Pain management a comprehensive review



Download 300.52 Kb.
Page7/7
Date conversion02.12.2016
Size300.52 Kb.
1   2   3   4   5   6   7

14. Educating patients

The prevalence of pain is high, and as a result exacts quite a large toll on society. Unfortunately though, both public and professional knowledge regarding pain falls short, particularly because, although pain should be a public health issue, it is remarkably underaddressed. States Brown, “If pain was formally recognized as part of our national public health policy, public awareness campaigns would highlight pain prevention and cover risk factors for the development of the disease” [142]. However, since pain is not a public health priority, the burden remains on practitioners, patients, and caregivers to educate themselves and to advocate for better pain management techniques.

Education strategies and tools for patient and caregivers should be presented in a variety of mediums that enhance wider learning. These include pain-specific brochures being displayed in-office; newsletters; videos; audio content; posters; the use of pain notebooks to track pain progression; referrals to credible web sites; structured education, and; web-based tools to educate and manage pain.

There are several key objectives that practitioners should keep in mind as they work to educate patients and caregivers. These objectives are:



  1. Increase understanding of pain;

  2. Address disparities and cultural differences with care;

  3. Discuss the goals of treatment;

  4. Address more than just the physical aspects of pain; psychosocial and spiritual aspects should be addressed as well;

  5. Empower individuals to advocate for themselves by providing tools, handouts, or other tips;

  6. Teach how to use pain treatment options appropriately;

  7. Create an environment in which people can discuss pain openly and ask questions; provider-patient communication is essential.

Educating patients is a central tool in improving the management of pain. Therefore, practitioners should be prepared to offer educational tools to patients that present pain in a way that the individual will understand. Additionally, it is essential that practitioners work to dispel myths and misperceptions about pain to provide a better educational experience. This can be done through dispelling the six most common myths about pain. These are [143]:

  • Pain is “all in your head” [142]. It is true to an extent that pain resides in the head, as the individual’s brain is responsible for processing the pain perception. However, this does not indicate that pain is an imaginary occurrence, even if the source of the pain is not understood that well. The pain is real to the person experiencing it; therefore, it must be adequately addressed.

  • Pain is an occurrence that one simply must live with. Traditionally views on pain state that pain is the inevitable consequence of a disease or condition. However, the fact is that most pain can be avoided or relieved through careful pain prevention or management.

  • Pain is just a natural part of growing older. It is true that pain becomes more common as people age, mostly because the conditions that cause pain, such as arthritis, shingles, or osteoporosis, are more common in older adults. However, regardless of age, pain is not something that anyone should have to endure untreated.

  • The practitioner is the best judge of pain. There is not much of a relationship between what the practitioner judges the pain to be and the actual patient experience. This means that the patient must have the final word on pain existence and severity. The most reliable pain indicator is self-report.

  • Seeking medical care for pain means that the patient is weak. Seeking medical care for pain often has a stigma attached because patients don’t want practitioners to view them as whiners, or bad patients. For this reason, patients don’t always mention pain and how it affects their life.

  • Using strong pain medications leads to addiction. It is important to remember that drugs such as opioids are not universally addictive. There are risks associated with their use, but risks may be managed through properly prescribing and monitoring the use of the medication (i.e. taking the medication as it is prescribed).

There are several things that patients who experience pain want to know about their pain. It is therefore important to keep these things in mind when educating the patient or caregiver. These include:

  • How to understand the pain, most specifically, how to understand the cause of the pain;

  • What to expect in terms of when the pain may be experienced and what it will feel like;

  • Treatment options, which include options involving medication, surgical treatments, and nonpharmacological approaches;

  • The best way to cope with pain;

  • How pain can negatively impact the individual’s life in a variety of ways, including physical, psychological, and social impacts;

  • How to connect with other people experiencing the same kind of pain to gain understanding of their pain through peer experience;

  • Where to find specialists to help manage pain, as well as who should be consulted;

  • How to effectively describe pain [144].

