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Pain management

Pain is complex, so there are many treatment options, from medications to mind-body techniques. Pain management involves identifying the source of the problem when possible and using appropriate treatments. Learn more about treatment options below.

Home palliative care a key to respecting end of life wishes

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Music can help ease your hospital stay

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Evidence Summary

Physical activity-based interventions using electronic feedback may be ineffective in reducing pain and disability in patients with chronic musculoskeletal pain
Archives of Physical Medicine and Rehabilitation (2017)
Evidence Summary

Self-management education programmes for osteoarthritis
Cochrane Database of Systematic Review (2014)
Evidence Summary

Paracetamol versus placebo for knee and hip osteoarthritis.
Cochrane Database Syst Rev (2019)
Evidence Summary

In people with chronic noncancer pain, opioids reduce pain by a small amount
JAMA (2018)
Evidence Summary

Pregabalin for neuropathic pain in adults.
Cochrane Database Syst Rev (2019)
Evidence Summary

In people with chronic noncancer pain, cannabinoid drugs reduce pain by a small amount but increase adverse events
Pain (2018)
Evidence Summary

Self-management interventions for women can reduce cardiac pain
Canadian Journal of Cardiology (2017)
Evidence Summary

Cannabis-based medicines for chronic neuropathic pain in adults.
Cochrane Database Syst Rev (2018)
Web Resource Rating

Several non-invasive treatments work for neck pain
Institute for Work & Health

Educational videos, exercise, and neck mobilization were more beneficial for treating neck pain or whip lash than ultrasound or electrical stimulation. Laser therapy, exercise and massage or acupuncture may help with chronic pain. Hard or soft collars did not work.
Patient Decision Aid

Headaches: Should I Take Medicine to Prevent Migraines?
OHRI

This patient decision aid helps people considering taking medicine every day to prevent migraines decide on whether or not to use preventive treatment by comparing the benefits, risks and side effects of both options.
Patient Decision Aid

Managing Pain From a Broken Hip: A Guide for Adults and Their Caregivers.
OHRI

This patient decision aid helps older adults (more than 50 years old) who is in a hospital because of a hip fracture decide on methods of managing pain. It outlines options such as using acetaminophen, opioid analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs), and other treatments and compares the benefits and side effects associated with each option
Evidence Summary

Self-management education programs have some potential to manage physical and emotional pain among patients with cancer
Support Care Cancer (2017)
Evidence Summary

Case management programs may have benefits for informal caregivers  
International Journal of Geriatric Psychiatry (2017)
Evidence Summary

Rehabilitation at home can be just as good as hospital-based rehabilitation for patients after knee surgery
American Journal of Physical Medicine & Rehabilitation (2016)
Web Resource Rating

Bursitis
Mayo Clinic

Bursitis causes painful swelling and stiffness in joints like the shoulder, elbow, hip and knee, and is more likely as you age. Treatments include medication, physical therapy and - in extreme cases - surgery. Tips for prevention and home remedies in this resource.
Web Resource Rating

Patient education: Calcium pyrophosphate crystal deposition (CPPD) disease (Beyond the Basics)
UpToDate - patient information

Calcium pyrophosphate crystal deposition (CPPD) is caused by calcium pyrophosphate crystals being deposited in joint tissues. Treatment options for the pain and swelling that accompany CPPD include injections and oral medications.
Evidence Summary

NSAIDs increase the risk for heart attack
BMJ (2017)
Web Resource Rating

Patient education: Biceps tendinitis or tendinopathy (Beyond the Basics)
UpToDate - patient information

Pain in the front of the shoulder can be a tendon injury, often from overuse or wear and tear. Until your symptoms get better, try to avoid lifting heavy items and reaching motions. Frist line treatment options also include nonsteroidal anti-inflammatory drugs. For more severe cases, physical therapy and surgery may help.
Evidence Summary

Oral nonsteroidal anti-inflammatory drugs for fibromyalgia in adults.
Cochrane Database Syst Rev (2017)
Web Resource Rating

Patient education: Gout (Beyond the Basics)
UpToDate - patient information

Gout is a painful condition that develops in some people who have high blood levels of urate. This condition can be prevented with anti-inflammatories and by lowering urate with diet changes. The goal of treatment is to reduce pain.
Web Resource Rating

