Abstract
This research paper attempts to evaluate whether patients suffering from chronic pain are more likely to be misdiagnosed as suffering from depression because their condition and disease is 'invisible' to physicians. More specifically the paper attempts to determine if there is a relationship between depression and chronic pain, and if so what the nature of that relationship is.

Introduction
Preliminary Literature Review
Conclusions

From the Paper
"There is a large body of evidence that suggests that patients suffering from chronic pain also suffer from psychological illnesses such as anxiety or depression (Hendler, 2003; Nelson & Novy, 1997). The question to be explored is whether or not the pain experienced results from the psychological illness (depression) or the depression results from the chronic pain. Common practice in the medical community up until this point in time has been to assume that chronic pain or the perception of pain results more from psychological factors such as depression, rather than to view depression as resulting from the inadequate treatment of chronic pain symptoms."

Tags:physicians, relief, symptoms, anxiety, medical, management

Abstract
The paper discusses a program that is targeted at older adults who suffer from chronic pain, utilizing a combination of therapies that are holistic and address conditions that affect the mind, body and emotions. The paper explains that chronic pain must include issues of loss and stress and this can only be achieved through the use of complementary and alternative interventions. The paper concludes that while there are restrictions on the implementation of this program, its main value is that it incorporates patients who are otherwise excluded, such as those with dementia.

Outline:
Introduction
The Necessity of the Program
The Elements of the Program
Health Teaching
Interventions and Individual Differences
Outcomes of the Program
Conclusion

From the Paper
"A complex continuing care program is intended to provide care for older patients who experience complex medical conditions in a non-acute hospital setting. Complex medical conditions include pain and symptom management, recovery from stroke, along with other chronic medical conditions which impact on patients' physical, emotional, social and spiritual well-being. The program was developed because pain among the elderly is often not adequately treated. When pain in older adults is not effectively managed, there are serious impacts on their physical and psychological functioning as well as on their quality of life (Herr, 2002)."

Tags:holistic, therapies, alternative, interventions, loss, stress, functioning

Abstract
Specifically the paper shows the connection between chronic pain and depression. It defines these terms and examines how it affects the person and the ones around them. The paper addresses treatment options and discusses ways to break the cycle.

From the Paper
"What causes depression? For thousands of years, depression was thought to simply be a weakness of the mind, often called "melancholia. "Depression is caused, in part, by certain life goals which become unfeasible, but which a person cannot abandon, this resulting in reflection upon lost goals. To gradually abandon these goals and to work towards other goals is to overcome the depression" (Miletich, 1995, p. 11). Today, we know depression is a treatable disease, and often physicians and therapists treat it with a variety of anti-depressive drugs, gaining very positive results. However, there is another kind of depression that is much more difficult to treat, because it is linked to a physical ailment, chronic pain. "

Tags:disease, suicide, health, care, patient, treatment

Abstract
This paper gives an in-depth analysis of a complex continuing care program intended to provide care for older patients who experience complex medical conditions in a non-acute hospital setting. Complex medical conditions include pain and symptom management, recovery from stroke, along with other chronic medical conditions which impact on patients' physical, emotional, social and spiritual well-being. The paper states that the program was developed because pain among the elderly is often not adequately treated.

From the Paper
"A complex continuing care program is intended to provide care for older patients who experience complex medical conditions in a non-acute hospital setting. Complex medical conditions include pain and symptom management, recovery from stroke, along with other chronic medical conditions which impact on patients' physical, emotional, social and spiritual well-being. The program was developed because pain among the elderly is often not adequately treated. When pain in older adults is not effectively managed,..."

Tags:program, management, pain

Abstract
This paper uses Foucault?s work on biopower and governmentality to analyse chronic pain as a resistance to power/knowledge formations that express themselves in terms of control over the body. It attempts to analyse chronic pain by using three different notions of resistance. It looks at how chronic pain causes a contraction of the social world especially in situations of biomedical practice when the moral decision ?it?s all in your head? can often be made by doctors. It examines how this process resists speech (and thus resocialisation) by analysing the dialectical tension this resistance has with the stress, rage and the impulse that drives us to unsettle or confound the fixed order of things. It then explores the resistance that people have to the pain that they feel followed by rage for order.

