Advanced Innovations for Pain
Abstract Chronic pain represents one of the most important public health problems in terms of both the number of patients afflicted and health care costs. Most patients with chronic pain are treated with medications as the mainstay of therapy, and yet most medically treated patients continue to repo...
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| Veröffentlicht in: | Mayo Clinic proceedings 2016-02, Vol.91 (2), p.246-258 |
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| creator | Lamer, Tim J., MD Deer, Timothy R., MD Hayek, Salim M., MD, PhD |
| description | Abstract Chronic pain represents one of the most important public health problems in terms of both the number of patients afflicted and health care costs. Most patients with chronic pain are treated with medications as the mainstay of therapy, and yet most medically treated patients continue to report ongoing pain. Additionally, adverse effects from pain medications represent a major challenge for clinicians and patients. Spinal cord stimulation and intrathecal drug delivery systems are well-established techniques that have been utilized for over 25 years. Intrathecal drug delivery systems have proven efficacy for a wide variety of intractable pain conditions and fewer adverse effects than systemic medical therapy in patients with refractory cancer-related pain. Spinal cord stimulation is cost-effective and provides improved pain control compared with medical therapy in patients with a variety of refractory pain conditions including complex regional pain syndrome, painful diabetic neuropathy, and chronic radiculopathy. Patients who have intractable pain that has not responded to reasonable attempts at conservative pain care measures should be referred to a qualified interventional pain specialist to determine candidacy for the procedures discussed in this article. |
| doi_str_mv | 10.1016/j.mayocp.2015.12.001 |
| format | Article |
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Most patients with chronic pain are treated with medications as the mainstay of therapy, and yet most medically treated patients continue to report ongoing pain. Additionally, adverse effects from pain medications represent a major challenge for clinicians and patients. Spinal cord stimulation and intrathecal drug delivery systems are well-established techniques that have been utilized for over 25 years. Intrathecal drug delivery systems have proven efficacy for a wide variety of intractable pain conditions and fewer adverse effects than systemic medical therapy in patients with refractory cancer-related pain. Spinal cord stimulation is cost-effective and provides improved pain control compared with medical therapy in patients with a variety of refractory pain conditions including complex regional pain syndrome, painful diabetic neuropathy, and chronic radiculopathy. Patients who have intractable pain that has not responded to reasonable attempts at conservative pain care measures should be referred to a qualified interventional pain specialist to determine candidacy for the procedures discussed in this article.</description><identifier>ISSN: 0025-6196</identifier><identifier>EISSN: 1942-5546</identifier><identifier>DOI: 10.1016/j.mayocp.2015.12.001</identifier><identifier>PMID: 26848005</identifier><identifier>CODEN: MACPAJ</identifier><language>eng</language><publisher>England: Elsevier Inc</publisher><subject>Analgesics - administration & dosage ; Analgesics - adverse effects ; Care and treatment ; Chronic pain ; Chronic Pain - economics ; Chronic Pain - etiology ; Chronic Pain - physiopathology ; Chronic Pain - therapy ; Cost-Benefit Analysis ; Diagnosis ; Humans ; Injections, Spinal - adverse effects ; Injections, Spinal - methods ; Internal Medicine ; Outcome Assessment (Health Care) ; Pain Management - methods ; Pain Management - trends ; Patient Selection ; Spinal Cord Stimulation - adverse effects ; Spinal Cord Stimulation - methods</subject><ispartof>Mayo Clinic proceedings, 2016-02, Vol.91 (2), p.246-258</ispartof><rights>2016</rights><rights>Copyright © 2016. Published by Elsevier Inc.</rights><rights>COPYRIGHT 2016 Frontline Medical Communications Inc.</rights><rights>Copyright Mayo Foundation for Medical Education and Research Feb 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c587t-5118c77344ea70b8c8513de1c3ad45b6ccf3880e63dce5ca12dad1281a2485573</citedby><cites>FETCH-LOGICAL-c587t-5118c77344ea70b8c8513de1c3ad45b6ccf3880e63dce5ca12dad1281a2485573</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1762624406?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,64364,64366,64368,72218</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26848005$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lamer, Tim J., MD</creatorcontrib><creatorcontrib>Deer, Timothy R., MD</creatorcontrib><creatorcontrib>Hayek, Salim M., MD, PhD</creatorcontrib><title>Advanced Innovations for Pain</title><title>Mayo Clinic proceedings</title><addtitle>Mayo Clin Proc</addtitle><description>Abstract Chronic pain represents one of the most important public health problems in terms of both the number of patients afflicted and health care costs. Most patients with chronic pain are treated with medications as the mainstay of therapy, and yet most medically treated patients continue to report ongoing pain. Additionally, adverse effects from pain medications represent a major challenge for