How to enhance pain communication:

  1. Utilize pain questions that are kept handy for each appointment. These questions include:

    1. Where is the pain located?

    2. How is the pain characterized?

    3. When and how did the pain start?

    4. Is the pain intermittent or continuous?

    5. What makes the pain feel better or worse – factors would include medication, activity, rest, stress, or the application of hot or cold to the affected area.

    6. Has the patient experienced any sleep disturbances as a result of their pain?

    7. Does the patient have any ongoing medical concerns that could have caused or could be exacerbating pain?

    8. How is the individual functioning at school or work?

    9. Does the pain affect certain quality of life activities, such as sex or recreation?

    10. What does the patient expect from pain treatments?

  2. Instruct the individual to keep a pain diary and to utilize pain intensity scales to measure pain. Pain diaries not only help patients keep track of and measure their pain experiences and the effects of the pain on a variety of functions; they also offer practitioners the opportunity to educate the patient about their pain.

  3. Encourage the individual to reach out for support. Support groups, whether they are in person or online, offer patients the opportunity to connect with others who are suffering in the same way as well as provide an opportunity for education through peer information exchange.

15. Conclusion

Pain is considered a “universal disorder” [1] that comes in many forms. Up to 80% of visits to physicians are for treatment of pain. Regardless of the form that pain is seen in, everyone experiences pain, with the perception of pain occurring differently in each individual.

At its simplest, pain serves to warn the individual that something is not quite right. Pain can, however, be so severe that it disrupts productivity, well-being, and indeed, the entire life of the individual experiencing the pain. At its core, pain is complex and differs greatly among individuals, including those who seem to have identical injuries or illnesses.

Pain today is a costly and very serious public health issue. It is also a challenge for friends and family as well as health care practitioners to offer support to the individual suffering from the pain. In order to offer this support, both practitioners and friends and family must be willing to try a variety of pain management methods, or even a combination of methods. Further, both practitioners and friends and family must listen carefully as symptoms are described in order to ensure that the pain is treated effectively.



Finally, it is also important to address the education of both the individual as well as their friends and family in order to ensure effective pain management. Pain that is not managed effectively can alter the physical and psychological state of the individual experiencing the pain. Understanding how to effectively manage pain is therefore essential. Additionally, it is important as well to be mindful of the treatment gap that exists in pain management. Women, children and older adults are at greater risk of being negatively affected by chronic pain and frequently end up receiving treatment that falls short. Through education, careful listening, and exploration of the variety of treatment methods available to practitioners, successful pain management may be attained.

References

  1. NIH. Pain: hope through research. NINDS 2001;01-2406.

  2. Kleinman A, Brodwin PE, Good BJ, DelVecchio Good MJ. Pain as human experience: an introduction. Pain As Human Experience: An Anthropological Perspective. University of California Press 1994.

  3. Ryder SA, Stannard CF. Treatment of chronic pain:antidepressant, antiepileptic and antiarrhythmic drugs. Contin Educ Anaesth Crit Care Pain. 2005;5(1):18 – 21.

  4. Shankland WE. Factors that affect pain behavior. Cranio 2011;29(2):144-54.

  5. AMA. Pathophysiology of pain and pain assessment. 2010.

  6. Definition of Pain. Retrieved from: http://www.medterms.com/script/

main/art.asp?articlekey=4723. Last accessed June 10, 2013.

  1. Coghill Rc, McHaffie JG, and Yen Y. Neural correlates of interindividual differences in the subjective experience of pain. Proc. Nat. Acad Sci. 2013.

  2. Shankland WE. Factors that affect pain behavior. Cranio 2011;29(2):144-54.

  3. Coghill RC. Individual differences in the experience of pain. Retrieved from: http://www.wakehealth.edu/Research/Neurobiology-and-Anatomy/Individual-Differences-in-the-Experience-of-Pain.htm. Last accessed June 10, 2013.

