How medical screenings cause harm. - By Darshak Sanghavi - Slate Magazine

The truth is that screening tests are just like any other drug or medical procedure, with potentially deadly risks that must be balanced with the potential benefits. The same people who would agonize over the decision to take estrogen-replacement therapy, for example, don't think twice before getting a mammogram. However, as the data indicate, they sometimes should. Screening tests can cause harm in two major ways: false-positive diagnoses and unnecessary treatment of benign conditions. Unfortunately, these problems can be masked because a little-known but vital error pervades almost every major study involving screening for deadly diseases, especially cancers—and makes the tests appear better than they really are.

http://www.slate.com/id/2154563/fr/nl/

Rehabilitation- and Research Centre for Torture Victims

A world without torture and other forms of organised violence

Objectives RCT's work is basically founded on the respect for human rights and the dignity and integrity of each individual. Therefore, it is RCT's proclaimed objective to help alleviate the human suffering resulting from torture – both for the individual, the family members and the community. RCT also aims at preventing torture. RCT seeks to achieve this aim by altering the mechanisms resulting in torture in each country. By preventing torture, we also ensure respect for human rights, social justice and a development towards a society without human suffering.

 

The objectives are:

• to expose and document torture on a health professional basis
• to develop clinical diagnoses and treatment methods of torture survivors on the basis of systematic examination of the torture survivors and research into torture and organised violence
• to apply the experiences thus achieved in the education and advocacy in order to contribute to the global effort to abolish torture.

RCT aims at achieving the three objectives by:

• running a centre that undertakes clinical research and method development in order to provide knowledge on torture and the form and extent of the after-effects of torture as well as treats and rehabilitates persons who have been subjected to torture
• conducting education and advocacy in order to promote knowledge of the reasons for torture, conventions and laws, treatment methods and prevention of torture
• carrying out project work in the South in co-operation with centres and programmes aiming at treating and rehabilitating torture survivors and preventing torture

http://www.torture.dk/About_RCT/Vision.aspx

Annual Report, 2005:

http://www.torture.dk/upload/files/rctannualreport2005.pdf

International links:

http://www.torture.dk/About_RCT/Links/International_sites.aspx

BBC NEWS | Health | 'Only surgery can cure my headache'

Until three years ago teacher Barbara Cullen was fit and healthy, spending most of her leisure time outdoors pursuing various hobbies which included a passion for surfing.

Suddenly out of the blue she started getting severe headaches.

As they first began around Christmas time she wondered if it was due to yuletide excess, but the headaches became more and more severe. All her husband Fred could do was to sit and watch.

"To actually watch somebody holding their head in their hands and then getting down on their knees on the floor and literally shaking, you think this is not a normal headache," he said.

= = =

At the National Barbara's headaches were diagnosed as cluster headaches.

The pain they cause is thought to be ten times worse than childbirth - they have been nicknamed suicide headaches because of the excruciating pain - like being stabbed in the head with a needle.

Barbara's only chance of getting rid of the pain was to have an operation to implant an occipital nerve stimulator into the back of her head.

= = =

In consultation with Barbara, Mr Watkins had to explain that the operation was relatively new and that he could not predict the outcome.

My impression is that it seems to work in about two out of three people. Of course there is always a slight unknown with something that hasn't been around for a long time.

"We're only really doing it with patients who have chronic headache continuously and where nothing else has worked."

Barbara's operation involved planting two electrodes near the occipital nerves which run up the back of her head, through an incision in the skin in her neck.

The electrodes were then connected to a stimulator - a little like a pacemaker - which was implanted in her abdomen.

http://news.bbc.co.uk/2/hi/health/6170246.stm

Is Surgery Best Way To Stop Back Pain?, New Major Study Suggests Sometimes People Are Too Quick With Procedure - CBS News

The herniated disc, or bulge, can press on the nerves in the spine, causing pain. Some people can tolerate the pain with physical therapy, medications and steroid injections. But others choose surgery to remove that bulge that causes the pain. 

In an effort to determine which approach is best, Dr. Weinstein's launched a major study of over 1,200 patients with back pain. He says he thinks that sometimes people are too quick with surgery. "I think that it be important for people to have good information," he adds. 

Whether you have surgery often depends on where you live and what doctor you see. Earlier studies show that a patient is 20 times more likely to have surgery in Idaho Falls, Missoula and Mason City, as compared to Newark, Bangor and Terre Haute. 

