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Archive | Pain

Rational Corticosteroid Therapy

Glucocorticosteroids are normal physiological hormones with important roles in daily functioning and the regulation of stress responses in reaction to physical and emotional insults. Corticosteroids are physiologically produced by the adrenal glands and secretion is under central nervous system control. Adrenocorticotrophic hormone (ACTH), released from the pituitary gland when stimulated by a releasing hormone from […]

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Diclofenac vs NSAIDs IN OA, RA

A recent meta-analysis compared diclofenac to other traditional nonsteroidal anti-inflammatory drugs and cyclooxygenase-2 inhibitors in patients with osteoarthritis or rheumatoid arthritis: a network meta-analysis. The aim of the study was to compare the efficacy, safety, and tolerability of traditional non-steroidal anti-inflammatory drugs (NSAIDs – diclofenac, ibuprofen, and naproxen) and cyclooxygenase-2 inhibitors (COXIBs – celecoxib and […]

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Transdermal fentanyl for cancer pain

Cancer patients are some of the sickest patients in the healthcare system and they deserve the best care we have to give. This was the message of Dr Sonia Hitchcock of Kalafong Hospital and the University of Pretoria, who spoke at Adcock’s Pain Summit earlier this year. (more…)

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Opioid tolerance and dependency

Dr César Margarit Ferri, Chief: Pain Unit, Anesthesiology-Critical Care-Pain Medicine  Although opioids have been used to treat patients with chronic cancer and non-cancer pain for many years, when opioids are initiated, it can highlight the lack of knowledge regarding some aspects of opioid therapy for both physicians and patients. One of the most important areas is […]

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Opioid tolerance and dependency

Dr César Margarit Ferri, Chief: Pain Unit, Anesthesiology-Critical Care-Pain Medicine Department, Alicante Hospital, Spain Although opioids have been used to treat patients with chronic cancer and non-cancer pain for many years, when opioids are initiated, it can highlight the lack of knowledge regarding some aspects of opioid therapy for both physicians and patients. One of […]

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A place for NSAIDs

Dr Sean Chetty, Head of Anaesthesiology at Rahima Moosa Mother & Child Hospital and Senior Clinical Lecturer at Wits University, recently shared his knowledge and experience in the use of non-steroidal anti-inflammatory drugs (NSAIDs). “There was a previous misconception that only COX-2 inhibitors (coxibs) are dangerous. This is out the window and we now think […]

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Opioid misuse and abuse

Dr Luc Evenepoel Over the last decade, the use of opioids to treat chronic non-cancer pain has become more and more widespread. One of the reasons is that the scientific literature points out that our original fear for addiction was exaggerated and maybe even unfounded. However, have we been measuring the right things? Our thinking […]

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Placebo analgesia: It’s all in the head

Dr Luc Evenepoel Psychological aspects of placebo The placebo effect can be a partly learned phenomenon, but also occur without any conditioning. Its learned analgesic effects are elicited by telling the patient what benefit can be expected, for example, especially if paired with other pain-reducing modalities. With repeated exposure, this also enhances expectations of future […]

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Current evidence in the management of lower back pain

Dr Mike Marshall, Sports Medicine Specialist, Prime Human Performance Institute, Durban Lower back pain (LBP) is pain that occurs posteriorly in the region between the lower rib margin and the gluteal fold/proximal thigh. Acute pain is defined as pain of less than four weeks duration. Subacute LBP lasts between 4-12 weeks and chronic LBP is defined as […]

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Managing pain in oncology patients

By Dr Liz Gwyther, CEO: Hospice Palliative Care Association of SA The key to effective pain management is good assessment of pain. Many people with cancer expect to suffer pain. If patients are not asked, they do not describe their pain, as they see it as a part of their illness to be endured. This means that […]

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