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. 2005 Fall;9(4):9-18.
doi: 10.7812/TPP/05-067.

Treating chronic pain: new knowledge, more choices

Christine E Whitten, Marilee Donovan, Kristene Cristobal

Treating chronic pain: new knowledge, more choices

Christine E Whitten et al. Perm J. 2005 Fall.
No abstract available

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Figures

Figure 1
Figure 1
Diagram compares acute and chronic pain processes and pathways.
Figure 2
Figure 2
Functional MRI scans show brain response in pain-sensitive (left) and nonsensitive (right) patients. (Reproduced by permission of the author from: Coghill RC. Brain mechanisms of pain: Overview. Section on: Neural correlates of inter-individual differences in the subjective experience of pain [homepage on the Internet]. [cited 2005 Oct 4] Available from: http://www1.wfubmc.edu/Nba/Faculty/Labs/coghill/Individual+Differences.htm.5)
Figure 3
Figure 3
Diagram shows “vicious cycle” of pain.
Figure 4
Figure 4
In chronic pain syndromes, pain is often generated by more than the mechanism at the receptor level. To optimize therapy, treatment must be matched to the pain mechanism.
Figure 5
Figure 5
Flowchart shows recommended pharmacological management of chronic pain. (Reproduced with permission of the publisher from: Kaiser Permanente. Care Management Institute. Guide to chronic pain assessment and management in primary care [monograph on the Intranet]. [Oakland (CA): Care Management Institute]; 2004. [cited 2005 Mar 4] Available from: cl/kp.org/pkc/national/cmi/programs/chronicpain/files/clintools/CPtrifold04.pdf.18)
Figure 6
Figure 6
Algorithm for multimodal management of chronic pain. (Adapted and reproduced with permission of author and publisher from: Marcus DA. Treatment of nonmalignant chronic pain. Am Fam Physician 2000 Mar 1;61(5):1331–8, 1345–6.11)
Figure 7
Figure 7
Graph shows disadvantages of using short-acting opioid drugs to treat chronic pain.
Figure 8
Figure 8
Graph illustrates how long-acting opioid drugs provide smoother pain control than do short-acting opioid drugs for treating chronic pain.
See this image and copyright information in PMC

References

    1. Glajchen M. Chronic pain: treatment barriers and strategies for clinical practice. J Am Board Fam Pract. 2001 May–Jun;14(3):211–8. - PubMed
    1. Woolf CJ, American College of Physicians; American Physiological Society Pain: moving from symptom control toward mechanism-specific pharmacologic management. Ann Intern Med. 2004 Mar 16;140(6):441–51. - PubMed
    1. Brookoff D. Chronic pain: 1. A new disease? Hosp Pract (Off Ed) 2000 Jul 15;35(7):45–52. 59. - PubMed
    1. International Association for the Study of Pain. IASP Pain Terminology [homepage on the Internet; about 8 screens] [cited 2005 July 19]. Available from: www.iasp-pain.org/terms-p.html.
    1. Coghill RC. Brain mechanisms of pain: Overview Section on: Neural correlates of inter-individual differences in the subjective experience of pain [homepage on the Internet] [cited 2005 Oct4]. Available from: www1.wfubmc.edu/Nba/Faculty/Labs/coghill/Individual+Differences.htm.

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