Patient education: Knee pain (Beyond the Basics)
UpToDate - patient information

Of all the joints in the body, the knee is at the greatest risk of injury and arthritis. Treatment for pain includes ice, stretching, and strength exercises. Try to avoid activities that put strain on your knees.
Web Resource Rating

Traditional opioids for chronic non-cancer pain: Untidy, unsatisfactory, and probably unsuitable
Evidently Cochrane

Opioids are a type of medicine that can be prescribed by your doctor for chronic pain. Not everyone gets adequate pain relief from opioids and many people can become addicted to this type of medication. Most people should not take opioids for a long time.
Evidence Summary

Pregabalin for pain in fibromyalgia in adults.
Cochrane Database Syst Rev (2016)
Web Resource Rating

Patient education: Fibromyalgia (Beyond the Basics)
UpToDate - patient information

Chronic muscle pain and tenderness are symptoms of fibromyalgia. There are medications to help ease symptoms. Also try exercise, relaxation therapy, tai chi, or yoga.
Evidence Summary

Oxycodone for neuropathic pain in adults.
Cochrane Database Syst Rev (2016)
Web Resource Rating

The evidence on arthroscopic knee surgery
Evidence-based Living

Arthroscopic knee surgery involves small incisions to remove damaged tissue. This procedure helps provide short term pain relief, but not long term benefits and there are risks involved. Researchers do not recommend it for middle aged or older adults.
Evidence Summary

Cannabinoids for fibromyalgia.
Cochrane Database Syst Rev (2016)
Evidence Summary

Local anaesthetic sympathetic blockade for complex regional pain syndrome.
Cochrane Database Syst Rev (2016)
Evidence Summary

Acupuncture for the prevention of episodic migraine.
Cochrane Database Syst Rev (2016)
Web Resource Rating

Hormone therapy for the menopause after endometriosis surgery - friend or foe?
Evidently Cochrane

There is not enough research to deny hormone therapy to women who have had their ovaries removed. However, there may be an increased risk of returning pain and more surgery. More research is needed.
Evidence Summary

Paracetamol (acetaminophen) for acute treatment of episodic tension-type headache in adults.
Cochrane Database Syst Rev (2016)
Web Resource Rating

Patient education: Elbow tendinopathy (tennis and golf elbow) (Beyond the Basics)
UpToDate - patient information

Tendinopathy refers to injuries to the tendons. Age, repetitive movements and certain medical conditions make you more susceptible. To prevent elbow tendinopathy, take breaks from repetitive movements and take care with lifting and gripping objects. Read more information about causes, treatment and prevention in this resource.
Evidence Summary

Acupuncture for the prevention of tension-type headache.
Cochrane Database Syst Rev (2016)
Evidence Summary

Physiotherapy for pain and disability in adults with complex regional pain syndrome (CRPS) types I and II.
Cochrane Database Syst Rev (2016)
Evidence Summary

Home-based supervised exercise may prove an effective, alternative treatment for leg and muscle pain among people living with peripheral arterial disease
Journal of Rehabilitation Medicine (2015)
Web Resource Rating

Patient education: Nonsteroidal antiinflammatory drugs (NSAIDs) (Beyond the Basics)
UpToDate - patient information

Nonsteroidal antiinflammatory drugs (NSAIDS) help relieve pain and inflammation and are some of the most commonly used medicines. NSAIDS may cause complications for people with certain medical conditions or taking certain medications. Read this resource for details and discuss with your doctor.
Evidence Summary

Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment.
Cochrane Database Syst Rev (2015)
Evidence Summary

Acupuncture for neck disorders.
Cochrane Database Syst Rev (2016)
Evidence Summary

Lidocaine for preventing postoperative sore throat.
Cochrane Database Syst Rev (2015)
Evidence Summary

Venlafaxine for neuropathic pain in adults.
Cochrane Database Syst Rev (2015)
Evidence Summary

Ibuprofen for acute treatment of episodic tension-type headache in adults.
Cochrane Database Syst Rev (2015)
Web Resource Rating

Gout attacks: Pain relief
Informed Health Online

Some medications can relieve symptoms of acute gout attacks, including anti-inflammatory painkillers, cochicine and corticosteroids. Some have more serious side effects.
Evidence Summary

