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"Pain ladder", or analgesic ladder, was created by the World Health Organization (WHO) as a guideline for the use of drugs in the management of pain. Originally published in 1986 for the management of cancer pain , it is now widely used by medical professionals for the management of all types of pain .
The anterolateral system (ALS) is an ascending bundle of fibers in the spinal cord, carried in three main pathways or tracts. [1] The tracts convey pain, [6] temperature (protopathic sensation), and crude touch from the periphery to the brain. The most important of these is the spinothalamic tract. [2]
Cordotomy is performed as for patients with severe intractable pain, usually but not always due to cancer.Being irreversible and relatively invasive, cordotomy is used exclusively for pain where treatment to level 3 of the World Health Organization pain ladder (i.e., use of major opiates such as morphine) has proved inadequate.
An analgesic adjuvant is a medication that is typically used for indications other than pain control but provides control of pain in some painful diseases. This is often part of multimodal analgesia, where one of the intentions is to minimize the need for opioids. [1] [2] [3]
The tract transmits slow nociceptive/pain information (but thermal, and crude touch information as well) from the spinal cord to reticular formation which in turn relays the information to the thalamus via reticulothalamic fibers as well as to other parts of the brain (as opposed to the spinothalamic tract - the direct pathway of the ...
Diffuse noxious inhibitory controls (DNIC) or conditioned pain modulation (CPM) refers to an endogenous pain modulatory pathway which has often been described as "pain inhibits pain". [1] It occurs when response from a painful stimulus is inhibited by another, often spatially distant, noxious stimulus.
The exact medications recommended will vary by country and the individual treatment center, but the following gives an example of the WHO approach to treating chronic pain with medications. If, at any point, treatment fails to provide adequate pain relief, then the doctor and patient move onto the next step.
Interventional pain management or interventional pain medicine is a medical subspecialty defined by the National Uniforms Claims Committee (NUCC) as, " invasive interventions such as the discipline of medicine devoted to the diagnosis and treatment of pain related disorders principally with the application of interventional techniques in managing sub acute, chronic, persistent, and intractable ...