"It is so interesting that geography is destiny," Dr. Weinstein says. "It's not rational." 

But no matter where you live, surgery is not necessarily the best or only option. In fact, Dr. Weinstein's findings, released today in the Journal of the American Medical Association, conclude that surgery is only slightly more effective in some cases than a non-surgical approach. 

http://www.cbsnews.com/stories/2006/11/21/eveningnews/main2204297.shtml

Health Disparities Persist for Men, and Doctors Ask Why - New York Times

Statistics show that men are more likely than women to suffer an early death.

Now some advocates and medical scientists are beginning to ask a question that in some circles might be considered politically incorrect: Is men’s health getting short shrift?

The idea, they say, is not to denigrate the importance of women’s health but to focus public attention on the ways in which men may be uniquely at risk — and on what a growing men’s health movement has termed the “health disparity” between the sexes and its most glaring example, a persistent longevity gap that has narrowed but still shortchanges men of five years of life compared with women.

“We’ve got men dying at higher rates of just about every disease, and we don’t know why,” said Dr. Demetrius J. Porche, an associate dean at Louisiana State University’s Health Sciences Center School of Nursing in New Orleans, and the editor of a new quarterly, American Journal of Men’s Health, that will publish its first issue next March.

http://www.nytimes.com/2006/11/14/health/14men.html?ex=1321160400&en=1668bba63d9e835d&ei=5090&partner=rssuserland&emc=rss

Study: Botox shots could help ease knee pain in osteoarthritis patients

Those who suffer from severe knee pain may be able to get relief from Botox shots, suggests new research presented at the American College of Rheumatology's annual meeting this week in Washington.

Researchers at the University of Minnesota say the neurotoxin, widely known for its wrinkle-smoothing capabilities, may also be used to treat patients with severe to moderate osteoarthritis.

Some of the 37 patients involved in the six-month study were injected with Botox, while others were injected with a placebo.

After one month, the patients treated with Botox who suffered from severe pain showed a 28 per cent decrease in pain and a 25 per cent improvement in function. But the study found the injections had little effect on those with moderate pain. Two members of the placebo group dropped out of the study from lack of benefit at the end of the first month.

There will be a three-month assessment of the treatment in January and the trial is due to be completed in August.

http://www.cbc.ca/cp/health/061115/x111502A.html

Fatigue in women is reduced in stress-related cortisol study

That low cortisol levels are found in such maladies as chronic fatigue syndrome, post-traumatic stress disorder, fibromyalgia and atypical depression is not new. However, the study, published in the November issue of Psychophysiology, combined with other findings emerging from a comprehensive project, appear to support the idea that sex hormones tend to separate men from women in their reactions to stress, said Mattie Tops, a postdoctoral research associate in the NeuroInformatics Center at the University of Oregon. 

The study is the first to demonstrate improvements in fatigue and vigor in healthy female subjects, a finding that "is particularly relevant because of the high prevalence of hypocortisolemic fatigue syndromes in women and the association in healthy women between low morning cortisol levels and complaints of fatigue and muscular pain," Tops and his colleagues wrote in their conclusion. 

http://www.physorg.com/news82647908.html

Optimum Management of Pre-amputation Pain Eliminates Phantom Pain at 6 Months

Patients scheduled for lower extremity amputation who receive optimum pain management before, during, and after surgery are unlikely to experience prolonged phantom limb pain.

Patients on optimized analgesia had lower scores on the Phantom pain Visual Analog Scale (VAS) and the Pain Rating Index - Affective (PRI) at all time points compared with controls. This effect was most pronounced in the group receiving preoperative epidural analgesia (group 1, P < .05) at 1 and 6 months.

At 6 months none of the 8 patients in group 1 had phantom pain, compared with 71% of 7 in group 5 (P < .007). There was no significant stump pain at 6 months in any group.

http://www.docguide.com/news/content.nsf/news/852571020057CCF685257209004BB7DD

Antioxidants New Kid On The Block For Pain Relief

Antioxidant-based pain killers may one day become a viable alternative to addictive medications such as morphine. Researchers found that synthetic antioxidants practically eradicated pain-like behavior in nearly three-quarters of mice with inflamed hind paws.

