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Pain management in rheumatology research, training, and practice.

Publication ,  Journal Article
Borenstein, DG; Hassett, AL; Pisetsky, D
Published in: Clin Exp Rheumatol
2017

The Pain Management Task Force of the American College of Rheumatology published a report in 2010 highlighting pain management as a fundamental aspect of clinical practice, training and research. In the interim, the consideration of pain as a focus of attention of rheumatologists and rheumatology health professionals has become even more challenging than in 2010 because of the epidemic of opiate addiction and overdose death. The characterisation of categories of pain by mechanism (e.g., inflammation, joint degeneration, abnormalities of central pain processing) can help guide treatment. However, such categorisation can overlook the overlap of these processes and their interaction to create mixed pain states. Further complicating the assessment of pain, outcome measures in rheumatic disease often assess the degree of pain indirectly while concentrating on the quantification of inflammation. Non-inflammatory pain often persists despite treatment, highlighting the need for alternative analgesic therapies. Recommended therapies include acetaminophen, nonsteroidal anti-inflammatory drugs, and stimulators of the pain inhibitory pathway. Each of these non-opioid therapies has incomplete efficacy and potential toxicities that can limit their utility. Non-pharmacologic therapies can show efficacy that rivals or surpasses pharmacologic therapies in the control of pain and improving function in a variety of rheumatic disorders including chronic low back pain and fibromyalgia. A limitation of the use of these therapies is inadequate training and appreciation of their benefits. Furthermore, the supply of trained practitioners to provide non-pharmacological care and support patient efforts for self-management is often limited. Together, these considerations suggest the importance of a renewed effort to implement task force recommendations.

Duke Scholars

Published In

Clin Exp Rheumatol

ISSN

0392-856X

Publication Date

2017

Volume

35 Suppl 107

Issue

5

Start / End Page

2 / 7

Location

Italy

Related Subject Headings

  • Rheumatology
  • Rheumatic Fever
  • Rheumatic Diseases
  • Pain Management
  • Osteoarthritis
  • Humans
  • Biomedical Research
  • Arthritis & Rheumatology
  • 1103 Clinical Sciences
 

Citation

APA
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ICMJE
MLA
NLM
Borenstein, D. G., Hassett, A. L., & Pisetsky, D. (2017). Pain management in rheumatology research, training, and practice. Clin Exp Rheumatol, 35 Suppl 107(5), 2–7.
Borenstein, David G., Afton L. Hassett, and David Pisetsky. “Pain management in rheumatology research, training, and practice.Clin Exp Rheumatol 35 Suppl 107, no. 5 (2017): 2–7.
Borenstein DG, Hassett AL, Pisetsky D. Pain management in rheumatology research, training, and practice. Clin Exp Rheumatol. 2017;35 Suppl 107(5):2–7.
Borenstein, David G., et al. “Pain management in rheumatology research, training, and practice.Clin Exp Rheumatol, vol. 35 Suppl 107, no. 5, 2017, pp. 2–7.
Borenstein DG, Hassett AL, Pisetsky D. Pain management in rheumatology research, training, and practice. Clin Exp Rheumatol. 2017;35 Suppl 107(5):2–7.

Published In

Clin Exp Rheumatol

ISSN

0392-856X

Publication Date

2017

Volume

35 Suppl 107

Issue

5

Start / End Page

2 / 7

Location

Italy

Related Subject Headings

  • Rheumatology
  • Rheumatic Fever
  • Rheumatic Diseases
  • Pain Management
  • Osteoarthritis
  • Humans
  • Biomedical Research
  • Arthritis & Rheumatology
  • 1103 Clinical Sciences