From the Paper
"Chronic pain confounds many of the concepts and methods used for its analysis, in part because of the privileging of certain spheres of analysis. This is noticeable in a set of assumptions that are part of both biomedical and western philosophical theory. This set of assumptions assumes a divide between mind and body; it assumes that diseases are universal biological or pyschophysiological entities resulting from somatic lesions and dysfunctions. These can produce signs of symptoms, and one must decode the cultural elements of patients systems in terms of their underlying somatic referents. If the symptoms do not fit this mould, then one is denied illness in the biomedical model."

Tags:torture, mind, body, foucalt, biopower, governmentality

Abstract
In the paper, the writer examines the growing demand by patients suffering from chronic pain for pain management and relief treatments that will improve the quality of their lives. The writer contends that America's rapidly growing population of Seniors, coupled with increased longevity is the reason for this demand and examines some of the solutions that doctors are able to provide. The author then examines the growth of specialized care in pain management and the current system for subspecialty certification for physicians, before making his final conclusions and recommendations.

Outline:
Introduction
Specialized Pain Management Growth
Increased Opportunity For Care
Current Opportunity for Specialization in Pain Management/Proposed AA System
Conclusion
References

From the Paper
"The current system for subspecialty certification for physicians, in pain medicine comes in the form of an annual exam offered by the ABPM. The organization certifies about 2200 physicians per year in this specialty through the successful completion of the exam, which has about an 80% pass rate. (ABPM, 2008, NP) It would be conducive to structure the AA system in a similar manner with the inclusion of preparatory post grad fellowship continuing education opportunities. Individual AA's who took the seminar style two semester prep classes, and who were signed off by a governing anesthesiologist or their work institution as working within this field successfully for greater than one year would be eligible to sit for the exam and would then be certified in the subspecialty of pain medicine if success was achieved on the exam. All preparation would also qualify the individual for continuing education credits, toward their general licensure and facility requirements. Some legislation for a broadening of services offered might also be needed to alter the current state of allowable practical functions of an AA. The development of such legislative changes would likely be welcomed, as cost reduction seems to be the rule of the day with regard to medical care and spending, and this would likely improve the availability and reduce the cost of procedures significantly."

Tags:physicians, medicine, insurers, anesthesiologist, hospital, chronic, epidural, medication, healthcare

Abstract
The paper defines pain, illness and the process of sensitization. The paper discusses the use of acupuncture in treating chronic pain conditions. The paper relates how unlike conventional treatments using synthesized oral pills, tablets or syrups, acupuncture enlists the natural body forces and processes to produce the relief or control of pain. The paper points out acupuncture's effectiveness, virtual lack of side effects and its safety and so argues for its recognition as a legitimate pain control treatment mode.

Outline:
Introduction
Review of Method
Conclusion

From the Paper
"Pain has been described as a jabbing, throbbing, burning or stinging sensation (Mayo Clinic Staff 2007). The uncomfortable experience is partly physical and partly influenced by psychological and cultural factors. Questions have remained as to what exactly happens when a part of the body or mind is affected and the time the person feels pain. Pain proceeds from a series of exchanges within the three major components of the nervous system, such as the peripheral nerves, the spinal cord and the brain. The peripheral nerves sense touch, pressure, vibration, cold and warmth."

Tags:chronic, backaches, side, effects, treatment

Abstract
This paper discusses the difficulties facing health care providers as they treat patients with chronic pain and pre-existing addictions. The paper suggests that physicians avoid prescribing opoids because of their addictive properties in spite of the fact that these drugs would provide pain relief. Methadone and buprenorphine treatments for addictions and pain relief are also discussed. The paper concludes by stressing that understanding the dynamics of addiction and chronic pain will allow medical professionals to offer their patients better care and support.

Outline
The Scope of the Problem
JCAHO Regulations and Patient Rights
Malignant vs. Non-Malignant Pain: Differences in Issuing Opioids
Malignant Pain
Non-Malignant Pain
Alzheimer's and Dementia
Factors That Influence the Pain Experience
Specificity Theory
Gate Control Theory of Pain
Cancer
Accident Injuries
Maintaining a Pain Journal
The Prescribing Physician
Methadone Treatments
Methadone Addiction: Scope and Scale
Buprenorphine
New Hope for Pain Management with Addictions?
Discussion