  4. West, C. Measuring magnitude. Observer 2009;22(6).

  5. Srivastava AK. Clinical characteristics of pain. Retrieved from: http://www.homeorizon.com/homeopathic-articles/neurology/clinical-characteristics-of-pain. Last accessed June 10, 2013.

  6. Cleveland Clinic. Acute vs. chronic pain. Retrieved from: my.clevelandclinic.org/

services/pain_management. Last accessed June 10, 2013.

  1. Harstall C. How prevalent is chronic pain? IASP Pain Clinical Updates XI. 2003: 1-4.

  2. McCleane GJ, Suzuki R, Dickenson AH. Does a single intravenous injection of the 5HT3 receptor antagonist ondansetron have an analgesic effect in neuropathic pain? A double-blinded, placebo-controlled cross-over study. Anesth Analg 2003;97:1474-8.

  3. Ready L. The Management of Pain. New York: Churchill Livingstone; 1998. The interface between acute and chronic pain.

  4. Dray A. Neuropathic pain: emerging treatments. Br J Anaesth 2008; 101: 48-58.

  5. Voscopoulos C, Lema M. When does acute pain become chronic? Br. J. Anaesth 2010;105(Supp 1):i69-85.

  6. Torebjork HE, Lundberg LE, LaMotte RH. Central changes in processing of mechanoreceptive input in capsaicin-induced secondary hyperalgesia in humans. J Physiol 1992;448:765-80.

  7. Devor M. Sodium channels and mechanisms of neuropathic pain. J Pain 2006;7:S3-S12.

  8. Macrae WA. Chronic post-surgical pain: 10 years on. Br J Anaesth 2008;101:77-86.

  9. Amir R, Liu CN, Kocsis JD, Devor M. Oscillatory mechanism in primary sensory neurones. Brain 2002;125:421-35.

  10. Jenkins JT, O'Dwyer PJ. Inguinal hernias. Br Med J 2008;336:269-72.

  11. Wang J, Ren Y, Zou X, et al. Sympathetic influence on capsaicin-evoked enhancement of dorsal root reflexes in rats. J Neurophysiol 2004;92:2017-26.

  12. Mayo Clinic. Pelvic pain. Retrieved from: www.mayoclinic.com/health/pelvic-pain. Last accessed June 10, 2013.

  13. National Institute of Neurological Disorders and Stroke. Headache: Hope through research. Retrieved from: www.nih.gov/disorders/headache. Last accessed June 10 2013.

  14. IHS Classification. Part one: the primary headaches. Retrieved from: www.ihs-classification.org. Last accessed June 10, 2013.

  15. Prakash S, Belani P, Susvirkar A, et al. Paroxysmal hemicrania: a retrospective study of a consecutive series of 22 patients and a critical analysis of the diagnostic criteria. J Headache and Pain 2013;14:26

  16. Benoliel R. Trigeminal autonomic cephalgias. Br J Pain 2012; 6(3):106-23.

  17. Mainyar FH, Sprenger T, Schankin C, and Goadsby PJ. Imaging th premonitory phase of mighraine – new insights into generation of the migraine attack. J Headache and Pain 2013;(Supp 1):112.

  18. Chitsantikul P, Becker WJ. SUNCT, SUNA and pituitary tumors: clinical characteristics and treatment. Cephalgia 2013;33(3):160-70.

  19. IHS. The international headache society’s core curriculum on headache for neurologists. Br J Pain 2012;6(3):103-5.

  20. Zakrewska JM, McMillan R. Trigeminal neuralgia: the disgnosis and management of this excruciating an dpoorly understood facial pain. Postgrad Med J 2011;87:410-16.

  21. Norman AT, Judkins KC. Pain in the patient with burns. Contin Educ Anaesth Crit Care Pain 2004;4(2):57-61.

  22. Judkins KC. Pain management in the burned patient. Pain Rev 1998;5:133–46

  23. McClain BC. Primary and secondary hyperalgesia. The Essence of Analgesia and Analgesics. Cambridge University Press 2010.

