Painrelief-resoucepage

2005-11-08T16:16:00.000-08:00

coma treatment for chronic pain

The influence of such factors should also be examined during studies
aimed at defining the efficacy of specific treatments and their
associated side effects. Drug interactions during long-term cancer pain
treatment require clarification. It is unclear whether a mechanism-
based approach to diagnosing and relieving each component of pain
in an individual is more effective than an empiric regimen in which
each patient's treatment is based upon pain intensity alone. Another
key unanswered question is how to optimally combine drug with non-
drug therapies, given that the latter are safe and inexpensive. Despite
the importance of pediatric cancer pain control, practically no
analgesic drug trials focus on children.

2005-11-08T15:16:00.000-08:00

sombra pain relief cream

High-quality trials of cancer pain relief should enroll greater numbers
of patients for longer intervals than has generally been true in the past;
apply blinding and active placebos when appropriate, or uniform
control treatments otherwise; employ adequate between-arm washout
intervals and consider advancing disease state in crossover trials; and
assess side effects, pain mechanisms, and rest, incident, or
breakthrough pain in a standardized, combinable fashion.
Investigations of cancer pain and its control should seek to evaluate
the influence of gender, race, age, psychosocial context, ethnicity, and
culture on the experience and report of pain.

2005-11-08T01:16:00.000-08:00

pain relief from shingles

Prevalence of Cancer-related Fatigue
Estimations of fatigue prevalence have been performed in the setting
of many types of cancer treatment, in the palliative setting, and among
cancer survivors, but the data is by no means consistent or
comprehensive. Many types of cancer were not specifically
addressed.

2005-11-07T19:16:00.000-08:00

acute fleetin kidney pain

Study Selection
Only studies that assessed the prevalence of the symptom as the
primary purpose of the study were used for estimating the prevalence
of cancer-related symptoms. For assessment, both retrospective and
prospective studies were used, as well as randomized and
nonrandomized trials, and cross-sectional and longitudinal studies.
Randomized controlled trials were used to analyze efficacy of
interventions.

2005-11-07T16:16:00.000-08:00

ovarian cancer pain spotting

Return to Contents

2005-11-07T15:16:00.000-08:00

pain american cancer society paraneoplastic syndrome

Prevalence of cancer-related pain.
Prevalence of cancer-related depression.
Prevalence of cancer-related fatigue.
Assessment of cancer-related pain.
Assessment of cancer-related depression.
Assessment of cancer-related fatigue.
Treatment of cancer-related pain.
Treatment of cancer-related depression.
Treatment of cancer-related fatigue.
For some of these topics, in particular the treatment of cancer pain,
there are multiple questions. The Evidence-Based Practice Center
(EPC) produced the evidence report on the Management of Cancer
Pain based on a literature search conducted in December 1998. For
the cancer-related pain topics, the results for the key questions
addressed in the prior EPC report have been thoroughly updated. At
the request of the conference planning committee, two new topics
were added to the treatment of cancer-related pain: oral mucositis
and post-herpetic neuralgia. The methodological approach is
summarized and the new evidence reported. Readers are referred to
the earlier evidence report for detailed information about the
methodological approach and the findings. New systematic reviews
are also included for the symptoms of cancer-related depression and
cancer-related fatigue.

2005-11-07T09:16:00.000-08:00

presentation management of acute chest pain

----------------------------------------------------------------------
----------

2005-11-07T02:16:00.000-08:00

acute chest pain

Return to Contents
Availability of the Full Report
The full evidence report from which this summary was taken was
prepared for the Agency for Healthcare Research and Quality
(AHRQ) by the New England Medical Center Evidence-based
Practice Center (EPC), Boston, MA, under contract number
290-97-0019. Printed copies may be obtained free of charge from
the AHRQ Publications Clearinghouse by calling 1-800-358-9295.
Requesters should ask for Evidence Report/Technology Assessment
No. 61, Management of Cancer Symptoms: Pain, Depression, and
Fatigue.
The Evidence Report is also online at the National Library of
Medicine Bookshelf, or can be downloaded as a set of PDF files or
as a zipped file.

2005-11-06T07:16:00.000-08:00

pain treatment & illinois

Although trazodone, an atypical antidepressant, showed some benefit
in treating depressive symptoms, it is not commonly used as an
antidepressant because of severe sedation at therapeutic doses.
Although there have been reports describing alternative or
complementary therapy programs, there have been no controlled trials
for their efficacy for depression in people with cancer.

