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Migraine Headache Prophylaxis - American Family Physician

Jan 1, 2019 - Migraines impose significant health and financial burdens. Approximately 38% of patients with episodic migraines would benefit from preventive therapy, but less than 13% take prophylactic medications. Preventive medication therapy reduces migraine frequency, severity, and ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0101/p17.html

Acute Migraine Headache: Treatment Strategies - American Family Physician

Feb 15, 2018 - Migraine is a primary headache disorder characterized by recurrent attacks. Acetaminophen, nonsteroidal anti-inflammatory drugs, triptans, antiemetics, ergot alkaloids, and combination analgesics have evidence supporting their effectiveness in the treatment of migraine. Acetaminophen ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0215/p243.html

Nonoperative Management of Cervical Radiculopathy - American Family Physician

May 1, 2016 - Cervical radiculopathy describes pain in one or both of the upper extremities, often in the setting of neck pain, secondary to compression or irritation of nerve roots in the cervical spine. It can be accompanied by motor, sensory, or reflex deficits and is most prevalent in persons 50 ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0501/p746.html

Manipulative Therapies: What Works - American Family Physician

Feb 15, 2019 - Manipulative therapies include osteopathic manipulative treatment and many other forms of manual therapies used to manage a variety of conditions in adults and children. Spinal manipulative therapy may provide short-term improvement in patients with acute or chronic low back pain, ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0215/p248.html

Alzheimer Disease: Pharmacologic and Nonpharmacologic Therapies for Cognitive and ...

Jun 15, 2017 - Alzheimer disease comprises a syndrome of progressive cognitive and functional decline. Treatments should target cognitive and functional symptoms. Cholinesterase inhibitors, memantine, and a combination of a cholinesterase inhibitor and memantine have produced statistically significant...

American Family Physician : Article

https://www.aafp.org/afp/2017/0615/p771.html

Epilepsy: Treatment Options - American Family Physician

Jul 15, 2017 - The occurrence of a single seizure does not always require initiation of antiepileptic drugs. Risk of recurrent seizures should guide their use. In adults, key risk factors for recurrence are two unprovoked seizures occurring more than 24 hours apart, epileptiform abnormalities on ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0715/p87.html

Prevention and Treatment of Motion Sickness - American Family Physician

Jul 1, 2014 - Motion sickness is a common syndrome that occurs upon exposure to certain types of motion. It is thought to be caused by conflict between the vestibular, visual, and other proprioceptive systems. Although nausea is the hallmark symptom, it is often preceded by stomach awareness, ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0701/p41.html

Cervical Radiculopathy: Nonoperative Management of Neck Pain and Radicular Symptoms - ...

Jan 1, 2010 - Cervical radiculopathy is a disease process marked by nerve compression from herniated disk material or arthritic bone spurs. This impingement typically produces neck and radiating arm pain or numbness, sensory deficits, or motor dysfunction in the neck and upper extremities. Magnetic ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0101/p33.html

Treating Painful Diabetic Peripheral Neuropathy: An Update - American Family Physician

Aug 1, 2016 - Painful diabetic peripheral neuropathy occurs in approximately 25% of patients with diabetes mellitus who are treated in the office setting and significantly affects quality of life. It typically causes burning pain, paresthesias, and numbness in a stocking-glove pattern that progresses...

American Family Physician : Article

https://www.aafp.org/afp/2016/0801/p227.html

Treatment of Acute Migraine Headache - American Family Physician

Feb 1, 2011 - Migraine headache is a common and potentially debilitating disorder often treated by family physicians. Before diagnosing migraine, serious intracranial pathology must be ruled out. Treating acute migraine is challenging because of substantial rates of nonresponse to medications and ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0201/p271.html

Pharmacologic Therapy for Acute Pain - American Family Physician

Jun 1, 2013 - The approach to patients with acute pain begins by identifying the underlying cause and a disease-specific treatment. The first-line pharmacologic agent for the symptomatic treatment of mild to moderate pain is acetaminophen or a nonsteroidal anti-inflammatory drug (NSAID). The choice ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0601/p766.html

Weighing the Risks and Benefits of Chronic Opioid Therapy - American Family Physician

Jun 15, 2016 - Evidence supports the use of opioids for treating acute pain. However, the evidence is limited for the use of chronic opioid therapy for chronic pain. Furthermore, the risks of chronic therapy are significant and may outweigh any potential benefits. When considering chronic opioid ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0615/p982.html

Behavioral Disorders in Dementia: Appropriate Nondrug Interventions and Antipsychotic ...

