Articles: pain-management-methods.
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Adjuvant analgesics (co-analgesics) are medications whose primary indication is the management of a medical condition with secondary effects of analgesia. Cancer pain is multifactorial and often involves inflammatory, nociceptive, and neuropathic pain subtypes. ⋯ When utilizing analgesic adjuvants in the treatment of cancer pain, providers must take into account the particular side effect profile of the medication. Ideally, adjuvant analgesics will be initiated at lower dosages and escalated as tolerated until efficacy or adverse effects are encountered.
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Musculoskeletal injuries are commonly treated by prehospital providers. The American College of Surgeons Committee on Trauma supports the early management of musculoskeletal injuries including analgesia, repositioning and splint application. ⋯ Strongly consider administering analgesia to any patient with a suspected musculoskeletal injury; the majority of these patients go on to receive analgesia in the hospital while their time in the ambulance is likely the most uncomfortable period of their care. When applying a splint, remember that effective splints are complete, compact and comfortable.
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The aim of this study was to determine by consensus the components of an opioid essential prescription package (OEPP) to be used when initiating a prescription for the control of moderate to severe chronic pain. Palliative care physicians (n=60) were sampled from the International Association for Hospice and Palliative Care (IAHPC) membership list to represent a range of countries of varying economic levels and diverse geographical regions. Using a Delphi study method, physicians were asked to rank preferences of drug and dosing schedule for first-line opioid, antiemetic, and laxative for the treatment of adults with chronic pain due to cancer and other life-threatening conditions. ⋯ There was consensus (93% agreement) that laxatives should always be given regularly when opioid treatment is started. Further work is needed to establish a recommended dose of metoclopramide and a type and dose of laxative. The resulting OEPP is international in scope and is designed to ensure that opioids are better tolerated by reducing adverse effects of opioids, which could lead to more sustained improvements in pain management.
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J Orthop Sports Phys Ther · Feb 2012
Manual physical therapy for injection-confirmed nonacute acromioclavicular joint pain.
Prospective single-cohort study. ⋯ Therapy, level 4.