2005-11-05T21:15:00.000-08:00

alternative treatments back pain

Other tools applied in the selected studies include global evaluations
of efficacy and the McGill-Melzack pain questionnaire. Also applied
were measures of analgesic consumption and a four-point side effect
scale. Descriptions of the need for detailed assessment conducted
within a psychosocial framework are presented in virtually all
guidelines or monographs on cancer pain management. A voluminous
literature describes the multidimensional, experiential nature of cancer
pain and links poor control of cancer pain to impaired quality of life,
including functionality.

2005-11-05T16:16:00.000-08:00

arthritis sternum pain

Prevalence of Cancer-related Depression
Major depression and depressive symptoms occur frequently in
patients with cancer. Despite standardized measures to calculate
incidence and prevalence, there is a wide range of reported data.
Prevalence rates varied from 10 to 25 percent for major depressive
disorders and a similar range exists for clinically significant depressive
symptoms. This range is the probable result of several factors that
include timing of the assessment, concurrent treatment, medical
morbidity, and pain, gender, and age. Cancer patients are a
heterogeneous population with different sociodemographics, cancer
types, treatments, and responses to treatment. Given that the
estimated point prevalence of major depression in the general
population is 2.2 percent, the rates in cancer patients may be at least
four times greater.

2005-11-05T14:15:00.000-08:00

ultra sound message treatment for spine pain

This disturbing finding reflects data from developed countries, where
patients are often in tertiary care or specialist consultative settings.
The likelihood of pain increases, as does its severity, with advancing
cancer stage. (Minorities, women, and the elderly may be at greater
risk for undertreatment of cancer pain.) Pain is generally not
eliminated, despite analgesic therapy administered according to the
World Health

2005-11-05T11:16:00.000-08:00

pain treatment merec

2005-11-05T10:16:00.000-08:00

limb ischemic rest pain right lower extremity treatment

The searches were supplemented with reviews of bibliography of
selected references. The EPC also identified published meta-analyses
and used their data for selected topics.

2005-11-05T00:16:00.000-08:00

arthritis hip disease and groin pain

Overview
This evidence report on Management of Cancer Symptoms: Pain,
Depression, and Fatigue was produced on request from the Office of
Medical Applications of Research (OMAR) at the National Institutes
of Health (NIH) for a State-of-the-Science Conference.

2005-11-04T20:15:00.000-08:00

cognitive behavior treatment for chronic pain

" The First Amendment requires that restrictions on commercial
speech must directly advance a substantial government interest and be
no more extensive than necessary to serve that interest. Commissioner
Swindle explained that "[b]ecause it has not been proven that the false
superior efficacy belief in this case is likely to linger, there is no false
belief that needs to be corrected to prevent deception; therefore,
corrective advertising cannot directly advance any substantial
governmental interest."

2005-11-04T15:16:00.000-08:00

treatments for arthritis pain and stiffness

The Order requires ads and packaging for Doan's pills to include,
clearly and conspicuously, the message, "Although Doan's is an
effective pain reliever, there is no evidence that Doan's is more
effective than other pain relievers for back pain." The statement will
be carried on all packaging and advertising for one year, except radio
and television ads of 15 seconds or less, and until Novartis has
expended on Doan's advertising an amount equal to the average spent
annually during the eight-year campaign - $8 million.

2005-11-04T11:16:00.000-08:00

traction treatments for spinal pain

In March 1998, Administrative Law Judge (ALJ) Lewis F. Parker
upheld the FTC charges that the Doan's ads were unsubstantiated and
false but did not impose a corrective ad remedy sought by complaint
counsel. Both parties appealed the ALJ's decision to the full
Commission.

2005-11-04T05:16:00.000-08:00

urinary tract infection pain treatment

Availability of the Full Report
The full evidence report from which this summary was taken was
prepared for the Agency for Healthcare Research and Quality
(AHRQ) by the New England Medical Center Evidence-based
Practice Center (EPC), Boston, MA, under contract number
290-97-0019. Printed copies may be obtained free of charge from
the AHRQ Publications Clearinghouse by calling 1-800-358-9295.
Requesters should ask for Evidence Report/Technology Assessment
No. 61, Management of Cancer Symptoms: Pain, Depression, and
Fatigue
The Evidence Report is also online at the National Library of
Medicine Bookshelf, or can be downloaded as a set of PDF files or
as a zipped file.