Exercise therapy reduces fatigue in chronic fatigue syndrome
Cochrane Database Syst Rev (2016)
Evidence Summary

Selective serotonin reuptake inhibitors for fibromyalgia syndrome.
Cochrane Database Syst Rev (2015)
Evidence Summary

Topical NSAIDs for acute musculoskeletal pain in adults.
Cochrane Database Syst Rev (2015)
Web Resource Rating

Patient education: Low back pain in adults (Beyond the Basics)
UpToDate - patient information

Low back pain is one of the most common disorders and often people recover quickly. Treatment includes exercise, heat, pain medication, or acupuncture. Read more here about when to seek help.
Web Resource Rating

Patient education: Neck pain (Beyond the Basics)
UpToDate - patient information

Neck pain can be caused by muscle strain, ligament sprains, arthritis or pinched nerves. Most people get better with therapy. Treatments include ice, heat, massage and stretching (examples in this resource).
Evidence Summary

In people who have chest pain without a known cause, cognitive–behavioural therapy reduces pain in the short-term
Cochrane Database Syst Rev (2015)
Evidence Summary

Drug treatments can help people with pain from damaged nerves (neuropathic pain)
Lancet Neurol (2015)
Evidence Summary

Mind and body therapy for fibromyalgia.
Cochrane Database Syst Rev (2015)
Evidence Summary

Several drugs reduce pain related to diabetic neuropathy in the short-term
Ann Intern Med (2014)
Evidence Summary

In people with cancer, music therapy reduces anxiety, depression, pain, and fatigue
Cancer Nurs (2014)
Evidence Summary

eHealth interventions should be used more extensively to improve palliative care patients’, caregivers’ and health professionals’ access to needed information
Journal of Medical Internet Research (2014)
Evidence Summary

NSAIDS, except naproxen, increase major coronary events; all NSAIDs increase heart failure and upper gastrointestinal complications
Lancet (2013)
Evidence Summary

Epidural corticosteroid injections have a small, short-term benefit for leg pain and disability in patients with sciatica
Ann Intern Med (2012)
Evidence Summary

Herbal medicinal products or preparations for neuropathic pain.
Cochrane Database Syst Rev (2019)
Evidence Summary

Mixed exercise training for adults with fibromyalgia.
Cochrane Database Syst Rev (2019)
Evidence Summary

Acupuncture and related interventions for the treatment of symptoms associated with carpal tunnel syndrome.
Cochrane Database Syst Rev (2018)
Evidence Summary

Botulinum toxins for the prevention of migraine in adults.
Cochrane Database Syst Rev (2018)
Patient Decision Aid

Lumbar Spinal Stenosis: Should I Have Surgery?
OHRI

This patient decision aid helps patients with lumbar spinal stenosis decide on whether or not to have surgery by comparing the benefits, risks, and side effects of both options. It also includes alternative options to surgery such as trying medicine, exercise, and/or physical therapy.
Web Resource Rating

Can marijuana be the answer for pain?
WebMD

If you have chronic pain, cannabis could help. Cannabis can have negative side effects like lowering your blood pressure and increasing your risk of falling. More research is needed about the health effects of cannabis.
Evidence Summary

Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults.
Cochrane Database Syst Rev (2017)
Evidence Summary

Aerobic exercise training for adults with fibromyalgia.
Cochrane Database Syst Rev (2017)
Evidence Summary

Tramadol for neuropathic pain in adults.
Cochrane Database Syst Rev (2017)
Evidence Summary

Oxycodone for cancer-related pain.
Cochrane Database Syst Rev (2017)
Web Resource Rating

Deep vein thrombosis (DVT)
Mayo Clinic

Deep vein thrombosis can be caused by prolonged bedrest or sitting for long periods of time. Symptoms include leg pain or swelling in the leg. This condition can be very serious since it increases your risk for pulmonary embolism. If you have signs of DVT, see your doctor.
Web Resource Rating

Lately, I've had a lot of leg pain, especially when sitting at my desk or standing in line at the store. Should I be concerned about this new aching?
Mayo Clinic

Leg pain can have many causes including a build-up of fluid in the leg veins. New and lasting leg pain is a good reason to visit your doctor. Support socks or hose can help ease pain from fluid buildup.
Patient Decision Aid

