Created by Gary B. Rollman, Emeritus Professor of Psychology, University of Western Ontario (In addition to links below, see weekly archives in the right column)
Saturday, September 30, 2006
Chronic Pain Anonymous
Thursday, September 28, 2006
Tuesday, September 26, 2006
Is Hysteria Real? Brain Images Say Yes - New York Times
Friday, September 22, 2006
AARP Issues Blog: Art Buchwald on Hospice and Life While Dying (click here)
Chronic Pain Information Page: National Institute of Neurological Disorders and Stroke (NINDS)
NINDS Chronic Pain Information Page
Table of Contents (click to jump to sections)
What is Chronic Pain?
Is there any treatment?
What is the prognosis?
What research is being done?
Organizations
Related NINDS Publications and Information
Additional resources from MEDLINEplus
What is Chronic Pain?
While acute pain is a normal sensation triggered in the nervous system to alert you to possible injury and the need to take care of yourself, chronic pain is different. Chronic pain persists. Pain signals keep firing in the nervous system for weeks, months, even years. There may have been an initial mishap -- sprained back, serious infection, or there may be an ongoing cause of pain -- arthritis, cancer, ear infection, but some people suffer chronic pain in the absence of any past injury or evidence of body damage. Many chronic pain conditions affect older adults. Common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, neurogenic pain (pain resulting from damage to the peripheral nerves or to the central nervous system itself), psychogenic pain (pain not due to past disease or injury or any visible sign of damage inside or outside the nervous system).
Is there any treatment?
Medications, acupuncture, local electrical stimulation, and brain stimulation, as well as surgery, are some treatments for chronic pain. Some physicians use placebos, which in some cases has resulted in a lessening or elimination of pain. Psychotherapy, relaxation and medication therapies, biofeedback, and behavior modification may also be employed to treat chronic pain.
What is the prognosis?
Many people with chronic pain can be helped if they understand all the causes of pain and the many and varied steps that can be taken to undo what chronic pain has done. Scientists believe that advances in neuroscience will lead to more and better treatments for chronic pain in the years to come.
What research is being done?
Clinical investigators have tested chronic pain patients and found that they often have lower-than-normal levels of endorphins in their spinal fluid. Investigations of acupuncture include wiring the needles to stimulate nerve endings electrically (electroacupuncture), which some researchers believe activates endorphin systems. Other experiments with acupuncture have shown that there are higher levels of endorphins in cerebrospinal fluid following acupuncture. Investigators are studying the effect of stress on the experience of chronic pain. Chemists are synthesizing new analgesics and discovering painkilling virtues in drugs not normally prescribed for pain.
Select this link to view a list of studies currently seeking patients.
Organizations
National Institute of Dental and Craniofacial Research (NIDCR) National Institutes of Health, DHHS 31 Center Drive, Room 5B-55 Bethesda, MD 20892 Tel: 301-496-4261 | American Chronic Pain Association (ACPA) P.O. Box 850 Rocklin, CA 95677-0850 Tel: 916-632-0922 800-533-3231 Fax: 916-632-3208 |
American Council for Headache Education 19 Mantua Road Mt. Royal, NJ 08061 Tel: 856-423-0258 800-255-ACHE (255-2243) Fax: 856-423-0082 | National Headache Foundation 820 N. Orleans Suite 217 Chicago, IL 60610-3132 Tel: 312-274-2650 888-NHF-5552 (643-5552) Fax: 312-640-9049 |
National Foundation for the Treatment of Pain P.O. Box 70045 Houston, TX 77270 Tel: 713-862-9332 Fax: 713-862-9346 | Mayday Fund [For Pain Research] c/o SPG 136 West 21st Street, 6th Floor New York, NY 10011 Tel: 212-366-6970 Fax: 212-366-6979 |
American Pain Foundation 201 North Charles Street Suite 710 Baltimore, MD 21201-4111 Tel: 888-615-PAIN (7246) Fax: 410-385-1832 | Arthritis Foundation 1330 West Peachtree Street Suite 100 Atlanta, GA 30309 Tel: 800-568-4045 404-872-7100 404-965-7888 Fax: 404-872-0457 |
University of Michigan Health System: Pain Management
Tuesday, September 19, 2006
The mesmerizing ad for HeadOn (click here for video)
Saturday, September 16, 2006
The Sting of Ignorance - New York Times
LATE on a summer afternoon not long ago, the water at Lucy Vincent Beach on Martha’s Vineyard was warm, and the toxic jellyfish that had plagued bathers weeks earlier had floated out to sea. Body-surfing in on my last wave, I suddenly felt as if someone had whacked my leg with a lead pipe studded with nails. On the 1-to-10 pain scale we use with patients, I would have called it a 14. When I rubbed the area with my hand, my whole palm stung. Apparently those toxic jellyfish hadn’t all left.