Aug 15, 2016 - Behavioral and psychological symptoms of dementia pose management challenges for caregivers and clinicians. Firstline nonpharmacologic treatments include eliminating physical and emotional stressors, modifying the patient’s environment, and establishing daily routines. Family members ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0815/p276.html

Pharmacologic Management of Pain at the End of Life - American Family Physician

Jul 1, 2014 - Although many patients experience debilitating pain at the end of life, there are many options to improve analgesia and quality of life. Pain assessment using a validated tool, with attention to patient function and specific goals, helps tailor individual treatment plans. The World ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0701/p26.html

Gabapentinoids for Pain: Potential Unintended Consequences - Editorials - American ...

Dec 1, 2019 - The widespread and often indiscriminate prescribing of gabapentinoids is not supported by robust evidence, and it carries known and unknown risks.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/1201/p672.html

Infiltrative Anesthesia in Office Practice - American Family Physician

Jun 15, 2014 - When choosing an infiltrative anesthetic agent, the type of procedure, the length of time required for anesthesia, and the pharmacodynamics of each medication are important considerations. Distraction techniques and buffering with sodium bicarbonate can be used to decrease the pain ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0615/p956.html

Subacute Management of Ischemic Stroke - American Family Physician

Dec 15, 2011 - Ischemic stroke is the third leading cause of death in the United States and a common reason for hospitalization. The subacute period after a stroke refers to the time when the decision to not employ thrombolytics is made up until two weeks after the stroke occurred. Family physicians ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1215/p1383.html

Herpes Zoster and Postherpetic Neuralgia: Prevention and Management - American Family ...

Jun 15, 2011 - Herpes zoster (shingles) is diagnosed clinically by recognition of the distinctive, painful vesicular rash appearing in a unilateral, dermatomal distribution. An estimated 1 million cases occur in the United States each year, and increasing age is the primary risk factor. Laboratory ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0615/p1432.html

Transient Ischemic Attack: Part II. Risk Factor Modification and Treatment - American ...

Sep 15, 2012 - Interventions following a transient ischemic attack are aimed at preventing a future episode or stroke. Hypertension, current smoking, obesity, physical inactivity, diabetes mellitus, and dyslipidemia are all well-known risk factors, and controlling these factors can have dramatic ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0915/p527.html

Subacute to Chronic Mild Traumatic Brain Injury - American Family Physician

Dec 1, 2012 - Although a universally accepted definition is lacking, mild traumatic brain injury and concussion are classified by transient loss of consciousness, amnesia, altered mental status, a Glasgow Coma Score of 13 to 15, and focal neurologic deficits following an acute closed head injury. ...

American Family Physician : Article

https://www.aafp.org/afp/2012/1201/p1045.html

Treatment of Vertigo - American Family Physician

Mar 15, 2005 - Vertigo is the illusion of motion, usually rotational motion. As patients age, vertigo becomes an increasingly common presenting complaint. The most common causes of this condition are benign paroxysmal positional vertigo, acute vestibular neuronitis or labyrinthitis, Ménière's ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0315/p1115.html

Medications for Migraine Prophylaxis - American Family Physician

Jan 1, 2006 - Sufficient evidence and consensus exist to recommend propranolol, timolol, amitriptyline, divalproex, sodium valproate, and topiramate as first-line agents for migraine prevention. There is fair evidence of effectiveness with gabapentin and naproxen sodium. Botulinum toxin also has ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0101/p72.html

Treatment of Alzheimer Disease - American Family Physician

Jun 15, 2011 - Alzheimer disease is the most common form of dementia, affecting more than one-third of Americans older than 85 years. It is characterized by progressive memory loss and cognitive decline. Amyloid plaque accumulation, neurofibrillary tau tangles, and depletion of acetylcholine are among...

American Family Physician : Article

https://www.aafp.org/afp/2011/0615/p1403.html

Rational Use of Opioids for Management of Chronic Nonterminal Pain - American Family ...

Aug 1, 2012 - Opioid prescribing for chronic nonterminal pain has increased in recent years, although evidence for its long-term effectiveness is weak and its potential for harm is significant. Nonmedical use of prescription opioids, diversion, and overdose deaths have also increased sharply, ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0801/p252.html

Dual Antiplatelet Therapy for High-Risk TIA and Minor Stroke: BMJ Rapid Recommendation ...