clinicians and patients. Spinal cord stimulation and intrathecal drug delivery systems are well-established techniques that have been utilized for over 25 years. Intrathecal drug delivery systems have proven efficacy for a wide variety of intractable pain conditions and fewer adverse effects than systemic medical therapy in patients with refractory cancer-related pain. Spinal cord stimulation is cost-effective and provides improved pain control compared with medical therapy in patients with a variety of refractory pain conditions including complex regional pain syndrome, painful diabetic neuropathy, and chronic radiculopathy. Patients who have intractable pain that has not responded to reasonable attempts at conservative pain care measures should be referred to a qualified interventional pain specialist to determine candidacy for the procedures discussed in this article.</description><subject>Analgesics - administration & dosage</subject><subject>Analgesics - adverse effects</subject><subject>Care and treatment</subject><subject>Chronic pain</subject><subject>Chronic Pain - economics</subject><subject>Chronic Pain - etiology</subject><subject>Chronic Pain - physiopathology</subject><subject>Chronic Pain - therapy</subject><subject>Cost-Benefit Analysis</subject><subject>Diagnosis</subject><subject>Humans</subject><subject>Injections, Spinal - adverse effects</subject><subject>Injections, Spinal - methods</subject><subject>Internal Medicine</subject><subject>Outcome Assessment (Health Care)</subject><subject>Pain Management - methods</subject><subject>Pain Management - trends</subject><subject>Patient Selection</subject><subject>Spinal Cord Stimulation - adverse effects</subject><subject>Spinal Cord Stimulation - methods</subject><issn>0025-6196</issn><issn>1942-5546</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkl2L1DAUhoMo7rj6D1QGBPGmNSdN0vRGGBY_FhYUVPAuZJJTN2ObzDbtwPx70-n6tTeSi0B43pPDeQ4hT4GWQEG-3pW9OUa7LxkFUQIrKYV7ZAUNZ4UQXN4nK0qZKCQ08ow8SmlHKa2bhj8kZ0wqrigVK_Js4w4mWHTryxDiwYw-hrRu47D-ZHx4TB60pkv45PY-J1_fvf1y8aG4-vj-8mJzVVih6rEQAMrWdcU5mppulVUCKodgK-O42Epr20opirJyFoU1wJxxwBQYxpUQdXVOXi1190O8mTCNuvfJYteZgHFKGmrJGtkAlRl9cQfdxWkIubsTJRnnJ6pcqO-mQ-1DG8fB2Hwc9t7GgK3P7xvOBQUlmMiBl38FrtF043WK3XSax78gX0A7xJQGbPV-8L0ZjhqonsXonV7E6FmMBqazmBx7ftv2tO3R_Q79MpGBNwuAec4Hj4NO1uNsxg9oR-2i_98PdwvYzgdvTfcDj5j-TEmnHNCf5-WYdwMEpY2ov1U_Af3-sQo</recordid><startdate>20160201</startdate><enddate>20160201</enddate><creator>Lamer, Tim J., MD</creator><creator>Deer, Timothy R., MD</creator><creator>Hayek, Salim M., MD, PhD</creator><general>Elsevier Inc</general><general>Frontline Medical Communications Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4U-</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20160201</creationdate><title>Advanced Innovations for Pain</title><author>Lamer, Tim J., MD ; Deer, Timothy R., MD ; Hayek, Salim M., MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c587t-5118c77344ea70b8c8513de1c3ad45b6ccf3880e63dce5ca12dad1281a2485573</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Analgesics - administration & dosage</topic><topic>Analgesics - adverse effects</topic><topic>Care and treatment</topic><topic>Chronic pain</topic><topic>Chronic Pain - economics</topic><topic>Chronic Pain - etiology</topic><topic>Chronic Pain - physiopathology</topic><topic>Chronic Pain - therapy</topic><topic>Cost-Benefit Analysis</topic><topic>Diagnosis</topic><topic>Humans</topic><topic>Injections, Spinal - adverse effects</topic><topic>Injections, Spinal - methods</topic><topic>Internal Medicine</topic><topic>Outcome Assessment (Health Care)</topic><topic>Pain Management - methods</topic><topic>Pain Management - trends</topic><topic>Patient Selection</topic><topic>Spinal Cord Stimulation - adverse effects</topic><topic>Spinal Cord Stimulation - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lamer, Tim J., MD</creatorcontrib><creatorcontrib>Deer, Timothy R., MD</creatorcontrib><creatorcontrib>Hayek, Salim M., MD, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>University Readers</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Mayo Clinic proceedings</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lamer, Tim J., MD</au><au>Deer, Timothy R., MD</au><au>Hayek, Salim M., MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Advanced Innovations for Pain</atitle><jtitle>Mayo Clinic proceedings</jtitle><addtitle>Mayo Clin Proc</addtitle><date>2016-02-01</date><risdate>2016</risdate><volume>91</volume><issue>2</issue><spage>246</spage><epage>258</epage><pages>246-258</pages><issn>0025-6196</issn><eissn>1942-5546</eissn><coden>MACPAJ</coden><abstract>Abstract Chronic pain represents one of the most important public health problems in terms of both the number of patients afflicted and health care costs. 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| subjects | Analgesics - administration & dosage Analgesics - adverse effects Care and treatment Chronic pain Chronic Pain - economics Chronic Pain - etiology Chronic Pain - physiopathology Chronic Pain - therapy Cost-Benefit Analysis Diagnosis Humans Injections, Spinal - adverse effects Injections, Spinal - methods Internal Medicine Outcome Assessment (Health Care) Pain Management - methods Pain Management - trends Patient Selection Spinal Cord Stimulation - adverse effects Spinal Cord Stimulation - methods |
| title | Advanced Innovations for Pain |
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