By Dawn Marcus

Best ache professional sunrise A. Marcus, MD, deals fundamental care clinicians sensible, transparent, and succinct evidence-based ways to the analysis and therapy of the painful stipulations they see of their workplaces each day. the writer simplifies the usually advanced care of sufferers with persistent soreness by means of supplying functional thoughts for concentrating on vital signs, constructing real looking remedy targets, and dealing with sufferers with tutorial sheets that may be copied at once from the booklet and used for either schooling and the tracking of healing compliance and reaction. various case-oriented useful purposes illustrate the evaluate, analysis, and remedy of sufferers with persistent soreness within the context of a hectic place of work perform. vital sections on opioid remedy and unique sufferer teams also are incorporated. Supplementary good points contain a value-added compact disk containing an publication model of the booklet or use within the reader's computing device or PDA, and carrying on with scientific schooling (CME) questions that offer the chance to obtain five AMA/PRA classification 1 credit.

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Extra info for Chronic Pain: A Primary Care Guide to Practical Management (Current Clinical Practice)

Example text

Medication overuse will not cause headache in a headache-free patient; however, the headache pattern of the chronic headache sufferer will be aggravated by medication overuse. Typically, patients experience a change from intermittent migraine to a daily tension-type headache. Another common scenario is the perpetuation of posttraumatic headache, with frequent headaches persisting longer than expected. Every patient reporting frequent headache should be repeatedly queried about medication overuse and required to complete a headache diary to log both headache and medication use.

Pain 1990; 43:205–218. 8. Guilbaud G, Gautron M, Jazat F, et al. Time course of degeneration and regeneration of myelinated nerve fibers following chronic loose ligatures of the rat sciatic nerve: can nerve lesions be linked to the abnormal pain-related behaviours? Pain 1993; 53:147–158. 9. Behbehani MM, Dollberg-Stolik O. Partial sciatic nerve ligation results in an enlargement of the receptive field and enhancement of the response of dorsal horn neurons to noxious stimulation by an adenosine agonist.

Patients with frequent or daily headache often focus on their most troubling headache, neglecting to mention the additional frequent headache that is often associated with medication overuse. Diaries will also help identify if menstruation is a consistent headache trigger. Fig. 4. Headache diagnostic algorithm. Chapter 4 / Headache 41 41 42 Part III / Common Chronic Pain Conditions Fig. 5. Diary samples compared with headache diagnoses and treatment recommendations. Chapter 4 / Headache 43 Fig.

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