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Acupuncture for Pain - American Family Physician

Jul 15, 2019 - Acupuncture has been increasingly used as an integrative or complementary therapy for pain. It is well-tolerated with little risk of serious adverse effects. Traditional acupuncture and nontraditional techniques, such as electroacupuncture and dry needling, often result in reported pain...

American Family Physician : Article

https://www.aafp.org/afp/2019/0715/p89.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

Pain: Chronic - American Family Physician

Apr 1, 2018 - This collection features AFP content on chronic pain and related issues, including end-of-life care, NSAIDs, and opioid therapy. This collection features AFP content on chronic pain and related issues, including end-of-life care, NSAIDs, and opioid therapy.

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=61

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

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

Common Questions About the Diagnosis and Management of Fibromyalgia - American Family ...

Apr 1, 2015 - Fibromyalgia has a distinct pathophysiology involving central amplification of peripheral sensory signals. Core symptoms are chronic widespread pain, fatigue, and sleep disturbance. Most patients with fibromyalgia have muscle pain and tenderness, forgetfulness or problems concentrating,...

American Family Physician : Article

https://www.aafp.org/afp/2015/0401/p472.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

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

Labor Analgesia - American Family Physician

Mar 1, 2012 - Regional analgesia has become the most common method of pain relief used during labor in the United States. Epidural and spinal analgesia are two types of regional analgesia. With epidural analgesia, an indwelling catheter is directed into the epidural space, and the patient receives a ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0301/p447.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

NSAID Prescribing Precautions - American Family Physician

Dec 15, 2009 - Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used, but have risks associated with their use, including significant upper gastrointestinal tract bleeding. Older persons, persons taking anticoagulants, and persons with a history of upper gastrointestinal tract bleeding ...

American Family Physician : Article

https://www.aafp.org/afp/2009/1215/p1371.html

Evidence for the Use of Intramuscular Injections in Outpatient Practice - American ...

Feb 15, 2009 - There are few studies comparing the outcomes of patients who are treated with oral versus intramuscular antibiotics, corticosteroids, nonsteroidal anti-inflammatory drugs, or vitamin B12. This may lead to confusion about when the intramuscular route is indicated. For example, ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0215/p297.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

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

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

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

Management of Common Opioid-Induced Adverse Effects - American Family Physician

Oct 15, 2006 - Opioid analgesics are useful agents for treating pain of various etiologies; however, adverse effects are potential limitations to their use. Strategies to minimize adverse effects of opioids include dose reduction, symptomatic management, opioid rotation, and changing the route of ...

American Family Physician : Article

https://www.aafp.org/afp/2006/1015/p1347.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

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

Acupuncture for Pain - American Family Physician

Sep 1, 2009 - Acupuncture is increasingly used as an alternative or complementary therapy for the treatment of pain. It is well tolerated, with a low risk of serious adverse effects. Traditional and modern acupuncture techniques may result in reported improvement in pain patterns. Research on ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0901/p481.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

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

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

Fibromyalgia - American Family Physician

Jul 15, 2007 - Fibromyalgia is an idiopathic, chronic, nonarticular pain syndrome with generalized tender points. It is a multisystem disease characterized by sleep disturbance, fatigue, headache, morning stiffness, paresthesias, and anxiety. Nearly 2 percent of the general population in the United ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0715/p247.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

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

Low Back Pain: American College of Physicians Practice Guideline on Noninvasive ...

Sep 15, 2017 - The American College of Physicians has released a guideline, which partially updates its 2007 guideline, to provide recommendations for noninvasive treatment of acute (duration less than four weeks), subacute (duration of four to 12 weeks), and chronic (duration longer than 12 weeks) ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0915/p407.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

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

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

How Family Physicians Can Combat the Opioid Epidemic - Editorials - American Family ...

Sep 15, 2017 - Family physicians must commit to responsible prescribing of opioid medications. The decision to initiate opioid therapy should be a careful and deliberate one, especially in patients who are at risk of addiction.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0915/p357.html

Pregabalin for Fibromyalgia Pain in Adults - Cochrane for Clinicians - American Family ...

