition to a general discussion on the causes of back pain, 2 drawings can serve as an aid to an improved understanding of the physiology involved. Several tips and techniques for pain relief and the prevention of back injury are offered. Access checked November 6, 2008.
Low Back Pain Fact Sheet
From: National Institute of Neurological Disorders and Stroke (NINDS); Updated in 2007; 8 pages.
See HTML factsheet online at: http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm
 This factsheet covers back pain basics, including a description of the anatomy of the back and a brief definition of acute versus chronic pain. The causes of low back pain plus the names and descriptions of conditions that cause it are discussed. Explanations of the methods used for a thorough diagnosis, including a description of all tests that could be prescribed, are presented. Potential treatments, from self-care to surgery, are described and tips for prevention and back-strengthening are offered. Access checked November 6, 2008.
What Is Back Pain?
From: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); 2006; 5 pages.
PDF of factsheet is available here for download: http://www.niams.nih.gov/Health_Info/Back_Pain/back_pain_ff.pdf
This easy-to-read factsheet contains a good summary of the causes of back pain as well as options for prevention. A concise checklist of specific symptoms that should alert a patient to see a doctor precedes an explanation of the various types of treatment available for back pain. Access checked November 6, 2008.
Handout on Health: Back Pain
From: National Institute of Arthritis and Musculoskeletal and Skin Diseases; September 2005; 44 pages.
PDF of booklet available here for download: http://www.pain-topics.org/pdf/BackPain_NIH_Sept2005.pdf.
Also available online in HTML at: http://www.niams.nih.gov/Health_Info/Back_Pain/.
 This booklet is for patients with back pain, as well as family members, friends, and others who want to learn more about it. In straightforward language, the booklet describes causes, diagnoses, and treatments, and research efforts seeking to learn more about back pain, many of which are supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and other components of the Department of Health and Human Services' National Institutes of Health (NIH). Patients having further questions after reading this booklet, can discuss them with their healthcare providers.
Topics covered include: How common is back pain and what are the causes? When should a doctor be seen for the pain? How is back pain treated?
Copies of this booklet are available at no charge from NIAMS and may be ordered at the website noted above. Access checked November 6, 2008.
Anatomy Guide: Low Back Disorders
From: WebMD; 2004; 6 pages
See animations online at: http://www.webmd.com/content/tools/1/anatomy_low_back.htm?z=3628_81000_0000_03_04&src=pemedscape.
This web page presents an animated display of the pathophysiology of 6 low back disorders. Each animation offers a good depiction of how physiological changes in the body cause the pain experienced by the patient. Each disorder is described in one paragraph of text and an animation displays the changes in normal physiology for the following 6 disorders: herniated disc, spinal stenosis, osteoporosis, osteoarthritis, ankylosing spondylitis, and spondylisthesis. To see the animation, click the button marked 'Click for Animation', then, when the animation begins, click on the 'View Labels' button to display anatomical landmarks. Access checked November 6, 2008.
Upper Back Pain
From: Virginia Tech Schiffert Health Center; 2004; 3 pages.
PDF of factsheet is available here for download: http://www.healthcenter.vt.edu/pdf/MCOrthoRehab-UpperBack.pdf
This factsheet explains that most upper back pain, not due to traumatic injury, is muscle strain that could be the result of improper lifting, bending, or poor posture. The tip sheet includes a list of quick self-treatment options plus guidelines on symptoms that signal the need to see a doctor. Emphasis is placed on the use of exercise for rehabilitation and muscle strengthening after the initial pain has subsided. Access checked November 6, 2008.
Lower Back Pain: Self-Care Flow Chart
From: American Academy of Family Physicians (AAFP); 1996; 1 page.
See HTML chart online at: http://familydoctor.org/online/famdocen/home/tools/symptom/531.printerview.html
Back pain is common, but its causes range from minor strains to serious disorders and injuries. This self-care flow chart from AAFP helps to guide patients through a series of yes-&-no questions about their symptoms to assist them in decision-making related to seeking medical help. It is meant to help educate the patient with low back pain and not to serve as the sole tool in the decision-making process. Access checked November 6, 2008.
 Back Pain Exercises
A healthcare provider should be consulted before beginning an exercise program for back pain. The following resources provide instructions and/or demonstrations of back exercises that may be beneficial in healing or preventing back pain.
Back Exercises
From: MedlinePlus Patient Education Institute; Updated in 2005; 69 slides.
