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One of the Most Rapidly Advancing Fields in Modern Neuroscience The success of molecular biology and the new tools derived from molecular genetics have revolutionized pain research and its translation to therapeutic effectiveness. Bringing together recent advances in modern neuroscience regarding genetic studies in mice and humans and the practical
Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
A textbook and practical clinical handbook for all students and practitioners concerned with the evaluation, diagnosis, assessment and management of neck pain and cervical headache particularly in relation to whiplash. It is likely to become essential study for final year physiotherapy and chiropractic students, for all manipulative physiotherapy MSc students and a widely used clinical ref text for all involved in the assessment and management of whiplash and related neck and head pain. ? This book presents the applied sciences, clinical assessment methods and rehabilitation protocols for the management of persons with neck pain. ? The material presented in this book represents the translation of research into clinical practice and provides a systematic approach to assessment and an evidence base for conservative clinical management strategies for neck pain. ? Unique topics in this book include: . Provides an understanding of the pathophysiological processes in the sensory, motor and sensorimotor systems and how they present in patients with neck pain disorders. . Presents multimodal approaches to management of neck pain guided by the evidence of presenting dysfunctions . Presents a comprehensive description of a therapeutic exercise approach based on motor control which has proven efficacy.
The most recent high-profile advocate for Americans with disabilities, actor Christopher Reeve, has highlighted for the public the economic and social costs of disability and the importance of rehabilitation. Enabling America is a major analysis of the field of rehabilitation science and engineering. The book explains how to achieve recognition for this evolving field of study, how to set priorities, and how to improve the organization and administration of the numerous federal research programs in this area. The committee introduces the "enabling-disability process" model, which enhances the concepts of disability and rehabilitation, and reviews what is known and what research priorities are emerging in the areas of: Pathology and impairment, including differences between children and adults. Functional limitationsâ€"in a person's ability to eat or walk, for example. Disability as the interaction between a person's pathologies, impairments, and functional limitations and the surrounding physical and social environments. This landmark volume will be of special interest to anyone involved in rehabilitation science and engineering: federal policymakers, rehabilitation practitioners and administrators, researchers, and advocates for persons with disabilities.
Chronic pain costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the Institute of Medicine (IOM) in examining pain as a public health problem. In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America. To reach the vast multitude of people with various types of pain, the nation must adopt a population-level prevention and management strategy. The IOM recommends that HHS develop a comprehensive plan with specific goals, actions, and timeframes. Better data are needed to help shape efforts, especially on the groups of people currently underdiagnosed and undertreated, and the IOM encourages federal and state agencies and private organizations to accelerate the collection of data on pain incidence, prevalence, and treatments. Because pain varies from patient to patient, healthcare providers should increasingly aim at tailoring pain care to each person's experience, and self-management of pain should be promoted. In addition, because there are major gaps in knowledge about pain across health care and society alike, the IOM recommends that federal agencies and other stakeholders redesign education programs to bridge these gaps. Pain is a major driver for visits to physicians, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority.
Basic science and clinical pain research is particularly challenging for several reasons. First, pain is a subjective experience in response to nociception that follows actual or potential tissue damage. Since the ability to respond to this warning signal is essential for our survival, the nociceptive system that produces and transmits nociceptive signals is remarkably redundant and involves diffuse regions of the central nervous system. Second, unlike other sensory modalities, pain is a multi-dimensional experience including at least cognitive, affective, and sensory-discriminative components. Third, pain experiences can be influenced by psychological, socioeconomic, cultural, and genetic predispositions, making it exceedingly complicated to study pain and pain modulation. The topics covered in this volume are carefully selected and directly related to the daily practice of pain medicine. These topics include 1) central mechanisms of pain and pain modulation (Dickenson, Donovan-Rodriguez, Mattews) and clinical use of ion channel blockers (Chen); 2) spinal glutamatergic mechanisms (Guo, Dubner, Ren) and issues related to glutamate receptor antagonists in pain management (Mao); 3) basic science of opioid analgesics (Gintzler, Chakrabarti) and clinical opioid use (Smith, McCleane); 4) inflammatory cytokines (Samad) and clinical use of anti-inflammatory drugs (Fink, Brenner); 5) role of the sympathetic nervous system in pain mechanisms and its relation to clinical pain management (Sharma, Raja); 6) preclinical studies on tricyclic antidepressants (Gerner, Wang) and clinical use of antidepressants in pain management (Greenberg); 7) developing pain pathways and analgesic mechanisms during the developmental stage (Fitzgerald) and challenges of pediatric pain management (Lebel); 8) basic science mechanisms of serotonin agonists and their use in the clinical management of migraine headache (Biondi); 9) clinical research on gender differences in clinical pain and their implications for clinical pain management (Holdcroft); 10) current modalities of clinical cancer pain management (Popescu, Hord); and 11) preclinical and clinical information on alternative medicine (Chen).