“When it comes to pain killers, there aren't many choices between over-the-counter pain relievers like ibuprofen and aspirin and prescription opiates like morphine,” said Robert Stephens, a professor of physiology and cell biology at Ohio State University. He's the lead author of a study examining the effects of antioxidants as pain killers. 

“We need drugs that fall somewhere between these two extremes,” Stephens said. “Someone suffering from chronic pain can become dependent on, or even addicted to, heavy-duty pain killers like morphine.” 

http://www.physorg.com/news82136238.html

Betty

New painkiller draws mixed reviews from doctors

New painkiller draws mixed reviews from doctors (11-13-06)

The first published studies of Arcoxia, the drug that Merck & Co. hopes will take the place of its withdrawn painkiller Vioxx, are getting mixed reviews from doctors, some of whom say the results do not make a case for the medication's approval.

The critics cite not just Arcoxia's side effects but also that Merck tested it against diclofenac, an older painkiller known to raise heart risks. A fairer comparison would have been to a medicine that does not do that, such as naproxen, sold as Aleve, they say.

"The development program for Arcoxia is fatally flawed," said Dr. Steven Nissen, a Cleveland Clinic cardiologist who formerly headed the Food and Drug Administration's cardiac drug advisory panel. "My advice to the FDA is that they should not approve this drug."

Dr. David Graham, an FDA drug safety expert who has criticized his agency's handling of Vioxx, agreed.

"It's my own suspicion that this study was intentionally designed to minimize the possibility of their having a repeat of what happened with VIGOR," the study that revealed Vioxx's heart risks, he said.

http://www.chron.com/disp/story.mpl/headline/nation/4330749.html

Also:

Chronology of events surrounding Vioxx, other painkillers (08-19-05)

http://www.chron.com/disp/story.mpl/side2/3317940.html

Vioxx jury awards widow $253 million (08-20-05)

http://www.chron.com/disp/story.mpl/metropolitan/3318293.html

Merck Wins Latest Vioxx Suit (11-15-06)

http://www.chron.com/disp/story.mpl/ap/fn/4338836.html

Prevention and management of pain in the neonate: An update (American Academy of Pediatrics)

The prevention of pain in neonates should be the goal of all caregivers, because repeated painful exposures have the potential for deleterious consequences. Neonates at greatest risk of neurodevelopmental impairment as a result of preterm birth (ie, the smallest and sickest) are also those most likely to be exposed to the greatest number of painful stimuli in the NICU. Although there are major gaps in our knowledge regarding the most effective way to prevent and relieve pain in neonates, proven and safe therapies are currently underused for routine minor yet painful procedures. Every health care facility caring for neonates should implement an effective pain-prevention program, which includes strategies for routinely assessing pain, minimizing the number of painful procedures performed, effectively using pharmacologic and nonpharmacologic therapies for the prevention of pain associated with routine minor procedures, and eliminating pain associated with surgery and other major procedures.

http://aappolicy.aappublications.org/cgi/reprint/pediatrics;118/5/2231.pdf

ACTION Atlantic - For People with Chronic Pain

Chronic pain affects one in five Canadians. Here in Atlantic Canada, this means almost 500,000 people are suffering. They often can't get the help they need – leaving many in constant, excruciating, dehabilitating pain. Are you one of them?

• Are you waiting months or years to get medical help from a pain specialist?
• Are you having trouble getting the medications you need?
• Are you unable to access proper care that addresses all aspects of your pain?
• Have your tried everything and still can't find help?

You are not alone. Don't suffer in silence. Share Your Story with fellow pain sufferers. And take action – use our simple interactive tool to write a letter to your MLA or MHA demanding improvements in pain care now!

What is the problem?

1. Lack of services and treatment options. Depending on where you live you might not be able to get the help you need for Chronic Pain in our region.
2. Waiting lists for pain clinics and specialized pain doctors in Atlantic Canada are as long as five years. People are suffering needlessly.
3. Many politicians and members of the public are not aware of this issue and the toll it takes on Atlantic Canadians. Pain is a silent epidemic.

What is the solution?

