Cancer doctors score low on pain management: study

Myofascial pain syndrome often leaves doctors baffled and patients untreated

In myofascial pain syndrome, muscle fibers contract but dont release. This creates knots of taut muscle, or trigger points, that send pain throughout the body, even to parts that are perfectly healthy.

The survey also included two scenarios, invented by the study authors, about a patient who’s in pain despite being on a relatively high dose of strong painkillers called opioids, such as morphine. Oncologists were asked if they would increase the dose, switch to a different medication or add a new drug on top of the original one. The right answers, according to pain specialists, included adding fast-acting drugs to doctors houston tx the original regimen or making small increases in the daily dose of the original drug. Most doctors missed the correct answers — 60 percent on one scenario and 87 percent on the other question, which required doctors to explain why a steep increase in an opioid dose would be dangerous. Doctors did generally agree that opioids should be the first choice to treat chronic cancer pain and are better used in regular doses than only when needed. They also said that patients’ reluctance to report pain and to take strong painkillers were barriers to appropriate care — but few regularly referred patients to pain specialists.
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Although physicians increasingly recognize referred pain today, diagnosis and treatment of myofascial pain often takes more time than most physicians can provide, according to Taylor. Practitioners need specific training to recognize trigger points. And they must examine and palpate patients carefully to identify and locate these taut bands of muscle fiber. In a 2000 survey, more than 88 percent of pain specialists agreed that myofascial pain syndrome was a legitimate diagnosis, but they differed over the criteria for diagnosing it. Norman Harden, the medical director of the Center for Pain Studies at the Rehabilitation Institute of Chicago, c onducted that survey. He believes that practitioners need clear, validated criteria for diagnosing myofascial pain and identifying effective treatments. He recently conducted another survey to determine if the level of recognition among pain specialists has changed.
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How Is Pain Measured And How Should I Talk About Pain With My Doctor?

Answer: A person with pain often asks whether or not pain can be measured and whether pain should be discussed with a physician. To answer this question, it’s very important to understand that although pain is a natural, biological phenomenon without which a person could not survive , when pain is acute and severe or pain becomes chronic , there’s no biological advantage. In fact, any patient who has chronic pain, pain that goes on for a period of months or outlasts the healing of an acute injury, any such person should consider the pain as being a chronic illness . Now, obviously people with the chronic illness of pain should be discussing this with their physicians. And they need to recognize that pain can be described in a variety of different ways. One way that’s common is to describe pain in terms of its severity or its intensity.
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Debbie Rowe: Michael Jackson Feared Pain and Trusted Doctors

The activity of your clearance system is based on your genetic code. Once tested, this knowledge about an individuals unique drug metabolizing system can help guide physicians. What is the purpose of PGT? Physicians would like to be able to anticipate how one may respond to a drug instead of relying on a trial-and-error process. By knowing the specific way one may break-down drugs, a physician can tailor treatment according to an individuals unique metabolism and immediately find the right drug. Not only will this information help physicians predict which drug will best treat pain, a physician will also be able to predict the effective dose and potential for toxicity.
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Could genetic testing help doctors treat pain more effectively?

Rowe testified that Jackson placed too much trust in his various doctors, whom she thought were trying to out-do each other in the pain medications they gave the singer. Jackson “needed somebody to be there for him … to not look at him as a cash cow,” said Rowe, who frequently burst into tears on the witness stand as she recalled the singer’s fear of pain and trust of physicians. “Michael had a very low pain tolerance and his fear of pain was incredible,” Rowe said. “I think the doctors took advantage of him that way.” In court, Rowe became frustrated at times with AEG’s attorneys. “You’re making it sound like he was going in all the time [for procedures that involved drugs or sedation], and he wasn’t,” Rowe said tearfully as she stretched her hands wide apart for emphasis. “You’re talking about a 12-year period here.” But Rowe, who said she’d known Jackson for roughly 20 years, was also humorous at times.
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