  24. Mayo Clinic. Postherpetic neuralgia. Retrieved from: http://www.mayoclinic.com/

health/postherpetic-neuralgia/DS00277. Last accessed June 10, 2013.

  1. Charlston Labs. Acute pain & side effects. Retrieved from: http://charlestonlabs.com/

therapeutic-focus/acute-pain-side-effects/. Last accessed June 10, 2013.

  1. Zacharoff KL. The pathophysiology of pain. Retrieved from: http://www.nwrpca.org/health-center-news/156-the-pathophysiology-of-pain.html. Last accessed June 10, 2013.

  2. Journal of the Am Geriatrics Society 1998;46:635-51.

  3. Linton. Models of Pain Perception. Elsevier Health 2005.

  4. Dallenbach KM. Pain: History and present status. American Journal of Psychology. July 1939;52:331–47.

  5. Meldrum M. “A History of Pain Management." Opioids : Past, Present and Future. Journal of the American Medical Association. 2011.

  6. Melzack R, Katz J. The gate control theory: reaching for the brain. Pain: Psychological Perspectives. Mahwah, N.J: Lawrence Erlbaum Associates, Publishers; 2004.

  7. Bonica JJ. The management of pain. 2 ed. Vol. 1. London: Lea & Febiger; 1990..

  8. Finger S. Origins of neuroscience: a history of explorations into brain function. USA: Oxford University Press; 2001.

  9. Kenshalo DR. Sensory, motivational and central control determinants of chronic pain: A new conceptual model. The Skin Senses: Proceedings of the First International Symposium on the Skin Senses, held at the Florida State University in Tallahassee, Florida: 42.

  10. Raj PP. Taxonomy and classification of pain. The Handbook of Chronic Pain. Nova Biomedical Books; 2007.

  11. Bruehl S, Burns JW, Chung OY, Chont M. Pain-related effects of trait anger expression: neural substrates and the role of endogenous opioid mechanisms. Neurosci Biobehav Rev. 2009;33(3):475–91.

  12. Derek A. Denton. The primordial emotions: the dawning of consciousness. Oxford University Press; 2006.

  13. Craig AD. Interoception: the sense of the physiological condition of the body. Current Opinion in Neurobiology. 2003;13(4):500–505.

  14. Wynne CF, Ling SM, Remsburg RR. Comparison of pain assessment instruments in cognitively intact and cognitively impaired nursing home residents. Geriatric Nursing 2000;21(1):20-3.

  15. Visual analog scale. Retrieved from: http://www.ttuhsc.edu/provost/

clinic/forms/ACForm3.02.A.pdf. Last accessed June 10, 2013.

  1. Faces pain scale. Retrieved from: http://www.ttuhsc.edu/provost/clinic/

forms/ACForm3.02.A.pdf. Last accessed June 10, 2013.

  1. Pain in infants. Retrieved from: http://www.ttuhsc.edu/provost/clinic/

forms/ACForm3.02.A.pdf. Last accessed June 10, 2013.

  1. LPCHS. Pain management. Retrieved from: http://www.lpch.org/

DiseaseHealthInfo/HealthLibrary/oncology/painman.html. Last accessed June 10, 2013.

  1. Ibraham A. Preoperative assessment, preparation and premedication. Powerpoint presentation.

  2. Livingstone C. Balanced anesthesia. Retrieved from: http://web.squ.edu.om/med-Lib/MED_CD/E_CDs/anesthesia/site/content/v02/020359r00.htm. Last accessed June 10, 2013.

  3. Karanikolas M, Aretha D, Kiekkas P, Monantera G, Tsolakis I, Filos KS. Case report. Intravenous fentanyl patient-controlled analgesia for perioperative treatment of neuropathic/ischaemic pain in haemodialysis patients: a case series. J Clin Pharm Ther 2010;35(5):603–8.