1. Provincial governments need to provide more funding and resources to reduce waiting lists for Chronic Pain treatment in Atlantic Canada and improve access to care.
2. Provincial governments need to establish a special billing fee code in each province that pays doctors a special rate for treating and managing chronic pain. This will encourage better treatment and more specialization and education of doctors in treating Chronic Pain.
3. Provincial governments, medical schools, patients and healthcare professionals need to work together to create education programs to improve the tools, resources and skills of family doctors and pain patients in Atlantic Canada.
4. e all need to work together to make chronic pain a key health issue in Atlantic Canada for decision-makers and the public.

http://www.paincantwait.ca/take_action.php

Canadian Pain Coalition

The Canadian Pain Coalition is a Partnership of patient pain groups, health professionals who care for people in pain, and scientists studying better ways of treating pain. This partnership began in May 2002 as an initiative of the Canadian Pain Society, which remains an active partner.

Our Purpose is to promote sustained improvement in the treatment of all types of pain through:

• Developing educational programs for the public
• Informing government about the needs of the pain community
• Increasing media coverage of pain

http://www.canadianpaincoalition.ca/

Natural painkiller found in human spit - Compound in saliva could be more powerful than morphine.

A new painkilling substance has been discovered that is up to six times more potent than morphine when tested in rats — and it's produced naturally by the human body. Natural painkillers are very rare, and researchers hope that this recent find might be harnessed as a clinical treatment.

Naturally produced painkillers might help to avoid some of the side effects experienced by patients treated with synthetic compounds such as morphine, including addiction and tolerance with prolonged use. But the new substance will first have to be tested to confirm whether it will be an effective drug, experts warn.

The compound, dubbed opiorphin, seems to work by prolonging the body's own defences against pain, explain Catherine Rougeot of the Pasteur Institute in Paris, France, and her colleagues, who report the discovery in Proceedings of the National Academy of Sciences. It does so by preventing the breakdown of chemicals called enkephalins, which in turn activate opiate receptors that block pain signals from reaching the brain. 

Rougeot's team tracked down the new compound after previously finding a similar natural painkiller in rats, called sialorphin. They wondered whether humans might produce something similar — and by analysing saliva samples, hit upon opiorphin. 

This is the first natural substance to be found in humans that exploits this mechanism to relieve pain. But it's unlikely that opiorphin ordinarily has a painkilling role in the body, says Alistair Corbett, a specialist on opioids at Glasgow Caledonian University, UK. The substance could play a general role in protecting chemicals in the body from being broken down, he says. 

http://www.nature.com/news/2006/061113/full/061113-4.html

Scientists use pixels to ease amputees' pain

Scientists use pixels to ease amputees' pain

Academics from the School of Computer Science and School of Psychological Sciences have developed a virtual reality system, which gives the illusion that a person's amputated limb is still there.

The computer system created by Dr Stephen Pettifer and Toby Howard of the School of Computer Science, immerses patients into a life-size virtual reality world.

By putting on a headset, patients will see themselves with two limbs. They can use their remaining physical limb to control the movements of a computer-generated limb, which appears in the 3D computer-generated world in the space of their amputated limb.

So for example, they can use their physical right arm to control the movement of their virtual left arm.

Patients have complex hand-eye coordination and can move their fingers, hands, arms, feet and legs. They can also use their virtual limb to play ball games.

Phantom limb pain or PLP is discomfort felt by a person in a limb that is missing due to amputation. Previous research has found that when a person's brain is 'tricked' into believing they can see and move a 'phantom limb', pain can decrease.

So far, five patients living in the Manchester area – including one who has suffered from PLP for 40 years – have used the virtual reality system over several weeks in a small-scale study.

But this initial project has produced startling results, with four out of the five patients reporting improvement in their phantom limb pain. Some improvements were almost immediate.

The Manchester team's findings were recently presented at a major conference in Denmark on the use of virtual reality for rehabilitation.

Dr Stephen Pettifer, of the School of Computer Science said: "Most people know about 3D graphics and virtual reality from their use in the entertainment industry, in computer games and special effects in films.

"It's very satisfying being able apply the same technology to something that may have a real positive impact on someone's health and well being."

Project leader, Dr Craig Murray of the School of Psychological Sciences, said "Many people who undergo an amputation experience a phantom limb. These are often very painful for the person concerned. They can persist for many years, and are very difficult to treat.

"One patient felt that the fingers of her amputated hand were continually clenched into her palm, which was very painful for her. However, after just one session using the virtual system she began to feel movement in her fingers and the pain began to ease."

Each participant used the system between seven and 10 times over the course of two to three months. Sessions lasted around 30 minutes and involved putting on a special virtual reality headset.