Sep 15, 2019 - Based on a recent randomized controlled trial followed by a systematic review, the BMJ and MAGIC group concluded that dual antiplatelet therapy use for a limited period after mild stroke is beneficial.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0915/p378.html

Treating Diabetic Peripheral Neuropathic Pain - American Family Physician

Jul 15, 2010 - Diabetic peripheral neuropathic pain affects the functionality, mood, and sleep patterns of approximately 10 to 20 percent of patients with diabetes mellitus. Treatment goals include restoring function and improving pain control. Patients can realistically expect a 30 to 50 percent ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0715/p151.html

Behavior Disorders of Dementia: Recognition and Treatment - American Family Physician

Feb 15, 2006 - Psychosis may pose a greater challenge than cognitive decline for patients with dementia and their caregivers. The nature and frequency of psychotic symptoms varies over the course of illness, but in most patients, these symptoms occur more often in the later stages of disease. ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0215/p647.html

Ibuprofen Plus Acetaminophen Equals Opioid Plus Acetaminophen for Acute Severe ...

Mar 1, 2018 - In adults presenting to the emergency department with acute extremity pain severe enough to warrant radiologic investigation, ibuprofen plus acetaminophen was equally effective in reducing pain intensity at two hours compared with three different opioid and acetaminophen combination ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0301/p348.html

Erenumab (Aimovig) for Migraine Prophylaxis in Adults - STEPS - American Family Physician

Jun 15, 2019 - Erenumab is a safe option for migraine prophylaxis in adults. However, it is expensive and should be reserved for patients who have experienced intolerable adverse effects while taking oral migraine prophylaxis medication or who have poor adherence to daily preventive treatment.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0615/p781.html

Management of Status Epilepticus - American Family Physician

Aug 1, 2003 - Status epilepticus is an increasingly recognized public health problem in the United States. Status epilepticus is associated with a high mortality rate that is largely contingent on the duration of the condition before initial treatment, the etiology of the condition, and the age of ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0801/p469.html

Chronic Neck Pain: Nonpharmacologic Treatment - Implementing AHRQ Effective Health Care...

Aug 1, 2019 - Which noninvasive nonpharmacologic treatments for chronic neck pain improve function or pain for at least one month?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2019/0801/p180.html

Integrating Medical Acupuncture into Family Medicine Practice - Editorials - American ...

Jul 15, 2019 - Acupuncture is an evidence-based therapy to reduce pain that can meet patient demand for nonpharmacologic treatment. Now is the time to offer training in medical acupuncture to more family physicians.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0715/p76.html

Gabapentin and Pregabalin Not Effective for Low Back Pain with or Without Radiculopathy...

Mar 15, 2019 - The use of anticonvulsants like gabapentin (Neurontin) for painful conditions has increased greatly in recent years. This review finds good evidence that these drugs are not an effective treatment for low back pain with or without radiculopathy, and are associated with an increased risk...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od2.html

Alternative Interventions for Chronic Prostatitis/Chronic Pelvic Pain Syndrome in Men -...

Jun 1, 2019 - In men with chronic pelvic pain and urinary dysfunction who have not responded to standard medical management, extracorporeal shock wave therapy reduces symptoms and increases quality of life. Acupuncture may also provide benefit to some patients.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0601/p677.html

Short-Term Clopidogrel Plus Aspirin Prevents Second Ischemic Stroke Better Than Aspirin...

Aug 15, 2019 - Combined treatment with clopidogrel and aspirin, started within 24 hours of the first event, will decrease the likelihood of a recurrent stroke in an additional 2% of patients compared with aspirin alone, with a slight increase in the risk of extra-cranial bleeding.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0815/p249.html

Acute Lumbar Disk Pain: Navigating Evaluation and Treatment Choices - American Family ...

Oct 1, 2008 - Acute lumbar disk herniations are the most common cause of sciatica. After excluding emergent causes, such as cauda equina syndrome, epidural abscess, fracture, or malignancy, a six-week trial of conservative management is indicated. Patients should be advised to stay active. If ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1001/p835.html

Pharmacologic Interventions for Apathy in Patients with Alzheimer Disease - Cochrane ...

