Re: Ear Pain Treatment Adults
Cherly Fleitas
Virtual reality (VR) can present advantages in the treatment of chronic low back pain. The objective of this systematic review and meta-analysis was to analyze the effectiveness of VR in chronic low back pain. This review was designed according to PRISMA and registered in PROSPERO (CRD42020222129). Four databases (PubMed, Cinahl, Scopus, Web of Science) were searched up to August 2021. Inclusion criteria were defined following PICOS recommendations. Methodological quality was assessed with the Downs and Black scale and the risk of bias with the Cochrane Risk of Bias Assessment Tool. Fourteen studies were included in the systematic review and eleven in the meta-analysis. Significant differences were found in favor of VR compared to no VR in pain intensity postintervention (11 trials; n = 569; SMD = -1.92; 95% CI = -2.73, -1.11; p < 0.00001) and followup (4 trials; n = 240; SDM = -6.34; 95% CI = -9.12, -3.56; p < 0.00001); and kinesiophobia postintervention (3 trials; n = 192; MD = -8.96; 95% CI = -17.52, -0.40; p = 0.04) and followup (2 trials; n = 149; MD = -12.04; 95% CI = -20.58, -3.49; p = 0.006). No significant differences were found in disability. In conclusion, VR can significantly reduce pain intensity and kinesiophobia in patients with chronic low back pain after the intervention and at followup. However, high heterogeneity exists and can influence the consistency of the results.
This article examines acute pain management practices for patients 65 years of age and older who were hospitalized during 1999 for hip fracture. Data were collected from the medical records of patients (N = 709) admitted to 12 hospitals in the Midwest and from questionnaires on pain practices completed by nurses (N = 172) caring for these patients. The major variables examined were (1). pharmacological and nonpharmacological treatments for acute pain in hospitalized elders, (2). nurses' perceived stage of adoption for avoiding meperidine use and for administering analgesics around-the-clock, and (3). nurses' perceived barriers to optimal treatment of acute pain in elders. Acetaminophen was the most frequently administered analgesic, but administered doses were far less than the maximum daily recommended dose. More than one third (39%) of the nurses reported that they always avoided the use of meperidine, and over half reporting avoiding its use sometimes. However, the majority of patients (56.8%) received at least one dose of meperidine, even though evidence suggests that other analgesic agents are more appropriate for treatment of acute pain in elders. Only 27% of patients received patient-controlled analgesia, and only 22.3% of patients received around-the-clock administration during the first 24 hours after admission of analgesics that had been ordered on a prn basis. The majority of nurses were aware that around-the-clock administration of analgesics was preferable, but only 33.7% were persuaded (believed) that this method should be used. Intramuscular injection was used for 52.2% of patients, even though this route is not recommended for older adults. The most frequently used nonpharmacological intervention was repositioning, followed by use of pressure relief devices and cold application. Nurses reported difficulty contacting physicians and difficulty communicating with them about type and/or dose of analgesics as the greatest barriers to pain management. Findings from this multi-site study show that active and focused "translation" interventions are needed to promote adoption of evidence-based acute pain management practices by health care providers.
The body has pain receptors that are attached to 2 main types of nerves that detect danger. One nerve type relays messages quickly, causing a sharp, sudden pain. The other relays messages slowly, causing a dull, throbbing pain.
Some areas of the body have more pain receptors than others. For example, the skin has lots of receptors so it is easy to tell the exact location and type of pain. There are far fewer receptors in the gut, so it is harder to pinpoint the precise location of a stomach ache.
If pain receptors in the skin are activated by touching something dangerous (for example something hot or sharp), these nerves send alerts to the spinal cord and then to part of the brain called the thalamus.
Pain medicines work in various ways. Aspirin and other NSAIDs are pain medicines that help to reduce inflammation and fever. They do this by stopping chemicals called prostaglandins. Prostaglandins cause inflammation, swelling and make nerve endings sensitive, which can lead to pain.
Medicines for chronic pain are best taken regularly. Talk to your doctor or pharmacist if your medicines are not working or are causing problems, such as side effects. These are more likely to occur if you are taking pain medicines for a long time.
You can find a more complete list of side effects in a Consumer Medicine Information leafletExternal Link . Talk to your doctor or pharmacist before taking any pain medicine to ensure it is safe for you.
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Abdominal pain is pain felt anywhere from below your ribs to your pelvis. It is also known as tummy pain or stomach pain. The abdomen houses many organs, including your stomach, liver, pancreas, small and large bowel, and reproductive organs. There are also major blood vessels in the abdomen.
Serious causes of abdominal pain include appendicitis and pregnancy problems. However, most abdominal pain is harmless and goes away without surgery.
Most people only need relief from their symptoms. Sometimes, abdominal pain can stop and the cause will never be known, or the cause may becomes more obvious with time.
There are many reasons why you may have pain in your abdomen. People often worry about appendicitis, gallstones, ulcers, infections and pregnancy problems. Doctors also worry about these, as well as many other conditions.
Abdominal pain may not come from the abdomen. Some surprising causes include heart attacks and pneumonia, conditions in the pelvis or groin, some skin rashes like shingles, and problems with stomach muscles like a strain. The pain may occur along with problems in passing urine or with bowel motions, or period problems.
With so many organs and structures in the abdomen, it can be hard for a doctor to be absolutely sure about the cause of your problem.
The doctor will ask you several questions and then examine you carefully. The doctor may perform no further tests. The cause of your pain may be quite clearly not serious. Another scenario may be that the doctor is unable to find a cause, but the pain gets better within hours or days. The doctor will assess whether the pain requires surgery or admission to hospital.
Doctors and other health professionals will first ask you where you feel the pain. Pain above the umbilicus (belly button) but below the ribcage on the right may be gallstone pain. Gallstone pain may spread (or radiate) to the right shoulder or the back.
Health professionals will usually ask you to rate the pain or give a pain score out of 10. Mild pain might be rated 3 to 4, noticeable and unpleasant (like a toothache) but not severe enough to interfere with usual activity.
Period pain can be severe and may indicate an underlying problem such as endometriosis or pelvic inflammatory disease, while pain in the middle of the menstrual cycle can be due to an ovarian follicle.
This is an important question as it might point to the cause of the pain. Examples are trauma such as a sporting injury or car accident, recent medication such as anti-inflammatories or antibiotics, or heavier than usual alcohol intake, which might trigger pancreatitis.
Recommendations for individual drugs or drug classes based on the GRADE classification and for first-, second-, and third-line drugs for neuropathic pain. Drugs pertaining to the same drug class are presented in alphabetical order.
Limitations of current clinical trials in neuropathic pain as outlined by the present meta-analysis and systematic review, and NeuPSIG recommendations for implementation of future clinical trials in neuropathic pain
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