Sep 1, 2017 - There is high-quality evidence that pregabalin in daily dosages of 300 mg, 450 mg, and 600 mg reduces pain associated with fibromyalgia. The most effective dosage seems to be 450 mg daily; this dosage is more effective than placebo at reducing pain by at least 50% (number needed to ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0901/p291.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

Antipsychotics for Fibromyalgia in Adults - Medicine by the Numbers - American Family ...

Aug 1, 2017 - Quetiapine may be considered for a limited period (less than 12 weeks) to improve pain, sleep, and depression in fibromyalgia, while considering the potential for weight gain.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0801/od1.html

Management of Chronic Pain and Opioid Misuse: A Position Paper from the AAFP - Practice...

Apr 1, 2017 - Overprescribing, misuse, diversion, and dependence on opioids have occurred as a result of external pressures, physician behavior, inadequate evidence, and pharmacologic development. Family physicians could play an important role in alleviating these problems; therefore, the American ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0401/p458.html

Chronic Pain Management and Opioid Misuse: Guidance for Family Physicians - Editorials ...

Apr 1, 2017 - Family physicians are committed to advancing population and community health, and we must take the lead in reducing opioid misuse and overdose before outside entities mandate practice strategies that may not be patient-centered.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0401/p420.html

Cyclobenzaprine in the Treatment of Low Back Pain - Medicine by the Numbers - American ...

Feb 1, 2016 - Studies show that 1 in 3 patients experiences global improvement in back pain symptoms at 10 days, while 1 in 4 patients experiences medication adverse effects. Read more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/0201/od2.html

Chronic Musculoskeletal Pain in Children: Part I. Initial Evaluation - American Family ...

Jul 1, 2006 - Musculoskeletal pain can be difficult for children to characterize. Primary care physicians must determine whether the pain may be caused by a systemic disease. Change in activity, constitutional symptoms such as fevers and fatigue, or abnormal examination findings without obvious ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0701/p115.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

Low-Dose Morphine Less Effective Than Diclofenac or Acetaminophen for Renal Colic - ...

Oct 15, 2016 - This is a good example of how a well-done study can lead to erroneous conclusions. The comparator most likely to be effective here—titrated morphine—was used at a low dose and found to be less effective than intramuscular diclofenac or intravenous paracetamol (acetaminophen).

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1015/p665.html

Selective Serotonin Reuptake Inhibitors for Fibromyalgia - Cochrane for Clinicians - ...

Oct 1, 2016 - SSRIs may have a small to moderate effect on pain (number needed to treat [NNT] = 10), global improvement (NNT = 7), and depression (NNT = 13) in patients with fibromyalgia, but the quality of evidence is very low because of bias and small studies. SSRIs do not reduce fatigue related to...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/1001/p548.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

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

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

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

Managing Pain in the Dying Patient - American Family Physician

Feb 1, 2000 - End-of-life care can be a challenge requiring the full range of a family physician's skills. Significant pain is common but is often undertreated despite available medications and technology. Starting with an appropriate assessment and following recommended guidelines on the use of ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0201/p755.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

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

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

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

Chronic Musculoskeletal Pain in Children: Part II. Rheumatic Causes - American Family ...

Jul 15, 2006 - Primary care physicians should have a working knowledge of rheumatic diseases of childhood that manifest primarily as musculoskeletal pain. Children with juvenile rheumatoid arthritis can present with painless joint inflammation and may have normal results on rheumatologic tests. ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0715/p293.html

Gabapentin for Chronic Neuropathic Pain - Medicine by the Numbers - American Family ...

Dec 1, 2015 - Studies show that 1 in 6 patients were helped with diabetic neuropathy and 1 in 8 were helped with postherpetic neuralgia. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2015/1201/od1.html

The Role of Levetiracetam in Treating Chronic Neuropathic Pain Symptoms - Cochrane for ...