Jan 1, 2019 - Methylphenidate may improve apathy in select patients with AD (mean difference [MD] = –4.99 on the apathy evaluation scale; 95% confidence interval [CI], –9.55 to –0.43), although the clinical significance associated with these findings remains unclear and the evidence is considered low...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0101/p14.html

Sialorrhea--A Management Challenge - American Family Physician

Jun 1, 2004 - Sialorrhea (drooling or excessive salivation) is a common problem in neurologically impaired children (i.e., those with mental retardation or cerebral palsy) and in adults who have Parkinson's disease or have had a stroke. It is most commonly caused by poor oral and facial muscle ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0601/p2628.html

Management of Herpes Zoster (Shingles) and Postherpetic Neuralgia - American Family ...

Apr 15, 2000 - Herpes zoster (commonly referred to as

American Family Physician : Article

https://www.aafp.org/afp/2000/0415/p2437.html

Chronic Nonmalignant Pain in Primary Care - American Family Physician

Nov 15, 2008 - A systematic approach to chronic nonmalignant pain includes a comprehensive evaluation; a treatment plan determined by the diagnosis and mechanisms underlying the pain; patient education; and realistic goal setting. The main goal of treatment is to improve quality of life while ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1115/p1155.html

No Reduction in Delirium with the Use of Haloperidol or Ziprasidone in Critically Ill ...

Apr 1, 2019 - For patients with acute respiratory failure or shock who develop delirium in the intensive care unit (ICU), the use of haloperidol or ziprasidone (Geodon) does not reduce the duration of delirium. This trial was powered to detect at least a two-day difference in the duration of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p460.html

Osteopathic Manipulative Treatment: A Primary Care Approach - Editorials - American ...

Feb 15, 2019 - Osteopathic manipulative treatment is a valuable modality that has the potential to decrease cost and improve pain/function in patients.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0215/p214.html

Complementary and Integrative Treatments for Pain Management in Labor - Cochrane for ...

Feb 1, 2019 - There is evidence that all of the studied interventions have some benefit in labor, but the evidence is of low to very low quality. Massage, thermal interventions (warm and cold packs), relaxation techniques, yoga, and music reduce pain during latent labor, but not during active labor.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0201/p154.html

Restless Legs Syndrome - American Family Physician

Jul 15, 2008 - Restless legs syndrome is a common neurologic movement disorder that affects approximately 10 percent of adults. Of those affected with this condition, approximately one third have symptoms severe enough to require medical therapy. Restless legs syndrome may be a primary condition, or ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0715/p235.html

Clopidogrel Plus Aspirin Provides More Net Benefit Than Aspirin Alone After Minor ...

Feb 1, 2019 - This study provides support for a strategy of adding clopidogrel to aspirin for the first week or so after a minor ischemic stroke or TIA because this is when the greatest benefit occurs. Harms were spread fairly evenly throughout the study period.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0201/p188a.html

Deprescribing Antipsychotics for Behavioral and Psychological Symptoms of Dementia and ...

Sep 15, 2018 - As part of the Deprescribing Guidelines in the Elderly Project, a Canadian team consisting of two family physicians, one geriatric psychiatrist, two geriatricians, and four pharmacists has provided recommendations to guide physicians in deprescribing antipsychotics for behavioral and ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0915/p394.html

Epidural Analgesia and Risk of Cesarean Delivery - FPIN's Help Desk Answers - American ...

Nov 1, 2018 - There is no difference in the risk of cesarean delivery in women who receive epidural analgesia before 4 to 5 cm cervical dilation compared with later dilation.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/1101/od2.html

Tourette's Syndrome - American Family Physician

Mar 1, 2008 - Tourette's syndrome is a movement disorder most commonly seen in school-age children. The incidence peaks around preadolescence with one half of cases resolving in early adulthood. Tourette's syndrome is the most common cause of tics, which are involuntary or semivoluntary, sudden, ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0301/p651.html

Acupuncture Effective for Chronic Pain Conditions - POEMs - American Family Physician

Nov 15, 2018 - Acupuncture, with its meridians, chi, and other concepts that do not seem to line up with anything physiologic, is vexing to most of us who trained in Western medicine. However, this meta-analysis, based on data from almost 21,000 patients, found it to be more effective than no ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1115/od2.html

Cannabinoids Somewhat Helpful for Nausea, Maybe Helpful for Spasticity, Probably Not ...