From the Paper
"Pain management for patients with addiction problems has been quite challenging for specialists to treat. Typically, the stigma attached to addictions has led to an under-management of pain symptoms leaving the prescribing physician in an awkward position. Generally, what transpires between the physician and patient is a push-pull of treatment options. The physician does not want to add to the addiction problem, or create a new addiction. Similarly, physicians are obligated to treat pain symptoms reported by patients- or they run the risk of being cited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) (Green & Mc Phail-Pruitt, 2004: JCAHO, 2009). This paper aims to explore and demystify the pain management process by addressing complications created by pre-existing addiction problems and the patient. New hope for reducing opioid addiction problems with the use of buprenorphine rather than methodone will also be discussed.
"Life can become extremely trying and difficult for pain sufferers (Passik & Kirsh, 2008). The primary problem that constantly requires attention is maintaining the optimum level of pain medication in order to prevent flare-ups and the rebound effect. Once a pain medication has had the opportunity to wear off, the problem is that pain will return with greater intensity, and more medication is required to achieve results (Vedhara & Irwin, 2005)."

Tags:Buprenorphine, Methadone, Opioids

Abstract
This paper focuses its analysis on the treatment of pain, or oligoanalgesia, in the setting of hospital emergency rooms. The paper explains that pain is a complex neurobiological problem that involves the nervou, cognitive, and emotional systems, and its highly subjective nature makes its assessment and management a complex problem. The paper notes that multimodal or combinational therapy is found to be the most effective in providing relief from acute pain. The paper opines that analgesia should be given a high priority in the ED setting. The paper also discusses pseudo addiction, and how it often leads to under treatment of chronic pain. The paper concludes that there is enough research evidence to suggest that a framework for pain management should be formulated and implemented in all hospital emergency departments, which would definitely reduce patient waiting time and improve pain management outcome.

Outline:
Abstract
Introduction
Pathology of Pain
Psychology of Pain
Chronic Pain in the ED
Training for Acute Pain Management
Addictive Personality and Pseudo Addiction
Treatment Modality
Conclusion
References

From the Paper
"One of the major issues revolving around pain care medication is the possibility of abuse. While in most cases patients are under treated there is also a significant percentage of emergency department visits by patients who have developed an addiction to opiate analgesics and other synthetic drugs. On the other hand over suspicion and interrogation may lead to oligonalgesia leaving the patient under treated and highly dissatisfied. Identifying this drug seeking behavior from genuine patients is a big problem for the physician. However, it is necessary that the patient presenting to the ED be screened for possible drug abuse and provided substance abuse treatment. A 1996 research by Rocket et.al involved an extensive study of patients in Tennessee emergency departments. The study observed that while 23% of these patients were identified as requiring substance abuse treatment only 1% was clinically documented for alcohol or drug related problems. This shows the underreported and largely ignored nature of substance abuse problem and the largely unmet treatment requirement for substance abuse. A subsequent study by the same author analyzed the cost effects of providing abuse related treatment in the ED. It was found that Tennessee patients with unmet substance abuse treatment incurred an addition of 777 million dollars to the ED treatment costs. It was concluded that the cost of ED screening and treatment of substance abuse would be more than compensated by the cost savings resulting from the decrease in the frequency of visits to ED. [11]"

Tags:oligoanalgesia, relief, analgesia

Abstract
The paper discusses the types of pain that include chronic pain, acute pain and breakthrough pain. The paper looks at the methods to make an effective diagnosis of pain and provides an understanding of how pain occurs. The paper then explores alternative therapies for pain and focuses on massage therapy and deep breathing. The paper concludes that there is enough evidence that unconventional and alternative strategies for treatment can have beneficial effects.

Outline:
Introduction
Mechanism of Pain
Kinds of Pain
Alternative Therapies for Pain Management
Massage Therapy
Use of Massage Therapy
Deep Breathing
Conclusion

From the Paper
"There is a journal that is dedicated to the subject of pain--Pain. Pain is an important aspect of life because it is the mechanism by which the body protects itself. The capacity to monitor the integrity of our bodies and to be made immediately aware of injury through the experience of pain is critical for our survival. Individuals who are born without this capacity frequently die at relatively young ages from injuries or illnesses that they never realized they had. There are different therapeutic modalities to treat pain. Of these, massage therapy or deep breathing are two. The International Association for the Study of Pain defines pain as "... an unpleasant sensory and emotional experience associated with actual or potential tissue damage."(Merskey, 1979) Margaret McCaffrey, a social scientist and registered nurse was quoted in cancer-pain.org as saying: "Pain is whatever the experiencing person says it is, and exists whenever he says it does." (McCaffrey, 1972)"

Tags:nerves, stress, cortisol, relaxation, wellbeing, immune, system