Access the audio-visual program online at: http://www.nlm.nih.gov/medlineplus/tutorials/backexercises/htm/_no_50_no_0.htm
 This easy-to-follow audio-visual slide program begins with an explanation of the benefits of back exercise and emphasizes that regular stretching and strengthening exercises can prevent back pain. A few general tips on the safe and effective implementation of an exercise routine are presented and would be exceptionally beneficial for the beginner who has not previously received such guidance. Stretching and strengthening exercises are demonstrated with the use of drawings; specific muscles being exercised are indicated in each graphic. Access checked November 6, 2008.
Low Back Pain Exercise Guide
From: American Academy of Orthopaedic Surgeons; 2000; 6 pages.
See HTML article online at: http://www.orthoinfo.org/booklet/view_exercise.cfm?Thread_ID=18&topcategory=Spine
 To meet the needs of patients at various levels of recovery and ability, this handout provides basic descriptions and drawings to instruct patients in performing 15 back strengthening exercises at 3 different levels: initial, intermediate, and advanced. The exercise ball is used in several intermediate and advanced exercises. Access checked November 6, 2008.
Neck/Shoulder Pain
Neck Pain
From: American College of Rheumatology (ACR); 2006; 4 pages
See HTML article online at: http://www.rheumatology.org/public/factsheets/diseases_and_conditions/neckpain.asp
This patient fact sheet provides a good summary of basic important facts about neck pain. Diagnostic techniques and causes of neck pain are discussed; specific description of spinal stenosis, osteoarthritis, and intervertebral disc herniation are included. Prevention is covered in a cursory manner but patients could benefit from the techniques for treating neck pain which are provided. Access checked November 5, 2008.
Practical Management of Whiplash
From: British Columbia Medical Association; 2002; 5 pages.
PDF available here for download: http://www.bcmj.org/files/WhiplashHandout.pdf (275 KB)
This handout begins with a question-and-answer section that addresses many patient uncertainties regarding different types of whiplash, diagnosis, treatment, and the recovery process. The second half of the handout discusses the need for neck-specific exercises, suggests precautions, and describes 5 exercises in detail (including graphic instructions for implementation). Access checked November 6, 2008.
Joint Pain
JAMA Patient Page: Knee Pain
From: Journal of the American Medical Association (JAMA); April 2007(Apr);297(15):1740. 1 page.
PDF available online at: http://jama.ama-assn.org/cgi/reprint/297/15/1740.
HTML version also available online at: http://jama.ama-assn.org/cgi/content/full/297/15/1740.
 This patient information page provides a good overview of the causes of knee pain, including recommendations for initial care and guidelines regarding when to get medical advice. The drawings of the knee are nicely detailed and include the ligaments that are frequently injured. Access checked November 6, 2008.
TMJ (Temporomandibular Joint) Disorders
From: National Institute of Dental and Craniofacial Research; 2006; 20 pages.
PDF available here for download: http://www.nidcr.nih.gov/NR/rdonlyres/39C75C9B-1795-4A87... (687 KB)
This booklet from the National Institutes of Health describes TMJ disorder, its causes, and other conditions that may challenge a patient simultaneously. Diagnosis and the symptoms of TMJ are discussed briefly. An overview of treatment—from conservative measures and self-care treatments to surgery—provides brief information on the current thinking regarding effectiveness for pain relief in TMJ. The booklet suggests that readers need to be cautious in finding a qualified practitioner and warn against choosing treatments that will cause permanent changes in the jaw. Access checked November 6, 2008.
Tendonitis/Bursitis
From: American College of Rheumatology (ACR); 2005; 4 pages.
See HTML article online at: http://www.rheumatology.org/public/factsheets/diseases_and_conditions/tendonitis.asp?aud=pat.
The pain of tendonitis or bursitis can be severe and can occur suddenly. This factsheet defines tendonitis and bursitis—each caused by an inflammatory reaction involving the elbow, knee, hip, wrist, ankle, or shoulder—and includes a discussion of diagnostic methods. Treatment approaches are described and prevention methods that may reduce the risk of injury are explained. Access checked November 6, 2008.
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Nerve (Neuropathic) Pain
About Neuropathic Facial Pain and TN (Trigeminal Neuralgia)
From: Trigeminal Neuralgia Association; Undated; 2 pages. A Pain Treatment Topics affiliate organization.
See HTML article online at: http://www.fpa-support.org/aboutfp/
 Trigeminal neuralgia is a nerve disorder that can be very painful and somewhat challenging to diagnose. This webpage provides a description of trigeminal neuralgia and other less common nerve disorders that cause facial pain. The site also provides a good drawing of the placement of the trigeminal nerve in relation to other facial structures. Several links are available to the reader for additional descriptions of facial nerve pain and a 22-item diagnostic questionnaire that could benefit patients and practitioners during the diagnostic visit. Access checked November 6, 2008.
