Articles: pain-management-methods.
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Review
Psychosocial interventions for managing pain in older adults: outcomes and clinical implications.
Interest in the use of psychosocial interventions to help older adults manage pain is growing. In this article, we review this approach. ⋯ The second section highlights three psychosocial interventions used with older adults: cognitive behavioural therapy, emotional disclosure, and mind-body interventions (specifically mindfulness-based stress reduction and yoga). The final section of the paper highlights important future directions for work in this area.
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Neuropathic pain is a common chronic pain condition that can be challenging to treat, particularly for non-specialists. The development of the Map of Medicine care pathway for the management of neuropathic pain was led by the British Pain Society. Focusing on treatment by non-specialists, this pathway is based on new evidence, consensus, and the interests of service users. ⋯ Although the emphasis was not on specialist treatment, advice is given on existing interventions, including neural stimulation and multi-disciplinary care. These, and other steps on the pathway, will be subject to further review as more evidence becomes available. In the meantime, the pathway represents a straightforward, valuable and accessible approach for healthcare professionals managing the distress and impact of neuropathic pain.
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Psychological interventions are a mainstay of modern pain management practice and a recommended feature of a modern pain treatment service. Systematic reviews for the evidence of psychological interventions are reviewed in this article. The evidence for effectiveness is strongest for cognitive behavioural therapy with a focus on cognitive coping strategies and behavioural rehearsal. ⋯ Reasons for the relatively modest treatment effects are discussed within the context of all treatments for chronic pain being disappointing when measured by the average. Suggestions for improving both trials and evidence summaries are made. Finally, consideration is given to what can be achieved by the pain specialist without access to specialist psychology resource.
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Anesthesia and analgesia · Jul 2013
ReviewReview article: is ultrasound guidance advantageous for interventional pain management? A systematic review of chronic pain outcomes.
Modern ultrasound (US) is an attractive alternative to anatomical landmark-, nerve stimulation-, and fluoroscopic-guided techniques for interventional procedures performed to treat chronic pain syndromes. ⋯ There are presently insufficient data to support improved efficacy with procedures performed with US guidance for relieving both short- and long-term chronic pain.
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The noble gas xenon has been known for >50 years in the field of anesthesia with an emerging series of favorable features; several clinical and preclinical studies performed over the last years reveal a renewed interest because they substantially agree on attributing relevant analgesic properties to xenon. The main mechanism of action is the inhibition of N-methyl-D-aspartate receptors of glutamate; it involves the blocking of painful stimuli transmissions from peripheral tissues to the brain and it also avoids the development of pain hypersensitivity. ⋯ Several forms of pain share such mechanisms in their maintenance, and xenon can be successfully used at low dosages, which have no effects on vital parameters. The literature shows that analgesic features could also emerge outside the field of anesthesia; thus, this could permit xenon to have a larger usage according to local availability.