Headaches: Should I Take Prescription Medicine for Tension Headaches?
OHRI

This patient decision aid helps individuals with chronic tension headaches that interfere with daily living decide on whether or not to take daily prescription medicine by comparing the benefits, risks, and side effects of both options.
Evidence Summary

Digital health technologies may help with some aspects of pain management in older people
Archives of Gerontology and Geriatrics (2016)
Evidence Summary

Gabapentin for chronic neuropathic pain in adults.
Cochrane Database Syst Rev (2017)
Web Resource Rating

Chronic pain: In depth
National Center for Complementary and Integrative Health

Chronic pain is mild to severe pain that lasts longer than six months. Some alternative approaches (acupuncture, yoga, herbal supplements), used in addition to conventional medicine, may help people manage chronic pain. Speak with your doctor before you begin any alternative health approach to make sure it is safe for you.
Evidence Summary

Acupuncture improves functioning and provides short-term relief of knee pain due to osteoarthritis
J Bone Joint Surg Am (2016)
Web Resource Rating

Managing chronic pain and depression in arthritis
Johns Hopkins Arthritis Center

Patients with chronic pain should have underlying medical conditions treated and be assessed for anxiety and distress. Antidepressants can be used to treat many chronic pain disorders.
Evidence Summary

Ketoprofen for episodic tension-type headache in adults.
Cochrane Database Syst Rev (2016)
Web Resource Rating

Chronic pain
Health Link B.C.

Chronic pain lasts 3 months or longer and can range from mild to severe. It is common in older adults, but not a normal part of aging. This resource includes answers to frequently asked questions like, "What can I do at home to help my symptoms?"
Web Resource Rating

Breast pain
Mayo Clinic

Breast pain affects many women and is often caused by hormone changes. Breast pain is unlikely a sign of breast cancer. Choose a well-fitting bra, try hot or cold compresses, relaxation and pain relievers. Speak to your doctor if the pain persists or gets worse over time.
Web Resource Rating

Pelvic pain in women
Patient.co.uk

There are many causes of pelvic pain in women, including bowel, bladder, muscle and bone problems. Visit your doctor if you have recurring or severe pelvic pain.
Web Resource Rating

Muscle relaxants
Patient.co.uk

Muscle relaxants are used to help reduce or prevent muscle spasms and sometimes anxiety, insomnia or seizures. Only use them when prescribed by your doctor. Muscle relaxants have a number of side effects.
Evidence Summary

Pain relief for women with cervical intraepithelial neoplasia undergoing colposcopy treatment.
Cochrane Database Syst Rev (2016)
Web Resource Rating

Pain and injury survival tips
SaveYourself.ca

Over 50 self-treatment tips for relief of common pain problems and injuries, including strength training, icing, swimming and stress relief.
Web Resource Rating

Joint pain
Mayo Clinic

Apply ice for 15-20 minutes a few times each day, use a heating pad and try an over-the-counter pain reliever to help with mild joint pain. See your doctor if you have joint pain with swelling, redness, tenderness or warmth around the joint or if joint pain is caused by an injury.
Web Resource Rating

5 Strengthening Exercises for Lower Back Pain
HealthLine

Some exercises may help to reduce low back pain and dysfunction. Try stretching exercises such as bridges, the drawing in maneuver, leg raises, supermans and partial curls. This resource details how to do each of these exercises.
Evidence Summary

Oral tapentadol for cancer pain.
Cochrane Database Syst Rev (2015)
Web Resource Rating

How effective is medical marijuana?
Evidence-based Living

Medical marijuana is a promising way to treat chronic pain and help reduce muscle spasms for people with MS. There is no evidence it helps treat depression, anxiety or glaucoma. Medical marijuana has numerous side effects and is not federally regulated in the US.
Web Resource Rating

Easing the strain: Put your feet up for constipation
Evidently Cochrane

Squatting may help constipation. Use a stool to raise your feet and avoid straining while you are on the toilet. Other tips: drink plenty of water, avoid caffeine, eat more fibre, exercise and take your time on the toilet.
Evidence Summary

Corticosteroids for the management of cancer-related pain in adults.
Cochrane Database Syst Rev (2015)
Evidence Summary

