Knowledge (XXG)

Pain management

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1723:, monitoring one's own symptoms, goal setting and action planning. It also includes patient-physician shared decision-making, among others. The benefits of self-management vary depending on self-management techniques used. They only have marginal benefits in management of chronic musculoskeletal pain. Some research has shown that self-management of pain can use different approaches. Those approaches can range from different therapies such as yoga, acupuncture, exercise and other relaxation techniques. Patients could also take a more natural approach by taking different minerals, vitamins or herbs. However, research has shown there is a difference between rural patients and non-rural patients having more access to different self-management approaches. Physicians in these areas may be readily prescribing more pain medication in these rural cities due to being less experienced with pain management. Simply put, it is sometimes easier for rural patients to get a prescription that insurance pays for instead of natural approaches that cost more money than they can afford to spend on their pain management. Self-management may be a more expensive alternative. 487:, promote harmony of the mind and body through total body awareness. These practices incorporate breathing techniques, meditation and a wide variety of movements, while training the body to perform functionally by increasing strength, flexibility, and range of motion. Physical activity can also benefit chronic sufferers by reducing inflammation and sensitivity, and boosting overall energy. Physical activity and exercise may improve chronic pain (pain lasting more than 12 weeks), and overall quality of life, while minimizing the need for pain medications. More specifically, walking has been effective in improving pain management in chronic low back pain. 531:
excitability of large cortical areas. tDCS may have a role in pain assessment by contributing to efforts in distinguishing between somatic and affective aspects of pain experience. Zaghi and colleagues (2011) found that the motor cortex, when stimulated with tDCS, increases the threshold for both the perception of non-painful and painful stimuli. Although there is a greater need for research examining the mechanism of electrical stimulation in relation to pain treatment, one theory suggests that the changes in thalamic activity may be due the influence of motor cortex stimulation on the decrease in pain sensations.
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experiential behavior change methods. The central process in ACT revolves around psychological flexibility, which in turn includes processes of acceptance, awareness, a present-oriented quality in interacting with experiences, an ability to persist or change behavior, and an ability to be guided by one's values. ACT has an increased evidence base for range of health and behavior problems, including chronic pain. ACT influences patients to adopt a tandem process to acceptance and change, which allows for a greater flexibility in the focus of treatment.
898:. However it can be used by medical professionals as a general principle when managing any type of pain. In the treatment of chronic pain, the three-step WHO Analgesic Ladder provides guidelines for selecting the appropriate medicine. The exact medications recommended will vary by country and the individual treatment center, but the following gives an example of the WHO approach to treating chronic pain with medications. If, at any point, treatment fails to provide adequate pain relief, then the doctor and patient move onto the next step. 1858:
measure of pain. Self-report pain scales involve younger kids matching their pain intensity to photographs of other children's faces, such as the Oucher Scale, pointing to schematics of faces showing different pain levels, or pointing out the location of pain on a body outline. Questionnaires for older children and adolescents include the Varni-Thompson Pediatric Pain Questionnaire (PPQ) and the Children's Comprehensive Pain Questionnaire. They are often utilized for individuals with chronic or persistent pain.
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depression, and the use of psychotropic medications. Physicians who prescribe opioids should integrate this treatment with any psychotherapeutic intervention the patient may be receiving. The guidelines also recommend monitoring not only the pain but also the level of functioning and the achievement of therapeutic goals. The prescribing physician should be suspicious of abuse when a patient reports a reduction in pain but has no accompanying improvement in function or progress in achieving identified goals.
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autoimmune neurological disorder, which consists of the demyelination of the nerve axons and disruption of nerve conduction velocity and efficiency. In one study, electrodes were placed over the lumbar spine and participants received treatment twice a day and at any time when they experienced a painful episode. This study found that TENS would be beneficial to MS patients who reported localized or limited symptoms to one limb. The research is mixed with whether or not TENS helps manage pain in MS patients.
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fibromyalgia. Evidence for the usefulness of CBT in the management of adult chronic pain is generally poorly understood, due partly to the proliferation of techniques of doubtful quality, and the poor quality of reporting in clinical trials. The crucial content of individual interventions has not been isolated and the important contextual elements, such as therapist training and development of treatment manuals, have not been determined. The widely varying nature of the resulting data makes useful
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with each other about how pain responds to treatments. There is a risk in many types of pain management for the patient to take treatment that is less effective than needed or which causes other difficulties and side effects. Some treatments for pain can be harmful if overused. A goal of pain management for the patient and their health care provider is to identify the amount of treatment needed to address the pain without going beyond that limit.
155: 597:, energy created from light, from these photochemical reactions provide the reactants with energy provide the reactants with energy to embed in muscles, thus managing pain. One study conducted by Stausholm et al. showed that at certain wavelengths, LLLT reduced pain in participants with knee osteoarthritis. LLLT stimulates a variety oof cell types, which in turn can help treat tendonitis, arthritis, and pain relating to muscles. 365: 7529: 7559: 144: 7569: 298:, however, frequently requires the coordinated efforts of the pain management team. Effective pain management does not always mean total eradication of all pain. Rather, it often means achieving adequate quality of life in the presence of pain, through any combination of lessening the pain and/or better understanding it and being able to live happily despite it. Medicine treats 434:, as well as therapeutic exercises and behavioral therapy. These techniques are usually part of an interdisciplinary or multidisciplinary program that might also include pharmaceutical medicines. Spa therapy has showed positive effects in reducing pain among patients with chronic low back pain. However, there are limited studies looking at this approach. Studies have shown that 554: 7549: 7539: 753:
mindfulness were also observed in a study applying ACT to chronic pain in older adults. In addition, these primary results suggested that an ACT based treatment may significantly improve levels of physical disability, psychosocial disability, and depression post-treatment and at a three-month follow-up for older adults with chronic pain.
795:(BT) is effective for reducing this type of pain, however BT may be useful for improving a person's mood immediately after treatment. This improvement appears to be small, and is short term in duration. CBT may have a small positive short-term effect on pain immediately following treatment. CBT may also have a small effect on reducing 808:
maintained for at least three months following the therapy. Psychological treatments may also improve pain control for children or adolescents who experience pain not related to headaches. It is not known if psychological therapy improves a child or adolescents mood and the potential for disability related to their chronic pain.
1398:, studies have shown that properly managed medical use of opioid analgesic compounds (taken exactly as prescribed) is safe, can manage pain effectively, and rarely causes addiction." In 2013, the FDA stated that "abuse and misuse of these products have created a serious and growing public health problem". 1789:
recommend. Some studies about gender biases have concluded that female pain recipients are often overlooked when it comes to the perception of their pain. Whether they appeared to be in high levels of pain didn't make a difference for their observers. The women participants in the studies were still
1641:, various studies were cited in demonstrating that cannabinoids exhibit comparable effectiveness to opioids in models of acute pain and even greater effectiveness in models of chronic pain. It is mainly the THC strain of medical marijuana that provide analgesic benefits, as opposed to the CBD strain. 1271:
which is convenient for chronic pain management. In addition to the intrathecal patch and injectable fentanyl formulations, the FDA (Food and Drug Administration) has approved various immediate release fentanyl products for breakthrough cancer pain (Actiq/OTFC/Fentora/Onsolis/Subsys/Lazanda/Abstral).
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Boswell, Mark V.; Trescot, Andrea M.; Datta, Sukdeb; Schultz, David M.; Hansen, Hans C.; Abdi, Salahadin; Sehgal, Nalini; Shah, Rinoo V.; Singh, Vijay; Benyamin, Ramsin M.; Patel, Vikram B.; Buenaventura, Ricardo M.; Colson, James D.; Cordner, Harold J.; Epter, Richard S.; Jasper, Joseph F.; Dunbar,
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Fibromyalgia is a disorder in which an individual experiences dysfunctional brain activity, musculoskeletal pain, fatigue, and tenderness in localized areas. Research examining tDCS for pain treatment in fibromyalgia has found initial evidence for pain decreases. Specifically, the stimulation of the
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Transcranial direct current stimulation (tDCS) is a non-invasive technique of brain stimulation that can modulate activity in specific brain cortex regions, and it involves the application of low-intensity (up to 2 mA) constant direct current to the scalp through electrodes in order to modulate
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When treating moderate to severe pain, the type of the pain, acute or chronic, needs to be considered. The type of pain can result in different medications being prescribed. Certain medications may work better for acute pain, others for chronic pain, and some may work equally well on both. Acute
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Acceptance and Commitment Therapy (ACT) is a form of cognitive behavioral therapy that focuses on behavior change rather than symptom change, includes methods designed to alter the context around psychological experiences rather than to alter the makeup of the experiences, and emphasizes the use of
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A common challenge in pain management is communication between the health care provider and the person experiencing pain. People experiencing pain may have difficulty recognizing or describing what they feel and how intense it is. Health care providers and patients may have difficulty communicating
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Caregivers may provide nonpharmacological treatment for children and adolescents because it carries minimal risk and is cost effective compared to pharmacological treatment. Nonpharmacologic interventions vary by age and developmental factors. Physical interventions to ease pain in infants include
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community has been shown to suffer significantly when it comes to trusting the medical community to treat them. Oftentimes medication although available to be prescribed is dispensed in less quantities due to their pain being perceived on a smaller scale. The black community could be undermined by
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There are other prevalent reasons that undertreatment of pain occurs. Gender is a factor as well as race. When it comes to prescribers treating patients racial disparities has become a real factor. Research has shown that non-white individuals pain perception has affected their pain treatment. The
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in the reduction of pain in some conditions. However the studies had some limitations like small study sizes, bringing up issues of power to detect group differences, and lacking credible controls for placebo or expectation. The authors concluded that "although the findings provide support for the
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Cognitive behavioral therapy (CBT) helps patients with pain to understand the relationship between their pain, thoughts, emotions, and behaviors. A main goal in treatment is cognitive (thinking, reasoning or remembering) restructuring to encourage helpful thought patterns. This will target healthy
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Another problem with pain management is that pain is the body's natural way of communicating a problem. Pain is supposed to resolve as the body heals itself with time and pain management. Sometimes pain management covers a problem, and the patient might be less aware that they need treatment for a
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Pain assessment in children is often challenging due to limitations in developmental level, cognitive ability, or their previous pain experiences. Clinicians must observe physiological and behavioral cues exhibited by the child to make an assessment. Self-report, if possible, is the most accurate
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The task of medicine is to relieve suffering under three circumstances. The first is when a painful injury or pathology is resistant to treatment and persists. The second is when pain persists after the injury or pathology has healed. Finally, the third circumstance is when medical science cannot
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organizations establish guidelines to determine the treatment for pain which health care providers ought to offer. For various social reasons, persons in pain may not seek or may not be able to access treatment for their pain. Health care providers may not provide the treatment which authorities
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to be in less pain than they actually were. Men participants on the other hand were offered pain relief while their self reporting indicated that their pain levels didn't necessarily warrant treatment. Biases exist when it comes to gender. Prescribers have been seen over and under prescribing
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Hypnosis has reduced the pain of some harmful medical procedures in children and adolescents. In clinical trials addressing other patient groups, it has significantly reduced pain compared to no treatment or some other non-hypnotic interventions. The effects of self hypnosis on chronic pain are
841:, concluded, "that MBIs decrease the intensity of pain for chronic pain patients." A 2019 review of studies of brief mindfulness-based interventions (BMBI) concluded that BMBI are not recommended as a first-line treatment and could not confirm their efficacy in managing chronic or acute pain. 1431:
Although opioids are strong analgesics, they do not provide complete analgesia regardless of whether the pain is acute or chronic in origin. Opioids are effective analgesics in chronic malignant pain and modestly effective in nonmalignant pain management. However, there are associated adverse
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For children and adolescents, a review of RCTs evaluating the effectiveness of psychological therapy for the management of chronic and recurrent pain found that psychological treatments are effective in reducing pain when people under 18 years old have headaches. This beneficial effect may be
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Studies have demonstrated the usefulness of cognitive behavioral therapy in the management of chronic low back pain, producing significant decreases in physical and psychosocial disability. CBT is significantly more effective than standard care in treatment of people with body-wide pain, like
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primary motor cortex resulted in significantly greater pain improvement in comparison to the control group (e.g., sham stimulation, stimulation of the DLPFC). However, this effect decreased after treatment ended, but remained significant for three weeks following the extinction of treatment.
