Update in Pain Medicine (2008)

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Journal of General Internal Medicine

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More than 75 million Americans have chronic or recurrent pain.1 Pain accounts for 20% of all outpatient visits2 and more than $100 billion dollars per year in direct (i.e., health care services) and indirect costs (i.e., lost productivity)3; analgesics account for 12% of all prescriptions.4 Chronic pain is a leading cause of work loss, and disability and is a common reason for use of alternative medicine.5 Our aims were to: review recent pain medicine studies and their key findings and understand how these new findings may impact generalist clinical practice.

We used a systematic search strategy for the period of January 1, 2006 through March 31, 2007 for human subject, English language, peer-reviewed articles that could potentially change generalist care of patients with chronic pain. We searched MEDLINE and PubMed using the medical subject heading (MeSH) terms pain, chronic pain, and primary care. Members of the Society of General Internal Medicine’s Pain Medicine Interest Group also suggested other relevant articles. We narrowed the initial list of 314 references to 33. We independently rated the 33 remaining articles using a 5-point Likert scale (1 = poor to 5 = outstanding) on: impact on general internal medicine clinical practice, clinical policy and research, and the quality of the study methods. Based on ratings and consensus deliberations, we chose a subset of 12 articles. We categorized the articles into 5 topic areas: (1) chronic pain and comorbidities; (2) systems approaches to managing chronic pain; (3) opioids and chronic pain; (4) non-pharmacologic approaches to treating chronic pain; and (5) complementary and alternative pain treatments.


© 2008 Springer Nature Switzerland AG. Part of Springer Nature.

*At the time of publication, C. Nicolaidis was affiliated with OHSU.

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