In people with chronic pain, there is no evidence on the effect of long-term opioids on pain, function, or quality of life
Ann Intern Med (2015)
Evidence Summary

In people with cancer, strong opioid painkillers do not differ from each other for pain relief or side effects
Cochrane Database Syst Rev (2015)
Evidence Summary

Exercises for mechanical neck disorders.
Cochrane Database Syst Rev (2015)
Evidence Summary

Nortriptyline for neuropathic pain in adults.
Cochrane Database Syst Rev (2015)
Web Resource Rating

Treating migraine attacks: New evidence to guide choices
Evidently Cochrane

Sumatriptan and Zolmitriptan medications can help relieve migraine symptoms. They both offer pain relief and the side effects from both these drugs are generally mild.
Evidence Summary

Patients and carers receiving home-based palliative care report unmet needs related to communication and support for non-physical suffering
Palliative Medicine (2013)
Web Resource Rating

Aging well with post-polio syndrome: Dealing with pain
Healthy Aging & Physical Disability (RRTC)

If you find that pain is interfering with daily activities of your life, you should seek help. Research is being done to find the best way to treat post-polio pain.
Blog Post

Living with dementia: Non-drug options for pain management

Pain reduction in people living with dementia. Non-drug options may be a good first step.
Blog Post

Getting “alternative” with nerve pain: Could herbal treatments be a source of relief?

Considering complementary and alternative options for nerve pain? You should know that the current evidence base on the potential benefits and harms of herbal treatments—specifically, nutmeg and St John's wort—is uncertain.
Blog Post

Fact or fiction: What the research says about cannabis use for common conditions

Cannabis is increasingly touted as an effective treatment for a variety of ailments. But does the research support this? Find out whether cannabis is “worth the hype” for three common health conditions.
Blog Post

Walking: An age-old strategy to boost your health

As you get older, getting from one place to another can be a challenge. To put you on the road to better health, invest in a sturdy pair of shoes and use the power of your own two feet to get you to where you need to be.
Blog Post

Living with gout? Explore your treatment options

A gout flare-up can be a very unpleasant and painful experience. Several treatment options are available, so speak with your healthcare provider about which treatment might work best for you.
Blog Post

Cannabis for chronic nerve pain: A half-baked solution?

Although some people suffering from chronic neuropathic pain might find some relief with cannabis-based medications, the side effects may outweigh the benefits.
Blog Post

Do you have a hidden heart risk in your medicine cabinet?

Many people will pop a nonsteroidal anti-inflammatory drug casually at the slightest pain. Make sure that you are aware of the risks, and review your medications with your doctor.
Blog Post

Fact or fiction: research reveals the truth about common medications

Based on the research evidence, some drugs are getting credit they don’t deserve! They may even be doing more harm than good.
Blog Post

What works best for relieving back pain?

Low back pain can be debilitating but it can be managed with non-drug therapies and medications if needed. What works best? Find out recommendations from recent research evidence.
Blog Post

3 research-based benefits of yoga for healthy aging

Want to age well? Consider making yoga part of your regular activities.
Blog Post

3 alternative options for pain relief

Alternative options for managing pain can bring relief without the risks associated with prescription drugs.
Blog Post

A closer look at opioids for chronic pain

Do the benefits of opioids outweigh the risks? Or, is it time to re-examine their role in relieving pain?
Blog Post

Acupuncture: An effective treatment for chronic headaches

Research shows that acupuncture is worth a try for people who suffer from chronic headaches or migraines.
Blog Post

Back pain? Try exercise!

Low back pain can make getting through the day challenging enough without worrying about keeping up your exercise regimen. But before you throw in the (gym) towel, read the latest research about the best types of exercise for relieving back pain.
Blog Post

Make it stop! Should patients manage their own pain after surgery?

Most people experience pain after surgery and need to take pain killers for at least a few days. Being in charge of their own medications gives patients some control and may result in improved pain relief.
Blog Post

Music can help ease your hospital stay

If you’re undergoing surgery or other hospital treatments you’re probably not thinking of boogying to the beat. But research shows music therapy can reduce anxiety and pain and help ease depression and fatigue.
Blog Post

Home palliative care a key to respecting end of life wishes

Home palliative care – provided by specially trained health professionals – increases the likelihood of a patient dying at home and may even help to ease symptoms.

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