Jul 1, 2015 - Based on low-quality evidence, levetiracetam was found to be ineffective for the treatment of chronic neuropathic pain symptoms. Moreover, patients who were taking levetiracetam experienced adverse effects at a significantly higher rate than those who were taking placebo.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0701/p23.html

Acetaminophen (Paracetamol) Minimally Effective for Back Pain and Osteoarthritis - ...

Oct 1, 2015 - Although acetaminophen was hoped to be a safer alternative to nonsteroidal anti-inflammatory drugs and opioids for the treatment of common musculoskeletal problems, on average it provides only minimal pain relief and improvement in function for patients with low back pain or ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1001/p642.html

Oral Analgesics for Acute Nonspecific Pain - American Family Physician

Mar 1, 2005 - Physicians most often recommend or prescribe oral medication for relief of acute pain. This review of the available evidence supports the use of acetaminophen in doses up to 1,000 mg as the initial choice for mild to moderate acute pain. In some cases, modest improvements in analgesic ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0301/p913.html

Procedural Sedation in the Acute Care Setting - American Family Physician

Jan 1, 2005 - Many patients require sedation during diagnostic or therapeutic procedures. Ideally, procedural sedation minimizes the patient's awareness and discomfort while maintaining the patient's safety. Appropriate monitoring by trained personnel is the key to successful procedural sedation. ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0101/p85.html

Controlled-Release Oxycodone for Neuropathic Pain and Fibromyalgia in Adults - Cochrane...

Mar 1, 2015 - Oxycodone CR has limited effectiveness for the treatment of diabetic neuropathy or postherpetic neuralgia. Evidence is lacking regarding treatment benefit for other neuropathic pain syndromes or fibromyalgia. Adverse effects of oxycodone CR therapy are common.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0301/p286.html

Antidepressants and Antiepileptic Drugs for Chronic Non-Cancer Pain - American Family ...

Feb 1, 2005 - The development of newer classes of antidepressants and second-generation antiepileptic drugs has created unprecedented opportunities for the treatment of chronic pain. These drugs modulate pain transmission by interacting with specific neurotransmitters and ion channels. The actions of...

American Family Physician : Article

https://www.aafp.org/afp/2005/0201/p483.html

Opioids for Chronic Back Pain: Short-Term Effectiveness, Long-Term Uncertain - POEMs - ...

Aug 15, 2014 - Overall, in patients with chronic low-back pain, opioids are moderately more effective than placebo in the short term for pain relief and slightly more effective in the short term for improving function. However, data for long-term use are virtually nonexistent. The long-term use of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0815/od5.html

Beyond Analgesia in Palliative Care and End-of-Life Interventions - Editorials - ...

Jul 1, 2014 - Family physicians need a basic skill set that includes facilitating discussions on advance planning and goals, identifying and treating depression and anxiety, and managing pain and symptoms at the end of life.

American Family Physician : Editorials

https://www.aafp.org/afp/2014/0701/p20.html

Regional Anesthesia For Office Procedures: Part I. Head and Neck Surgeries - American ...

Feb 1, 2004 - Although local anesthesia usually is used in surgical procedures, field or nerve blocks can provide more effective anesthesia in some situations. In a field block, local anesthetic is infiltrated around the border of the surgical field, leaving the operative area undisturbed. In field ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0201/p585.html

Regional Anesthesia For Office Procedures: Part II. Extremity and Inguinal Area ...

Feb 15, 2004 - The hand can be anesthetized effectively with blocks of the median, ulnar, or radial nerve. Each digit is supplied by four digital nerves, which can be blocked with injections on each side of the digit. Anterior or posterior ankle blocks can be used for regional anesthesia for the foot....

American Family Physician : Article

https://www.aafp.org/afp/2004/0215/p896.html

Tapentadol (Nucynta) for Treatment of Pain - STEPS - American Family Physician

May 1, 2012 - Tapentadol is a DEA schedule II opioid medication with a safety profile, duration of action, frequency of dosing, and analgesic effect similar to those of other oral narcotics, although it is more expensive. At low doses, immediate-release tapentadol is better tolerated than oxycodone ...