Upper-limb amputees were fitted with a special data glove and had sensors attached to the elbow and wrist joints. Sensors were fitted to the knee and ankle joints of lower-limb amputees. Head and arm movements were also monitored.

The three men and two women who took part in the study were aged between 56 and 65. The group included three arm amputees and two leg amputees, who had lost limbs between one and 40 years ago.

The University of Manchester research team hopes to include a larger number of patients in their future work in order to identify those most likely to benefit from the virtual reality system they have developed.

###

For more information about the University of Manchester project see http://aig.cs.man.ac.uk/research/phantomlimb/phantomlimb.php

For more information about the International Conference Series On Disability, Virtual Reality And Associated Technologies in Denmark see http://www.icdvrat.reading.ac.uk

http://www.eurekalert.org/pub_releases/2006-11/uom-sup111406.php

A New Target for Painkillers

Nov. 13, 2006 -- A brand new approach to treating severe nerve pain – by aiming drugs at a previously unrecognized molecular target – has been discovered by University of Utah scientists who study the venoms of deadly, sea-dwelling cone snails.

"We found a new way to treat a chronic and debilitating form of pain suffered by hundreds of millions of people on Earth," says J. Michael McIntosh, a University of Utah research professor of biology, and research director and professor in the Department of Psychiatry. "It is a previously unrecognized mechanism for treating pain."

The findings are being published the week of Nov. 13 in the online edition of the journal Proceedings of the National Academy of Sciences.

The study in rats found that cone snail toxins named RgIA and Vc1.1 can treat nerve hypersensitivity and pain by blocking a molecule in cells known as the "alpha9alpha10 nicotinic acetylcholine receptor."

http://www.unews.utah.edu/p/?r=103106-1

Wall and Melzack's Textbook of Pain Online

Welcome to www.textbookofpain.com - the dynamic online version
of Wall and Melzack's Textbook of Pain, 5th Edition

Edited by Stephen McMahon, PhD & Martin Koltzenburg, MD FRCP

One of the very first references to address pain management in an authoritative and comprehensive fashion, Wall and Melzack's Textbook of Pain is now radically transformed to provide today's most advanced guidance in the field!

More than 125 leading experts document all of the very latest information on the neurophysiology, psychology, and assessment of every type of pain syndrome, and describe today's full range of pharmacologic, surgical, electrostimulative, physiotherapeutic, and psychological management options.

http://www.textbookofpain.com/toc.cfm

Agency for Healthcare Research and Quality: Effective Health Care for arthritis and non-traumatic joint disorders

Arthritis and non-traumatic joint disorders

Key Questions

1. What is the evidence for benefits and harms of treating osteoarthritis with oral medication(s)? How do these benefits and harms change with dosage and duration of treatment, and what is the evidence that alternative dosage strategies, such as intermittent dosing and drug holidays, affect the benefits and harms of oral medication use?

2. Are there clinically important differences in the harms and benefits of oral treatments for osteoarthritis for certain demographic and clinical subgroups? (Demographic subgroups include age, sex, and race; Co-existing diseases include hypertension, edema, ischemic heart disease, heart failure; PUD; history of previous bleeding due to NSAIDS; Concomitant medication use includes anticoagulants).

3. What is the evidence that the gastrointestinal harms of NSAID use are reduced by co-prescribing of H2-antagonists, misoprostol, or proton pump inhibitors?

4. What are the benefits and safety of treating osteoarthritis with oral medications as compared with topical preparations?

http://effectivehealthcare.ahrq.gov/synthesize/reports/final.cfm?Document=10&Topic=31

EndLink-Resource for End of Life Care Education (Northwestern University)

Purpose of the Site

EndLink was developed as an educational resource for people involved in end-of-life care. Rather than providing answers, we attempt here to offer frameworks for thinking about caring for dying individuals and their families.

Read More

What You Will Find Here

The content of the site was written primarily for health care professionals who work with dying patients and their families. The material presented on the site encompasses the complex, multidimensional considerations involved in caring for individuals at the end of life.

Read More

How to Use the Site

EndLink contains a vast amount of information compared to many Internet sites. In order to improve the usability of the site, we have organized the material into modules, each including four sections: What, Why, How and Resources.

