David M. Cline
Epidemiology Pathophysiology Clinical.Features Diagnosis
Treatment chronicPainjn the, Elderly Disposition
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Specific Issues: Legal Implications Treatment and Disposition Chapter, References
Chronic pain is defined as a painful condition that lasts longer than 3 months. 1 Chronic pain can also be defined as pain that persists beyond the reasonable time for an injury to heal or a month beyond the usual course of an acute disease. There are four basic types of chronic pain: (1) pain persisting beyond the normal healing time for a disease or injury, (2) pain related to a chronic degenerative disease or persistent neurologic condition, (3) cancer-related pain, (4) pain that emerges or persists without an identifiable cause. Chronic pain differs from acute pain in its function. Acute pain is an essential biologic signal to warn the individual to stop a potentially injurious activity or to prompt one to seek medical care. Chronic pain serves no obvious biologic function. Chronic pain patients presenting to the emergency department (ED) have not been well studied, despite their apparent numbers.
Complete eradication of pain is not a reasonable end point in most cases. Rather, the goal of therapy is pain reduction and return to functional status. Chronic pain syndromes discussed in this chapter include myofascial headaches, "transformed" migraine headaches, fibromyalgia, myofascial chest pain, back pain, complex regional pain types I and II, postherpetic neuralgia, and phantom limb pain. Drug-seeking patients are also covered.
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Are Headaches Taking Your Life Hostage and Preventing You From Living to Your Fullest Potential? Are you tired of being given the run around by doctors who tell you that your headaches or migraines are psychological or that they have no cause that can be treated? Are you sick of calling in sick because you woke up with a headache so bad that you can barely think or see straight?