American Family Physician : STEPS

https://www.aafp.org/afp/2012/0501/p910.html

Analgesics for Osteoarthritis - Implementing AHRQ Effective Health Care Reviews - ...

Mar 1, 2013 - What are the comparative effectiveness, benefits, and adverse effects of oral and topical analgesics for osteoarthritis?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2013/0301/p354.html

Principles of Office Anesthesia Part II: Topical Anesthesia - American Family Physician

Jul 1, 2002 - The development of topical anesthetics has provided the family physician with multiple options in anesthetizing open and intact skin. The combination of tetracaine, adrenaline (epinephrine), and cocaine, better known as TAC, was the first topical agent available for analgesia of ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0701/p99.html

Principles of Office Anesthesia: Part I. Infiltrative Anesthesia - American Family ...

Jul 1, 2002 - The use of effective analgesia is vital for any office procedure in which pain may be inflicted. The ideal anesthetic achieves 100 percent analgesia in a short period of time, works on intact or nonintact skin without systemic side effects, and invokes neither pain nor toxicity. Because...

American Family Physician : Article

https://www.aafp.org/afp/2002/0701/p91.html

Caffeine as an Analgesic Adjuvant for Acute Pain in Adults - Cochrane for Clinicians - ...

Jan 1, 2013 - Overall, there appears to be a small but clinically significant benefit to adding caffeine to analgesic therapy for various types of acute pain. More research is needed to determine the optimal dosing.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2013/0101/p11.html

Opioid Abuse and Pain Management - Editorials - American Family Physician

Oct 1, 2012 - Chronic nonmalignant pain affects a significant number of Americans. Concurrent with the increased need for pain management is a considerable increase in the use of prescription pain relievers for nonmedical purposes. Nonmedical use of prescription pain relievers is now the second most ...

American Family Physician : Editorials

https://www.aafp.org/afp/2012/1001/p600.html

Opioid Dependence - Clinical Evidence Handbook - American Family Physician

Sep 15, 2012 - What are the effects of drug treatments for stabilization (maintenance), withdrawal, and relapse prevention in persons with opioid dependence?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2012/0915/p565.html

Epidural Analgesia for Labor Pain - Cochrane for Clinicians - American Family Physician

Aug 1, 2012 - Compared with other types of analgesia or no analgesia, epidurals offered better pain relief, but were associated with a longer second stage of labor and increased risk of instrumental vaginal delivery, maternal fever, and oxytocin (Pitocin) administration. There were no statistically ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2012/0801/p241.html

Epidural Analgesia During Labor - American Family Physician

Nov 15, 1998 - Epidural analgesia is a commonly employed technique of providing pain relief during labor. The number of parturients given intrapartum epidural analgesia is reported to be over 50 percent at many institutions in the United States. The procedure has few contraindications, the primary ...

American Family Physician : Article

https://www.aafp.org/afp/1998/1115/p1785.html

Challenges in Pain Management at the End of Life - American Family Physician

Oct 1, 2001 - Effective pain management in the terminally ill patient requires an understanding of pain control strategies. Ongoing assessment of pain is crucial and can be accomplished using various forms and scales. It is also important to determine if the pain is nociceptive (somatic or visceral ...

American Family Physician : Article

https://www.aafp.org/afp/2001/1001/p1227.html

Prolotherapy for Chronic Musculoskeletal Pain - Editorials - American Family Physician

Dec 1, 2011 - Prolotherapy is an injection-based complementary therapy for common chronic musculoskeletal conditions including tendinopathy, knee osteoarthritis, and low back pain. It involves the injection of irritant solutions into tender ligamentous and tendinous attachments and adjacent joint ...

American Family Physician : Editorials

https://www.aafp.org/afp/2011/1201/p1208.html

New Concepts In Acute Pain Therapy: Preemptive Analgesia - American Family Physician

May 15, 2001 - Pain, which is often inadequately treated, accompanies the more than 23 million surgical procedures performed each year and may persist long after tissue heals. Preemptive analgesia, an evolving clinical concept, involves the introduction of an analgesic regimen before the onset of ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0515/p1979.html

ICSI Releases Guideline on Chronic Pain Assessment and Management - Practice Guidelines...

