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Management and Pharmacotherapy of Chronic Pain Syndromes Including Opioid Pharmacotherapy

Published online by Cambridge University Press:  07 November 2014

Abstract

Emphasizing the importance of an interdisciplinary approach in the treatment and management of patients with chronic pain syndromes (CPS), this article reviews, first, non-pharmacologic approaches and modalities for CPS patients, and next, pharmacologic approaches for CPS patients. Flexibility and the use of multiple modalities are emphasized. The article concludes with the controversial subject of the use of long-term analgesic opioid pharmacotherapy in patients with chronic benign pain syndromes.

Type
Feature Articles
Copyright
Copyright © Cambridge University Press 1999

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References

REFERENCES

1.Quoted in: Anthony, JE. Sherlock Holmes, Dr. Watson and Victorian Medicine. London, UK: Minerva Press; 1997:9.Google Scholar
2.Bonica, JJ. The Management of Pain. Philadelphia, Pa: Lea & Febiger; 1953.Google ScholarPubMed
3.Boyd, DB, Merskey, H, Nielsen, JS. The pain clinic: an approach to the problem of chronic pain. In: Smith, WL, Merskey, H, Gross, SC, eds. Pain: Meaning and Management. New York: S.P. Medical and Scientific Books; 1980:159165.CrossRefGoogle Scholar
4.Bonica, JJ. Organization and function of a pain clinic. Adv Neurol. 1974;4:433443.Google Scholar
5.Miller, TW, Kraus, RF. An overview of chronic pain. Hosp Community Psychiatry. 1990;41:433440.Google ScholarPubMed
6.Krishnan, KRR, France, RB, Houpt, JL. Chronic low back pain and depression. Psychosomatics. 1985;26:299302.CrossRefGoogle ScholarPubMed
7.Fordyce, WE, Roberts, AH, Sternbach, RA. The behavioral management of chronic pain: a response to critics. Pain. 1985;22:113125.CrossRefGoogle ScholarPubMed
8.Bonica, JJ. General considerations of chronic pain. In: Bonica, JJ, ed. The Management of Pain. Vol 1. 2nd ed. Philadelphia, Pa: Lea & Febiger; 1990:180196.Google Scholar
9.Kinder, BN, Curtiss, G, Kalichman, S. Anxiety and anger as predictors of MMPI elevations in chronic pain patients. J Pers Assess. 1986;50:896911.CrossRefGoogle ScholarPubMed
10.Katon, W, Eagan, K, Miller, D. Chronic pain: lifetime psychiatric diagnoses and family history. Am J Psychiatry. 1985;142:11561160.Google ScholarPubMed
11.Katz, WA. The needs of a patient in pain. Am J Med. 1998;105:2S7S.CrossRefGoogle ScholarPubMed
12.Pilowsky, I. Pain and illness behavior: assessment and management. In: Wall, PD, Melzack, R, eds. Textbook of Pain. 3rd ed. New York: Churchill-Livingstone; 1994:13091319.Google Scholar
13.Wall, PD. The placebo and the placebo response. In: Wall, PD, Melzack, R, eds. Textbook of Pain. 3rd ed. New York: Churchill-Livingstone; 1994:12971308.Google Scholar
14.Turk, DC, Rudy, TE. Cognitive-behavioral perspective on chronic pain: beyond the scalpel and syringe. In: Tollison, CD, Satterthwaite, JR, Tollison, JW, eds. Handbook of Pain Management. 2nd ed. Baltimore, Md: Williams & Wilkins; 1997:136151.Google Scholar
15.Tunks, ER, Merskey, H. Psychotherapy in the management of chronic pain. In: Bonica, JJ, ed. The Management of Pain. Vol 2. 2nd ed. Philadelphia, Pa: Lea & Febiger; 1990:17511756.Google Scholar
16.Levy, MH. Symptom control manual. In: Cassileth, BR, Cassileth, PA, eds. Clinical Care of the Terminal Cancer Patient. Philadelphia, Pa: Lea & Febiger; 1992:214262.Google Scholar
17.Goodgold, J, ed. Rehabilitation Medicine. St Louis, Mo: The C.V. Mosby Co; 1988.Google Scholar