  4. Jewell CS, Chambers JQ, Chearney L, et al. The Facts on File encyclopedia of health and medicine. New York: Facts on File. 2007.

  5. UMKC. P.R.N. Retrieved from: http://www.med.umkc.edu/prn/. Last accessed June 10, 2013.

  6. Designing individualized dosage regimens using one compartment model equations. Retrieved from: http://accesspharmacy.com/Content.aspx?searchStr=one-compartment+open+model&aid=3518643. Last accessed June 10, 2013.

  7. Bertsekas D: Dynamic Programming: Deterministic and Stochastic Models. Prentice-Hall, Englewood NJ;1987:144-46.

  8. Bayard D, Milman M and Schumitzky A: Design of Dosage Regimens: a Multiple Model Stochastic Control Approach. Int. J. Biomed. Comput. 1994;36:103-15.

  9. Bayard D and Jelliffe R: Bayesian Estimation of Posterior Densities for Pharmacokinetic Models having Changing Parameter Values. To be presented at the Tenth Annual International Conference on Health Sciences Simulation, San Diego CA, January 23-27, 2000.

  10. Karanikolas M, Aretha D, Kiekkas P, et al. Case report. Intravenous fentanyl patient-controlled analgesia for perioperative treatment of neuropathic/ischaemic pain in haemodialysis patients: a case series. J Clin Pharm Ther 2010;35(5):603–8.

  11. Patient controlled analgesia for adults. Thomson Healthcare, Inc. 2010.

  12. Beers, M. Injuries. The Merck Manual of Diagnostics and Therapy (18th ed.). Merck Research Laboratories. 2006.

  13. Shahi K, Geeta B. Making local anesthesia less painful: tips and techniques. Internet J Surg 2009;20(2).

  14. Armstrong P, Young C, McKeown DW. Ethyl chloride and venepunture pain: a comparison with intradermal lidocaine. Can J Anaesth 1990;37:656-58.

  15. Edlich RF, Smith JF, Mayer NE, et al. Performance of disposable needle syringe systems for local anesthesia. J Emerg Med 1987;5:83-90.

  16. Arndt KA, Burton C, Noe JM. Minimizing the pain of local anesthesia. Plast Reconstr Surg 1983;72:676-9.

  17. Serour F ,Mandelberg A, Mori J. Slow injection of local anaesthetic will decrease pain during dorsal penile nerve block. Acta Anaesthesiol Scand 1998;42:926-928.

  18. Candiotti K. Use of opioid analgesics in pain management: an overview and short history. Retrieved from: http://www.prescriberesponsibly.com/topics/opioids. Last accessed June 10, 2013.

  19. Ballantyne JC, Mao J. opioid analgesics therapy for chronic pain. The New England Journal of Medicine. 2003;349:1943-53.

  20. Fishman SM. Pain Question & Answer: Side Effects of opioid analgesics. The American Pain Foundation.

  21. Kelly JP, Cook SF, Kaufman DW, et al. Prevalence and characteristics of opioid analgesics use in the US adult population. Pain. 2008;138:507-13.

  22. Coluzzi F, Pappagalio M. Opioid analgesics therapy for chronic noncancer pain: practice guidelines for initiation and maintenance of therapy. Minerva Anestesiol. 2005;71:425-33.

  23. Hong D, Flood P, Diaz G. The side effects of morphine and hydromorphone patient-controlled analgesia. Anesthesia & Analgesia. 2008;107(4):1384-89.

  24. Eisenberg E, McNicol ED, Carr DB. opioid analgesics for neuropathic pain (Review). The Cochrane Library. 2009;2:1-42.

  25. Kalso E, Edwards JE, Moore RA, et al.Opioid analgesics in chronic non-cancer pain: systematic review of efficacy and safety. Pain. 2004;112:372-78.

  26. National Pharmaceutical Council in collaboration with Joint Commission on Accreditation of Healthcare Organizations. Pain: Current Understanding of Assessment, Management, and Treatments. 2001;1-29.

