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The mission of Pain Treatment Topics is to serve as a noncommercial resource for healthcare professionals, providing open access to clinical news, information, research, and education for a better understanding of evidence-based pain-management practices. Advertising is not accepted.
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May-June 2008 News/Research UPDATES
 In this latest edition >>
> Vitamin D for Relieving Chronic Pain Examined
> Methylnaltrexone Relieves Opioid-Induced Constipation
> Frequent Opioid Use May Increase Risk of Chronic Migraine
> Transdermal Fentanyl Provides Osteoarthritis Pain Relief
> Opioid Pain-Relief Benefits Outweigh Risks of Abuse
> Associations of Daily Chronic Pain & Diabetes Studied
> Pregabalin Offers Long-Term Relief of Painful Neuropathy
> Duloxetine Effective for OA Knee Pain; Research Report
> What is Consumer Reports Telling Patients About Opioids?
> Recent Drug or Device Approvals and Announcements
And, more... See News/Research Updates...>
New Section - INNOVATIONS in Pain Tx
Vitamin D – A Surprising “Analgesic” for Chronic Pain
By: Stewart B. Leavitt, MA, PhD, Pain Treatment Topics, June 2008.
 Helping patients overcome their chronic musculoskeletal pain and fatigue syndromes may be as simple, well tolerated, and inexpensive as an extra daily supplement of vitamin D. A comprehensive Report and a shorter Practitioner Briefing review the clinical evidence and provide clinical guidance for healthcare providers. A special Brochure for patients explains what vitamin D is, how it works, and how it can help them.
Go to the Documents...>
New Current Comments - Signs of Pain
Using Objective Signs of Severe Pain to Guide Opioid Prescribing
By: Forest Tennant, MD, DrPH, Pain Treatment Topics, June 2008.
 This brief paper tells how uncontrolled severe pain can almost always be identified by objective physical signs that help practitioners to differentiate between drug-seekers and relief-seekers, as well as to determine if opioid dose is adequate. Uncontrolled pain stirs observable physiologic responses as well as signs relating to how patients seek positional relief, sensory avoidance, and pain distraction.
See Article...>
Guidelines/Reports Sections UPDATED
Quite a number of new additions and changes have been made under the Pain-Topics.org Guidelines/Reports tab.
As always, look for the “NEW” icon to see at-a-glance what items are new or have changed.
Position/Policy/Consensus Statements
11 new entries and 18 updates were made to this section. One new item focuses on "Opioids and the management of chronic severe pain in the elderly." Go to Section...>
Pain Treatment Guidelines
4r new guidelines were added. For example, one focuses on ACR 2008 recommendations for the use of non-biologic and biologic DMARD in rheumatoid arthritis. Another addresses opioids in the management of chronic non-cancer pain. Go to Section...>
Systematic Reviews
4 new reviews have been added. This section includes reviews pertaining to pain management from the Cochrane Database as well as from many other sources. Go to Section...>
Updated Methadone Safety Guidance
Methadone is a good choice for cancer pain and chronic noncancer pain, but special safety cautions must be observed as methadone's pharmacokinetics and pharmacodynamics are unique among opioids. These documents discuss the critical safety issues and provide guidance for methadone analgesia dosing, as well as special instructions for patients.
Access These Documents...>
Oral Methadone Dosing for Chronic Pain
By: James D. Toombs, MD; March 2008.
Methadone Safety Handout for Patients
By: Stewart B. Leavitt, MA, PhD; March 2008.
Keeping Patients Safe from Iatrogenic Methadone Overdoses
From: Institute for Safe Medication Practices (ISMP). February 14, 2008.
NEW PATIENT RESOURCES of Importance...
Vitamin D: A Champion of Pain Relief
Overcoming chronic pain may be as simple, safe, and inexpensive as an extra dose of vitamin D each day. This 6-page brochure explains in easy-to-understand language what vitamin D is and how it works. In also describes how inadequate vitamin D intake may play a role in aches and pains, as well as the benefits of vitamin D supplementation for relieving these symptoms. See Details...>
FIBROMYALGIA offerings added...
> Fibromyalgia (from Mayo Clinic; 2008)
> What is Fibromyalgia? Fast Facts (from NIAMS; 2007)
> Fibromyalgia Factsheet (from ACR; 2006)
> Questions and Answers About Fibromyalgia (from NIAMS)
See Details...>
Pain Resource Guide: Getting the Help You Need
From: American Pain Foundation; 2007; 27 pages.
This booklet is designed to help patients take charge of their pain care. It provides important information about pain, answers to common questions, and helpful tips for getting quality pain care. In easy-to-read fashion, the booklet discusses why pain management is important, how to find pain specialists, and methods commonly used to assess and diagnose pain conditions. See Details...>
SPECIAL ANNOUNCEMENTS 
New APF Report Addresses Opioid Analgesia Concerns
The American Pain Foundation (APF) released a new report outlining critical barriers to opioid prescribing for pain management, and calls for a more balanced consideration of the risks and benefits of these vital analgesics. A 16-page document summarizes key challenges and actionable solutions discussed by leading pain experts at a recent roundtable meeting.
<Download the Report>
The Pain Practitioner Special Edition - FIBROMYALGIA
This special issue of The Pain Practitioner journal focusing on fibromyalgia (FM) is designed to show exactly how real the syndrome is and how far it has come medically. An excellent compendium of 9 articles is authored by experts in the field. Topics include: advances in FM research, treatment options, treating comorbidities of FM, psychosocial aspects, and adopting integrative approaches that combine basics with innovative therapies.
<See Details and Download Journal >
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Stewart B. Leavitt, MA, PhD; Publisher & Editor-in-Chief
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