Pain is a common complaint of patients who visit a family physician, and its
appropriate management is a medical mandate. The fundamental principles for
pain management are: placing the patient at the center of care; adequately assessing
and quantifying pain; treating pain adequately; maximizing function; accounting
for culture and gender differences; identifying red and yellow flags early;
understanding and differentiating tolerance, dependence and addiction; minimizing
side effects; and being familiar with and using CAM therapies when good evidence
of efficacy exists. The pharmacologic management of pain requires thorough knowledge
of nonsteroidal anti-inflammatory drugs, cyclo-oxygenase-2-specific inhibitors,
and opioids. A table of equianalgesic dosages is useful because patients may
need to move from one opioid to another. Accompanying this article are papers
discussing 5 common pain disorders seen by family physicians, including: neck
pain, low back pain, joint pain, pelvic pain, and cancer/end of life pain. The
family physician who learns these principles of pain management and the algorithms
for these common pain disorders can serve patients well. Bope ET, Douglass AB,
Gibovsky A, Jones T, Nasir L, Palmer T, Panchal S, Rainone F, Rives P,
Todd K, Toombs JD. J Am Board Fam Pract. 2004 Nov-Dec;17 Suppl:S1-12.
Full Text:
http://www.jabfp.org/cgi/content/full/17/suppl_1/S1
Credit: All abstracts retrieved from PubMed, developed by the National Center for
Biotechnology Information (NCBI) at the
National Library of Medicine (NLM).
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