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Opioid & Other Medication Safety
Methadone Safety Handout for Patients [in English and Spanish]
 From: Pain Treatment Topics, updated March 2008; 7 pages.
PDF available here for download: MethadoneHandout.pdf (266 KB)
These special 2-page Handouts for patients and their families or caretakers (in English and Spanish) offer vital instructions for treatment compliance and safety.
When appropriately prescribed and used, methadone is a safe medication offering effective and economical relief for chronic pain. However, patients must clearly understand that misuse or abuse of this strong opioid can be fatal. Taking extra doses or mixing methadone with alcohol or other drugs can have dire consequences. They also must appreciate the importance of safeguarding the medication from unauthorized access by other persons, children or adults. It should not be casually stored as other medications might be. NOTE: These instructions do not take the place of practitioner-provided guidance or the methadone package insert. Access checked November 6, 2008.
How to Dispose of Unused Medicines
 From: U.S. Office of National Drug Control Policy and the FDA; 2008; 2 pages.
PDF available here for download:
http://www.fda.gov/consumer/updates/drug_disposal062308.pdf
Improper disposal of unused prescription drugs raises concerns from both environmental and societal perspectives. A particular problem is that the improper disposal of opioid pain relievers has led to their diversion and misuse. This two-page handout presents a summary of the guidance contained in the Federal guidelines for prescription drug disposal that went into effect in February 2007. Access checked November 21, 2008.
Pain - Opioid Facts
From: PainKnowledge.org, Thomson Professional Postgraduate Services; 2007; 2 pages.
PDF available here for download: http://www.painknowledge.org/patiented/pdf/... (350 KB)
This factsheet provides patients with a good overview of the commonly prescribed opioids, routes of administration, and tips for taking them. Several concerns regarding addiction, dependency, and adverse effects are addressed in a question-and-answer format. Definitions for addiction, misuse, dependence, and tolerance are provided. Access checked November 6, 2008.
Patient Instructions Handout: Safely Taking Oxycodone [in English and Spanish]
 From: Pain Treatment Topics; June 2007; 7 pages.
PDF available here for download: OxycodoneHandout.pdf (350 KB)
These special 2-page, peer-reviewed “Patient Instructions” handouts on the safe use of oxycodone are available in English and Spanish and can be downloaded and reproduced free of charge for distribution at the time oxycodone analgesia is prescribed. Ideally, these also would be used as discussion guides for face-to-face education of patients — and their families or caregivers. The emphasis of the handouts is on medication compliance and safety, to help prevent misuse and avoidable adverse events potentially associated with oxycodone analgesia therapy. Access checked November 6, 2008.
Your Guide to Taking Oxycodone Safely
From: COVIDIEN/Mallinckrodt; 2007; 9 pages. A Pain Treatment Topics sponsor.
PDF available here for download: oxycodone-safety-guide.pdf (335 KB)
 This colorful, 9-page brochure explains to patients (and their caregivers) important risks and precautions in using oxycodone. Concise and easy-to-read text describes what patients need to know and do to safely take this strong opioid pain reliever. For example, the brochure includes descriptions of possible side effects, how best to take oxycodone, where to store it safely, concerns about addiction, and signs of an emergency situation requiring immediate action. Access checked November 6, 2008.
Facts About Prescription Drug Abuse
From: U.S. National Institute on Drug Abuse; April 2005; 2 pages.
PDF available here for download: RxDrugAbuseFacts.pdf
 This brief fact sheet describes the most commonly misused or abused prescription drugs, and how the reader can help prevent such problems. A convenient reference table lists the drugs by category and name, and provides examples of commercial or street names, how they are administered, intoxication effects, and potential health consequences. Access checked November 6, 2008.
Fact Sheets For Families: Acetaminophen Safety
From: California Childcare Health Program; 2002; 1 page.
PDF available here for download: http://www.ucsfchildcarehealth.org/pdfs/factsheets/acetaminen011804.pdf
This fact sheet alerts consumers to the dangers of using acetaminophen inappropriately. Information is provided on potential side effects, the symptoms of intoxication, and the types of individuals who may be at risk for toxicity. Tips for using acetaminophen safely are discussed. Access checked November 6, 2008.
Buying Prescription Medicine Online: A Consumer Safety Guide
From: U.S. Food and Drug Administration; undated; 2 pages.
PDF available here for download: BuyRxOnline.pdf
This pamphlet points out the many dangers of buying prescription drugs over the Internet. Helpful tips are provided for identifying legitimate websites and safe practices to follow when ordering online. Links to additional government websites are provided for further information. Access checked November 6, 2008.
Opioid Pain Relievers: What T | 