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Transcutaneous electrical nerve stimulation (TENS) is a self-operated portable device intended to help regulate and control chronic pain via electrical impulses. Limited research has explored the effectiveness of TENS in relation to pain management of multiple sclerosis (MS). MS is a chronic
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and the American Academy of Pain Medicine. Included in these guidelines is the importance of assessing the patient for the risk of substance abuse, misuse, or addiction. Factors correlated with an elevated risk of opioid misuse include a history of substance use disorder, younger age, major
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Recent research has applied ACT successfully to chronic pain in older adults due to in part of its direction from individual values and being highly customizable to any stage of life. In line with the therapeutic model of ACT, significant increases in process variables, pain acceptance, and
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Pizutti LT, Carissimi A, Valdivia LJ, Ilgenfritz CA, Freitas JJ, Sopezki D, et al. (June 2019). "Evaluation of Breathworks' Mindfulness for Stress 8-week course: Effects on depressive symptoms, psychiatric symptoms, affects, self-compassion, and mindfulness facets in Brazilian health
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physicians thinking they are not in as much pain as they are reporting. Another occurrence may be physicians simply making the choice not to treat the patient accordingly in spite of the self-reported pain level. Racial disparity is definitely a real issue in the world of pain management.
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medications can provide short, intermediate or long acting analgesia depending upon the specific properties of the medication and whether it is formulated as an extended release drug. Opioid medications may be administered orally, by injection, via nasal mucosa or oral mucosa, rectally,
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Thompson, Trevor; Terhune, Devin B.; Oram, Charlotte; Sharangparni, Joseph; Rouf, Rommana; Solmi, Marco; Veronese, Nicola; Stubbs, Brendon (April 2019). "The effectiveness of hypnosis for pain relief: A systematic review and meta-analysis of 85 controlled experimental trials".
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that may be associated with adult chronic pain. These benefits do not appear to last very long following the therapy. CBT may contribute towards improving the mood of an adult who experiences chronic pain, which could possibility be maintained for longer periods of time.
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drugs are used in chronic pain management and act primarily within the pain pathways of the central nervous system, though peripheral mechanisms have been attributed as well. They are generally used to treat nerve brain that results from injury to the nervous system.
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In relation to MS, a study found that after daily tDCS sessions resulted in an individual's subjective report of pain to decrease when compared to a sham condition. In addition, the study found a similar improvement at 1 to 3 days before and after each tDCS session.
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activities such as regular exercise and pacing. Lifestyle changes are also trained to improve sleep patterns and to develop better coping skills for pain and other stressors using various techniques (e.g., relaxation, diaphragmatic breathing, and even biofeedback).
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from the structures implicated as the source of chronic pain. Radiofrequency treatment has been seen to improve pain in patients for facet joint low back pain. However, continuous radiofrequency is more effective in managing pain than pulsed radiofrequency.
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Acupuncture involves the insertion and manipulation of needles into specific points on the body to relieve pain or for therapeutic purposes. An analysis of the 13 highest quality studies of pain treatment with acupuncture, published in January 2009 in the
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Hypnosis with analgesic (painkiller) has been seen to relieve chronic pain for most people and may be a safe and effective alternative to medications. However, high quality clinical data is needed to generalize to the whole chronic pain population.
2755:"Assessment: efficacy of transcutaneous electric nerve stimulation in the treatment of pain in neurologic disorders (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology" 1552:/paracetamol is not always included in this class of medications. However, acetaminophen may be administered as a single medication or in combination with other analgesics (both NSAIDs and opioids). The alternatively prescribed NSAIDs such as 1885:(CBT) aims to reduce the emotional distress and improve the daily functioning of school-aged children and adolescents with pain by changing the relationship between their thoughts and emotions. In addition this therapy teaches them adaptive 446:. Exercise alone or with other rehabilitation disciplines (such as psychologically based approaches) can have a positive effect on reducing pain. In addition to improving pain, exercise also can improve one's well-being and general health. 2655:
Vanti C, Andreatta S, Borghi S, Guccione AA, Pillastrini P, Bertozzi L (March 2019). "The effectiveness of walking versus exercise on pain and function in chronic low back pain: a systematic review and meta-analysis of randomized trials".
593:. Instead of thermal therapy, where reactant energy is originated through heat, Low Level Light Therapy (LLLT) utilizes photochemical reactions requiring light to function. Photochemical reactions need light in order to function. 6060:
Mayer EK, Ihm JM, Sibell DM, Press JM, Kennedy DJ (August 2013). "ACGME sports, ACGME pain, or non-ACGME sports and spine: which is the ideal fellowship training for PM&R physicians interested in musculoskeletal medicine?".
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and no acupuncture. A systematic review in 2019 reported that acupuncture injection therapy was an effective treatment for patients with nonspecific chronic low back pain, and is widely used in Southeast Asian countries.
5512:"The effectiveness of generic self-management interventions for patients with chronic musculoskeletal pain on physical function, self-efficacy, pain intensity and physical activity: A systematic review and meta-analysis" 1316:
are also not recommended in new patients except for acute pain where other analgesics are not tolerated or are inappropriate, for pharmacological and misuse-related reasons. In some countries potent synthetics such as
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and postoperatively. The major differences are that it is much more common for the drug to be delivered into the spinal fluid (intrathecal) rather than epidurally, and the pump can be fully implanted under the skin.
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Sandberg, Mårten; Hyldmo, Per Kristian; Kongstad, Poul; Dahl Friesgaard, Kristian; Raatiniemi, Lasse; Larsen, Robert; Magnusson, Vidar; Rognås, Leif; Kurola, Jouni; Rehn, Marius; Vist, Gunn Elisabeth (November 2020).
4935:"Comparison of analgesic efficacy of acetaminophen monotherapy versus acetaminophen combinations with either pethidine or parecoxib in patients undergoing laparoscopic cholecystectomy: a randomized prospective study" 2364:
Li Y, Yin Y, Jia G, Chen H, Yu L, Wu D (April 2019). "Effects of kinesiotape on pain and disability in individuals with chronic low back pain: a systematic review and meta-analysis of randomized controlled trials".
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Long, Jaqui; Briggs, Michelle; Long, Andrew; Astin, Felicity (October 2016). "Starting where I am: a grounded theory exploration of mindfulness as a facilitator of transition in living with a long-term condition".
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Elmer E.; Atluri, Sairam L.; Bowman, Richard C.; Deer, Timothy R.; Swicegood, John R.; Staats, Peter S.; Smith, Howard S.; Burton, Allen W.; Kloth, David S.; Giordano, James; Manchikanti, Laxmaiah (January 2007).
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Noori-Zadeh A, Bakhtiyari S, Khooz R, Haghani K, Darabi S (February 2019). "Intra-articular ozone therapy efficiently attenuates pain in knee osteoarthritic subjects: A systematic review and meta-analysis".
1580:. There are many NSAIDs such as parecoxib (selective COX-2 inhibitor) with proven effectiveness after different surgical procedures. Wide use of non-opioid analgesics can reduce opioid-induced side-effects. 1405:
transdermally, intravenously, epidurally and intrathecally. In chronic pain conditions that are opioid responsive, a combination of a long-acting (OxyContin, MS Contin, Opana ER, Exalgo and Methadone) or
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Starrels JL, Becker WC, Alford DP, Kapoor A, Williams AR, Turner BJ (June 2010). "Systematic review: treatment agreements and urine drug testing to reduce opioid misuse in patients with chronic pain".
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Specifically in chronic low back pain, education about the way the brain processes pain in conjunction with routine physiotherapy interventions may provide short term relief of disability and pain.
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could be used on individuals with chronic low back pain to reduce pain. The Center for Disease Control recommends that physical therapy and exercise can be prescribed as a positive alternative to
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Contreras Lopez WO, Navarro PA, Vargas MD, Alape E, Camacho Lopez PA (February 2019). "Pulsed Radiofrequency Versus Continuous Radiofrequency for Facet Joint Low Back Pain: A Systematic Review".
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general applicability of hypnosis in the treatment of chronic pain, considerably more research will be needed to fully determine the effects of hypnosis for different chronic-pain conditions."
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Zhorov BS, Ananthanarayanan VS (March 2000). "Homology models of mu-opioid receptor with organic and inorganic cations at conserved aspartates in the second and third transmembrane domains".
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Stausholm, Martin Bjørn; Naterstad, Ingvill Fjell; Joensen, Jon; Lopes-Martins, Rodrigo Álvaro Brandão; Sæbø, Humaira; Lund, Hans; Fersum, Kjartan Vibe; Bjordal, Jan Magnus (October 2019).
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Lopes SA, Vannucchi BP, Demarzo M, Cunha ÂG, Nunes MD (February 2019). "Effectiveness of a Mindfulness-Based Intervention in the Management of Musculoskeletal Pain in Nursing Workers".
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Cusens B, Duggan GB, Thorne K, Burch V (2010). "Evaluation of the breathworks mindfulness-based pain management programme: effects on well-being and multiple measures of mindfulness".
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In the nursing profession, one common definition of pain is any problem that is "whatever the experiencing person says it is, existing whenever the experiencing person says it does".
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In recent studies, it has been noted that people who have red-hair through the MC1R receptor gene may react to opioids and perceive pain differently than the rest of the population.
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doctor consultation is appropriate if headaches are severe, persistent, accompanied by fever, vomiting, or speech or balance problems; self-medication should be limited to two weeks
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Brown CA, Jones AK (March 2013). "Psychobiological correlates of improved mental health in patients with musculoskeletal pain after a mindfulness-based pain management program".
2984:"Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline" 3790:
Accardi MC, Milling LS (August 2009). "The effectiveness of hypnosis for reducing procedure-related pain in children and adolescents: a comprehensive methodological review".
852:(MBPM) is a mindfulness-based intervention (MBI) providing specific applications for people living with chronic pain and illness. Adapting the core concepts and practices of 1304:, known in North America as meperidine, is not recommended for pain management due to its low potency, short duration of action, and toxicity associated with repeated use. 4558:
Aiyer R, Gulati A, Gungor S, Bhatia A, Mehta N (August 2018). "Treatment of Chronic Pain With Various Buprenorphine Formulations: A Systematic Review of Clinical Studies".
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The list below consists of commonly used opioid analgesics which have long-acting formulations. Common brand names for the extended release formulation are in parentheses.
