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Medicine by the numbers

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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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Carbamazepine for Acute and Chronic Pain - Cochrane for Clinicians - American Family ...

May 1, 2006 - Two small trials have shown carbamazepine to be beneficial in the treatment of diabetic neuropathic pain. Carbamazepine shows similar clinical effect to gabapentin (Neurontin) and phenytoin (Dilantin), but there have been no head-to-head trials directly comparing these drugs. ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2006/0501/p1549.html

Cutting Back on High-Dosage Narcotics - Curbside Consultation - American Family Physician

Mar 1, 2004 - Over the past decade, the promotion of narcotics for control of malignant and non-malignant pain has been advocated by specialists in the pain community. While most physicians accept the use of aggressive narcotic analgesia in patients with cancer-related pain, the use of opioids in ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2004/0301/p1313.html

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

Feb 1, 2006 - Combined with methotrexate, subcutaneous adalimumab at a dosage of 40 mg every two weeks slows the progression of rheumatoid arthritis at one year. The combination is more effective than adalimumab monotherapy. Limited evidence suggests that adalimumab is also safe and effective when ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2006/0201/p435a.html

Preemptive Analgesia: Decreasing Pain Before It Starts - Editorials - American Family ...

May 15, 2001 - ...Physicians have a poor track record for relieving pain. A deplorably large number of studies during the past few decades document our persistent failure to adequately relieve pain in many patients, particularly in those undergoing surgery and those with cancer-related pain. There...

American Family Physician : Editorials

https://www.aafp.org/afp/2001/0515/p1924.html

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