Current pain and headache reports
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Curr Pain Headache Rep · Aug 2013
ReviewBorderline personality disorder and chronic pain: a practical approach to evaluation and treatment.
Patients with chronic pain present a spectrum of complexity that can be overwhelming for the individual practitioner. These patients require thoughtful care and a comprehensive treatment plan. This complexity should be acknowledged, not avoided, and the patient should be engaged, not shunned. ⋯ Studies investigating the prevalence of borderline personality disorder in patients with chronic pain averaged 30 %, highlighting the importance of being able to effectively treat this patient population. Appropriate management of these patients should focus on a collaboration to practice productive behaviors despite intense emotional distress. Longitudinal research provides a foundation for an optimistic prognosis that can be enhanced with this rehabilitative approach.
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Curr Pain Headache Rep · Aug 2013
ReviewComplementary therapies for fibromyalgia syndrome -- a rational approach.
Fibromyalgia syndrome (FMS) is a complex chronic condition, the treatment of which still poses many challenges. Complementary therapies (CT) have gained increasing popularity among FMS patients. ⋯ In the present paper, the authors propose some guidelines to conciliate the expectations of patients with the lack of solid evidence, in a practicable yet responsible way. Many items should be considered before prescribing, proscribing, or tolerating a CT, besides results from randomized controlled trials, such as efficacy (mechanisms of action); effectiveness (effect in practice); efficiency (cost-benefit ratio); safety; risk-benefit ratio; legislation; healthcare service involvement; practitioner characteristics; objective (purpose); and the potential of combination with conventional treatment.