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Rasche D, Ruppolt M, Stippich C, Unterberg A, Tronnier VM (March 2006). "Motor cortex stimulation for long-term relief of chronic neuropathic pain: a 10 year experience".
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Innovation in pain management : the transcript of a witness seminar held by the Wellcome Trust Centre for the History of Medicine at UCL, London, on 12 December 2002
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Innovation in pain management : the transcript of a Witness seminar held by the Wellcome Trust Centre for the History of Medicine at UCL, London, on 12 december 2002
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are commonly used to treat acute or chronic pain symptoms in children and adolescents. However a pediatrician should be consulted before administering any medication.
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Thomas R. Frieden, Harold W. Jaffe, Joanne Cono, et al. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. MMWR Recomm Rep 2016;65 Pg. 9-10
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Self-management of chronic pain has been described as the individual's ability to manage various aspects of their chronic pain. Self-management can include building
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Pain management practitioners come from all fields of medicine. In addition to medical practitioners, a pain management team may often benefit from the input of
1637:, "the available evidence from animal and human studies indicates that cannabinoids can have a substantial analgesic effect". In a 2013 review study published in 456:
therapy are safe interventions that likely reduce pain for patients with chronic low back pain. However, manipulation produces a larger effect than mobilization.
791:(RCTs) evaluated the clinical effectiveness of psychological therapies for the management of adult chronic pain (excluding headaches). There is no evidence that 375:
Pain management includes patient and communication about the pain problem. To define the pain problem, a health care provider will likely ask questions such as:
3098:"Efficacy of low-level laser therapy on pain and disability in knee osteoarthritis: systematic review and meta-analysis of randomised placebo-controlled trials" 205:
provide some pain control in the normal course of their practice, and for the more complex instances of pain, they also call on additional help from a specific
1977: 1693:, an alpha-2 receptor agonist, is another drug that has found use as an analgesic adjuvant. In 2021, researchers described a novel type of pain therapy — a 505: 496: 5713:""Brave Men" and "Emotional Women": A Theory-Guided Literature Review on Gender Bias in Health Care and Gendered Norms towards Patients with Chronic Pain" 7058: 1989: 442:
for decreasing one's pain in multiple injuries, illnesses, or diseases. This can include chronic low back pain, osteoarthritis of the hip and knee, or
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medication is often prescribed along with a shorter-acting medication (oxycodone, morphine or hydromorphone) for breakthrough pain, or exacerbations.
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Subdissociative-dose ketamine (SDK) may be used either alone or as part of a multimodal approach to pain relief for traumatic and nontraumatic pain.
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After asking such questions, the health care provider will have a description of the pain. Pain management will then be used to address that pain.
6998: 2886:"Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups" 525: 6318: 3445:"Treatment for chronic pain for adults in the seventh and eighth decades of life: a preliminary study of Acceptance and Commitment Therapy (ACT)" 5471:"What Works and Does Not Work in a Self-Management Intervention for People With Chronic Pain? Qualitative Systematic Review and Meta-Synthesis" 2845:"A randomized, sham-controlled, proof of principle study of transcranial direct current stimulation for the treatment of pain in fibromyalgia" 2557:
Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH, et al. (Cochrane Pain, Palliative and Supportive Care Group) (April 2017).
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each provide certification for a subspecialty in pain management following fellowship training. The fellowship training is recognized by the
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Turner JA, Clancy S (April 1988). "Comparison of operant behavioral and cognitive-behavioral group treatment for chronic low back pain".
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Yousefi-Nooraie R, Schonstein E, Heidari K, Rashidian A, Pennick V, Akbari-Kamrani M, et al. (April 2008). Yousefi-Nooraie R (ed.).
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is prescribed for chronic muscular pain in the arms, legs, neck and lower back with an opiate, or sometimes without it or with an NSAID.
6015: 5764:"Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites" 1541: 1173: 857: 2801:
Zaghi S, Thiele B, Pimentel D, Pimentel T, Fregni F (2011). "Assessment and treatment of pain with non-invasive cortical stimulation".
1905:(in the case of chronic pain). Many therapists will hold sessions for caregivers to provide them with effective management strategies. 717:
is an implantable medical device that creates electric impulses and applies them near the dorsal surface of the spinal cord provides a
7434: 6776: 6301: 2015: 2000:(AOABOS). As the field of pain medicine has grown rapidly, many practitioners have entered the field, some non-ACGME board-certified. 853: 5929:
Wente SJ (March 2013). "Nonpharmacologic pediatric pain management in emergency departments: a systematic review of the literature".
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Self-Selection all the Way: Improving Patients' Pain Experience and Outcomes on a Pilot Breathworks Mindfulness for Health Programme
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swaddling, rocking, or sucrose via a pacifier. For children and adolescents physical interventions include hot or cold application,
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used to deliver very small quantities of medications directly to the spinal fluid. This is similar to epidural infusions used in
228:. Relief of pain in general (analgesia) is often an acute affair, whereas managing chronic pain requires additional dimensions. 6659: 1092: 7424: 6858: 6345: 1614: 864:', and has been seen as sensitive to concerns about removing mindfulness teaching from its original ethical framework within 643: 102: 4311:
Doran NJ (June 2014). "Experiencing Wellness Within Illness: Exploring a Mindfulness-Based Approach to Chronic Back Pain".
3642:"Psychological therapies (remotely delivered) for the management of chronic and recurrent pain in children and adolescents" 1751:"). The Hellenic Society of Algology and the Turkish Algology-Pain Society are the relevant local bodies affiliated to the 6465: 5093:
Zogopoulos P, Vasileiou I, Patsouris E, Theocharis SE (February 2013). "The role of endocannabinoids in pain modulation".
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Other drugs which can potentiate conventional analgesics or have analgesic properties in certain circumstances are called
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Eaton, Linda H.; Langford, Dale J.; Meins, Alexa R.; Rue, Tessa; Tauben, David J.; Doorenbos, Ardith Z. (February 2018).
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Aboud T, Schuster NM (November 2019). "Pain Management in Multiple Sclerosis: a Review of Available Treatment Options".
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Intra-articular ozone therapy has been seen to efficiently alleviate chronic pain in patients with knee osteoarthritis.
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have significant cardiovascular and cerebrovascular risks which have limited their utilization. Common NSAIDs include
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is used across the Americas and Europe for relief of serious chronic pain. Its main slow-release formula is known as
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and diseases to support and speed healing. It treats distressing symptoms such as pain and discomfort to reduce any
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is present in approximately 15–25% of children and adolescents. It may be caused by an underlying disease, such as
682: 4213:[Mindfulness and Cancer: Application of the MBPM program of Respira Vida Breathworks in cancer patients]. 1818:
Acute pain is common in children and adolescents as a result of injury, illness, or necessary medical procedures.
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Evidence of medical marijuana's effect on reducing pain is generally conclusive. Detailed in a 1999 report by the
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to manage pain or other distress. They are generally viewed as insufficient when used alone, but also as helpful
3484: 1937:, among others. Together the multidisciplinary team can help create a package of care suitable to the patient. 7603: 7593: 7249: 7171: 7166: 7086: 6846: 6697: 2631: 838: 648: 435: 5185:"Low-dose Ketamine For Acute Pain Control in the Emergency Department: A Systematic Review and Meta-analysis" 2247: 1972:
doctors are also specialists in pain management. The American Society of Interventional Pain Physicians, the
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Geertzen JH, Van Wilgen CP, Schrier E, Dijkstra PU (March 2006). "Chronic pain in rehabilitation medicine".
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This article is about pain management across medicine. For cancer-related pain management specifically, see
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Eccleston C (August 2011). "Can 'ehealth' technology deliver on its promise of pain management for all?".
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Varrassi G, Paladini A, Marinangeli F, Racz G (March 2006). "Neural modulation by blocks and infusions".
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Zagustin TK (August 2013). "The role of cognitive behavioral therapy for chronic pain in adolescents".
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Dunn KM, Saunders KW, Rutter CM, Banta-Green CJ, Merrill JO, Sullivan MD, et al. (January 2010).
3694:"Psychological therapies for the management of chronic and recurrent pain in children and adolescents" 1673:, an anticonvulsant, can reduce neuropathic pain itself and can also potentiate opiates. Drugs with 1560:
have limited benefit in chronic pain disorders and with long-term use are associated with significant
1378:
are often used in the management of chronic pain, high doses are associated with an increased risk of
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Weydert JA (2013). "The interdisciplinary management of pediatric pain: Time for more integration".
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Young children can indicate their level of pain by pointing to the appropriate face on a children's
1114:
heartburn lasting more than a week requires medical attention; aspirin and NSAIDs should be avoided
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and others vary in such ways as duration of action, side effect profile and milligramme potency.
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may be used to target either the tissue structures and organ/systems responsible for persistent
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Daubresse M, Chang HY, Yu Y, Viswanathan S, Shah ND, Stafford RS, et al. (October 2013).
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There are many types of pain management. Each have their own benefits, drawbacks, and limits.
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Mehan S, Morris J (2018). "A literature review of Breathworks and mindfulness intervention".
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is sometimes used as an alternative to opioids for the treatment of acute pain in hospital
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Hoffman, Kelly M.; Trawalter, Sophie; Axt, Jordan R.; Oliver, M. Norman (19 April 2016).
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Carinci AJ, Mao J (February 2010). "Pain and opioid addiction: what is the connection?".
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for managing pain relief with pharmaceutical medicine. It was first described for use in
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Schiller F (1990). "The history of algology, algotherapy, and the role of inhibition".
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which contain oxycodone are available making it suitable for acute intractable pain or
1252: 1153: 1149: 1130: 615: 606: 449: 431: 359: 327: 323: 5346: 5329: 5305: 5288: 5157: 5140: 4933:
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1657:. Ketamine probably reduces pain more than opioids and with less nausea and vomiting. 876:. It has been subject to a range of clinical studies demonstrating its effectiveness. 364: 7587: 7477: 7266: 7261: 7123: 7063: 6966: 6616: 6581: 6533: 6493: 6331: 5452: 5220: 5011: 4416: 3461: 3444: 3168: 2739: 2024: 2010: 1720: 1622: 1593: 1549: 1545: 1497: 1473: 1455:
Clinical guidelines for prescribing opioids for chronic pain have been issued by the
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Moreno AM, Alemán F, Catroli GF, Hunt M, Hu M, Dailamy A, et al. (March 2021).
5122: 5027: 4809: 4766: 4587: 4383: 4340: 4195: 4125: 3913: 3885: 3819: 3572: 3416: 3372: 3262: 3184: 2685: 2394: 2301: 1196:, may provide greater relief than their separate use. A combination of opioid with 837:
A 2013 meta-analysis of studies that used techniques centered around the concept of
7542: 7482: 7467: 7293: 7018: 6868: 6853: 6799: 6528: 6513: 6508: 6270: 5823:"The assessment and management of acute pain in infants, children, and adolescents" 4508:"Using Opioids to Treat: Chronic Pain - Comparing Effectiveness, Safety, and Price" 3834: 3709: 3657: 3608: 3040: 2574: 1839: 1819: 1678: 1357: 1322: 1248: 1222: 1144: 1125:
opioids may be necessary if other drugs do not control pain and pain is persistent
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has healed, and is treated by one practitioner, with drugs such as pain relievers (
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Fisher E, Law E, Dudeney J, Palermo TM, Stewart G, Eccleston C (September 2018).