A crowd of passers-by gathered to offer tips from the tainted well of conventional wisdom. “Use ammonia.” “Rub in some meat tenderizer.” “Apply vinegar.”
Soon a small army of bronzed youths in official-looking tank tops arrived carrying enormous medical kits. One poured sterile water on the sting area; another rubbed it with an ice pack. A third worked an alcohol-based anesthetic into the wound. Each treatment made the pain worse.
Eventually our group attracted the attention of a nurse strolling down the beach. A year-round Vineyard resident, she had seen her share of vacation-related medical emergencies. “You’ve removed the tentacle, haven’t you?” she asked matter-of-factly. No one, including the medical-professor patient, had thought of this. She took a piece of gauze and pulled off a slimy, transparent string laced with neurotoxins. It had continued to send those toxins into my leg for the first 20 minutes of my care. They are particularly activated, I would later learn, by distilled water, by mechanical pressure (as from an ice pack), and by alcohol-based topical medicines — all the treatments I had so earnestly been given.
Now the pain began to abate. I drove home and reached for three of the most useful medicines I know: aspirin, acetaminophen (Tylenol) and the Internet.
Friday, September 15, 2006
Buried alive in your own skull. By William Saletan - Slate Magazine (click)
Something was awake inside that woman's skull. Without the scanner, no one but her would have known."
Seniors face much higher risk from drug mistakes (click)
Experts like Dr. Richard London in Milwaukee say the findings show that 'people with multiple health problems need to have a physician who is the quarterback.'
In the study, errors were flagged when a patient was prescribed a drug that was incompatible with medicines already being taken; when a drug could exacerbate another medical condition; or when an incorrect dosage was prescribed, said Dr. Glen Stettin, a Medco senior vice president.
'Clearly, the more medications you take, the more potential there is for them interacting with each other,' Stettin said. 'With more physicians providing care to patients, more prescriptions are being written -- however, there is clearly a communication breakdown between prescribers.'"
POZEN Pharmaceutical Development Company (click)
POZEN Pharmaceutical Development Company
Prawfsblawg
http://prawfsblawg.blogs.com/prawfsblawg/2006/09/stuntz_brings_t.html
Thursday, September 14, 2006
ISI Web of Science 6 -- Tutorial
Welcome to the Web of Science version 6.0 tutorial. This tutorial will give you an overview of Web of Science and tips on searching its databases. It will also introduce you to the new Structure Search, which may or may not be available at your institution.
Use the table of contents in the upper right-hand corner or the previous/next arrows at the bottom of the page to move through the tutorial.
