By Michael Serpell
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Sample text
Because many painful neuropathies affect only the small nerve fibres, the NCV and EMG will be normal. g. quantitative sensory testing) often requires specialized equipment and interpretive expertise. Diagnostic imaging is often not useful initially in identifying the anatomical cause of the chronic pain because the abnormalities causing the pain may not be detected. Instead, imaging should be used generally to confirm or rule out the suspected cause of the chronic pain. Summary Patient assessment is the start of the therapeutic process.
6). Psychosocial features have been shown to be predictors of the incidence and duration of chronic pain. It is important to realize that this does not imply that the pain has a psychological basis, only that psychological and social factors may be important drivers in the severity and maintenance of pain, amount of functional impairment and degree of responsiveness to treatment. 5 Features of neuropathic pain t May be unaccompanied by ongoing tissue damage and also occur in an area of sensory loss t May be burning or lancinating in nature.
50% fewer GI complications and no effects on platelet coagulation). They were previously recommended for those patients at risk for peptic ulcer disease, but subsequently were shown to increase the incidence of myocardial infarct and strokes. It transpires now that probably most of the other NSAIDs (except naproxen) suffer from the same problem and we need to evaluate the cardiovascular risk in all patients considered for NSAID therapy [1]. Step 2 and 3 opioids Use of the less potent Step 2 opioids such as codeine, dihydrocodeine and dextropropoxyphene is commonly but inappropriately practised.