2005-11-03T18:16:00.000-08:00

shoulder pain treatment

Data that address individual variations in preferences for, responses
to, and costs incurred by these options are a foundation for potential
evidence-based approaches to cancer pain control, but are sparse.
For example, the spinal route of analgesia is widely employed but
much remains to be learned about optimal patient selection, the
comparative efficacy of spinal drug infusion versus systemic drug
administration, and the selection of initial or secondary agents or
combinations. Exploring these fundamental questions will enhance the
ability of translational clinical research to clarify the clinical relevance
of an increasing number of basic insights into unique mechanisms and
mediators of cancer pain.

2005-11-03T09:16:00.000-08:00

back pain from cancer

One randomized controlled trial evaluated oral transmucosal fentanyl
citrate for breakthrough pain (using a study design in which rescue
doses of morphine were available) and demonstrated its superiority to
placebo. Another randomized study in ambulatory cancer patients
provided evidence for greater analgesia and faster onset of relief after
oral transmucosal fentanyl citrate than after the usual rescue drugs
used by these patients. The EPC found no randomized controlled
trials addressing analgesic efficacy and safety of NSAIDs selective for
the cyclooxygenase-2 isozyme in treating cancer pain. The use of
bisphosphonates and radiation therapy are both supported by the
retrieved trials. Unfortunately, studies that point to the optimal
sequence of application of the many currently available interventions
for pain control were not identified.

2005-11-03T04:16:00.000-08:00

cancer lung pain

Assessment of Cancer-related Pain
Many types of instruments are applied to assess pain and related
analgesic outcomes. In 218 trials, 125 distinct tools were employed.
By far the most frequently employed were unidimensional scales of
pain intensity, followed by scales of pain relief, then measures of peak
or summed pain intensity differences between experimental and
control groups. Other tools applied in the selected studies include
global evaluations of efficacy and the McGill-Melzack pain
questionnaire. Also applied were measures of analgesic consumption
and a four-point side effect scale. Descriptions of the need for
detailed assessment conducted within a psychosocial framework are
presented in virtually all guidelines or monographs on cancer pain
management. A voluminous literature describes the multidimensional,
experiential nature of cancer pain and links poor control of cancer
pain to impaired quality of life, including functionality. Current
expectations for detailed, multidimensional assessment of cancer pain,
including quality of life assessment, during cancer care contrast with
the minimalist assessments of pain intensity presented during relatively
brief observation intervals reported in nearly all of the trials. Side
effects limit analgesic dosage and hence impede pain control in many
patients, yet only one of the 16 most widely employed outcomes
measures is concerned with side effects; that one is a coarse, four-
point measure.

2005-11-02T16:16:00.000-08:00

breast cancer back pain

2005-11-02T14:16:00.000-08:00

testicle pain treatment soreness

Reporting the Evidence
The State-of-the-Science Conference planning committee
acknowledged that many symptoms are relevant to the care of cancer
patients, but because the current conference can address only a
limited number of topics, pain, depression, and fatigue were selected
as the focus. The planning committee identified prevalence,
assessment, and treatment as the key issues to be addressed for each
of the three chosen symptoms. The following questions were
formulated by the conference planning committee:

2005-11-02T09:16:00.000-08:00

type of pain from advanced colon cancer

2005-11-01T12:16:00.000-08:00

exercise for back pain sufferers

Carefully designed trials with cancer pain relief as a primary outcome
are required in patients with well-defined disease and pain
mechanisms. Such trials must conform to rising expectations for
clinical trials in general. High-quality trials of cancer pain relief should
enroll greater numbers of patients for longer intervals than has
generally been true in the past; apply blinding and active placebos
when appropriate, or uniform control treatments otherwise;

2005-10-31T20:15:00.000-08:00

knee pain arthritis

A very broad range of prevalence rates has been reported, from 4
percent in breast cancer prior to starting chemotherapy and 8 percent
in prostate cancer prior to radiation therapy, to 91 percent in breast
cancer patients after surgery and chemotherapy and before bone
marrow transplantation. Findings of significant concern were the
prevalence rates of fatigue in cancer survivors: 26 percent in
Hodgkin's disease survivors; 35 to 56 percent in breast cancer
survivors; and 48 percent in a cohort treated for various cancers.
Comparisons of the prevalence rates in these studies are problematic,
however, since each study used different criteria for defining the
presence or absence of fatigue and its severity.

2005-10-31T11:16:00.000-08:00

lhermittes sign pressure pain arthritis numb

The searches were supplemented with reviews of bibliography of
selected references. The EPC also identified published meta-analyses
and used their data for selected topics.