  27. Lynch EP, Lazor MA, Gellis JE. The impact of postoperative pain on the development of postoperative delirium. Regional Anesthesia and Pain Management. 1998;86:781-5.

  28. Bhamb B, Brown D, Hariharan J, et al. Survey of select practice behaviors by primary care physicians on the use of opioid analgesics for chronic pain. Current Medical Research and Opinion. 2006;22(9):1859-65.

  29. Jung B, Reidenberg MM. The risk of action by the Drug Enforcement Administration against physicians prescribing opioid analgesics for pain. Pain Medicine. 2006;7(4).

  30. Auret K, Schug SA. Underutilisation of opioid analgesics in elderly patients with chronic pain: approaches to correcting the problem. Drugs Aging. 2005;22(8):641-54.

  31. Fishbain DA, Cole B, Lewis J, et al. What percentage of chronic nonmalignant pain patients exposed to chronic opioid analgesics analgesic therapy develop abuse/addiction and/or aberrant drug-related behaviors? A structured evidence-based review. Pain Medicine. 2008;9(4):444-59.

  32. Simone Rossi, ed. Australian medicines handbook 2006. Adelaide: Australian Medicines Handbook Pty Ltd.

  33. Hinz, B, Cheremina, O, Brune, K. Acetaminophen (paracetamol) is a selective cyclooxygenase-2 inhibitor in man. The FASEB journal : official publication of the Federation of American Societies for Experimental Biology 2008;22(2):383–90.

  34. Bayer HealthCare Pharmaceuticals Inc. 2008 (PDF). USA: FDA.

  35. Royal Pharmaceutical Society of Great Britain. Five Infections. British National Formulary (BNF 57). BMJ Group and RPS Publishing.

  36. Richards BL, Whittle SL, Buchbinder R. Muscle relaxants for pain management in rheumatoid arthritis. Cochrane Database Syst Rev 2012;18(1).

  37. Mayo clinic. Anti-seizure medications: relief from nerve pain. Retrieved from: http://www.mayoclinic.com/health/pain-medications/PN00045. Last accessed June 13, 2013.

  38. FDA. Living with fibromyalgia, drugs approved to manage pain. Retrieved from: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm107802.htm. Last accessed June 13, 2013.

  39. Mayo clinic. Antidepressants are a mainstay in the treatment of many chronic pain conditions – even when depression isn’t a factor. Retrieved from: http://www.mayoclinic.com/health/pain-medications/PN00044. Last accessed June 13, 2013.

  40. Declerck I, Himpens B, Droogmans G, Casteels R. The alpha 1-agonist phenylephrine inhibits voltage-gated Ca2(+)-channels in vascular smooth muscle cells of rabbit ear artery". Pflugers Arch. 1990;417(1):117–9.

  41. Treatment and therapy – pain medication. Retrieved from: http://peripheralneuropathycenter.uchicago.edu/learnaboutpn/treatment/pain_med/alpha2_andr_agonists.shtml. Last accessed June 10, 2013.

  42. Borins M. Do alternative therapies work in pain management? Patient Care 2005;16(10):28-40.

  43. Preyde M. Effectiveness of massage therapy for subacute low back pain: a randomized control trial. CMAJ 2000;162(13);1815-20.

  44. Hernandez-Reif M. Migraine headaches are reduced by massage therapy. Intern J Neuroscience 1998;96:1-11.

  45. Hochschuler SH. Ice packs for back relief. Retrieved from: http://www.spine-health.com/treatment/heat-therapy-cold-therapy/ice-packs-back-pain-relief. Last accessed June 13, 2013.

  46. Lehmann JF. Therapeutic heat and cold. Williams & Wilkins 1982.

  47. Mooney V. Benefits of heat therapy for lower back pain. Retrieved from: http://www.spine-health.com/treatment/heat-therapy-cold-therapy/benefits-heat-therapy-lower-back-pain. Last accessed June 13, 2013.

