Pain management 417111 219295856 2008-06-14T15:15:15Z 85.133.26.2 {{Unreferenced|date=November 2007}} '''Pain management''' (also called pain medicine) is the [[medicine|medical]] discipline concerned with the relief of [[pain]]. ==Types of pain== [[Acute pain]], such pain resulting from [[Physical trauma|trauma]], often has a reversible cause and may require only transient measures and correction of the underlying problem. In contrast, [[chronic pain]] often results from conditions that are difficult to diagnose and treat, and that may take a long time to reverse. Some examples include [[cancer]], [[neuropathy]], and [[referred pain]]. Often, pain pathways ([[nociceptor]]s) are set up that continue to transmit the sensation of pain even though the underlying condition or injury that originally caused pain has been healed. In such situations, the pain itself is frequently managed separately from the underlying condition of which it is a symptom, or the goal of treatment is to manage the pain with no treatment of any underlying condition (e.g. if the underlying condition has resolved or if no identifiable source of the pain can be found). ==Methods== Pain management generally benefits from a [[multidisciplinary]] approach that includes [[pharmacology|pharmacologic]] measures ([[analgesics]] such as [[narcotics]] or [[Non-steroidal anti-inflammatory drug|NSAIDs]] and '''pain modifiers''' such as [[tricyclic antidepressant]]s or [[anticonvulsant]]s), non-pharmacologic measures (such as interventional procedures, physical therapy and [[physical exercise]], application of ice and/or heat), and [[psychological]] measures (such as [[biofeedback]] and [[cognitive therapy]]). The [[World Health Organization]] (WHO) recommended a ''[[pain ladder]]'' for managing analgesia<ref>http://www.who.int/cancer/palliative/painladder/en/</ref> which was first described for usage in cancer pain, but can be used by medical professionals as a general principle when dealing with analgesia for any type of pain. ==Medical specialties== Pain management practitioners come from all fields of medicine. Most often, pain fellowship trained physicians are [[anesthesiology|anesthesiologists]], [[neurology|neurologists]], [[physiatry|physiatrists]] or [[psychiatry|psychiatrists]]. Some practitioners focus more on the pharmacologic management of the patient, while others are very proficient at the interventional management of pain. Interventional procedures - typically used for chronic back pain - include: epidural steroid injections, facet joint injections, neurolytic blocks, [[Spinal Cord Stimulator]]s and [[intrathecal]] drug delivery system implants, etc. Over the last several years the number of interventional procedures done for pain has grown to a very large number. As well as medical practitioners, the area of pain management may often benefit from the input of [[Physiotherapists]], [[Chiropractors]], [[Clinical Psychologists]] and [[Occupational therapists]], amongst others. Together the multidisciplinary team can help create a package of care suitable to the patient. One of the pain management modalities are trigger point injections and nerve blocks utilizing long acting anesthetics and small doses of steroids. ==See also== * [[Coccydynia]] * [[Neuralgia]] * [[Neuropathy]] * [[Transcutaneous Electrical Nerve Stimulator]] * [[Temporomandibular joint disorder]] ==External links== * [http://www.painedu.org/ Pain Management Resources: PainEdu] {{Pain}} [[Category:Pain]] [[Category:Anesthesia]] [[da:Smertebehandling]] [[de:Schmerztherapie]] [[es:Tratamiento de dolor (Esquema de WHO)]] [[it:Terapia del dolore]] [[no:Smertebehandling]] [[sv:Smärtbehandling]] [[vi:Điều trị đau]]