2005-10-30T18:16:00.000-08:00

herbal pain treatment

Commissioner Swindle issued a separate statement, dissenting from
the imposition of the corrective advertising requirement. He said that
corrective advertising is "intended to prevent the harm to consumers
and competition that is caused when a false belief engendered by
prior deceptive advertising lingers."

2005-10-29T10:15:00.000-07:00

herniated disks upper back pain relief

Treatment of Cancer-related Pain
Direct inter-class comparisons of efficacy do not differentiate between
the relative efficacy of opioids and NSAIDs administered through
various routes to patients with mild, moderate, or severe cancer pain.
Opioid dose-sparing is achieved by co-administration of NSAIDs but
without a consistently demonstrable reduction in side effects. The
heterogeneity of existing trials precludes meta-analyses to address
most subquestions. A difference in analgesic efficacy between
NSAIDs was only evident in a single retrieved trial. Likewise, the
efficacy of NSAIDs versus "weak" opioids could not be discerned in
the retrieved trials. However, such trials enroll relatively small
numbers of patients and follow them for intervals of hours to days,
and only occasionally as long as 2 weeks. Many examine drugs not
available in the United States or no longer in general use for cancer
pain relief (e.g., pentazocine). Prior efforts described in the previous
evidence report to strengthen such evidence by examining
nonrandomized trials were not fruitful.

2005-10-28T05:16:00.000-07:00

pain relief arthritis in the neck

2005-10-27T19:16:00.000-07:00

acute shoulder joint pain during menstruation

The timing of measurements of depressive symptoms does appear to
be important and may contribute to the variance. One goal may be to
develop a statistical model that could predict the rate of depression
given the cancer and treatment demographics of the population.
Studies should always include assessment of past histories of
depression.

2005-10-27T16:15:00.000-07:00

relief low back pain

It is unclear whether a mechanism-based approach to diagnosing and
relieving each component of pain in an individual is more effective than
an empiric regimen in which each patient's treatment is based upon
pain intensity alone. Another key unanswered question is how to
optimally combine drug with non-drug therapies, given that the latter
are safe and inexpensive. Despite the importance of pediatric cancer
pain control, practically no analgesic drug trials focus on children.

2005-10-27T07:16:00.000-07:00

emu oil natural pain relief

2005-10-26T23:15:00.000-07:00

peroneal tendon pain treatment

2005-10-26T22:16:00.000-07:00

radio frequency ablation for pain control

2005-10-26T21:16:00.000-07:00

brain cancer leg pain and numbness

2005-10-26T20:15:00.000-07:00

gate control pain diagram

During the time frame of the studies, reports of incidence ranged
widely from about 2 to 17 percent. However, these studies like other
prevalence studies face the same difficulties of heterogeneous
populations, and there are too few naturalistic studies that follow
patients from the point of diagnosis and few that serially measure
depression.

2005-10-26T19:15:00.000-07:00

causes of acute penis pain

2005-10-26T18:16:00.000-07:00

how does modulation effect pain control with e-stim

Organization method for cancer pain relief, and may continue to be a
problem even after eradication of the underlying neoplasia. Multiple
processes underlie cancer-related pain, yet survey data for the most
part do not distinguish between different etiologies and mechanisms,
nor do they provide a comprehensive picture of pain over the
continuum of care, nor of the relationship between effectiveness of
pain control and quality of life. The number of patients enrolled in
methodologically sound trials of cancer pain relief is a small fraction of
those receiving care.

2005-10-26T16:16:00.000-07:00

pain relief for hip surgery

Findings
Prevalence of Cancer-related Pain
Surveillance data on the incidence and prevalence of cancer and
observational and survey data on the incidence of cancer-related pain
indicate that a majority of patients experience pain at some point
during their course of treatment, and that cancer pain impairs quality
of life and functionality.

2005-10-26T12:16:00.000-07:00

best pain relief for gout

Literature Search
Literature searches were conducted to identify studies published
between 1966 and 2001 in MEDLINE�, CANCERLIT�, and the
Cochrane Controlled Trials Registry. For cancer pain, the EPC
applied the same search strategy used in its previously published
Management of Cancer Pain evidence report to identify new studies
published in the period from December 1998 through June 2001. The
National Library of Medicine, as a partner in the NIH Consensus
Development Conference process, with input from the EPC staff,
performed the literature search for cancer-related depression and
cancer-related fatigue.