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Undertreatment of pain is the absence of pain management therapy for a person in
1609:
and post-stroke pain. These mechanisms vary and in general are more effective in
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Most opioid treatment used by patients outside of healthcare settings is oral (
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Drugs of other types can be used to help opioids combat certain types of pain.
947:
are used when the others do not work, or when migraines are frequent or severe
7314: 7281: 7053: 7003: 6988: 6983: 6976: 6961: 6951: 6687: 6601: 6439: 6375: 5942: 5576: 4750: 4179: 3869: 3856:
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Meglio M (July 2004). "Spinal cord stimulation in chronic pain management".
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which showed therapeutic potential in three mouse models of chronic pain.
1188:
Paracetamol, an NSAID or paracetamol in a combination product with a weak
1158:
evidence suggests that opioids are not effective in treating fibromyalgia
721:("tingling") sensation that alters the perception of pain by the patient. 7008: 6785: 6380: 6041:"Taking a Subspecialty Exam - American Board of Psychiatry and Neurology" 5487: 5470: 4688:, Yu Y, Viswanathan S, Shah ND, Stafford RS, et al. (October 2013). 4252:
Agostinis, Alessio; Barrow, Michelle; Taylor, Chad; Gray, Callum (2017).
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if inflammation is involved, NSAIDs may work better; short-term use only
944: 936: 920: 865: 817: 686: 656: 314:
identify the cause of pain. Treatment approaches to chronic pain include
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Liao J, Wang T, Dong W, Yang J, Zhang J, Li L, et al. (July 2019).
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this should be short term use; opioids may be necessary for severe pain
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are used less frequently. Clinical studies have shown that transdermal
1218: 1201: 1097: 631: 568:, was unable to quantify the difference in the effect on pain of real, 484: 476: 264: 5380:"Unique CRISPR gene therapy offers opioid-free chronic pain treatment" 5106: 4289: 3953: 3936: 3122: 2901: 2861: 2844: 5527: 4951: 4934: 2532: 1981: 1866: 1736: 1732: 1701: 1528:*Methadone and buprenorphine are each used both for the treatment of 1401: 1375: 1281: 1213:
pain medication is for rapid onset of pain such as from an inflicted
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effects, especially during the commencement or change in dose. When
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American Osteopathic Association Bureau of Osteopathic Specialists
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more than two weeks of pain requiring opioid treatment is unusual
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The Politics of Pain Medicine: A Rhetorical-Ontological Inquiry
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The International Journal of Clinical and Experimental Hypnosis
1605:). These drugs also reduce pain from viruses such as shingles, 816:
A 2007 review of 13 studies found evidence for the efficacy of
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some NSAIDs are marketed for cramps, but any NSAID would work
825:
roughly comparable to those of progressive muscle relaxation.
231:
A typical multidisciplinary pain management team may include:
5407:"Long-lasting analgesia via targeted in situ repression of Na 1239:
are compared. Semi-synthetic derivatives of morphine such as
6319:
World Health Organization (WHO) Treatment Guidelines on Pain
6277:. Wellcome Trust Centre for the History of Medicine at UCL. 4215:
Revista de Investigación y Educación en Ciencias de la Salud
1794:
treatment to individuals based on them being male or female
1041:
combinations of opioids may be prescribed if pain is severe
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Williams AC, Fisher E, Hearn L, Eccleston C (August 2020).
5626: 5608: 1225:
medication is for alleviating long-lasting, ongoing pain.
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Aerobic exercise can help when it comes to pain management
5469:
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1689:, and are useful in painful musculoskeletal conditions. 6549:
congenital insensitivity to pain with partial anhidrosis
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Techniques in Regional Anesthesia and Pain Management
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bitartrate (Hysingla ER) and bicarbonate (Zohydro ER)
430:
uses a range of physical techniques such as heat and
2632:"Chronic Pain: Symptoms, Diagnosis, & Treatment" 1889:
strategies. Integrated interventions in CBT include
224:
of anyone experiencing pain, whether acute pain or
220:
approach for easing the suffering and improving the
7445: 7383: 7144: 7072: 7027: 6936: 6807: 6792: 6706: 6673: 6640: 6594: 6559: 6474: 6430: 6407: 6368: 6361: 4071:"What is Mindfulness based Pain Management (MBPM)?" 1139:medical attention is recommended if pain persists. 123: 88: 83: 71: 59: 51: 46: 5045:Marijuana and Medicine: Assessing the Science Base 5042: 4498: 4496: 4494: 4492: 4490: 4488: 4486: 4484: 4482: 4480: 4478: 4476: 4474: 4472: 4470: 4468: 4466: 4464: 4462: 4460: 4458: 3833:American Psychological Association (2 July 2004). 2134: 2101: 1054:if inflammation involved, NSAIDs may work better. 5821:American Academy of Pediatrics (September 2001). 4456: 4454: 4452: 4450: 4448: 4446: 4444: 4442: 4440: 4438: 3982:Journal of Alternative and Complementary Medicine 3743:"Hypnotherapy for the management of chronic pain" 2515:Wood, Lianne; Hendrick, Paul A. (February 2019). 2171:Pain management: A practical guide for clinicians 1428:is rarely needed for patients with chronic pain. 904:Common types of pain and typical drug management 6544:congenital insensitivity to pain with anhidrosis 1544:(NSAID). They work by inhibiting the release of 1329:is a newer agent introduced in the last decade. 651:procedures for pain control, typically used for 5768:Proceedings of the National Academy of Sciences 3741:Elkins G, Jensen MP, Patterson DR (July 2007). 2153:Pain management: an interdisciplinary approach. 1753:International Association for the Study of Pain 1621:, and an example of an antidepressant would be 1601:can be due to chronic high blood sugar levels ( 330:; interventional procedures, physical therapy, 5903:. American Medical Association. Archived from 3935:Reiner K, Tibi L, Lipsitz JD (February 2013). 2137:Pain management: an interdisciplinary approach 1731:The medical treatment of pain as practiced in 1424:and skin patches can be prescribed. An opioid 685:, direct introduction of medication and nerve 557:Acupuncture can sometimes help to relieve pain 6770: 6339: 3835:"Hypnosis for the relief and control of pain" 3510:Journal of Consulting and Clinical Psychology 2415:Dowell D, Haegerich TM, Chou R (March 2016). 1945:Pain physicians are often fellowship-trained 1280:. Short-acting tablets, capsules, syrups and 8: 6132:Pain Medicine and Management: Just the Facts 1978:American Osteopathic Board of Anesthesiology 1564:. The use of selective NSAIDs designated as 41: 5646:History and Philosophy of the Life Sciences 4398:"WHO - WHO's cancer pain ladder for adults" 3698:The Cochrane Database of Systematic Reviews 3646:The Cochrane Database of Systematic Reviews 3597:The Cochrane Database of Systematic Reviews 3029:The Cochrane Database of Systematic Reviews 2563:The Cochrane Database of Systematic Reviews 506:Transcutaneous electrical nerve stimulation 497:Transcutaneous electrical nerve stimulation 391:What, if anything, makes the pain increase? 7059:Reproductive endocrinology and infertility 6804: 6777: 6763: 6755: 6365: 6346: 6332: 6324: 5860: 5858: 1990:American Board of Psychiatry and Neurology 1082:opioids usually needed if pain is severe. 900: 27:Interdisciplinary approach for easing pain 7400:Bachelor of Medicine, Bachelor of Surgery 6232: 5838: 5797: 5787: 5738: 5728: 5584: 5535: 5486: 5434: 5355: 5345: 5304: 5289:"Current pharmacotherapy of chronic pain" 5260: 5202: 5156: 4950: 4713: 4626: 4236: 4226: 4001: 3952: 3766: 3717: 3665: 3616: 3460: 3131: 3121: 3048: 2999: 2958: 2909: 2860: 2770: 2582: 2491: 2442: 2432: 2340: 2108:. U.K.: Greenwich Medical Media. p.  1200:can be frequently used such as Percocet, 872:and is delivered through the programs of 475:Physical activity interventions, such as 388:What, if anything, makes the pain lessen? 