  48. Mayer JC. Heat wrap therapy can reduce post-exercise low back pain. Retrieved from: http://www.spine-health.com/treatment/heat-therapy-cold-therapy/heat-wrap-therapy-can-reduce-post-exercise-low-back-pain. Last accessed June 13, 2013.

  49. Mayer, John M., et al. Continuous Low-Level Heat Wrap Therapy for the Prevention and Early Phase Treatment of Delayed-Onset Muscle Soreness of the Low Back: A Randomized Controlled Trial. Archives of Physical Medical Rehabilitation, 2006;87:1310-17.

  50. Mayer, John M., et al. Continuous Low-Level Heat Wrap Therapy for the Prevention and Early Phase Treatment of Delayed-Onset Muscle Soreness of the Low Back: A Randomized Controlled Trial. Archives of Physical Medical Rehabilitation, 2006;87:1313-14.

  51. Knight CA, Rutledge CR, Cox ME, et al. Effect of superficial heat, deep heat, and active exercise warm-up on the extensibility of the plantar flexors. Physical Therapy 2001;81(6):1206-14.

  52. NINDS. Low back pain fact sheet. Retrieved from: http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm. Last accessed June 13, 2013.

  53. APA. Hypnosis for the relief and control of pain. Retrieved from: http://www.apa.org/research/action/hypnosis.aspx. Last accessed June 13, 2013.

  54. York M, Paice JA. Treatment of low back pain with intraspinal opioids delivered via implanted pumps. Orthop Nurs. 1998;17(3):61-9.

  55. Astin JA. Why patients use alternative medicine: Results of a national study. JAMA 1998;279:1548-155

  56. Wirth JH, Hudgins, JC, Paice JA. Use of herbal therapies to relieve pain: a review of efficacy and adverse effects. Pain Manag Nurs. 2005;6(4):145-67.

  57. Barnes P, Powell-Griner E, McFann K, et al. Complementary and alternative medicine use among adults: United States. Advanced Data 2004;343:1-20.

  58. Eisenberg DM, Kessler RC, Van Rompay MI, et al. Perceptions about complementary therapies relative to conventional therapies among adults who use both: Results from a national survey. Annals of Internal Medicine 2001;135:344-51.

  59. Eliason BC, Huebner J, Marchand L. What physicians can learn from consumers of dietary supplements. Journal of Family Practice 1999;48:459-63.

  60. American Music Therapy Association. Music therapy and music-based interventions in the treatment and management of pain: selected references and key findings. Retrieved from: http://www.musictherapy.org/assets/1/7/

MT_Pain_2010.pdf. Last accessed June 14, 2013.

  1. Wirth JH, Hudgins, JC, Paice JA. Use of herbal therapies to relieve pain: a review of efficacy and adverse effects. Pain Manag Nurs. 2005;6(4):145-67.

  2. Ernst E. Herbal medicines: Where is the evidence? British Medical Journal 2000;321:395-96.

  3. Boon H, Stewart M, Kennard MA, Gray R, et al. Use of complementary/alternative medicine by breast cancer survivors in Ontario: prevalence and perceptions. J Clinical Oncology 2000;18:2515-21.

  4. Astin JA. Why patients use alternative medicine: results of a national study. JAMA 1998;279:1548-53.

  5. Kimby CK, Launso L, Henningsen I, et al. Choice of unconventional treatment by patients with cancer. Journal of Alternative & Complementary Medicine 2003;9:549-61.

  6. Fugh-Berman A, Ernst E. Herb-drug interactions: review and assessment of report reliability. Br J of Clinical Pharmacology 2001;52:587-95.

  7. Abbot NC, White AR, Ernst E. Complementary medicine. Nature 1996;381:61.

  8. Cassileth B, Deng G. Complementary and alternative therapies for cancer. The Oncologist 2004;9:80-9.

  9. Zuk CE. Herbal remedies are not dietary supplements: A proposal for regulatory reform. Hastings Women's Law Journal 2000;11:29-57.

