'Pain management' (also called pain medicine) is the discipline concerned with the relief of
pain.
'Acute pain', such as occurs with
trauma, often has a reversible cause and may require only transient measures and correction of the underlying problem. In contrast, '
chronic pain' often results from conditions that are difficult to diagnose and treat, and that may take a long time to reverse. Some examples include
cancer,
neuropathy, and
referred pain. Often, pain pathways are set up that continue to transmit the sensation of pain even though the underlying condition or injury that originally caused pain has been healed. In such situations, the pain itself is frequently managed separately from the underlying condition of which it is a symptom, or the goal of treatment is to manage the pain with no treatment of any underlying condition (e.g. if the underlying condition has resolved or if no identifiable source of the pain can be found).
Pain management generally benefits from a
multidisciplinary approach that includes
pharmacologic measures (
analgesics such as
narcotics or
NSAIDs and 'pain modifiers' such as
tricyclic antidepressants or
anticonvulsants), non-pharmacologic measures (such as interventional procedures, physical therapy and
physical exercise, application of ice and/or heat), and
psychological measures (such as
biofeedback and
cognitive therapy).
Pain management practitioners come from all fields of medicine. Most often, pain fellowship trained physicians are
anesthesiologists,
neurologists,
physiatrists or
psychiatrists. Some practitioners focus more on the pharmacologic management of the patient, while others are very proficient at the interventional management of pain. Interventional procedures - typically used for chronic back pain - include: epidural steroid injections, facet joint injections, neurolytic blocks,
Spinal Cord Stimulators and
intrathecal drug delivery system implants, etc. Over the last several years the number of interventional procedures done for pain has grown to a very large number.
As well as medical practitioners, the area of pain management may often benefit from the input of Specialist
Nurses,
Physiotherapists,
Clinical Psychologists &
Occupational therapists, amongst others. Together the multidisciplinary team can help create a package of care suitable to the patient.
See also
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Back pain
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Cancer
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Coccydynia (coccyx pain, tailbone pain)
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Neuralgia
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Neuropathy
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Phantom limb pain
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Transcutaneous Electrical Nerve Stimulator
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Temporomandibular joint disorder
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Whiplash
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Yoga as exercise some studies claim that this practice can be useful for managing certain kinds of chronic pain.
Footnotes
External links
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International Association for the Study of Pain
★ Barry Yeoman,
Prisoners of Pain, AARP: The Magazine
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Back pain and neck pain information for patients
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American chronic pain association
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Pain Management Information. Alternative & Conventional Treatments
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Chronic pain support group
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Online postgrad courses in Pain management at
University of Edinburgh following the International Association for the Study of Pain curriculum
Pain Talk: The national discussion forum and community for UK Healthcare Professionals with an interest in acute, chronic, or palliative Pain Management. Features articles on pain management, and a range of resources