2005-10-26T08:16:00.000-07:00

muscle pull pain relief

What are the directions for future research?
The symptoms and issues identified by the planning committee create
nine distinct topics, several of which are very broad in nature and
encompass interrelated issues. Addressing each of the nine topics fully
is beyond the scope of this evidence report. This report is structured
according to the following topics:

2005-10-26T03:16:00.000-07:00

heel spur pain relief

2005-10-25T20:16:00.000-07:00

throbbing acute pain side of mouth

2005-10-25T19:16:00.000-07:00

pain control specialist phoenix arizona

Responding to arguments by attorneys for Novartis that corrective
advertising would be punitive, Anthony wrote, ". . . it is not punitive to
require respondent to tell the truth."
The Commission vote to issue the Order was 4-0, with Commissioner
Orson Swindle concurring in part and dissenting in part.

2005-10-24T21:16:00.000-07:00

cloves tooth pain relief

2005-10-23T15:16:00.000-07:00

masqueliers+helps control pain

Despite dramatic advances in cancer biology and a widening array of
treatment options, cancer continues to cause devastating suffering not
only to hundreds of thousands of patients who die of it each year in
the United States, but also to some patients who are successfully
treated and become cancer survivors. Pain, depression, and fatigue
are prominent contributors to suffering in many of these individuals.
Clinical research on these symptoms holds out the hope of relief for
suffering through better understanding of these symptoms and the
development of new, more effective treatments.

2005-10-23T14:15:00.000-07:00

pain + neck fusion

2005-10-23T04:16:00.000-07:00

pain treatments

There is sufficient preliminary evidence to support randomized
controlled trials of several interventions for cancer-related fatigue,
including exercise programs, psychosocial interventions, and stimulant
medications. Further laboratory research and observational studies on
the physiology of cancer-related fatigue are needed in order to
generate rational hypotheses for future intervention trials. Clinical trials
for cancer-related fatigue need to utilize appropriate study designs,
including the prospective identification of outcomes of interest and
sample sizes calculated to provide a reasonable likelihood of detecting
those outcomes.

2005-10-22T18:16:00.000-07:00

neck pain in child

2005-10-22T17:16:00.000-07:00

neck pain in 5 child

2005-10-22T16:16:00.000-07:00

neck pain during bedrest

employ adequate between-arm washout intervals and consider
advancing disease state in crossover trials; and assess side effects,
pain mechanisms, and rest, incident, or breakthrough pain in a
standardized, combinable fashion. Investigations of cancer pain and its
control should seek to evaluate the influence of gender, race, age,
psychosocial context, ethnicity, and culture on the experience and
report of pain. The influence of such factors should also be examined
during studies aimed at defining the efficacy of specific treatments and
their associated side effects. Drug interactions during long-term
cancer pain treatment require clarification.

2005-10-22T15:16:00.000-07:00

neck pain excercises

2005-10-22T14:16:00.000-07:00

neck pain median nerve

The scientific evidence on cancer pain relief, however, compares
unfavorably with the massive amount of information known about the
efficacy and effectiveness of treatments for other high-impact
conditions, including cancer itself. Quality of life has not been
uniformly assessed in trials of analgesic drugs and non-drug
interventions for cancer pain. Limited evidence from the retrieved
trials demonstrates that optimal analgesia benefits quality of life.
Advances in quality-of-life assessment and insights from research on
chronic non-cancer pain into relationships between pain, disability,
and impairment offer the opportunity to begin to understand these
interactions in the context of cancer pain.

2005-10-22T11:16:00.000-07:00

neck pain travel pillows

2005-10-22T10:16:00.000-07:00

neck pain squamous cell

Although not all pharmacologic studies showed benefit for depression
in cancer patients, every study that used antidepressants and
conformed to usual practices for antidepressant trials did. Since
antidepressants typically can take 4 to 6 weeks for their full effect,
studies of antidepressants under 6 weeks tended to show less benefit.
Currently, there is data that selective serotonin reuptake inhibitors
(SSRIs) and tricyclic antidepressants are effective.

2005-10-22T09:16:00.000-07:00

neck pain releif

Treatment of Cancer-related Depression
Current evidence shows that psychosocial interventions are beneficial
for depressive symptoms in cancer patients, but the magnitude of the
effect size seems to be in the mild to moderate range. Because there
are hundreds of studies on psychosocial interventions in cancer
patients, we limited our analysis to published meta-analyses of these
studies. Here, the contribution of preventative studies and depression
treatment studies were not defined. The effects of these interventions
may vary in these two different kinds of studies.