  10. Widespread ignorance of regulation and labeling of vitamins, minerals and food supplements, according to a national Harris interactive survey, 2002. Retrieved from: http://harrisinteractive.com/news/allnewsbydate.asp?NewsID=560. Last accessed May 18, 2013.

  11. UMN. Reflexology. Retrieved from: http://takingcharge.csh.umn.edu/explore-healing-practices/reflexology. Last accessed June 13, 2013.

  12. Reflexology ‘as effective as pain killers’. The Telegraph. Retrieved from: http://www.telegraph.co.uk/science/9981099/Reflexology-as-effective-as-pain-killers.html. Last accessed June 13, 2013.

  13. Pittler MH, Brown EM, Ernst E.

  14. Static magnets for reducing pain: systematic review and meta-analysis of randomized trials. CMAJ. 2007;177(7):736–42.

  15. NIH. Magnets for pain relief. Retrieved from: http://nccam.nih.gov/health/

magnet/magnetsforpain.htm. Last accessed June 13, 2013.

  1. Morris CE, Skalak TC. Acute exposure to a moderate strength static magnetic field reduces edema formation in rats. American Journal of Physiology. Heart and Circulatory Physiology. 2008;294(1):H50–H57.

  2. Electrotherapy – pain management. Retrieved from: http://meddb.eznetpublish.ihealthspot.com/tabid/9153/mid/14786/ContentPubID/516/ContentClassificationGroupID/-1/Default.aspx. Last accessed June 13, 2013.

  3. American Polarity Therapy Association. What is polarity therapy. Retrieved from: http://www.polaritytherapy.org/index.php?option=

com_content&view=section&layout=blog&id=5&Itemid=3. Last accessed June 13, 2013.

  1. Acupressure evidence. Retrieved from: http://www.csh.umn.edu/

Integrativehealingpractices/tcm/evid/ev19.html. Last accessed June 13, 2013.

  1. Acupressure pain relief: How acupressure works & relieves chronic pain. Retrieved from: http://www.acupressure.com/articles/how_acupressure_works.htm. Last accessed June 13, 2013.

  2. La Acupunctura. Retrieved from: www.medicinas-alternativas.net. Last accessed June 17, 2013.

  3. Leng TT, Tan MY, Veith I. Acupuncture Therapy - Current Chinese Practice. Philadelphia: Temple University. 1973.

  4. What is emu oil? Retrieved from: http://www.longviewfarms.com/. Last accessed June 13, 2013.

  5. McVicar N. Grape juice pectin cure for arthritis unproven. The Sun Sentinel. 2001.

  6. Kim MJ, Nam ES, Paik SI. The effects of aromatherapy on pain, depression, and life satisfaction of arthritis patients. Taehan Kanho Hakhoe Chi. 2005; 35(1):186-94.

  7. What are homeopathics? Retrieved from: http://www.abchomeopathy.com/homeopathy.htm. Last accessed June 13, 2013.

  8. Briscoe C, Briscoe D. Macrobiotics America. Retrieved from: http://www.macroamerica.com/. Last accessed June 13, 2013.

  9. Browne M, Crowe A, Cousins S. Educating patients and caregivers about pain management: what clinicians need to know. American Pain Foundation. 2012.

  10. American Pain Foundation. Online health decision making guide. Retrieved from: www.painfoundation.org/learn/programs/health-decisionmaking. Last accessed June 10, 2013.

  11. Bender JL, Hohenadel J, Wong J, et al. What patients with cancer want to know about pain: a qualitative study. J Pain & Sympt Management. 2008;35(2):177-87.

ce4less.com ce4less.com  ce4less.com  ce4less.com  ce4less.com  ce4less.com ce4less.com


1   2   3   4   5   6   7


The database is protected by copyright ©dentisty.org 2016
send message

    Main page