Category Archives: Pain control

Chronic pain

Remember that most people who try a painkiller will get little benefit from it, but a few will improve quite a bit. When a drug works it’s typically helpful within 2 – 4 wks, so painkillers should be reassessed then … Continue reading

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CRPS

Complex regional pain syndrome (CRPS) is also known as reflex sympathetic dystrophy, Sudek’s atrophy, shoulder-hand syndrome or fracture disease. It consists of disproportionate, debilitating pain in a limb (usually but not always following trauma), associated with neuropathic changes. It usually … Continue reading

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Snippets

It’s now debatable whether we should give antibiotics for uncomplicated diverticulitis. While there isn’t sufficient evidence to say definitively that we shouldn’t, there are now a few trials showing that they don’t do anything, which certainly gives cause to question … Continue reading

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Assessment of pain in dementia

There are now scales for assessing pain in patients too demented to communicate. They rely on observation of behaviour over at least 5 minutes. PAINAD (Pain Assessment in Advanced Dementia) OPBAI (Observational Pain Behaviour Assessment Instrument) PADE (Pain Assessment in … Continue reading

Posted in Credits 2012, Elderly Medicine, Pain control, Psychiatry | Leave a comment

Chronic pain control

Useful tips: You’re probably not going to get the patient to a pain-free state. Be realistic and upfront about expectations, and aim for pain reduction to a manageable level, rather than elimination of pain. Tramadol works mainly through noradrenergic and … Continue reading

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Neuropathic pain

I’ve often wondered how long to persevere with medication for neuropathic pain before giving up on it. The advice from this article was two to eight weeks, with at least one or two weeks at maximum tolerated dosage.  It’s also … Continue reading

Posted in BMJ, Credits 2012, Medication, Neuropathy, Pain control | Leave a comment