2005-10-22T08:16:00.000-07:00

neck pain physicians venice florida

2005-10-22T07:16:00.000-07:00

neck pain pills

A difference in analgesic efficacy between NSAIDs was only evident
in a single retrieved trial. Likewise, the efficacy of NSAIDs versus
"weak" opioids could not be discerned in the retrieved trials.
However, such trials enroll relatively small numbers of patients and
follow them for intervals of hours to days, and only occasionally as
long as 2 weeks. Many examine drugs not available in the United
States or no longer in general use for cancer pain relief (e.g.,
pentazocine). Prior efforts described in the previous evidence report
to strengthen such evidence by examining nonrandomized trials were
not fruitful.

2005-10-22T06:16:00.000-07:00

pancreatic cancer pain relief

2005-10-22T05:16:00.000-07:00

abdominal pain management algorithm

Assessment of Cancer-related Fatigue
A wide array of patient self-assessment instruments has been used to
evaluate fatigue. Most studies in the last several years have used
instruments that assess multiple dimensions of fatigue and have been
tested for validity, consistency, and reliability. Issues still remain in
terms of the clinical interpretation of the scores obtained on these
instruments, and the comparison of fatigue measurements obtained
using different instruments. Methods for evaluating fatigue in practice
settings have not been the subject of extensive research. The NCCN
has published guidelines on cancer-related fatigue that include a
general approach to assessment of fatigue in clinical practice. This
approach is based on the experience of a panel of experts rather than
on evidence from randomized controlled trials.

2005-10-22T04:16:00.000-07:00

tylenol sinus pain relief

While the standard of care for diagnosing depression is a clinical
interview, available data on the sensitivity, specificity, predictive
values, and cross-correlations of assessment instruments are
presented in the evidence-based table.
Although these assessment tools may be valid, there is currently no
evidence on how widely they are used clinically or whether they affect
clinical care and outcomes.

2005-10-22T03:16:00.000-07:00

short course prednisone for back pain time period for relief

Assessment of Cancer-related Depression
Because depression may go undetected and thereby untreated in
oncology practice, the importance of appropriate assessment and
screening tools has been emphasized. Some assessments, like the
Structured Clinical Interview for the Diagnostic and Statistical Manual
of Mental Disorders (SCID), may be useful in research studies, but
they are too time consuming in a clinical setting. Briefer self-report
assessments are available for clinical use. These assessments range
from questionnaires to The Distress Thermometer, a visual analogue
scale that the National Comprehensive Cancer Network (NCCN)
guidelines suggest for the screening of psychosocial distress.

2005-10-22T02:16:00.000-07:00

canine pain relief

Current expectations for detailed, multidimensional assessment of
cancer pain, including quality of life assessment, during cancer care
contrast with the minimalist assessments of pain intensity presented
during relatively brief observation intervals reported in nearly all of the
trials. Side effects limit analgesic dosage and hence impede pain
control in many patients, yet only one of the 16 most widely employed
outcomes measures is concerned with side effects; that one is a
coarse, four-point measure.

2005-10-22T01:16:00.000-07:00

good sense sinus pain relief products

2005-10-21T23:15:00.000-07:00

arthritic pain relief

2005-10-21T22:16:00.000-07:00

bone cancer pain in hands

2005-10-21T21:16:00.000-07:00

thumb pain treatments

2005-10-21T19:15:00.000-07:00

rectal cancer pain testimonial

2005-10-21T18:15:00.000-07:00

medicines herbs pain relief european renaissance

2005-10-21T17:15:00.000-07:00

that stuff natural pain relief andnot blue

2005-10-21T16:15:00.000-07:00

sciatic nerve pain relief after surgery

Reporting the Results
The nine topics addressed in this evidence report are presented in the
order of prevalence, assessment, and treatment. Each of these issues
covers the symptoms of pain, depression, and fatigue. Evidence is
summarized using three complementary approaches. Evidence tables
provide detailed information about the characteristics and outcomes
of all the studies examined. Information from the evidence tables is
synthesized into summary tables describing the findings of each study.
A narrative description of the studies along with an evidence-grading
scheme accompanies the summary tables.

2005-10-21T15:16:00.000-07:00

chronic acute pain

2005-10-21T14:16:00.000-07:00

tooth and pain and relief and topical

The searches were supplemented with reviews of bibliography of
selected references. The EPC also identified published meta-analyses
and used their data for selected topics.