Wednesday, September 13, 2006
Seminars in Fetal and Neonatal Medicine - August 2006
1. | Title Page/Aims and Scope/Editorial Board • EDITORIAL BOARD PDF (32 K) |
2. | Pain control and sedation • EDITORIAL D. Tibboel and Rama Bhat SummaryPlus | Full Text + Links | PDF (59 K) |
3. | Pain perception development and maturation • ARTICLE Sinno H.P. Simons and Dick Tibboel SummaryPlus | Full Text + Links | PDF (153 K) |
4. | Fetal pain perception and pain management • ARTICLE Marc Van de Velde, Jacques Jani, Frederik De Buck and J. Deprest SummaryPlus | Full Text + Links | PDF (105 K) |
5. | Pain assessment: Current status and challenges • ARTICLE Pat Hummel and Monique van Dijk SummaryPlus | Full Text + Links | PDF (183 K) |
6. | Non-pharmacological pain relief • ARTICLE Andrew Leslie and Neil Marlow SummaryPlus | Full Text + Links | PDF (105 K) |
7. | Pain control: Non-steroidal anti-inflammatory agents • ARTICLE Evelyne Jacqz-Aigrain and Brian J. Anderson SummaryPlus | Full Text + Links | PDF (208 K) |
8. | Pain control: Opioid dosing, population kinetics and side-effects • ARTICLE Sinno H.P. Simons and K.J.S. Anand SummaryPlus | Full Text + Links | PDF (187 K) |
9. | Long-term consequences of pain in human neonates • ARTICLE Ruth E. Grunau, Liisa Holsti and Jeroen W.B. Peters SummaryPlus | Full Text + Links | PDF (153 K) |
Tuesday, September 12, 2006
Medical Education Resource Catalog
Monday, September 11, 2006
Law and the Problem of Pain: University of Cincinnati Law Review, 2005
Sunday, September 10, 2006
The Doctor of Last Resort - New York Times
Dr. David Podell entered the exam room and introduced himself to the patient. He knew this middle-aged woman was depending on him to finally solve the mystery of her illness. She had already been to three doctors, and none had any answers for her. In such cases, when the patient has already seen other doctors before arriving at your door, you need to approach the case with a different mind-set — with different assumptions. You know, for example, that whatever this patient has, it isn’t going to be obvious. Maybe it’s an unusual disease, known best by specialists, or perhaps it’s an unusual presentation of a more common illness. In any case, it won’t be routine.
The woman spoke in a slow, husky vibrato. “I can remember clear as day when it all began,” she said. “It was just over a year ago. I woke up and felt like my legs were on fire.” She had always been healthy, but that morning the pain had been so severe that she could hardly walk. And she had felt weak — especially in her left leg.
The cough started a few weeks later, she told him. At first it was a dry cough. Then she started to bring up blood. Recently she felt out of breath with even slight exertion.This morning, she had to stop and rest during the short walk from the parking lot to his office.
She had seen her internist throughout all this. He sent her to a neurologist for the burning and weakness and then a pulmonologist when the cough appeared. Despite their best efforts, the pain, weakness and shortness of breath persisted. She had been through dozens of tests and scans and a couple of courses of antibiotics, but the specialists were no more successful than her own doctor.
Finally her internist sent her to Podell, a rheumatologist. Such doctors, specialists in diseases of the connective tissue, are often a last resort when patients develop symptoms involving different systems and a diagnosis is elusive. Because connective tissues are found throughout the body, complex, multisystem illnesses are the rheumatologists’ bread and butter.
NYT: At $9.95 a Page, You Expected Poetry?
The Web site for an outfit called Term Paper Relief features a picture of a young college student chewing her lip.
“Damn!” a little comic-strip balloon says. “I’ll have to cancel my Saturday night date to finish my term paper before the Monday deadline.”
Well, no, she won’t — not if she’s enterprising enough to enlist Term Paper Relief to write it for her. For $9.95 a page she can obtain an “A-grade” paper that is fashioned to order and “completely non-plagiarized.” This last detail is important. Thanks to search engines like Google, college instructors have become adept at spotting those shop-worn, downloadable papers that circulate freely on the Web, and can even finger passages that have been ripped off from standard texts and reference works.
Saturday, September 09, 2006
Thursday, September 07, 2006
Pain Research and Management, Autumn 2006 (click here)
Whiplash can have lesions
Nikolai Bogduk
Introduction: Pain in children
G Allen Finley
Children’s self-reports of pain intensity: Scale selection, limitations and interpretation
Carl L von Baeyer
Self-report measures, such as faces scales, visual analogue scales and numerical scales, are often underutilized in assessing children’s pain. They can be used in conjunction with observer reports of pain and can provide a valuable indication of treatment outcome in both clinical and research contexts, although interpretation may be complex. Desirable features of pediatric pain intensity scales are outlined, and several instruments are recommended for clinical use.
