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Pain, Intractable

MedGen UID:
14574
•Concept ID:
C0030200
•
Sign or Symptom
Synonyms: Intractable Pain; Intractable Pains; Pain, Refractory; Pains, Intractable; Pains, Refractory; Refractory Pain; Refractory Pains

Definition

Persistent pain that is refractory to some or all forms of treatment. [from MeSH]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVPain, Intractable

Professional guidelines

PubMed

Current Understanding of Phantom Pain and its Treatment.
Culp CJ, Abdi S
Pain Physician 2022 Oct;25(7):E941-E957. PMID: 36288580
Progress in the treatment of diabetic peripheral neuropathy.
Yang K, Wang Y, Li YW, Chen YG, Xing N, Lin HB, Zhou P, Yu XP
Biomed Pharmacother 2022 Apr;148:112717. Epub 2022 Feb 19 doi: 10.1016/j.biopha.2022.112717. PMID: 35193039
Scheuermann's Kyphosis: Diagnosis, Management, and Selecting Fusion Levels.
Sardar ZM, Ames RJ, Lenke L
J Am Acad Orthop Surg 2019 May 15;27(10):e462-e472. doi: 10.5435/JAAOS-D-17-00748. PMID: 30407981

Recent clinical studies

Etiology

Best Practices in Spinal Cord Stimulation.
Sitzman BT, Provenzano DA
Spine (Phila Pa 1976) 2017 Jul 15;42 Suppl 14:S67-S71. doi: 10.1097/BRS.0000000000002220. PMID: 28459781
Medullary sponge kidney.
Gambaro G, Danza FM, Fabris A
Curr Opin Nephrol Hypertens 2013 Jul;22(4):421-6. doi: 10.1097/MNH.0b013e3283622b86. PMID: 23680648
Treatment of cancer pain.
Portenoy RK
Lancet 2011 Jun 25;377(9784):2236-47. doi: 10.1016/S0140-6736(11)60236-5. PMID: 21704873
Oral mucositis.
Raber-Durlacher JE, Elad S, Barasch A
Oral Oncol 2010 Jun;46(6):452-6. Epub 2010 Apr 18 doi: 10.1016/j.oraloncology.2010.03.012. PMID: 20403721
Thalamotomy.
Tasker RR
Neurosurg Clin N Am 1990 Oct;1(4):841-64. PMID: 2136173

Diagnosis

Inpatient Management of Migraine.
Marmura MJ, Hou A
Neurol Clin 2019 Nov;37(4):771-788. doi: 10.1016/j.ncl.2019.07.007. PMID: 31563232
Only in Silence.
Eison D
Hastings Cent Rep 2018 May;48(3):3-4. doi: 10.1002/hast.845. PMID: 29806890
Intractable pain.
Viswanathan A, Burchiel KJ
Neurosurg Focus 2013 Sep;35(3):Introduction. doi: 10.3171/2013.7.FOCUS13277. PMID: 23991823
Central post-stroke pain: clinical characteristics, pathophysiology, and management.
Klit H, Finnerup NB, Jensen TS
Lancet Neurol 2009 Sep;8(9):857-68. doi: 10.1016/S1474-4422(09)70176-0. PMID: 19679277
Cancer pain.
O'Neill WM
Middle East J Anaesthesiol 1996 Feb;13(4):373-8. PMID: 8713631

Therapy

Defining refractory rheumatoid arthritis.
Buch MH
Ann Rheum Dis 2018 Jul;77(7):966-969. Epub 2018 Mar 27 doi: 10.1136/annrheumdis-2017-212862. PMID: 29588276
Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC:CBD extract and THC extract in patients with intractable cancer-related pain.
Johnson JR, Burnell-Nugent M, Lossignol D, Ganae-Motan ED, Potts R, Fallon MT
J Pain Symptom Manage 2010 Feb;39(2):167-79. Epub 2009 Nov 5 doi: 10.1016/j.jpainsymman.2009.06.008. PMID: 19896326
Radiofrequency procedures.
Racz GB, Ruiz-Lopez R
Pain Pract 2006 Mar;6(1):46-50. doi: 10.1111/j.1533-2500.2006.00058.x. PMID: 17309709
Ziconotide.
Lyseng-Williamson KA, Perry C
CNS Drugs 2006;20(4):331-8; discussion 339-41. doi: 10.2165/00023210-200620040-00007. PMID: 16599651
Defining the clinically important difference in pain outcome measures.
Farrar JT, Portenoy RK, Berlin JA, Kinman JL, Strom BL
Pain 2000 Dec 1;88(3):287-294. doi: 10.1016/S0304-3959(00)00339-0. PMID: 11068116

