Update in Pain Medicine for Primary Care Providers: A Narrative Review, 2010-2012

Joseph W. Frank, Matthew J. Bair, William C. Becker, Erin E Krebs, Jane M. Liebschutz, Daniel P. Alford

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations

Abstract

Objective: This manuscript reviews peer-reviewed literature published from 2010-2012 relevant to the management of chronic pain in the primary care setting. Design: Narrative review of peer-reviewed literature. Methods: We searched MEDLINE, PubMed, and reference lists and queried expert contacts for English-language studies related to the management of chronic noncancer pain in adult patients in primary care settings. One investigator reviewed all eligible studies for relevance, and 47 studies were reviewed by all authors and rated according to their impact on 1) primary care clinical practice, 2) policy, 3) research, and 4) quality of study methods. Through iterative discussion, nine articles were selected for detailed review and discussion. Results: We present articles in six topic areas: interventional pain management; opioid dose and risk of overdose death; neuropathic pain; yoga for chronic low back pain; cognitive behavioral therapy; and systematic approaches to treating back pain. We discuss implications for pain management in primary care. Conclusions: There is growing evidence for the risks, benefits, and limitations of the multiple modalities available to primary care providers for the management of chronic pain. The dissemination and implementation of the evidence from these studies as well as novel system-level interventions warrant additional study and support from clinicians, educators, and policy makers.

Original languageEnglish (US)
Pages (from-to)425-431
Number of pages7
JournalPain Medicine (United States)
Volume15
Issue number3
DOIs
StatePublished - Mar 2014

Bibliographical note

Funding Information:
All authors are members of the Society of General Internal Medicine's Pain Medicine Interest Group. This article derives from the presentation “Update in Pain Medicine” at the 36th annual meeting of SGIM in April 2013 in Denver, Colorado. Dr. Frank was supported by an institutional National Research Service Award (T32HP10251). Drs. Becker and Krebs are supported by VA HSR&D Research Career Development Awards.

Keywords

  • Exercise
  • Interventional
  • Neuropathic Pain
  • Opioids
  • Pain Management
  • Physical Therapy
  • Primary Care
  • Psychotherapy

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