Ensuring pain relief for children at the end of life
Marie-Claude Grégoire, Gerri Frager
Pediatric palliative care is defined as the active and total approach to care, embracing physical, psychological and spiritual elements, focusing on enhancement of quality of life for the child and support for the family. It is not limited to end-of-life or terminal care but rather has a broader, more inclusive approach and integrates palliative care concurrently with curative-oriented goals. This article focuses on the management of pain at the end of life, which may extend from days to months. The understanding necessary within the team to ensure excellence when caring for infants, children and adolescents at the end of life is highlighted.
Innovative approaches to neuraxial blockade in children: The introduction of epidural nerve root stimulation and ultrasound guidance for epidural catheter placement
Ban CH Tsui
Pediatric epidural anesthesia has many benefits when used for perioperative analgesia, although techniques to ensure precise catheter placement are crucial. Maximum therapeutic potential with minimal medication dosage is important with pediatric patients. Innovative techniques for guiding and confirming placement of catheters include electrical epidural stimulation and bedside ultrasound. This article provides a brief and focused review of these techniques and highlights the relevant clinical experiences to date.
A survey of the pain experienced by males and females with Fabry disease
Andrea L Gibas, Regan Klatt, Jack Johnson, Joe TR Clarke, Joel Katz
Fabry disease is a rare, multisystemic disease marked by neuropathic pain. Males reportedly suffer extensively, whereas females are asymptomatic or mildly afflicted. However, in this study, Fabry disease pain produced comparable distress and impairment in both sexes. Additionally, females were diagnosed later in life than were males, and unlike males, they did not exhibit a decline in pain intensity with disease duration. Satisfaction with physician pain assessments was moderate, although to a lesser degree for female patients. Fabry disease females may be triply disadvantaged in the health care system due to devalued carrier status, sex and disease rarity.
Infrared therapy for chronic low back pain: A randomized, controlled trial
George D Gale, Peter J Rothbart, Ye Li
The objective of the present study was to assess the degree of pain relief obtained by applying infrared (IR) energy to the low back in patients with chronic, intractable low back pain. Forty patients with chronic low back pain of over six years’ duration were recruited from patients attending the Rothbart Pain Management Clinic, North York, Ontario. They came from the patient lists of three physicians at the clinic, and were randomly assigned to IR therapy or placebo treatment. The principle measure of outcome was pain rated on the numerical rating scale (NRS). The pain was assessed overall, then rotating and bending in different directions. The mean NRS scores in the treatment group fell showed a greater reduction than the NRS scores of the placebo group. It was concluded that the IR therapy unit used was effective in reducing chronic low back pain, and no adverse effects were observed.
Whiplash injuries can be visible by functional magnetic resonance imaging
Bengt H Johansson
Whiplash trauma can result in injuries that are difficult to diagnose. Diagnosis is particularly difficult in injuries to the upper segments of the cervical spine (craniocervical joint complex). Studies indicate that injuries in that region may be responsible for the cervicoencephalic syndrome with headache, balance problems, vertigo, dizziness, eye problems, tinnitus, poor concentration, sensitivity to light and pronounced fatigue. Consequently, diagnosis of lesions in the craniocervical joint complex region is important. Functional magnetic resonance imaging is a radiological technique that can visualize injuries of the ligaments and the joist capsules, and accompanying pathological movement patterns.
Psychology Wiki
Wednesday, September 06, 2006
The Psychological Management of Chronic Pain by William W. Deardorff, Ph.D.
Learning Objectives
This is a beginning to intermediate level course. After taking this course, mental health professionals will be able to:
- Discuss current theories of pain
- Utilize a model for understanding and treating chronic pain
- Discuss psychological factors that affect acute and chronic pain
- Use the following assessment tools in your evaluation: clinical interview, questionnaires, diaries, psychological tests, archival data
- Write a thorough report of a pain management evaluation using the forms included in this course
- Design a chronic pain reconditioning program using principles discussed in this course