Chronic non-cancer pain: an overview of assessment and contemporary management.
Pain is one of the foremost reasons for which people seek healthcare. The cost of pain to the American economy approximates $85 billion-$90 billion annually. Approximately one-third of Americans have some element of chronic pain. Acute and chronic pain are different entities requiring different approaches to treatment. The ability to assess chronic pain is fundamental to its management. The use of various subjective testing modalities, combined with a thorough history and physical examination and a review of pertinent laboratory data, enables the clinician to devise a management strategy. The management of chronic non-cancer pain syndrome often involves a concerted multidisciplinary endeavor that utilizes nerve block, pharmacological, psychological, surgical, and physical therapies. Trigger-point injections and sympathetic, epidural, subarachnoid, interpleural, intravenous, regional, and peripheral nerve blocks are utilized as indicated. Pharmacological management entails the use of numerous agents including nonsteroidal anti-inflammatory drugs, opioids, antidepressants, and anticonvulsants. Newer agents hold promise for facilitating the care of these patients.
Tulane University School of Medicine, USA.
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MC
Gitlin
D002908:Chronic Disease; D006801:Humans; D010146:Pain / Q000175:diagnosis*; D059408:Pain Management