Oct 15, 2018 - This umbrella review found a modest benefit of cannabinoids for the treatment of neuropathic pain; a greater benefit for the treatment of spasticity and nausea and vomiting; and substantial harms. The studies were extremely heterogeneous in terms of the comparators, dose, duration, and ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1015/od3.html

Nonopioids Equivalent to Opioids for Severe Chronic Back, Hip, or Knee Pain with Fewer ...

Sep 1, 2018 - Nonopioid medications were at least as effective as opioid medications for improving pain-related function over 12 months in adults with severe chronic back pain or knee or hip osteoarthritis pain. The evidence that opioids are not superior to nonopioid medications for chronic and acute...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0901/p316.html

Medications Ineffective to Prevent Cognitive Decline or Dementia - POEMs - American ...

Aug 15, 2018 - None of the medications in this systematic review prevented or delayed cognitive decline, cognitive impairment, or dementia.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0815/p248a.html

Antiepileptic Drug Monotherapy for Epilepsy - Cochrane for Clinicians - American Family...

May 1, 2018 - In patients with partial-onset (focal) seizures, levetiracetam (Keppra), lamotrigine (Lamictal), and carbamazepine (Tegretol) were associated with the longest time to treatment withdrawal (i.e., the recommended patient-oriented outcome measure that balances tolerability with ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0501/p572.html

NSAIDs for Postpartum Perineal Pain - FPIN's Help Desk Answers - American Family Physician

Jun 1, 2018 - Women with third- or fourth-degree perineal lacerations or who received an episiotomy can be given oral NSAIDs to reduce perineal pain in the first six hours postpartum.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0601/od3.html

Pregabalin (Lyrica) for Acute Fibromyalgia Pain - Medicine by the Numbers - American ...

May 1, 2018 - Pregabalin (Lyrica) provides good pain relief to some patients with acute fibromyalgia pain but does not work for most persons. Learn more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0501/od1.html

Short-Term Antipsychotics for Alzheimer Disease - FPIN's Help Desk Answers - American ...

Apr 1, 2018 - Physicians should consider not using antipsychotics in patients with dementia. Patients with dementia, including Alzheimer disease, who are treated with antipsychotics for any length of time have a higher mortality rate than those not taking antipsychotics.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0401/od2.html

Routine Oxygen Supplementation After Acute Stroke Does Not Improve Functional Outcomes ...

Apr 15, 2018 - For nonhypoxic patients with acute stroke, routine oxygen therapy for 72 hours, either continuously or at night only, does not improve functional outcomes at 90 days. Long-term outcomes were not assessed in this study, and the question remains whether 90 days is an adequate length of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0415/p533.html

No Added Benefit with Higher Doses of Ketorolac for Treatment of Acute Pain in the ...

Aug 15, 2017 - A 10-mg dose of ketorolac is as effective as higher doses for the short-term treatment of acute pain for patients in the emergency department.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0815/p262.html

Ibuprofen and Morphine Provide Similar Post-op Pain Relief in Kids; Ibuprofen Has Fewer...

Mar 15, 2018 - This carefully designed and adequately powered study found no difference in pain reduction between ibuprofen and oral morphine in children with postoperative pain. Adverse effects, however, were much more likely with morphine.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0315/p408a.html

Effectiveness of Skin-to-Skin Care for Procedure-Related Pain in Newborns - Cochrane ...

Feb 1, 2018 - Skin-to-skin care, also known as kangaroo care, effectively reduces physiologic and behavioral measures of pain in neonates during painful procedures and has no identified adverse effects. Infants who received skin-to-skin care during painful procedures had a heart rate of 10.8 beats ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0201/p170.html

Treatment of Chronic Insomnia in Adults: ACP Guideline - Practice Guidelines - American...

May 15, 2017 - The American College of Physicians (ACP) has provided recommendations for treatment of chronic insomnia in adults. Treatment, which can include psychological or pharmacologic therapy, alone or combined, as well as complementary and alternative methods, is aimed at improving sleep, ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0515/p669.html

Gabapentinoids for Chronic Low Back Pain: Limited Evidence, More Harm Than Benefit - ...

Dec 15, 2017 - The existing data on gabapentinoids for chronic low back pain are limited in number and quality. The amount of pain reduction is low to moderate, and the rate of adverse effects is high. The few studies that assessed function found no improvement.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1215/od3.html

Topical Capsaicin for Treatment of Chronic Neuropathic Pain in Adults - Medicine by the...