2005-10-21T13:16:00.000-07:00

arthritic hand pain relief

2005-10-21T12:16:00.000-07:00

treatment for sacral joint pain

Methodology
Patient Population and Settings
The EPC accepted all studies published in English of patients with a
diagnosis of cancer who suffered from pain, depression, or fatigue
due to cancer or treatment of cancer. It placed no restrictions on the
patients' age, gender, ethnicity, level of advancement of the primary
disease (staging), or presence of metastases. The conference planning
committee was interested in covering the full trajectory of disease,
including but not limited to, periods of active treatment and end of life.

2005-10-21T11:16:00.000-07:00

analgesicsfor narcotic pain relief

For some of these topics, in particular the treatment of cancer pain,
there are multiple questions. The Evidence-Based Practice Center
(EPC) produced the evidence report on the Management of Cancer
Pain based on a literature search conducted in December 1998. For
the cancer-related pain topics, the results for the key questions
addressed in the prior EPC report have been thoroughly updated. At
the request of the conference planning committee, two new topics
were added to the treatment of cancer-related pain: oral mucositis
and post-herpetic neuralgia. The methodological approach is
summarized and the new evidence reported. Readers are referred to
the earlier evidence report for detailed information about the
methodological approach and the findings. New systematic reviews
are also included for the symptoms of cancer-related depression and
cancer-related fatigue.

2005-10-21T10:16:00.000-07:00

administration view of pain management

2005-10-21T08:16:00.000-07:00

acute pain fentanyl

What are the treatments for cancer-related pain, depression, and
fatigue, and what is the evidence for their effectiveness?
What are the impediments to effective symptom management in
people diagnosed with cancer, and what are optimal strategies to
overcome these?

2005-10-21T07:16:00.000-07:00

foot arch pain relief

What is the occurrence of pain, depression, and fatigue, alone and in
combination, in people with cancer?
What are the methods used for clinical assessment of these symptoms
throughout the course of cancer and what is the evidence for their
reliability and validity in cancer patients?

2005-10-21T06:16:00.000-07:00

clinical presentation ovarian cancer pain side

2005-10-21T05:16:00.000-07:00

natural back pain relief

2005-10-21T04:16:00.000-07:00

pain management cancer

2005-10-21T03:16:00.000-07:00

cancer of the spine back chest lung pain

Management of Cancer Symptoms: Pain, Depression, and Fatigue
Summary Under its Evidence-based Practice Program, the Agency
for Healthcare Research and Quality (AHRQ) is developing scientific
information for other agencies and organizations on which to base
clinical guidelines, performance measures, and other quality
improvement tools. Contractor institutions review all relevant scientific
literature on assigned clinical care topics and produce evidence
reports and technology assessments, conduct research on
methodologies and the effectiveness of their implementation, and
participate in technical assistance activities.
Select for PDF File (62 KB). PDF Help.
Overview / Reporting the Evidence / Methodology / Findings / Future
Research / Availability of the Full Report

2005-10-21T01:16:00.000-07:00

canker sore pain relief

Moreover, he said that the majority had not shown that the corrective
advertising requirement here was no more extensive than necessary to
prevent deception because the majority had "not given adequate
consideration to alternatives to corrective advertising or to less
restrictive alternatives to the all-media corrective advertising remedy
imposed (such as a corrective statement [only] on the product label or
[in] point-of-sale materials)."

2005-10-21T00:16:00.000-07:00

cancer cervical pain

2005-10-20T23:15:00.000-07:00

pain sciatic relief

" He noted that, "The eight-year $65 million advertising campaign here
pales in comparison with other deceptive advertising campaigns
(especially when advertising expenditures are measured in constant
dollars) that have not resulted in the Commission imposing corrective
advertising." Commissioner Swindle also emphasized that the
"evidence is certainly far weaker than the evidence that proved the
existence of a lingering effect in Warner-Lambert," the only other
adjudicated case in the last 25 years in which the Commission has
ordered corrective advertising. Without adequate proof of a lingering
effect, Commissioner Swindle concluded that the Commission cannot,
as a matter of law, order corrective advertising, an "extraordinary
remedy."
Commissioner Swindle further concluded that "the corrective
advertising requirement, which is a form of compelled speech,
infringes on Novartis's right to engage in commercial speech under the
First Amendment to the United States Constitution.

2005-10-20T22:16:00.000-07:00

pain center treatment for pinched nerve

The majority concluded that the implied superior efficacy claim that
Novartis made in ads that ceased in May 1996 have created a false
belief that is likely to linger until the corrective advertising requirement
ends in July 2000 or beyond. Commissioner Swindle disagreed,
explaining that "the evidence offered to prove lingering effect is
extremely weak, consisting mainly of inconclusive extrinsic evidence,
indefinite expert testimony and broad inference.