368:Commonly used scale to depict pain levels 115:Bachelor of Medicine, Bachelor of Surgery 109:Bachelor of Medicine, Bachelor of Surgery 6171:Principles and practice of pain medicine 5137:American College of Emergency Physicians 4794:10.7326/0003-4819-152-11-201006010-00004 4141:British Journal of Healthcare Management 3902:Neuroscience & Biobehavioral Reviews 3489:American Psychological Association (APA) 2753:Dubinsky RM, Miyasaki J (January 2010). 1540:The other major group of analgesics are 5095:Fundamental & Clinical Pharmacology 4619:10.7326/0003-4819-152-2-201001190-00006 4034:Clinical Psychology & Psychotherapy 3485:"What Is Cognitive Behavioral Therapy?" 3001:10.7326/0003-4819-147-7-200710020-00007 2104:Chronic pain management: the essentials 2067:Archives of Biochemistry and Biophysics 2057: 1639:Fundamental & Clinical Pharmacology 1584:Antidepressants and antiepileptic drugs 1300:is effective at reducing chronic pain. 589:is an effective therapy for relieving 526:Transcranial direct-current stimulation 5892: 5890: 5888: 5334:Journal of Pain and Symptom Management 5293:Journal of Pain and Symptom Management 4504:Consumer Reports Health Best Buy Drugs 4065: 4063: 3438: 3436: 3434: 3432: 3430: 3428: 3426: 2838: 2836: 2834: 2832: 2803:Restorative Neurology and Neuroscience 2796: 2794: 2792: 2790: 2712:Current Treatment Options in Neurology 2705: 2703: 2701: 2699: 2697: 2695: 40: 34:. 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Other risks can include 428:Physical medicine and rehabilitation 423:Physical medicine and rehabilitation 7548: 6020:National Institutes of Health (NIH) 3443:McCracken LM, Jones R (July 2012). 3389:Complementary Therapies in Medicine 2982:Chou R, Huffman LH (October 2007). 2246:Consumer Reports (April 28, 2016). 1267:. It can also be administered via 1174:nonsteroidal anti-inflammatory drug 858:mindfulness-based cognitive therapy 7435:Medical Scientist Training Program 6296:. Johns Hopkins University Press. 6129:Staats P, Wallace M (March 2015). 6108:Diwan S, Staats P (January 2015). 4904:10.1097/01.smj.0000223946.19256.17 2016:List of investigational analgesics 1941:Pain medicine in the United States 1617:. A common anti-epileptic drug is 854:mindfulness-based stress reduction 334:, application of ice or heat; and 267:. The team may also include other 25: 6111:Atlas of Pain Medicine Procedures 5158:10.1016/j.annemergmed.2017.06.043 4739:Current Pain and Headache Reports 4256:. British Pain Society ASM 2017. 2421:MMWR. Recommendations and Reports 2041:Pain management during childbirth 1548:, which cause inflammatory pain. 850:Mindfulness-based pain management 845:Mindfulness-based pain management 780:within the field very difficult. 744:Acceptance and commitment therapy 738:Acceptance and commitment therapy 581:Research has found evidence that 209:devoted to pain, which is called 7567: 7557: 7547: 7537: 7528: 7527: 6539:Congenital insensitivity to pain 6499:Paroxysmal extreme pain disorder 6150:Fausett HJ, Warfield CA (2002). 5012:10.1111/j.1533-2500.2006.00055.x 3462:10.1111/j.1526-4637.2012.01407.x 3169:10.1111/j.1533-2500.2006.00056.x 1974:American Board of Anesthesiology 7568: 6069:(8): 718–23, discussion 723–5. 4547:Over-the-counter pain relievers 3914:10.1016/j.neubiorev.2019.02.013 1436:are used for prolonged periods 1093:gastroesophageal reflux disease 1062:or pain from dental procedures 912:typical initial drug treatment 675:drug delivery system implants. 306:during treatment, healing, and 7425:Doctor of Osteopathic Medicine 6859:Oral and maxillofacial surgery 6254:. Chicago Scholarship Online. 6169:Bajwa ZH, Warfield CA (2004). 5717:Pain Research & Management 5415:Science Translational Medicine 4098:Journal of Clinical Psychology 3858:Journal of Behavioral Medicine 3792:Journal of Behavioral Medicine 3710:10.1002/14651858.CD003968.pub5 3658:10.1002/14651858.cd011118.pub3 3609:10.1002/14651858.CD007407.pub4 3041:10.1002/14651858.CD005107.pub4 2575:10.1002/14651858.CD011279.pub3 2194:Pasero C, McCaffery M (1999). 2133:Main CJ, Spanswick CC (2000). 1615:complex regional pain syndrome 644:Interventional pain management 512:. However, it might help with 189:) in various dimensions, from 103:Doctor of Osteopathic medicine 1: 5347:10.1016/S0885-3924(99)00033-0 5306:10.1016/s0885-3924(99)00124-4 2670:10.1080/09638288.2017.1410730 2658:Disability and Rehabilitation 2274:Disability and Rehabilitation 2165:Thienhaus O, Cole BE (2002). 1396:National Institutes of Health 1079:paracetamol, NSAIDs, opioids 725:Intra-articular ozone therapy 216:Pain management often uses a 7405:Bachelor of Medical Sciences 7172:Neurosurgical anesthesiology 6225:10.1097/MLR.0b013e3182a95d86 5931:Journal of Emergency Nursing 5427:10.1126/scitranslmed.aay9056 5287:Portenoy RK (January 2000). 5145:Annals of Emergency Medicine 4706:10.1097/MLR.0b013e3182a95d86 4664:Food and Drug Administration 4572:10.1213/ANE.0000000000002718 4368:10.1097/AJP.0b013e31824c5d9f 4356:The Clinical Journal of Pain 2772:10.1212/WNL.0b013e3181c918fc 2636:NIH MedlinePlus the Magazine 2484:10.1016/j.spinee.2018.01.013 2167:"The classification of pain" 1883:Cognitive behavioral therapy 1392:Food and Drug Administration 789:randomized controlled trials 763:Cognitive behavioral therapy 757:Cognitive behavioral therapy 516:as well as other illnesses. 344:cognitive behavioral therapy 5898:"Pediatric Pain Management" 5253:10.1136/bmjopen-2020-038134 5190:Academic Emergency Medicine 5151:(3). Elsevier BV: 446–448. 4782:Annals of Internal Medicine 4607:Annals of Internal Medicine 4313:Qualitative Health Research 4278:Journal of Advanced Nursing 4262:10.13140/RG.2.2.14157.23526 4228:10.37536/RIECS.2018.3.2.101 4153:10.12968/bjhc.2018.24.5.235 3114:10.1136/bmjopen-2019-031142 2988:Annals of Internal Medicine 2951:10.1097/MD.0000000000016478 2608:"Exercise and Chronic Pain" 2333:10.1097/MD.0000000000017092 1814:Pain management in children 1784:and the recommendations of 1476:(Exalgo, Hydromorph Contin) 925:paracetamol/acetaminophen, 657:epidural steroid injections 622:are both examples of using 7620: 6192:. Philadelphia: Saunders. 6075:10.1016/j.pmrj.2013.07.004 5986:10.1016/j.pmrj.2013.05.009 5879:10.1053/j.trap.2014.07.006 4869:10.1016/j.mcna.2006.10.011 3557:10.1016/j.pain.2011.05.004 3522:10.1037/0022-006x.56.2.261 3401:10.1016/j.ctim.2018.11.023 3357:10.1016/j.wneu.2018.10.191 3247:10.1016/j.pain.2005.12.006 2031:Pain Catastrophizing Scale 1917:Professional certification 1811: 1762: 1613:pain disorders as well as 1566:selective COX-2 inhibitors 1394:stated: "According to the 1325:are used for severe pain. 1035:severe pain after surgery 760: 741: 641: 604: 546: 523: 494: 353: 29: 7523: 6294:Pain: A Political History 6152:Manual of pain management 5943:10.1016/j.jen.2012.09.011 5577:10.1016/j.pmn.2017.09.004 5049:. Institute of Medicine. 4751:10.1007/s11916-009-0086-x 4180:10.1016/j.pmn.2018.02.065 3870:10.1007/s10865-005-9031-6 3804:10.1007/s10865-009-9207-6 3759:10.1080/00207140701338621 3322:10.1016/j.nec.2004.02.009 3212:10.1016/j.nec.2004.02.012 2724:10.1007/s11940-019-0601-2 2286:10.1080/09638280500287437 2173:. CRC Press. p. 29. 2141:. Churchill Livingstone. 1909:In red-haired individuals 1494:, transdermal (Duragesic) 1024:minor pain after surgery 1016:NSAIDs, muscle relaxants 987:severe trauma, such as a 903: 886:World Health Organization 638:Interventional procedures 7359:Transplantation medicine 7250:Clinical neurophysiology 7167:Obstetric anesthesiology 7087:Interventional radiology 6847:Digestive system surgery 5516:European Journal of Pain 4892:Southern Medical Journal 4560:Anesthesia and Analgesia 4542:MedlinePlus Encyclopedia 4325:10.1177/1049732314529662 2849:Arthritis and Rheumatism 2606:University, Utah State. 2521:European Journal of Pain 2379:10.1177/0269215518817804 1500:*, transdermal (Butrans) 1259:has the benefit of less 1180:will relieve mild pain. 982:opioids not recommended 965:minor trauma, such as a 649:Interventional radiology 394:When did the pain start? 379:How intense is the pain? 296:chronic (long-term) pain 294:Effective management of 287:) and occasionally also 7230:Intensive care medicine 7204:Mass gathering medicine 7049:Maternal–fetal medicine 6660:Posteromarginal nucleus 6595:Measurement and testing 5789:10.1073/pnas.1516047113 5631:Algoloji - Ağrı Derneği 5565:Pain Management Nursing 4168:Pain Management Nursing 2367:Clinical Rehabilitation 1935:occupational therapists 1782:evidence-based medicine 1743:(from the Greek άλγος, 1263:release and thus fewer 1208:Moderate to severe pain 669:spinal cord stimulators 587:low level laser therapy 565:British Medical Journal 382:How does the pain feel? 253:recreational therapists 249:occupational therapists 42:Pain Medicine Physician 36:Pain Management (album) 6822:Cardiothoracic surgery 5840:10.1542/peds.108.3.793 2434:10.15585/mmwr.rr6501e1 2169:. In Weiner RS (ed.). 