Dec 1, 2017 - Based on low-quality evidence, high-concentration capsaicin patches reduce neuropathic pain from herpes and human immunodeficiency virus infection by 30% to 50% compared with the low-concentration capsaicin control group.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/1201/od1.html

Treatments for Nocturnal Leg Cramps - FPIN's Help Desk Answers - American Family Physician

Oct 1, 2017 - Calcium channel blockers or B vitamins may lead to short-term improvement in nocturnal leg cramps. Stretching has mixed results. Quinine is effective but is no longer recommended, and it is not approved for treatment of leg cramps because of potential toxicity.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/1001/od3.html

Use of Mindfulness or Self-Hypnosis Provides Immediate Pain Relief to Hospitalized ...

Nov 15, 2017 - Compared with psychoeducation, a single 15-minute session of training in mindfulness or self-hypnosis leads to greater immediate pain relief for hospitalized patients with at least moderate pain at baseline.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1115/od6.html

Clinical Evaluation and Treatment Options for Herniated Lumbar Disc - American Family ...

Feb 1, 1999 - Degeneration of the intervertebral disc from a combination of factors can result in herniation, particularly at the L4-5 and L5-S1 levels. The presence of pain, radiculopathy and other symptoms depends on the site and degree of herniation. A detailed history and careful physical ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0201/p575.html

Pregabalin Does Not Decrease the Pain of Sciatica - POEMs - American Family Physician

Aug 15, 2017 - Pregabalin does not relieve pain in patients with sciatica.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0815/p260.html

Dementia Care: More Than Just Prescription Drugs - Editorials - American Family Physician

Jun 15, 2017 - Rather than focusing on medications to achieve a small temporary difference in cognition, patients and families might be better served if we focused more on nonpharmacologic treatments, and on more important issues, such as advance directives, driving, living arrangements, caregiver ...

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0615/p766.html

Methadone Treatment for Pain States - American Family Physician

Apr 1, 2005 - Methadone is a synthetic opioid with potent analgesic effects. Although it is associated commonly with the treatment of opioid addiction, it may be prescribed by licensed family physicians for analgesia. Methadone's unique pharmacokinetics and pharmacodynamics make it a valuable option ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0401/p1353.html

Physical Fitness Training for Patients with Stroke - Cochrane for Clinicians - American...

Jun 1, 2017 - There is moderate-quality evidence that physical fitness training improves disability after stroke. Cardiovascular training that includes only aerobic exercise has a moderate effect on disability (standard mean difference [SMD] = 0.52 on a pooled disability scale), although it is not ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0601/p701.html

Mind-Body Therapies for Headache - American Family Physician

Nov 15, 2007 - Headache is one of the most common and enigmatic problems encountered by family physicians. Headache is not a singular entity, and different pathologic mechanisms are involved in distinct types of headache. Most types of headache involve dysfunction of peripheral or central nociceptive ...

American Family Physician : Article

https://www.aafp.org/afp/2007/1115/p1518.html

Evaluation and Treatment of the Child with Febrile Seizure - American Family Physician

May 15, 2006 - Up to 5 percent of children in North America and western Europe experience at least one episode of febrile seizure before six years of age. Most of these seizures are self-limited and patients do not require treatment. Continuous therapy after the seizure is not effective in reducing ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0515/p1761.html

Topiramate and Amitriptyline Not Effective for Migraine in Children - POEMs - American ...

May 15, 2017 - Topiramate, amitriptyline, and placebo all led to a similar, substantial improvement in migraine frequency and disability. How to harness this strong placebo effect for our patients is an important, but unanswered, question.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0515/od2.html

Antipsychotics Worsen Symptoms in Patients with Delirium Who Receive Palliative Care - ...

Mar 15, 2017 - For hospitalized patients with acute delirium and symptoms of distress who are receiving palliative care, the use of risperidone (Risperdal) or haloperidol at conservative oral doses worsens symptoms and may shorten overall survival.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0315/od3.html

AAN Updates Guidelines on the Uses of Botulinum Neurotoxin - Practice Guidelines - ...

Feb 1, 2017 - In 2008, the American Academy of Neurology (AAN) published guidelines on the use of botulinum neurotoxin. This summary highlights updates on four indications: blepharospasm, cervical dystonia, spasticity in adults, and headache.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0201/p198.html

Antiepileptic Drugs After First Unprovoked Seizure - Medicine by the Numbers - American...

