Articles: pain-management-methods.
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Eur J Phys Rehabil Med · Feb 2013
ReviewEducation and training of pain medicine specialists in the United States.
Many pain patients present with a complex set of symptoms and comorbidities that defy the acumen of any one specific medical specialty; thus the knowledge and skills of the pain physician must, out of necessity cross specialty borders. The competency that comes from mastering essential skills is accomplished during the pain medicine training. The goal of pain medicine training in the United States is to provide the postgraduate trainee with the exposure to multiple disciplines of medicine, as well as multiple interventions, so that upon completion of training, the pain physician will have the necessary skill set to provide competent, appropriate, comprehensive care for the often medically complicated pain patient. In the United States, many training programs are governed by guidelines that have been established by the Accreditation Council for Graduate Medical Education (ACGME).
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Journal of neurochemistry · Feb 2013
ReviewNerve growth factor-mediated regulation of pain signalling and proposed new intervention strategies in clinical pain management.
Nerve growth factor (NGF) is the founding member of the neurotrophins family of proteins. It was discovered more than half a century ago through its ability to promote sensory and sympathetic neuronal survival and axonal growth during the development of the peripheral nervous system, and is the paradigmatic target-derived neurotrophic factor on which the neurotrophic hypothesis is based. Since that time, NGF has also been shown to play a key role in the generation of acute and chronic pain and in hyperalgesia in diverse pain states. ⋯ HSAN type IV and HSAN type V are caused by mutations in TrkA and NGF respectively. This review will focus firstly on the biology of NGF and its role in pain modulation. We will review neuropathies and clinical presentations that result from the disruption of NGF signalling in HSAN type IV and HSAN type V and review current advances in developing anti-NGF therapy for the clinical management of pain.
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Review
Do mindfulness-based interventions reduce pain intensity? A critical review of the literature.
Mindfulness-based interventions (MBIs) emphasizing a nonjudgmental attitude toward present moment experience are widely used for chronic pain patients. Although changing or controlling pain is not an explicit aim of MBIs, recent experimental studies suggest that mindfulness practice may lead to changes in pain tolerance and pain intensity ratings. ⋯ Findings suggest that MBIs decrease the intensity of pain for chronic pain patients. We discuss implications for understanding mechanisms of change in MBIs.
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Am J Hosp Palliat Care · Feb 2013
Review Case ReportsManagement of severe neuropathic cancer pain: an illustrative case and review.
Neuropathic cancer pain is common, very disabling and difficult to treat. It can be related to tumor invasion of neural structures and neuronal damage by surgery, chemotherapy and radiation therapy. ⋯ This case illustrates the challenges of managing severe pain in a patient with head and neck cancer while undergoing anti-tumor treatment. A review of the adjuvant analgesics and opioids, particularly methadone, in the management of neuropathic pain is also included.
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Review
Drugs for chronic pain in children: a commentary on clinical practice and the absence of evidence.
Pediatric chronic pain is widespread, under-recognized and undertreated. Best management usually involves a multimodal approach coordinated by a multidisciplinary team. The present commentary specifically discusses common pharmacological approaches to chronic pain in children, identifies gaps in knowledge and suggests several research directions that would benefit future clinical care.