2079:10.1006/abbi.1999.1529 1931:clinical psychologists 1854: 1765:Undertreatment of pain 1700:method for repressing 1518:* (Metadol, Methadose) 1172:(acetaminophen), or a 1030:opioids rarely needed 868:. It was developed by 833:Mindfulness meditation 733:Psychological approach 715:spinal cord stimulator 661:facet joint injections 558: 472: 463:Exercise interventions 369: 241:clinical psychologists 197:and challenging. Most 159: 151: 7473:Personalized medicine 7332:Reproductive medicine 7257:Occupational medicine 7211:Evolutionary medicine 6744:Drug-seeking behavior 6632:Visual analogue scale 3994:10.1089/acm.2018.0351 2815:10.3233/RNN-2011-0615 2196:Pain: clinical manual 1848: 1655:emergency departments 1635:Institute of Medicine 1457:American Pain Society 1184:Mild to moderate pain 1110:proton-pump inhibitor 679:Pulsed radiofrequency 556: 470: 367: 322:(pain killer drugs), 233:medical practitioners 157: 146: 7493:Traditional medicine 7453:Alternative medicine 7320:Addiction psychiatry 7134:Transfusion medicine 7129:Medical microbiology 7044:Gynecologic oncology 6896:Reproductive surgery 6655:Anterolateral system 5730:10.1155/2018/6358624 5693:, Human Rights Watch 5299:(1 Suppl): S16–S20. 2198:. St. Louis: Mosby. 1962:emergency physicians 1891:relaxation technique 1836:functional disorders 1832:rheumatoid arthritis 1482:(M-Eslon, MS Contin) 1247:(Numorphan, Opana), 1136:paracetamol, NSAIDs 1122:paracetamol, NSAIDs 1065:paracetamol, NSAIDs 1051:paracetamol, NSAIDs 1027:paracetamol, NSAIDs 979:paracetamol, NSAIDs 941:paracetamol, NSAIDs 257:physician assistants 203:health professionals 173:involving relief of 158:Image of visual pain 147:Active and inactive 7515:History of medicine 7498:Veterinary medicine 7305:Preventive medicine 7157:Adolescent medicine 6999:Infectious diseases 6188:Waldman SD (2006). 5780:2016PNAS..113.4296H 2023:, an example of an 1980:(recognized by the 1838:such as migraines, 1727:Society and culture 1603:diabetic neuropathy 1442:chemical dependency 1332:For moderate pain, 1219:post-operative pain 999:, or severe sprain 888:(WHO) recommends a 514:diabetic neuropathy 43: 7463:Molecular oncology 7420:Doctor of Medicine 7410:Master of Medicine 7327:Radiation oncology 7199:Emergency medicine 7152:Addiction medicine 7119:Clinical chemistry 7114:Clinical pathology 6906:Transplant surgery 6864:Orthopedic surgery 6842:Colorectal surgery 6734:Philosophy of pain 6409:Respiratory system 6250:Graham SS (2015). 5685:Human Rights Watch 5488:10.1093/ptj/pzy029 5204:10.1111/acem.14159 4979:www.brainfacts.org 4939:Medicinski Glasnik 4523:: Consumer Reports 4110:10.1002/jclp.22749 3345:World Neurosurgery 1855: 1824:sickle cell anemia 1773:when treatment is 1677:activity, such as 1667:analgesic adjuvant 1532:and as analgesics 1362:dextropropoxyphene 1119:chronic back pain 630:to other forms of 559: 473: 385:Where is the pain? 370: 338:measures, such as 318:measures, such as 273:massage therapists 160: 152: 149:μ-opioid receptors 97:Doctor of Medicine 90:Education required 7581: 7580: 7415:Master of Surgery 7379: 7378: 7364:Tropical medicine 7310:Prison healthcare 7225:Hospital medicine 7189:Disaster medicine 7179:Aviation medicine 6994:Hospital medicine 6901:Surgical oncology 6886:Pediatric surgery 6880: 6827:Endocrine surgery 6752: 6751: 6607:Cold pressor test 6590: 6589: 6292:Wailoo K (2014). 6284:978-0-85484-097-7 6199:978-0-7216-0334-6 6180:978-0-07-144349-4 6161:978-0-7817-2313-8 6121:978-0-07-173876-7 5774:(16): 4296–4301. 5421:(584): eaay9056. 5107:10.1111/fcp.12008 5064:978-0-309-07155-0 4898:(11): 1245–1255. 4521:Yonkers, New York 4428:978-0-85484-097-7 4290:10.1111/jan.12998 4284:(10): 2445–2456. 4077:. 22 January 2019 3954:10.1111/pme.12006 2902:10.1136/bmj.a3115 2862:10.1002/art.22195 2855:(12): 3988–3998. 2612:extension.usu.edu 2472:The Spine Journal 2180:978-0-8493-0926-7 2148:978-0-443-05683-3 2119:978-1-900151-85-6 2100:Hardy PA (1997). 2021:Opioid comparison 1950:anesthesiologists 1867:opioid analgesics 1786:medical specialty 1698:epigenome editing 1607:phantom limb pain 1364:(less commonly). 1286:breakthrough pain 1269:transdermal patch 1162: 1161: 1013:or pulled muscle 793:behaviour therapy 785:systematic review 774:systematic review 665:neurolytic blocks 653:chronic back pain 418:Physical approach 356:Threshold of pain 332:physical exercise 218:multidisciplinary 207:medical specialty 141: 140: 16:(Redirected from 7611: 7571: 7570: 7561: 7551: 7550: 7541: 7540: 7531: 7530: 7235:Medical genetics 7220:General practice 7097:Nuclear medicine 6972:Gastroenterology 6928:Vascular surgery 6878: 6805: 6779: 6772: 6765: 6756: 6707:Related concepts 6698:Pain eradication 6456: 6443: 6394: 6366: 6362:By region/system 6348: 6341: 6334: 6325: 6307: 6288: 6265: 6246: 6236: 6203: 6184: 6165: 6146: 6125: 6095: 6094: 6057: 6051: 6050: 6048: 6047: 6037: 6031: 6030: 6028: 6027: 6012: 6006: 6005: 5969: 5963: 5962: 5926: 5920: 5919: 5917: 5915: 5910:on June 11, 2014 5909: 5902: 5894: 5883: 5882: 5873:(2013): 188–94. 5862: 5853: 5852: 5842: 5818: 5812: 5811: 5801: 5791: 5759: 5753: 5752: 5742: 5732: 5708: 5702: 5701: 5700: 5698: 5681: 5670: 5669: 5641: 5635: 5634: 5623: 5617: 5616: 5605: 5599: 5598: 5588: 5556: 5550: 5549: 5539: 5528:10.1002/ejp.1253 5522:(9): 1577–1596. 5507: 5501: 5500: 5490: 5475:Physical Therapy 5466: 5457: 5456: 5438: 5402: 5396: 5395: 5393: 5391: 5376: 5370: 5369: 5359: 5349: 5325: 5319: 5318: 5308: 5284: 5275: 5274: 5264: 5231: 5225: 5224: 5206: 5180: 5174: 5173: 5160: 5133: 5127: 5126: 5090: 5084: 5083: 5081: 5079: 5048: 5038: 5032: 5031: 4995: 4989: 4988: 4986: 4985: 4971: 4965: 4964: 4954: 4952:10.17392/1245-21 4930: 4924: 4923: 4887: 4881: 4880: 4852: 4846: 4845: 4832:King SA (2010). 4829: 4823: 4820: 4814: 4813: 4777: 4771: 4770: 4734: 4728: 4727: 4717: 4681: 4675: 4674: 4672: 4670: 4656: 4650: 4647: 4641: 4640: 4630: 4598: 4592: 4591: 4555: 4549: 4538: 4532: 4531: 4530: 4528: 4512: 4500: 4433: 4432: 4412: 4406: 4405: 4394: 4388: 4387: 4351: 4345: 4344: 4308: 4302: 4301: 4272: 4266: 4265: 4249: 4243: 4242: 4240: 4230: 4206: 4200: 4199: 4163: 4157: 4156: 4136: 4130: 4129: 4096:professionals". 4092: 4086: 4085: 4083: 4082: 4067: 4058: 4057: 4029: 4016: 4015: 4005: 3973: 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Reports 2243: 2210: 2209: 2191: 2185: 2184: 2162: 2156: 2155: 2140: 2130: 2124: 2123: 2107: 2097: 2091: 2090: 2062: 1927:physiotherapists 1801:African-American 1687:muscle relaxants 1661:Other analgesics 1530:opioid addiction 1420:or liquid), but 1407:extended release 1176:(NSAID) such as 953:menstrual cramps 901: 703:intrathecal pump 624:auditory stimuli 414:deeper problem. 271:specialists and 245:physiotherapists 165:is an aspect of 73:Activity sectors 44: 21: 7619: 7618: 7614: 7613: 7612: 7610: 7609: 7608: 7604:Palliative care 7594:Pain management 7584: 7583: 7582: 7577: 7519: 7508:Chief physician 7441: 7386: 7375: 7369:Travel medicine 7354:Sports medicine 7337:Sexual medicine 7277:Palliative care 7272:Pain management 7216:Family medicine 7194:Diving medicine 7140: 7068: 7030: 7023: 6939: 6932: 6891:Plastic surgery 6837:General surgery 6817:Cardiac surgery 6798: 6796: 6788: 6783: 6753: 6748: 6702: 6669: 6642:Pathophysiology 6636: 6627:Tail flick test 6586: 6555: 6470: 6454: 6441: 6432:Musculoskeletal 6426: 6403: 6392: 6357: 6352: 6315: 6310: 6304: 6291: 6285: 6268: 6262: 6249: 6219:(10): 870–878. 6206: 6200: 6190:Pain Management 6187: 6181: 6168: 6162: 6149: 6143: 6135:. McGraw Hill. 6128: 6122: 6114:. McGraw Hill. 6107: 6103: 6101:Further reading 6098: 6059: 6058: 6054: 6045: 6043: 6039: 6038: 6034: 6025: 6023: 6014: 6013: 6009: 5971: 5970: 5966: 5928: 5927: 5923: 5913: 5911: 5907: 5900: 5896: 5895: 5886: 5864: 5863: 5856: 5820: 5819: 5815: 5761: 5760: 5756: 5710: 5709: 5705: 5696: 5694: 5687:(2 June 2011), 5683: 5682: 5673: 5643: 5642: 5638: 5625: 5624: 5620: 5609:"Αρχική Σελίδα" 5607: 5606: 5602: 5558: 5557: 5553: 5509: 5508: 5504: 5468: 5467: 5460: 5410: 5404: 5403: 5399: 5389: 5387: 5386:. 11 March 2021 5378: 5377: 5373: 5327: 5326: 5322: 5286: 5285: 5278: 5247:(11): e038134. 5233: 5232: 5228: 5182: 5181: 5177: 5135: 5134: 5130: 5092: 5091: 5087: 5077: 5075: 5065: 5040: 5039: 5035: 4997: 4996: 4992: 4983: 4981: 4973: 4972: 4968: 4932: 4931: 4927: 4889: 4888: 4884: 4854: 4853: 4849: 4838:Psychiatr Times 4831: 4830: 4826: 4821: 4817: 4788:(11): 712–720. 