Pain research & management : the journal of the Canadian Pain Society = journal de la société canadienne pour le traitement de la douleur
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Comparative Study
Chronic pain in Canada--prevalence, treatment, impact and the role of opioid analgesia.
To assess the prevalence, treatment and impact of chronic pain in Canada. ⋯ Chronic noncancer pain is common in Canadian adults and has a major social and economic impact. Despite growing evidence supporting the efficacy and safety of major opioid analgesics for chronic noncancer pain, less than 10% of chronic pain patients taking prescription medication were treated with a major opioid. Chronic pain is undertreated in Canada, and major opioid analgesics are probably underutilized in the management of moderate to severe pain as part of a multidisciplinary treatment program.
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Editorial Comment
Nerve blocks and cognitive therapy: a beneficial failure.
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To further develop an empirically based classification system for chronic pain patients through the examination of age and sex differences, and incorporation of pain duration in the grouping algorithm. ⋯ There are important age and sex differences in the clinical presentations of chronic pain patients. Some older patients present with unique clinical profiles that may reflect cohort differences, and/or physiological or psychological adjustment processes. There appears to be a greater number of distinct chronic pain presentations among females. Research on the classification of chronic pain patients within homogeneous diagnostic subgroups is needed.
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Pain perception is known to depend on integrated cognitive processing. Alzheimer's disease affects 5% to 10% of older adults, but the impact of this disease on pain sensitivity and report has yet to be fully investigated. ⋯ The present findings indicate that pain perception in response to an acute heat pain stimulus is not diminished in older persons with cognitive impairment. Patients with Alzheimer's disease may be slightly less reliable in threshold pain report, although the subjective rating of evoked pain and the level of poststimulus cortical activation following noxious stimulation were found to be similar to those of controls. A longer latency of the CERP may suggest slower cortical processing of nociceptive input by persons with Alzheimer's disease.