18.DeLisa, JA, Gans, BM, eds. Rehabilitation Medicine: Principles and Practice. 3rd ed. Philadelphia, Pa: Lippincott-Raven; 1998.Google Scholar
19.Goodman, CE. Pathophysiology of pain. Arch Intern Med. 1983;143:527530.CrossRefGoogle ScholarPubMed
20.Wasner, G, Bakonja, M-M, Baron, R. Traumatic neuralgias: complex regional pain syndromes (reflex sympathetic dystrophy and causalgia): clinical characteristics, pathophysiological mechanisms and therapy. Neurol Clin. 1988;16:851868.CrossRefGoogle Scholar
21.Reuler, JB, Girard, PE, Nardone, DA. The chronic pain syndrome: misconceptions and management. Ann Intern Med. 1980;93:588596.CrossRefGoogle ScholarPubMed
22.Gonzales, GR. Central pain: diagnosis and treatment strategies. Neurology. 1995;45:S11S16.CrossRefGoogle ScholarPubMed
23.Shiflett, SC. Complementary/alternative medicine: what is it? does it work? Paper presented at: The Academy of Medicine of New Jersey; Princeton, NJ. March 18, 1999.Google Scholar
24.Margoles, MS, Silvia, H. Reflex sympathetic dystrophy. In: Margoles, MS, Weiner, R, eds. Chronic Pain: Assessment, Diagnosis, and Management. Boca Raton, Fla: CRC Press; 1999:179191.Google Scholar
25.Hackett, TP. The pain patient: evaluation and treatment. In: Hackett, TP, Cassem, NH, eds. Massachusetts General Hospital Textbook of General Hospital Psychiatry. 1st ed. St Louis, Mo: The C.V. Mosby Co; 1978:4163.Google Scholar
26.Carruthers, SG. Clinical pharmacology of pain. In: Smith, WS, Merskey, H, Gross, SC, eds. Pain: Meaning and Management. New York: S.P. Medical and Scientific Books; 1980:89103.CrossRefGoogle Scholar
27.Clinical Practice Guideline Number 9: Management of Cancer Pain. Rockland, MD: US Dept of Health and Human Services, Agency for Health Care Policy and Research; 1994:1116. AHCPR publication # 94-0592.Google Scholar
28.Schnitzer, TJ. Non-NSAID pharmacologic treatment options for the management of chronic pain. Am J Med. 1998;105:45S52S.CrossRefGoogle ScholarPubMed
29.Brose, WG, Spiegel, D. Neuropsychiatric aspects of pain management. In: Udofsky, SC, Hales, RE, eds. Synopsis of Neuropsychiatry. Washington, DC: American Psychiatric Press; 1994:205229.Google Scholar
30.Fields, HL, Martin, JB. Pain: pathophysiology and management. In: Fauci, AS, Braunwald, E, Isselbacher, KJ, eds. Harrison's Principles of Internal Medicine. 14th ed. New York: McGraw-Hill; 1998:5358.Google Scholar
31.Walsh, NE, Dumitru, D, Schoenfeld, LS, Ramamurthy, S. Treatment of the patient with chronic pain. In: DeLisa, JA, Gans, BM, eds. Rehabilitation Medicine: Principles and Practice. 3rd ed. Philadelphia, Pa: Lippincott-Raven; 1998:13851421.Google Scholar
32.Rosenthal, E. Patients in pain find relief, not addiction in narcotics. New York Times. March 28, 1993; sect 1,24.Google Scholar
33.Portenoy, RK. Chronic opioid therapy in nonmalignant pain. J Pain Symptom Manage. 1990;5(suppl 1):S46S62.Google ScholarPubMed
34.Marks, RM, Sachar, EJ. Undertreatment of medical inpatients with narcotic analgesics. Ann Int Med. 1973;78:173181.CrossRefGoogle ScholarPubMed
35.Perry, SW. The undermedication for pain. Psychiatr Ann. 1984;4:808811.CrossRefGoogle Scholar
36.Greenfield, DP, ed. Prescription Drug Abuse and Dependence. Springfield, Ill: Charles C. Thomas; 1995.Google Scholar
37.Portenoy, RK. Opioid therapy for chronic nonmalignant pain: a review of the critical issues. J Pain Symptom Manage. 1996;11:203217.CrossRefGoogle Scholar
38.Portenoy, RK. Textbook of Pain Management: Theory and Practice. Baltimore, Md: Williams & Wilkins; 1996: 264271.Google Scholar