4779: 4778: 4774: 4736: 4735: 4731: 4700:(10): 870–878. 4683: 4682: 4678: 4668: 4666: 4658: 4657: 4653: 4648: 4644: 4600: 4599: 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465: 425: 420: 404: 402:Adverse effects 362: 352: 328:anticonvulsants 324:antidepressants 316:pharmacological 222:quality of life 163:Pain management 128: 126: 91: 74: 62: 61:Occupation type 39: 28: 23: 22: 15: 12: 11: 5: 7617: 7615: 7607: 7606: 7601: 7596: 7586: 7585: 7579: 7578: 7576: 7575: 7565: 7555: 7545: 7535: 7524: 7521: 7520: 7518: 7517: 7512: 7511: 7510: 7500: 7495: 7490: 7485: 7480: 7475: 7470: 7465: 7460: 7455: 7449: 7447: 7446:Related topics 7443: 7442: 7440: 7439: 7438: 7437: 7427: 7422: 7417: 7412: 7407: 7402: 7397: 7395:Medical school 7391: 7389: 7381: 7380: 7377: 7376: 7374: 7373: 7372: 7371: 7361: 7356: 7351: 7349:Sleep medicine 7346: 7345: 7344: 7334: 7329: 7324: 7323: 7322: 7312: 7307: 7302: 7296: 7291: 7290: 7289: 7279: 7274: 7269: 7264: 7259: 7254: 7253: 7252: 7242: 7237: 7232: 7227: 7222: 7213: 7208: 7207: 7206: 7196: 7191: 7186: 7181: 7176: 7175: 7174: 7169: 7162:Anesthesiology 7159: 7154: 7148: 7146: 7142: 7141: 7139: 7138: 7137: 7136: 7131: 7126: 7121: 7116: 7111: 7101: 7100: 7099: 7094: 7092:Neuroradiology 7089: 7078: 7076: 7070: 7069: 7067: 7066: 7061: 7056: 7051: 7046: 7041: 7035: 7033: 7029:Obstetrics and 7025: 7024: 7022: 7021: 7016: 7011: 7006: 7001: 6996: 6991: 6986: 6981: 6980: 6979: 6969: 6964: 6959: 6954: 6944: 6942: 6934: 6933: 6931: 6930: 6925: 6924: 6923: 6913: 6911:Trauma surgery 6908: 6903: 6898: 6893: 6888: 6883: 6882: 6881: 6874:Otolaryngology 6871: 6866: 6861: 6856: 6851: 6850: 6849: 6844: 6834: 6829: 6824: 6819: 6813: 6811: 6802: 6800:subspecialties 6790: 6789: 6784: 6782: 6781: 6774: 6767: 6759: 6750: 6749: 6747: 6746: 6741: 6736: 6731: 6726: 6721: 6719:Pain tolerance 6716: 6714:Pain threshold 6710: 6708: 6704: 6703: 6701: 6700: 6695: 6690: 6685: 6679: 6677: 6671: 6670: 6668: 6667: 6662: 6657: 6652: 6646: 6644: 6638: 6637: 6635: 6634: 6629: 6624: 6622:Hot plate test 6619: 6614: 6609: 6604: 6598: 6596: 6592: 6591: 6588: 6587: 6585: 6584: 6579: 6574: 6569: 6563: 6561: 6557: 6556: 6554: 6553: 6552: 6551: 6546: 6536: 6531: 6526: 6521: 6516: 6511: 6506: 6501: 6496: 6491: 6489:Pain asymbolia 6486: 6480: 6478: 6472: 6471: 6469: 6468: 6463: 6458: 6450: 6445: 6436: 6434: 6428: 6427: 6425: 6424: 6419: 6413: 6411: 6405: 6404: 6402: 6401: 6396: 6388: 6383: 6378: 6372: 6370: 6363: 6359: 6358: 6353: 6351: 6350: 6343: 6336: 6328: 6322: 6321: 6314: 6313:External links 6311: 6309: 6308: 6303:978-1421413655 6302: 6289: 6283: 6266: 6260: 6247: 6204: 6198: 6185: 6179: 6166: 6160: 6147: 6141: 6126: 6120: 6104: 6102: 6099: 6097: 6096: 6052: 6032: 6007: 5980:(8): 697–704. 5964: 5937:(2): 140–150. 5921: 5884: 5854: 5833:(3): 793–797. 5813: 5754: 5703: 5671: 5636: 5618: 5600: 5551: 5502: 5481:(5): 381–397. 5458: 5408: 5397: 5371: 5340:(6): 441–445. 5320: 5276: 5226: 5197:(4): 444–454. 5175: 5128: 5085: 5063: 5033: 4990: 4966: 4925: 4882: 4847: 4824: 4815: 4772: 4729: 4676: 4651: 4642: 4593: 4566:(2): 529–538. 4550: 4533: 4434: 4427: 4407: 4389: 4362:(3): 233–244. 4346: 4319:(6): 749–760. 4303: 4267: 4244: 4217:(in Spanish). 4201: 4158: 4147:(5): 235–241. 4131: 4104:(6): 970–984. 4087: 4059: 4017: 3988:(3): 265–278. 3968: 3947:(2): 230–242. 3927: 3891: 3848: 3825: 3798:(4): 328–339. 3782: 3753:(3): 275–287. 3733: 3681: 3632: 3578: 3535: 3516:(2): 261–266. 3500: 3476: 3455:(7): 860–867. 3422: 3378: 3335: 3316:(3): 335–342. 3300: 3283:Pain Physician 3268: 3241:(1–2): 43–52. 3225: 3206:(3): 297–306. 3190: 3147: 3088: 3064: 3015: 2994:(7): 492–504. 2974: 2945:(29): e16478. 2925: 2876: 2828: 2809:(6): 439–451. 2786: 2765:(2): 173–176. 2745: 2691: 2664:(6): 622–632. 2647: 2623: 2598: 2546: 2527:(2): 234–249. 2507: 2478:(5): 866–879. 2458: 2400: 2373:(4): 596–606. 2356: 2327:(37): e17092. 2307: 2280:(6): 363–367. 2264: 2211: 2204: 2186: 2179: 2157: 2147: 2125: 2118: 2092: 2056: 2054: 2051: 2049: 2048: 2043: 2038: 2033: 2028: 2018: 2013: 2007: 2005: 2002: 1996:(ABMS) or the 1942: 1939: 1918: 1915: 1812:Main article: 1809: 1806: 1763:Main article: 1760: 1759:Undertreatment 1757: 1728: 1725: 1716: 1713: 1703: 1662: 1659: 1646: 1643: 1630: 1627: 1590:antidepressant 1585: 1582: 1546:prostaglandins 1537: 1534: 1526: 1525: 1519: 1513: 1507: 1501: 1495: 1489: 1483: 1477: 1471: 1438:drug tolerance 1387: 1384: 1342:dihydrocodeine 1310:dextromoramide 1253:hydromorphinol 1209: 1206: 1185: 1182: 1166: 1163: 1160: 1159: 1156: 1154:anticonvulsant 1150:antidepressant 1147: 1141: 1140: 1137: 1134: 1131:osteoarthritis 1127: 1126: 1123: 1120: 1116: 1115: 1112: 1103: 1095: 1084: 1083: 1080: 1077: 1070: 1069: 1066: 1063: 1056: 1055: 1052: 1049: 1043: 1042: 1039: 1036: 1032: 1031: 1028: 1025: 1021: 1020: 1017: 1014: 1007: 1006: 1003: 1000: 984: 983: 980: 977: 962: 961: 958: 955: 949: 948: 942: 939: 933: 932: 929: 923: 917: 916: 913: 910: 906: 905: 881: 878: 846: 843: 834: 831: 813: 810: 799:and potential 761:Main article: 758: 755: 742:Main article: 739: 736: 734: 731: 726: 723: 642:Main article: 639: 636: 616:Audioanalgesia 607:Audioanalgesia 602: 599: 578: 575: 547:Main article: 544: 541: 524:Main article: 521: 518: 495:Main article: 492: 489: 464: 461: 432:electrotherapy 424: 421: 419: 416: 403: 400: 396: 395: 392: 389: 386: 383: 380: 360:Pain tolerance 351: 348: 193:and simple to 139: 138: 129: 124: 121: 120: 119: 118: 112: 106: 100: 92: 89: 86: 85: 81: 80: 75: 72: 69: 68: 63: 60: 57: 56: 53: 49: 48: 26: 24: 14: 13: 10: 9: 6: 4: 3: 2: 7616: 7605: 7602: 7600: 7597: 7595: 7592: 7591: 7589: 7574: 7566: 7564: 7560: 7556: 7554: 7546: 7544: 7536: 7534: 7526: 7525: 7522: 7516: 7513: 7509: 7506: 7505: 7504: 7501: 7499: 7496: 7494: 7491: 7489: 7486: 7484: 7481: 7479: 7478:Public health 7476: 7474: 7471: 7469: 7466: 7464: 7461: 7459: 7458:Allied health 7456: 7454: 7451: 7450: 7448: 7444: 7436: 7433: 7432: 7431: 7428: 7426: 7423: 7421: 7418: 7416: 7413: 7411: 7408: 7406: 7403: 7401: 7398: 7396: 7393: 7392: 7390: 7388: 7382: 7370: 7367: 7366: 7365: 7362: 7360: 7357: 7355: 7352: 7350: 7347: 7343: 7340: 7339: 7338: 7335: 7333: 7330: 7328: 7325: 7321: 7318: 7317: 7316: 7313: 7311: 7308: 7306: 7303: 7300: 7297: 7295: 7292: 7288: 7285: 7284: 7283: 7280: 7278: 7275: 7273: 7270: 7268: 7267:Oral medicine 7265: 7263: 7262:Ophthalmology 7260: 7258: 7255: 7251: 7248: 7247: 7246: 7243: 7241: 7238: 7236: 7233: 7231: 7228: 7226: 7223: 7221: 7217: 7214: 7212: 7209: 7205: 7202: 7201: 7200: 7197: 7195: 7192: 7190: 7187: 7185: 7182: 7180: 7177: 7173: 7170: 7168: 7165: 7164: 7163: 7160: 7158: 7155: 7153: 7150: 7149: 7147: 7143: 7135: 7132: 7130: 7127: 7125: 7124:Cytopathology 7122: 7120: 7117: 7115: 7112: 7110: 7107: 7106: 7105: 7102: 7098: 7095: 7093: 7090: 7088: 7085: 7084: 7083: 7080: 7079: 7077: 7075: 7071: 7065: 7064:Urogynecology 7062: 7060: 7057: 7055: 7052: 7050: 7047: 7045: 7042: 7040: 7037: 7036: 7034: 7032: 7026: 7020: 7017: 7015: 7012: 7010: 7007: 7005: 7002: 7000: 6997: 6995: 6992: 6990: 6987: 6985: 6982: 6978: 6975: 6974: 6973: 6970: 6968: 6967:Endocrinology 6965: 6963: 6960: 6958: 6955: 6953: 6949: 6946: 6945: 6943: 6941: 6935: 6929: 6926: 6922: 6919: 6918: 6917: 6914: 6912: 6909: 6907: 6904: 6902: 6899: 6897: 6894: 6892: 6889: 6887: 6884: 6877: 6876: 6875: 6872: 6870: 6867: 6865: 6862: 6860: 6857: 6855: 6852: 6848: 6845: 6843: 6840: 6839: 6838: 6835: 6833: 6830: 6828: 6825: 6823: 6820: 6818: 6815: 6814: 6812: 6810: 6806: 6803: 6801: 6795: 6791: 6787: 6780: 6775: 6773: 6768: 6766: 6761: 6760: 6757: 6745: 6742: 6740: 6737: 6735: 6732: 6730: 6727: 6725: 6722: 6720: 6717: 6715: 6712: 6711: 6709: 6705: 6699: 6696: 6694: 6691: 6689: 6686: 6684: 6681: 6680: 6678: 6676: 6672: 6666: 6663: 6661: 6658: 6656: 6653: 6651: 6648: 6647: 6645: 6643: 6639: 6633: 6630: 6628: 6625: 6623: 6620: 6618: 6617:Grimace scale 6615: 6613: 6610: 6608: 6605: 6603: 6600: 6599: 6597: 6593: 6583: 6582:Low back pain 6580: 6578: 6575: 6573: 6570: 6568: 6565: 6564: 6562: 6558: 6550: 6547: 6545: 6542: 6541: 6540: 6537: 6535: 6534:Referred pain 6532: 6530: 6527: 6525: 6522: 6520: 6517: 6515: 6512: 6510: 6507: 6505: 6502: 6500: 6497: 6495: 6494:Pain disorder 6492: 6490: 6487: 6485: 6482: 6481: 6479: 6477: 6473: 6467: 6466:Delayed-onset 6464: 6462: 6459: 6457: 6451: 6449: 6446: 6444: 6438: 6437: 6435: 6433: 6429: 6423: 6420: 6418: 6415: 6414: 6412: 6410: 6406: 6400: 6397: 6395: 6389: 6387: 6384: 6382: 6379: 6377: 6374: 6373: 6371: 6369:Head and neck 6367: 6364: 6360: 6356: 6349: 6344: 6342: 6337: 6335: 6330: 6329: 6326: 6320: 6317: 6316: 6312: 6305: 6299: 6295: 6290: 6286: 6280: 6276: 6272: 6269:Reynolds LA, 6267: 6263: 