Prognosis

Defining refractory rheumatoid arthritis.
Buch MH
Ann Rheum Dis 2018 Jul;77(7):966-969. Epub 2018 Mar 27 doi: 10.1136/annrheumdis-2017-212862. PMID: 29588276
Medullary sponge kidney.
Gambaro G, Danza FM, Fabris A
Curr Opin Nephrol Hypertens 2013 Jul;22(4):421-6. doi: 10.1097/MNH.0b013e3283622b86. PMID: 23680648
Treatment of cancer pain.
Portenoy RK
Lancet 2011 Jun 25;377(9784):2236-47. doi: 10.1016/S0140-6736(11)60236-5. PMID: 21704873
A controlled trial to improve care for seriously ill hospitalized patients. The study to understand prognoses and preferences for outcomes and risks of treatments (SUPPORT). The SUPPORT Principal Investigators.
JAMA 1995 Nov 22-29;274(20):1591-8. PMID: 7474243
Thalamotomy.
Tasker RR
Neurosurg Clin N Am 1990 Oct;1(4):841-64. PMID: 2136173

Clinical prediction guides

Neuromodulation in Pediatrics: Case Series.
Kim E, Gamble S, Schwartz A, Cucchiaro G
Clin J Pain 2018 Nov;34(11):983-990. doi: 10.1097/AJP.0000000000000632. PMID: 29794496
Pain in head and neck cancer: prevalence and possible predictive factors.
Bianchini C, Maldotti F, Crema L, Malagò M, Ciorba A
J BUON 2014 Jul-Sep;19(3):592-7. PMID: 25261640
Medullary sponge kidney.
Gambaro G, Danza FM, Fabris A
Curr Opin Nephrol Hypertens 2013 Jul;22(4):421-6. doi: 10.1097/MNH.0b013e3283622b86. PMID: 23680648
Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC:CBD extract and THC extract in patients with intractable cancer-related pain.
Johnson JR, Burnell-Nugent M, Lossignol D, Ganae-Motan ED, Potts R, Fallon MT
J Pain Symptom Manage 2010 Feb;39(2):167-79. Epub 2009 Nov 5 doi: 10.1016/j.jpainsymman.2009.06.008. PMID: 19896326
Ziconotide.
Lyseng-Williamson KA, Perry C
CNS Drugs 2006;20(4):331-8; discussion 339-41. doi: 10.2165/00023210-200620040-00007. PMID: 16599651

Recent systematic reviews

Medial thalamotomy using stereotactic radiosurgery for intractable pain: a systematic review.
Franzini A, Rossini Z, Moosa S, Tropeano MP, Milani D, Attuati L, Clerici E, Navarria P, Pessina F, Picozzi P
Neurosurg Rev 2022 Feb;45(1):71-80. Epub 2021 May 12 doi: 10.1007/s10143-021-01561-x. PMID: 33978923
Chronic and Refractory Pain: A Systematic Review of Pharmacologic Management in Oncology
.
Brant JM, Keller L, McLeod K, Yeh C, Eaton LH
Clin J Oncol Nurs 2017 Jun 1;21(3 Suppl):31-53. doi: 10.1188/17.CJON.S3.31-53. PMID: 28524906
Anterior Cingulotomy for the Treatment of Chronic Intractable Pain: A Systematic Review.
Sharim J, Pouratian N
Pain Physician 2016 Nov-Dec;19(8):537-550. PMID: 27906933
African Americans' Perceptions of Pain and Pain Management: A Systematic Review.
Booker SQ
J Transcult Nurs 2016 Jan;27(1):73-80. Epub 2014 May 19 doi: 10.1177/1043659614526250. PMID: 24841472
Assessment and classification of cancer breakthrough pain: a systematic literature review.
Haugen DF, Hjermstad MJ, Hagen N, Caraceni A, Kaasa S; European Palliative Care Research Collaborative (EPCRC)
Pain 2010 Jun;149(3):476-482. Epub 2010 Mar 16 doi: 10.1016/j.pain.2010.02.035. PMID: 20236762

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