Read More

http://endlink.lurie.northwestern.edu/index.cfm

Downloadable Documents

http://endlink.lurie.northwestern.edu/downloads.cfm

Doctors using Google to diagnose illnesses | the Daily Mail

Doctors using Google to diagnose illnesses

The internet search engine Google has added another impressive string to its bow - by helping doctors diagnose illnesses, according to a new study.

Researchers found that almost six-in-10 difficult cases can be solved by using the world wide web as a diagnostic aid.

Doctors fight disease by carrying about two million facts in their heads but with medical knowledge expanding rapidly, even this may not be enough.

Misdiagnosis is still a common occurrence in the medical profession despite all the tools available such as the blood tests and state of the art scanning equipment.

Studies of autopsies have shown doctors seriously misdiagnose fatal illnesses about 20 per cent of the time.

So millions of patients are being treated for the wrong disease. And the more astonishing fact may be that the rate has not really changed since the 1930s.

So a team at the Princess Alexandra Hospital in Brisbane identified 26 difficult diagnostic cases published in the New England Journal of Medicine last year, including obscure conditions such as Cushing's syndrome and Creutzfeldt-Jakob disease.

They selected three to five search terms from each case and did a Google search while blind to the correct diagnoses. Google gives users quick access to more than three billion medical articles.

The researchers then selected and recorded the three diagnoses that were ranked most prominently and appeared to fit the symptoms and signs, and compared the results with the correct diagnoses as published in the journal.

Google searches found the correct diagnosis in 15 (58 per cent) of cases. Respiratory and sleep physician Dr Hangwi Tang, who led the study, said: "Doctors adept at using the internet use Google to help them diagnose difficult cases.

"As described in the New England Journal of Medicine, a doctor astonished her colleagues including an eminent professor by correctly diagnosing IPEX (immunodeficiency, polyendocrinopathy, enteropathy, X linked) syndrome.

She admitted that the diagnosis 'popped right out' after she entered the salient features into Google."

The researchers, whose findings are published online by the British Medical Journal, suggest Google is likely to be a useful aid for conditions with unique symptoms and signs that can easily be used as search terms.

But they stress the efficiency of the search and the usefulness of the retrieved information depend on the searchers' knowledge base.

Dr Tang added: "Doctors and patients are increasing proficient with the internet and frequently use Google to search for medical information.

"Twenty five million people in the United Kingdom were estimated to have web access in 2001, and searching for health information was one of the most common uses of the web.

"Computers connected to the internet are now ubiquitous in outpatient clinics and hospital wards. Useful information on even the rarest medical syndromes can now be found and digested within a matter of minutes.

"Our study suggests that in difficult diagnostic cases, it is often useful to 'google for a diagnosis'. Web based search engines such as Google are becoming the latest tools in clinical medicine, and doctors in training need to become proficient in their use."

http://www.dailymail.co.uk/pages/live/articles/news/news.html?in_article_id=415562&in_page_id=1770

The National Pain Foundation: Pain and Your Mental Health

Pain and Your Mental Health

Pain so often is accompanied by loss—loss of function, loss of employment, loss of money, loss of friends and relationships to name just a few—it’s no wonder that people in chronic pain have an increased incidence of depression, anxiety, and sleep disturbances. It is natural to feel emotions ranging from fear, anger, denial, disappointment, guilt, and loneliness to hope and optimism. Every person reacts differently to pain at different times, which can make relationships and pain control difficult. The effect emotions and psychosocial well being have on pain cannot be ignored as emotions have a direct effect on your health. Taking care of the emotional aspects of chronic pain is necessary to treat your overall pain condition.

The articles listed below offer insight into the psychology of pain and the options available to persons in pain and hopefully the reassurance that you are not alone.

The Relationship Between Pain, Depression and Mood: An Interview with Rollin Gallagher, MD, MPH
Dr. Gallagher discusses the relationship between mood and pain, available treatments, and the things a person in pain can do to mitigate his or her depression.

The Link Between Pain and Depression
Pain and depression are inexorably linked in a complex way in your brain. Pain and pain-related disability affect mood — mood affects pain and pain-related disability. To successfully treat your chronic pain, you and your physician need to examine the emotional factors that may influence your pain level and physical disability. Read more about how pain and depression are connected and how to recognize symptoms in yourself.