6261:9780226264059 6257: 6253: 6248: 6244: 6240: 6235: 6230: 6226: 6222: 6218: 6214: 6210: 6205: 6201: 6195: 6191: 6186: 6182: 6176: 6172: 6167: 6163: 6157: 6153: 6148: 6144: 6142:9780071817455 6138: 6134: 6133: 6127: 6123: 6117: 6113: 6112: 6106: 6105: 6100: 6092: 6088: 6084: 6080: 6076: 6072: 6068: 6064: 6056: 6053: 6042: 6036: 6033: 6021: 6017: 6011: 6008: 6003: 5999: 5995: 5991: 5987: 5983: 5979: 5975: 5968: 5965: 5960: 5956: 5952: 5948: 5944: 5940: 5936: 5932: 5925: 5922: 5906: 5899: 5893: 5891: 5889: 5885: 5880: 5876: 5872: 5868: 5861: 5859: 5855: 5850: 5846: 5841: 5836: 5832: 5828: 5824: 5817: 5814: 5809: 5805: 5800: 5795: 5790: 5785: 5781: 5777: 5773: 5769: 5765: 5758: 5755: 5750: 5746: 5741: 5736: 5731: 5726: 5722: 5718: 5714: 5707: 5704: 5692: 5691: 5686: 5680: 5678: 5676: 5672: 5667: 5663: 5659: 5655: 5651: 5647: 5640: 5637: 5632: 5628: 5622: 5619: 5614: 5610: 5604: 5601: 5596: 5592: 5587: 5582: 5578: 5574: 5570: 5566: 5562: 5555: 5552: 5547: 5543: 5538: 5533: 5529: 5525: 5521: 5517: 5513: 5506: 5503: 5498: 5494: 5489: 5484: 5480: 5476: 5472: 5465: 5463: 5459: 5454: 5450: 5446: 5442: 5437: 5432: 5428: 5424: 5420: 5416: 5412: 5401: 5398: 5385: 5381: 5375: 5372: 5367: 5363: 5358: 5353: 5348: 5343: 5339: 5335: 5331: 5324: 5321: 5316: 5312: 5307: 5302: 5298: 5294: 5290: 5283: 5281: 5277: 5272: 5268: 5263: 5258: 5254: 5250: 5246: 5242: 5238: 5230: 5227: 5222: 5218: 5214: 5210: 5205: 5200: 5196: 5192: 5191: 5186: 5179: 5176: 5172: 5168: 5164: 5159: 5154: 5150: 5146: 5142: 5138: 5132: 5129: 5124: 5120: 5116: 5112: 5108: 5104: 5100: 5096: 5089: 5086: 5074: 5070: 5066: 5060: 5056: 5055:10.17226/6376 5052: 5047: 5046: 5037: 5034: 5029: 5025: 5021: 5017: 5013: 5009: 5005: 5001: 5000:Pain Practice 4994: 4991: 4980: 4976: 4970: 4967: 4962: 4958: 4953: 4948: 4944: 4940: 4936: 4929: 4926: 4921: 4917: 4913: 4909: 4905: 4901: 4897: 4893: 4886: 4883: 4878: 4874: 4870: 4866: 4863:(1): 97–111. 4862: 4858: 4851: 4848: 4843: 4839: 4835: 4828: 4825: 4819: 4816: 4811: 4807: 4803: 4799: 4795: 4791: 4787: 4783: 4776: 4773: 4768: 4764: 4760: 4756: 4752: 4748: 4744: 4740: 4733: 4730: 4725: 4721: 4716: 4711: 4707: 4703: 4699: 4695: 4691: 4687: 4684:Daubresse M, 4680: 4677: 4665: 4661: 4655: 4652: 4646: 4643: 4638: 4634: 4629: 4624: 4620: 4616: 4612: 4608: 4604: 4597: 4594: 4589: 4585: 4581: 4577: 4573: 4569: 4565: 4561: 4554: 4551: 4548: 4544: 4543: 4537: 4534: 4522: 4518: 4517: 4509: 4506:(July 2012), 4505: 4499: 4497: 4495: 4493: 4491: 4489: 4487: 4485: 4483: 4481: 4479: 4477: 4475: 4473: 4471: 4469: 4467: 4465: 4463: 4461: 4459: 4457: 4455: 4453: 4451: 4449: 4447: 4445: 4443: 4441: 4439: 4435: 4430: 4424: 4420: 4419: 4411: 4408: 4403: 4399: 4393: 4390: 4385: 4381: 4377: 4373: 4369: 4365: 4361: 4357: 4350: 4347: 4342: 4338: 4334: 4330: 4326: 4322: 4318: 4314: 4307: 4304: 4299: 4295: 4291: 4287: 4283: 4279: 4271: 4268: 4263: 4259: 4255: 4248: 4245: 4239: 4234: 4229: 4224: 4220: 4216: 4212: 4205: 4202: 4197: 4193: 4189: 4185: 4181: 4177: 4173: 4169: 4162: 4159: 4154: 4150: 4146: 4142: 4135: 4132: 4127: 4123: 4119: 4115: 4111: 4107: 4103: 4099: 4091: 4088: 4076: 4072: 4066: 4064: 4060: 4055: 4051: 4047: 4043: 4039: 4035: 4028: 4026: 4024: 4022: 4018: 4013: 4009: 4004: 3999: 3995: 3991: 3987: 3983: 3979: 3972: 3969: 3964: 3960: 3955: 3950: 3946: 3942: 3941:Pain Medicine 3938: 3931: 3928: 3923: 3919: 3915: 3911: 3907: 3903: 3895: 3892: 3887: 3883: 3879: 3875: 3871: 3867: 3864:(1): 95–124. 3863: 3859: 3852: 3849: 3836: 3829: 3826: 3821: 3817: 3813: 3809: 3805: 3801: 3797: 3793: 3786: 3783: 3778: 3774: 3769: 3764: 3760: 3756: 3752: 3748: 3744: 3737: 3734: 3729: 3725: 3720: 3715: 3711: 3707: 3703: 3699: 3695: 3688: 3686: 3682: 3677: 3673: 3668: 3663: 3659: 3655: 3651: 3647: 3643: 3636: 3633: 3628: 3624: 3619: 3614: 3610: 3606: 3602: 3598: 3594: 3587: 3585: 3583: 3579: 3574: 3570: 3566: 3562: 3558: 3554: 3550: 3546: 3539: 3536: 3531: 3527: 3523: 3519: 3515: 3511: 3504: 3501: 3490: 3486: 3480: 3477: 3472: 3468: 3463: 3458: 3454: 3450: 3449:Pain Medicine 3446: 3439: 3437: 3435: 3433: 3431: 3429: 3427: 3423: 3418: 3414: 3410: 3406: 3402: 3398: 3394: 3390: 3382: 3379: 3374: 3370: 3366: 3362: 3358: 3354: 3350: 3346: 3339: 3336: 3331: 3327: 3323: 3319: 3315: 3311: 3304: 3301: 3296: 3292: 3288: 3284: 3280: 3272: 3269: 3264: 3260: 3256: 3252: 3248: 3244: 3240: 3236: 3229: 3226: 3221: 3217: 3213: 3209: 3205: 3201: 3194: 3191: 3186: 3182: 3178: 3174: 3170: 3166: 3162: 3158: 3157:Pain Practice 3151: 3148: 3143: 3139: 3134: 3129: 3124: 3119: 3115: 3111: 3107: 3103: 3099: 3092: 3089: 3078: 3074: 3068: 3065: 3060: 3056: 3051: 3046: 3042: 3038: 3034: 3030: 3026: 3019: 3016: 3011: 3007: 3002: 2997: 2993: 2989: 2985: 2978: 2975: 2970: 2966: 2961: 2956: 2952: 2948: 2944: 2940: 2936: 2929: 2926: 2921: 2917: 2912: 2907: 2903: 2899: 2895: 2891: 2887: 2880: 2877: 2872: 2868: 2863: 2858: 2854: 2850: 2846: 2839: 2837: 2835: 2833: 2829: 2824: 2820: 2816: 2812: 2808: 2804: 2797: 2795: 2793: 2791: 2787: 2782: 2778: 2773: 2768: 2764: 2760: 2756: 2749: 2746: 2741: 2737: 2733: 2729: 2725: 2721: 2717: 2713: 2706: 2704: 2702: 2700: 2698: 2696: 2692: 2687: 2683: 2679: 2675: 2671: 2667: 2663: 2659: 2651: 2648: 2637: 2633: 2627: 2624: 2613: 2609: 2602: 2599: 2594: 2590: 2585: 2580: 2576: 2572: 2568: 2564: 2560: 2553: 2551: 2547: 2542: 2538: 2534: 2530: 2526: 2522: 2518: 2511: 2508: 2503: 2499: 2494: 2489: 2485: 2481: 2477: 2473: 2469: 2462: 2459: 2454: 2450: 2445: 2440: 2435: 2430: 2426: 2422: 2418: 2411: 2409: 2407: 2405: 2401: 2396: 2392: 2388: 2384: 2380: 2376: 2372: 2368: 2360: 2357: 2352: 2348: 2343: 2338: 2334: 2330: 2326: 2322: 2318: 2311: 2308: 2303: 2299: 2295: 2291: 2287: 2283: 2279: 2275: 2268: 2265: 2253: 2249: 2242: 2240: 2238: 2236: 2234: 2232: 2230: 2228: 2226: 2224: 2222: 2220: 2218: 2216: 2212: 2207: 2205:0-8151-5609-X 2201: 2197: 2190: 2187: 2182: 2176: 2172: 2168: 2161: 2158: 2154: 2150: 2144: 2139: 2138: 2129: 2126: 2121: 2115: 2111: 2106: 2105: 2096: 2093: 2088: 2084: 2080: 2076: 2072: 2068: 2061: 2058: 2052: 2047: 2044: 2042: 2039: 2037: 2034: 2032: 2029: 2026: 2025:equianalgesic 2022: 2019: 2017: 2014: 2012: 2011:Equianalgesic 2009: 2008: 2003: 2001: 1999: 1995: 1991: 1987: 1983: 1979: 1975: 1971: 1967: 1966:psychiatrists 1963: 1959: 1955: 1951: 1948: 1940: 1938: 1936: 1932: 1928: 1924: 1916: 1914: 1911: 1910: 1906: 1904: 1900: 1896: 1892: 1888: 1884: 1880: 1876: 1870: 1868: 1864: 1859: 1852: 1847: 1843: 1841: 1837: 1833: 1829: 1825: 1821: 1815: 1807: 1805: 1802: 1797: 1792: 1787: 1783: 1780:Consensus in 1778: 1776: 1772: 1766: 1758: 1756: 1754: 1750: 1746: 1742: 1738: 1734: 1726: 1724: 1722: 1721:self-efficacy 1714: 1712: 1710: 1707: 1699: 1696: 1692: 1688: 1684: 1680: 1676: 1672: 1669:medications. 1668: 1660: 1658: 1656: 1652: 1644: 1642: 1640: 1636: 1628: 1626: 1624: 1623:amitriptyline 1620: 1616: 1612: 1608: 1604: 1600: 1595: 1594:antiepileptic 1591: 1583: 1581: 1579: 1575: 1571: 1567: 1563: 1559: 1555: 1551: 1550:Acetaminophen 1547: 1543: 1535: 1533: 1531: 1523: 1520: 1517: 1514: 1511: 1508: 1505: 1502: 1499: 1498:Buprenorphine 1496: 1493: 1490: 1487: 1484: 1481: 1478: 1475: 1474:Hydromorphone 1472: 1469: 1466: 1465: 1464: 1461: 1458: 1453: 1451: 1447: 1443: 1439: 1435: 1429: 1427: 1423: 1422:suppositories 1419: 1415: 1410: 1408: 1403: 1399: 1397: 1393: 1390:In 2009, the 1385: 1383: 1381: 1377: 1372: 1370: 1369:Amitriptyline 1365: 1363: 1359: 1355: 1354:ethylmorphine 1351: 1347: 1343: 1339: 1335: 1330: 1328: 1324: 1320: 1315: 1311: 1307: 1303: 1299: 1298:buprenorphine 1295: 1291: 1287: 1283: 1279: 1275: 1270: 1266: 1262: 1258: 1254: 1250: 1246: 1242: 1241:hydromorphone 1238: 1235:to which all 1234: 1233:gold standard 1230: 1226: 1224: 1220: 1216: 1207: 1205: 1204:, or Norco. 1203: 1199: 1198:acetaminophen 1195: 1191: 1183: 1181: 1179: 1175: 1171: 1164: 1157: 1155: 1151: 1148: 1146: 1143: 1142: 1138: 1135: 1132: 1129: 1128: 1124: 1121: 1118: 1117: 1113: 1111: 1107: 1099: 1096: 1094: 1090: 1086: 1085: 1081: 1078: 1075: 1072: 1071: 1067: 1064: 1061: 1058: 1057: 1053: 1050: 1048: 1045: 1044: 1040: 1037: 1034: 1033: 1029: 1026: 1023: 1022: 1018: 1015: 1012: 1009: 1008: 1004: 1001: 998: 997:bone fracture 994: 990: 986: 985: 981: 978: 976: 972: 968: 964: 963: 959: 956: 954: 951: 950: 946: 943: 940: 938: 935: 934: 930: 928: 924: 922: 919: 918: 914: 911: 908: 907: 902: 899: 897: 893: 892: 887: 879: 877: 875: 871: 867: 863: 859: 855: 851: 844: 842: 840: 832: 830: 826: 822: 819: 811: 809: 805: 802: 798: 794: 790: 786: 781: 779: 778:meta-analysis 775: 769: 764: 756: 754: 750: 745: 737: 732: 730: 724: 722: 720: 716: 711: 708: 704: 699: 696: 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