2005-10-20T21:16:00.000-07:00

advanced pain management milwaukee wisconsin

2005-10-20T20:16:00.000-07:00

neck nerves arthritis pain management

2005-10-20T19:16:00.000-07:00

pain relief for shingles

2005-10-20T18:16:00.000-07:00

arthritis pain remedies

"The record establishes that consumers held misbeliefs about Doan's
superior efficacy, that such beliefs were created by or substantially
reinforced by the challenged advertising campaign, and that those
beliefs are likely to linger into the future. Therefore, we find that the
elements for corrective advertising are satisfied, and that corrective
advertising is appropriate and necessary," the majority wrote.

2005-10-20T17:16:00.000-07:00

severe knee arthritis allergies to pain medication

The opinion concludes that the false belief that Doan's was a superior
product for treating backache was likely to endure, because the
claims were ". . .(1) very salient to consumers (because superior
efficacy is among the primary considerations for a consumer in
selecting a back pain remedy), (2) clearly and consistently conveyed
in the challenged ads, and (3) an integral part of an eight-year
campaign." The respondent spent approximately $65,000,000
disseminating these claims, primarily in fifteen-second television and
radio ads whose primary message was the false superiority claim, the
opinion says.

2005-10-20T16:16:00.000-07:00

cancer lung pain shoulder

The Commission Opinion, written by FTC Commissioner Sheila F.
Anthony, says, "We reverse the ALJ's holding regarding corrective
advertising. . . . Contrary to the ALJ's suggestion, corrective
advertising is not a drastic remedy. Requiring the dissemination of a
truthful message to counteract beliefs created or reinforced by a
respondent's deceptive message is an appropriate method of restoring
the status quo ante and denying a respondent the ability to continue to
profit from its deception. . . . Corrective advertising is an appropriate
remedy if (1) the challenged ads have substantially created or
reinforced a misbelief; and (2) the misbelief is likely to linger into the
future."

2005-10-20T15:16:00.000-07:00

reflexology points arthritis pain in hands

2005-10-20T14:16:00.000-07:00

is alieve safe for relief of chronic back pain

"Doan's is made for back pain relief with an ingredient [other] pain
relievers don't have. Doan's makes back pain go away. ...The Back
Specialist.";
"If nothing seems to help, try Doan's. It relieves back pain no matter
where it hurts. Doan's has an ingredient these pain relievers don't
have."; and
"Back pain is different. Why use these pain relievers? Doan's is just
for back pain."
Through these and similar statements, the FTC alleged, Novartis
claimed that Doan's analgesic products were more effective than other
analgesics, including Advil, Aleve, Bayer, Motrin, and Tylenol, for
relieving back pain. The agency charged that the claims were
unsubstantiated.

2005-10-20T13:16:00.000-07:00

acute pain lower left abdomen near hip

In June 1996, the FTC charged the marketers of Doan's Pills with
making deceptive back-pain relief claims in violation of federal law
and announced it would seek an order prohibiting the claims in an
administrative trial. The FTC charged that, contrary to the advertising
claims for Doan's, there was no evidence that Novartis' pills are better
than competing over-the-counter analgesics in relieving back pain.
The complaint cited ads that displayed packages of Doan's and other
pain relievers that contained statements such as:

2005-10-20T12:16:00.000-07:00

foods to avoid that cause arthritis pain

Novartis, headquartered in Summit, New Jersey, is a subsidiary of
Novartis AG, a Swiss pharmaceutical company.

2005-10-20T11:16:00.000-07:00

pain free arthritis

The Federal Trade Commission has ordered the makers of Doan's
Pills to run ads to correct misbeliefs resulting from their
unsubstantiated claim that Doan's Pills are superior to other over-the-
counter analgesics for treating back pain. The Order, contained in a
Commission opinion announced today, would require advertising and
packaging to carry the message, "Although Doan's is an effective pain
reliever, there is no evidence that Doan's is more effective than other
pain relievers for back pain." The order also would prohibit Novartis
Corporation and Novartis Consumer Health, Inc., the marketers of
Doan's, from representing that the product is more effective than other
over-the-counter products unless they possess and rely upon
competent and reliable scientific evidence -- including at least two
clinical studies -- to substantiate their claims. In addition, the order
would require Novartis to have scientific substantiation for any claims
made regarding the efficacy, safety, benefits or performance of any
over-the counter analgesic they market. Doan's has been marketed
and sold for over 90 years and always has been advertised as a
backache product.