Aug 15, 2010 - The Institute for Clinical Systems Improvement (ICSI) released a guideline on the assessment and management of chronic pain in adults and physiologically mature adolescents 16 to 18 years of age.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2010/0815/p434.html

Treatment of Nonmalignant Chronic Pain - American Family Physician

Mar 1, 2000 - Nonmalignant, chronic pain is associated with physical, emotional and financial disability. Recent animal studies have shown that remodeling within the central nervous system causes the physical pathogenesis of chronic pain. This central neural plasticity results in persistent pain ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0301/p1331.html

Opioid Therapy for Chronic Noncancer Pain - Cochrane for Clinicians - American Family ...

Jul 1, 2010 - Weak evidence suggests that opioids reduce chronic noncancer pain in some highly selected patients, although the effects on quality of life and functional status are unclear.1 Many patients will discontinue opioids because of adverse effects or inadequate pain relief.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2010/0701/p40.html

Cyclooxygenase-2 Enzyme Inhibitors: Place in Therapy - American Family Physician

Jun 15, 2000 - Nonsteroidal anti-inflammatory drugs (NSAIDs) play a major role in the management of inflammation and pain caused by arthritis. A new class of NSAIDs that selectively inhibit the cyclooxygenase-2 (COX-2) enzyme has been developed. The first COX-2 inhibitors, celecoxib and rofecoxib, are...

American Family Physician : Article

https://www.aafp.org/afp/2000/0615/p3669.html

Opioids for Osteoarthritis of the Knee or Hip - Cochrane for Clinicians - American ...

May 1, 2010 - Compared with placebo, the benefits achieved from opioid therapy are modest in terms of pain relief and improvement in function, and do not outweigh the increase in adverse effects. No single opioid stands out as more effective or safer than the rest.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2010/0501/p1094.html

Guidelines for the Use of Opioid Therapy in Patients with Chronic Noncancer Pain - ...

Dec 1, 2009 - The American Pain Society and American Academy of Pain Medicine recently released a guideline for the use of opioids in patients with chronic noncancer pain. Chronic opioid therapy is controversial because of the potential for adverse effects and abuse.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2009/1201/p1315.html

Nonmalignant Chronic Pain: Taking the Time to Treat - Curbside Consultation - American ...

May 1, 2009 - Nonmalignant chronic pain is a common, yet challenging, health problem.1 Numerous factors over the past decade have put primary care physicians in a central role in the management of this pain.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2009/0501/p743.html

When a Patient's Chronic Pain Gets Worse - Curbside Consultation - American Family ...

Jul 1, 2009 - This case encapsulates many of the significant challenges in providing care for patients with chronic noncancer pain.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2009/0701/p77.html

Medical Marijuana: Informational Resources for Family Physicians - Editorials - ...

Oct 15, 2009 - Advertisement << Previous article Next article >> Oct 15, 2009 Issue Editorials Medical Marijuana: Informational Resources for Family Physicians JAMES MacDONALD, MD, FAAFP, University of California Santa Cruz Cowell Student Health Center, Santa Cruz, California Am Fam Physician. 2009...

American Family Physician : Editorials

https://www.aafp.org/afp/2009/1015/p779.html

Patient-Controlled Analgesia for Postoperative Pain - Cochrane for Clinicians - ...

Dec 1, 2007 - Patient-controlled opioid analgesia is safe and provides a statistically significant improvement in analgesia in postoperative patients, but the clinical significance of the improvement is marginal.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2007/1201/p1645.html

Group Medical Visits for the Management of Chronic Pain - FPIN's Clinical Inquiries - ...