Feb 1, 2017 - The decision to start an antiepileptic drug after a first unprovoked seizure has long been a clinically challenging one.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0201/od1.html

Sertraline Reduces Risk of Depression in Adults After Traumatic Brain Injury - POEMs - ...

Feb 1, 2017 - This study found that sertraline is more effective than placebo (number needed to treat = 6) in preventing the onset of a major depressive disorder in adults following a TBI. This study included patients with mild, moderate, and severe TBI.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0201/p194.html

Management of Head and Neck Injuries by the Sideline Physician - American Family Physician

Oct 15, 2006 - Injuries to the head and neck are common in sports. Sideline physicians must be attentive and prepared with an organized approach to detect and manage these injuries. Because head and neck injuries often occur simultaneously, the sideline physician can combine the head and neck ...

American Family Physician : Article

https://www.aafp.org/afp/2006/1015/p1357.html

Alpha-adrenergic Agonists for the Management of Opioid Withdrawal - Medicine by the ...

Jan 1, 2017 - Alpha-adrenergic agonists were more efficacious than placebo in the management of opioid withdrawal, but are best reserved as an alternative to methadone.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0101/od1.html

Prognosis Following Mild Head Injury in Children - Point-of-Care Guides - American ...

Dec 15, 2016 - Concussion, also referred to as mild traumatic brain injury, is a common injury in children. It is defined as a transient disturbance in mental status following head trauma, and it can cause a variety of physical, cognitive, and emotional sequelae. Symptoms continuing for more than 28 ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2016/1215/p1006.html

Trigeminal Neuralgia - Clinical Evidence Handbook - American Family Physician

Jul 15, 2016 - What are the effects of ongoing treatments in persons with trigeminal neuralgia?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2016/0715/p133.html

Management of Cluster Headache - American Family Physician

Feb 15, 2005 - Cluster headache, an excruciating, unilateral headache usually accompanied by conjunctival injection and lacrimation, can occur episodically or chronically, and can be difficult to treat. Existing effective treatments may be underused because of underdiagnosis of the syndrome. Oxygen ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0215/p717.html

The Management of the Acute Migraine Headache - American Family Physician

Dec 1, 2002 - As many as 30 million Americans have migraine headaches. The impact on patients and their families can be tremendous, and treatment of migraines can present diagnostic and therapeutic challenges for family physicians. Abortive treatment options include nonspecific and migraine-specific ...

American Family Physician : Article

https://www.aafp.org/afp/2002/1201/p2123.html

Acetaminophen for the Treatment of Pain in Newborns - Cochrane for Clinicians - ...

Aug 1, 2016 - Acetaminophen does not significantly reduce pain associated with heel lance, eye examinations, or assisted vaginal births in newborns. Acetaminophen may reduce the total amount of morphine a newborn needs in the first 48 hours following major abdominal or thoracic surgery.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/0801/p216.html

Rural Opioid Use Disorder Treatment Depends on Family Physicians - Graham Center Policy...

Oct 1, 2016 - The nation's growing opioid use disorder epidemic disproportionately impacts rural areas, where physicians who can prescribe buprenorphine are scarcest. Among physicians approved to prescribe buprenorphine, family physicians (FPs) are the most likely to work in rural areas.

American Family Physician : Graham Center Policy One-Pagers

https://www.aafp.org/afp/2016/1001/p546.html

Family Medicine: An Underutilized Resource in Addressing the Opioid Epidemic? - Graham ...

Sep 1, 2016 - Opioid overdose rates have tripled since 2000, and although overprescribing of opioids by physicians is widely accepted as a causal factor, the physician's role in providing medication-assisted treatment for opioid use disorder is less appreciated. Despite a clear willingness to ...

American Family Physician : Graham Center Policy One-Pagers

https://www.aafp.org/afp/2016/0901/p350.html

Stop Using Antipsychotics to Treat or Prevent Delirium—They Are No Better Than Placebo ...

Aug 15, 2016 - The available data indicate that antipsychotic medications are ineffective in preventing or treating delirium in hospitalized patients. Because there are concerns about falls and extrapyramidal effects with antipsychotics (not reported in this study), we should stop using them.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0815/p318.html

Exercise to Improve Functioning in Patients with Dementia - FPIN's Help Desk Answers - ...