Looking Beyond the Pain: The Role of Psychological Assessment in Medical Treatment
Don’t be offended if your doctor asks questions about your mental state—part of treating pain is relieving emotional symptoms related to pain. Conditions like anxiety and depression significantly affect how well a patient responds to pain treatment. Learn more about the important role psychological assessment plays in treating pain.

Pain and Depression
This article is adapted from a lecture given by NPF Board member Dr. Michael Loes.

Psychological Factors Related to Pain
Dr. Mark Disorbio outlines how pain is both a physical and psychological experience.

Pediatric Pain: Psychological Factors Related to Chronic Pain in Children and Adolescents

The Psychology of Pain — Arthritis

The Psychology of Pain — Cancer

The Psychology of Pain — Complex Regional Pain Syndrome

The Psychology of Pain — Fibromyalgia

The Psychology of Pain — Headaches

http://www.nationalpainfoundation.org/MyTreatment/MyTreatment_PainAndYourMentalHealth.asp

Google Groups: alt.support.chronic-pain (click)

From: dianewillgo@w...
Wed, Nov 8 2006 3:43 pm
alt.support.chronic-pain

If this is a duplicate message I am sorry.
I have been (mostly) a lurker in this group for many years. I am in
chronic pain do to an accident on the Atlantic Cit Expwy in 1998. I
have had two Spinal Fusions-lumbar and am on
the following pain meds: Duragesic Patch 100 mcg 1 every other day,
Oxcycontin ER 80 mg 4Xday, Oycodone 5 mg 4x day BT & lidocaine 3%
patch 2-3 every night for 12 hours. If you could get me back into the
grup I wold really appreciate it, I am not too literate on the Web but
especially during Flare ups when I can do nothing it helps to be able
to read your discussions. Thank you very much.
^^^
From: Jimmy
Wed, Nov 8 2006 8:44 pm
alt.support.chronic-pain

dianewil...@... wrote: "stuff!'

WELCOME diane, welcome. Sorry about your pain, yet this is to be one
one of the best places if you have any.
Welcome.
Jimmy
^^^
From: Joe_Z
Wed, Nov 8 2006 9:53 pm

hi! your here, just post away like you just did, welcome, how can we
help you? have a pain free evening...joe

Pain Information Center - Living With Pain

Not all pain is alike.

We've all experienced pain at one time or another. Sharp, dull, quick, recurring. However you describe it, pain technically fits into one of 2 categories – acute or chronic. Acute pain is pain that hits you suddenly – after falling from a ladder, being tackled on the football field or lifting a load that is just too heavy, for example. Acute pain comes on quickly and often leaves just as quickly. But chronic pain is different.

Are you suffering from chronic pain?

According to the American Chronic Pain Association, chronic pain is pain that continues a month or more beyond the usual recovery period for an injury or illness, or that goes on for months or years due to a chronic condition. Pain signals keep firing in the nervous system for weeks, months, even years. There may have been an initial mishap – a sprained back or serious infection – or there may be an ongoing cause of pain – arthritis or cancer. But you may suffer chronic pain in the absence of any past injury or evidence of body damage. And you live with it. Day in and day out. Perhaps working extra hard to get out of bed each morning. And struggling to do all the little things – like tying your shoes, climbing the stairs or lifting your child or grandchild.

Two common chronic conditions.

This site was designed to teach you more about chronic pain, and takes a closer look at 2 very common types – chronic back pain and chronic osteoarthritis pain. Only your doctor can diagnose chronic pain. But you can help manage it, and find appropriate treatments once and for all.

http://www.paininformationcenter.com/

THOR Center for Neuroinformatics: Composite of some pain neuroimaging studies (click here)

Beliefs About Pain questionnaire

Back Sense By Dr. Ronald D. Siegel, Michael H. Urdang And Dr. Douglas R. Johnson

Charts and Exercises from Back Sense

A number of readers have asked us to provide online copies of the charts and participatory exercises in the Back Sense program so that they could easily make copies of them. We are providing them here in Adobe Acrobat (PDF) format, so that they can be printed on almost any computer system.

http://www.backsense.org/

NOVA Online | Secrets of the Mind | From Ramachandran's Notebook

From Ramachandran's Notebook

Vilayanur Ramachandran has been called a Sherlock Holmes of neuroscience. Director of the Center for Brain and Cognition at the University of California, San Diego, and adjunct professor at the Salk Institute for Biological Studies in La Jolla, California, Ramachandran has brilliantly sleuthed his way through some of the strangest maladies of the human mind. He has done this by marrying simple tools such as mirrors and cotton swabs with an insatiably inquisitive mind and a tonic sense of humor.