Dec 1, 2007 - Improvements of possible practical significance were seen for various clinical measures in studies of group treatment sessions for patients with back pain, arthritis, and rheumatic disease. However, studies on group treatment for patients with nonspecific pain are lacking, especially in...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2007/1201/p1704.html

Practice Guidelines - Sep 15, 2007 - American Family Physician

Sep 15, 2007 - Physicians should consider the increased risks associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and cyclooxygenase-2 (COX-2) inhibitors, according to new guidelines issued by the American Heart Association (AHA).

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2007/0915/p894a.html

Practice Guidelines - Sep 15, 2007 - American Family Physician

Sep 15, 2007 - Patients on dialysis are particularly susceptible to methicillin-resistant Staphylococcus aureus (MRSA) infection. The Centers for Disease Control and Prevention (CDC) reports that patients on dialysis who have invasive devices or a catheter also are at increased risk.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2007/0915/p894.html

Tramadol Relieves Neuropathic Pain - Cochrane for Clinicians - American Family Physician

May 1, 2007 - Tramadol is an effective treatment for neuropathic pain. One out of four patients who take the medication achieves at least 50 percent pain relief.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2007/0501/p1335.html

Treating Opioid Dependency and Coexistent Chronic Nonmalignant Pain - Editorials - ...

Nov 15, 2008 - Advertisement << Previous article Next article >> Nov 15, 2008 Issue Editorials Treating Opioid Dependency and Coexistent Chronic Nonmalignant Pain RICHARD D. BLONDELL, MD, and LISHAM ASHRAFIOUN, BS, State University of New York at Buffalo, Buffalo, New York Am Fam Physician. 2008...

American Family Physician : Editorials

https://www.aafp.org/afp/2008/1115/p1132.html

Are Opioids Effective in the Treatment of Neuropathic Pain? - Cochrane for Clinicians -...

Apr 1, 2007 - Eight to 60 days of opioid therapy for the treatment of neuropathic pain effectively reduces pain scores as measured by a visual analog scale. A lack of response to opioids in the first 24 hours should not be used to predict whether longer-term opioid therapy might be beneficial. There ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2007/0401/p999.html

Pregabalin (Lyrica) for the Management of Pain Associated with Diabetic Neuropathy - ...

Dec 15, 2006 - Pregabalin is safe and effective for the management of neuropathic pain associated with diabetic peripheral neuropathy. Drawbacks include the cost and the lack of studies demonstrating equivalence or superiority to other treatments. However, pregabalin’s ease of dosing titration, ...

American Family Physician : STEPS

https://www.aafp.org/afp/2006/1215/p2093.html

Opioids for Management of Breakthrough Pain in Cancer Patients - Cochrane for ...

Dec 1, 2006 - Oral transmucosal fentanyl citrate (OTFC [Actiq]), a rapid-acting opioid, has been shown to be an effective treatment for breakthrough cancer pain. Other opioids, including immediate-release oral morphine (MSIR), also may be effective; however, evidence comparing these agents with OTFC ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2006/1201/p1855.html

Cochrane for Clinicians - Jul 1, 2006 - American Family Physician

Jul 1, 2006 - Intravenous lidocaine and oral mexiletine provide a modest reduction in neuropathic pain with no indication of serious adverse effects. However, safety data are limited because most studies were of relatively short duration and fewer than 400 patients have been studied in total for each...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2006/0701/p79.html

Cochrane for Clinicians - Jul 1, 2006 - American Family Physician

Jul 1, 2006 - Induction of labor in patients with PROM does not increase the rates of cesarean delivery or operative vaginal delivery. Among patients who are induced there is a slightly lower incidence of chorioamnionitis (relative risk [RR] 0.74; 95% confidence interval [CI], 0.56 to 0.97) and a ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2006/0701/p79a.html

Antidepressants for the Treatment of Neuropathic Pain - Cochrane for Clinicians - ...

Jun 1, 2006 - Tricyclic antidepressants, particularly amitriptyline, are effective for the treatment of painful diabetic neuropathy and post herpetic neuralgia, and may be beneficial in other neuropathic pain syndromes, but they should be used with caution in patients at increased risk of adverse ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2006/0601/p1933.html

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