Frederick J Goldstein. Management of acute pain. J Am Osteopath Assoc 1999;99(6_suppl):S1–S5. doi: 10.7556/jaoa.1999.99.6.S1.
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In the United States, acute pain is still an undertreated condition. Effective management requires: (1) an understanding of the neurophysiologic, pathologic, sociologic, psychologic, and spiritual components present in the suffering patient; (2) proper and continual assessment using a pain scale (preferably 0 to 10); (3) charting the pain as the fifth vital sign; (4) use of preemptive analgesia to reduce postsurgical pain; (5) knowledge of barriers that exist among healthcare professionals, patients, and health care systems so that they can be countered; (6) recognition that neuropathic pain may be more effectively treated with local anesthestics, antidepressants, and anticonvulsants than with opioids; (7) knowledge that in certain conditions, nonsteroidal
anti-inflammatory drugs will be more effective than acetaminophen. The physician must also clearly understand that opioids do not cause addiction (psychological dependence). Osteopathic physicians also have the additional benefit of providing nonpharmacologic treatment to patients presenting with acute pain.
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