One of the areas in which he has made some of his greatest strides is in the arena of phantom limbs, in which amputees and even those born without one or more limbs feel pain and other sensations in their missing body parts. Here, read Ramachandran's vivid descriptions of his experiences with phantom-limb patients and how he has managed to understand their singular dilemmas and thereby help them.


http://www.pbs.org/wgbh/nova/mind/notebook.html

Physiology of the Senses: Touch (Dr. Tutis Vilis, University of Western Ontario)

http://www.physpharm.fmd.uwo.ca/undergrad/sensesweb/L7Touch/L7Touch.pdf

Flash:

http://www.physpharm.fmd.uwo.ca/undergrad/sensesweb/L7Touch/L7Touch.swf

ULTRAM-ER.com Pain Profiler

Help your doctor – and yourself.

Before you and your doctor can effectively treat your pain, your doctor will need to understand exactly what it is you're feeling. The Pain Profiler can help you summarize your pain in a clear, concise way. Take just a couple of minutes to answer the step-by-step questions. Then take your printable profile with you to your appointment.

http://www.ultram-er.com/html/pult/pain-profiler.jsp

Neuroethics - University of Pennsylvania

What is neuroethics?

'Neuroethics' is the ethics of neuroscience, analogous to the term 'bioethics' which denotes the ethics of biomedical science more generally.

Neuroethics encompasses a wide array of ethical issues emerging from different branches of clinical neuroscience (neurology, psychiatry, psychopharmacology) and basic neuroscience (cognitive neuroscience, affective neuroscience).

These include ethical problems raised by advances in functional neuroimaging, brain implants and brain-machine interfaces and psychopharmacology as well as by our growing understanding of the neural bases of behavior, personality, consciousness, and states of spiritual transcendence.

http://www.neuroethics.upenn.edu/index.html

Migraine Headaches: Can Electricity Block Migraines? - Health News - New York Times

It May Come as a Shock

In ancient Rome, patients with unbearable head pain were sometimes treated with jolts from the electricity-producing black torpedo fish, or electric ray.

Recently, electrical or electromagnetic devices that hark back to the head-zapping torpedo fish have come into vogue among the country’s most prominent migraine researchers. Two different kinds of stimulatory devices are now in large-scale clinical trials for possible use in patients with the most severe migraine cases. Many researchers believe that such devices are likely to play a greater role in migraine treatment in the future.

http://www.nytimes.com/2006/11/07/health/07migr.html?ex=1320555600&en=ff014705cb4a5138&ei=5090&partner=rssuserland&emc=rss

NYT: Better ending takes planning - Take time to prepare for a ‘good death’

As sudden deaths from heart attacks continue to decline and more people leave this life after a protracted illness, the concept of “a good death” has become ever more important to both the dying and those who survive them.

But what is a good death, and is it really the same for everyone? And what are the consequences of different approaches to death for those left behind?

===

The study identified six components of a good death, described in The Annals of Internal Medicine of May 16, 2000:

•Pain and symptom management. Pain, more so than dying itself, is too often the cause of acute anxiety among patients and their families.

•Clear decision making. Patients want to have a say in treatment decisions.

•Preparation for death. Patients want to know what to expect as their illness progresses and to plan for what will follow their deaths.

•Completion. This includes reviewing one’s life, resolving conflicts, spending time with family and friends, and saying good-bye.

•Contribution to others. Many people nearing death achieve a clarity as to what is really important in life and want to share that understanding with others.

•Affirmation. Study participants emphasized the importance of being seen as a unique and whole person and being understood in the context of their lives, values and preferences.

This study says that dying can, and should, be a much less painful experience for many more people and their loved ones than it now is.

http://www.telegram.com/apps/pbcs.dll/article?AID=/20061106/COLUMN40/611060328/1012

Google Groups: alt.med.fibromyalgia

Topics 1 - 10 of 100,670 Older »

http://groups.google.com.au/group/alt.med.fibromyalgia?hl=en

alt.support.chronic-pain

Topics 1 - 10 of 29,357 Older »

http://groups.google.com.au/group/alt.support.chronic-pain?lnk=rgh&hl=en