Pain Management

An often overlooked condition, central neuropathic pain ensues directly when any type of central nervous system (CNS) lesion causes the dysfunction of somatosensory CNS pathways. It occurs most often after a stroke or as sequelae of multiple sclerosis or spinal cord injury, explained James C. Watson, MD, Associate Professor of Neurology, Mayo Clinic, Rochester, MN, at the 2016 American Academy of Pain Medicine meeting. Central neuropathic pain is challenging to diagnose and treat.
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“Of course, the Holy Grail of pain treatment would be to treat the affected site directly,” said Max M. Klein, PhD, Instructor of Neurology, Massachusetts General Hospital, Boston, at the 2016 American Academy of Pain Medicine meeting.
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In February 2016, the FDA published a special report in the New England Journal of Medicine, alerting the medical community, including providers, policymakers, and drug manufacturers about “the growing epidemic of opioid abuse, addiction, and overdose—an epidemic directly related to the increasingly widespread use of powerful opioid pain medications”.
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The analgesic effects of tramadol (Ultram), 1 of the 5 most often prescribed opioids in the world, may be sex-dependent, according to a study presented at the 2015 American Academy of Pain Medicine annual meeting.
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Until recently, the selection of patients for aggressive pain control therapy, including high-dose opioids and implanted delivery systems, has mostly been done on a subjective basis.
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In the treatment of chronic nonmalignant pain, patient-specific factors, especially household income, more accurately predicted quality-of-life outcomes than opioid use, according to a study presented at the 2015 American Academy of Neurology annual meeting.
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At the 2015 AAN meeting, experts discussed the role and responsibility of neurologists who prescribe opioids for chronic pain management in light of growing concerns of opioid misuse and abuse.
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