The Clinical journal of pain
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Although those in the field of pain management have long recognized the multidimensional character of pain, global pain intensity remains the most frequently assessed domain measured in clinical trials of pain treatments. However, a number of specific pain qualities have been shown to be associated with neuropathic versus nociceptive pain and, as such, can be used for diagnostic purposes. ⋯ A number of such measures are currently available, each with its strengths and weaknesses. These measures are reviewed, and potential future uses of these tools are discussed.
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The concept of rational polypharmacy is now well established in the field of pain management. This concept has evolved in concert with progress in understanding the pathophysiologic mechanisms of pain diseases and disorders and how medications affect these processes. ⋯ This article will review how pain diagnosis, pain mechanisms, pain phenomenology, medication efficacy, and risk profile influence medication selection in pain medicine practice, with a selective focus on the treatment of neuropathic pain. In addition, the role of psychosocial factors as they affect pain management will be discussed.