Aug 1, 2016 - Exercise programs lasting at least two months moderately increase the ability of patients with dementia to perform ADLs.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2016/0801/p242.html

CDC Develops Guideline for Opioid Prescribing - Practice Guidelines - American Family ...

Jun 15, 2016 - A recently released guideline aims to establish patient-centered approaches to initiating, managing, and discontinuing opioid use. The recommendations from the Centers for Disease Control and Prevention (CDC) emphasize the serious risks and harms associated with opioids.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2016/0615/p1042.html

Acupuncture for Frequent Tension-Type Headaches - Medicine by the Numbers - American ...

Aug 1, 2016 - Studies show an NNT of 3 to have at least a 50% reduction of headache frequency compared with routine care. Want to know more?

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/0801/od1.html

Pioglitazone After Stroke or TIA Reduces Stroke and MI, but Also Has Significant Harms ...

Aug 15, 2016 - In patients with a recent stroke or TIA and evidence of insulin resistance, pioglitazone reduces the likelihood of myocardial infarction (MI) or stroke (number needed to treat [NNT] = 36 over five years) but increases the risk of significant weight gain (number needed to treat to harm ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0815/p319.html

Alpha-Lipoic Acid for Treatment of Diabetic Peripheral Neuropathy - FPIN's Help Desk ...

May 1, 2016 - Intravenous (IV) ALA can improve neuropathy symptoms when administered for three weeks, but symptom improvement with oral ALA is not clinically significant. There is no evidence evaluating long-term treatment.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2016/0501/p786.html

When to Discontinue Antiepileptic Drug Therapy for Patients in Remission - Cochrane for...

Jun 1, 2016 - Children with epilepsy should be seizure-free for at least two years before stopping antiepileptic drug therapy, especially those who have partial seizures or a history of abnormal electroencephalography (EEG) results.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/0601/p914.html

Topical NSAIDs for Acute Musculoskeletal Pain in Adults - Medicine by the Numbers - ...

Jul 1, 2016 - Studies show that patients had improved pain control with diclofenac gel, ketoprofen gel, and ibuprofen gel with no increase in local or systemic adverse events. See why.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/0701/od1.html

Caring for Patients with Job Insecurity Who Are Experiencing Chronic Work-Related Pain ...

Jul 15, 2016 - In addition to providing direct medical care, the physician can help this patient by obtaining an occupational history, formulating hypotheses about the cause of the pain and potential interventions, and establishing a therapeutic relationship.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2016/0715/p145.html

Antiviral Therapy for Bell Palsy - Cochrane for Clinicians - American Family Physician

May 1, 2016 - The combination of antiviral agents and corticosteroids is more effective than corticosteroids alone for the complete recovery of patients with Bell palsy (number needed to treat [NNT] = 15) and for the resolution of motor synkinesis and excessive tear production (NNT = 12). Antivirals ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/0501/p742.html

Using the CDC Guideline and Tools for Opioid Prescribing in Patients with Chronic Pain ...

Jun 15, 2016 - The new CDC guideline is intended to help clinicians decide whether and how to prescribe opioids for chronic pain; offer safer, more effective care for patients with chronic pain; improve clinician-patient communication; and prevent opioid use disorder and opioid-related overdose.

American Family Physician : Editorials

https://www.aafp.org/afp/2016/0615/p970.html

Use of Atypical Antipsychotics in Patients with Dementia - American Family Physician

Jun 1, 2003 - Increasingly, atypical antipsychotic drugs are prescribed for elderly patients with symptoms of psychosis and behavioral disturbances. These symptoms often occur in patients with Alzheimer's disease, other dementias, or Parkinson's disease. As the average age of Americans increases, the...

American Family Physician : Article

https://www.aafp.org/afp/2003/0601/p2335.html

The Opioid Epidemic: AMA’s response - Editorials - American Family Physician

Jun 15, 2016 - With Lembke article and opioid PG

American Family Physician : Editorials

https://www.aafp.org/afp/2016/0615/p975.html

Treatment of Degenerative Lumbar Spinal Stenosis - American Family Physician

Aug 1, 2004 - Spinal stenosis is a narrowing of the vertebral canal that compresses spinal nerves and may cause leg pain and difficulty walking. The symptoms of degenerative lumbar stenosis commonly occur in elderly adults and can be treated conservatively with pain-relieving agents or aggressively ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0801/p517.html

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