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      Uso de terapias alternativas, desafío actual en el manejo del dolor

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          Abstract

          El dolor, definido como una experiencia sensorial o emocional desagradable de daño tisular real o potencial, ha sido motivo de múltiples investigaciones que buscan explicar su fisiopatología, desde sus bases genéticas y moleculares, hasta sus principios físicos y biológicos, con el fin de desarrollar diferentes opciones terapéuticas que permitan disminuir o erradicar su presentación entre la población. Durante las últimas décadas, el uso de las terapias complementarias y alternativas ha tomado fuerza y ganado popularidad, siendo particularmente útiles en algunos grupos específicos de pacientes, como aquellos que presentan dolor crónico oncológico. Estas terapias están constituidas por un amplio y variado grupo de intervenciones terapéuticas tales como medicina herbal, ayurvédica, homeopatía, aromaterapia, entre otras; es importante entonces que el personal de salud las conozca y las considere como una opción en el manejo integral del dolor.

          Translated abstract

          Pain, defined as an unpleasant sensory or emotional experience from actual or potential tissue damage, it has been the subject of multiple investigations seeking to explain its pathophysiology, from their genetic and molecular bases until their physical and biological principles, in order to develop different therapeutic options that reduce or eradicate his presentation among the population. During recent decades, the use of complementary and alternative therapies has taken strength and gained popularity, being particularly useful in some specific groups of patients, like those who have chronic pain. These therapies are constituted by a wide and varied group of therapeutic interventions such as ayurvedic medicine, homeopathy, herbal, aromatherapy, among others; it is important that health professional know it and consider it as an option in the integral management of the pain.

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          Most cited references 110

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          The epidemiology of chronic pain of predominantly neuropathic origin. Results from a general population survey.

          Progress in the understanding of chronic pain with neuropathic features has been hindered by a lack of epidemiologic research in the general population. The Leeds Assessment of Neuropathic Symptoms and Signs score (S-LANSS) was recently validated for use in postal surveys, making the identification of pain of predominantly neuropathic origin possible. Six family practices in 3 UK cities (Aberdeen, Leeds, and London) generated a total random sample of 6,000 adults. The mailed questionnaire included demographic items, chronic pain identification, and intensity questions, the S-LANSS, the Level of Expressed Needs questionnaire, and the Neuropathic Pain Scale. With a corrected response rate of 52%, the prevalence of any chronic pain was 48% and the prevalence of pain of predominantly neuropathic origin was 8%. Respondents with this chronic neuropathic pain were significantly more likely to be female, slightly older, no longer married, living in council rented accommodation, unable to work, have no educational qualifications, and be smokers than all other respondents. Multiple logistic regression modeling found that pain of predominantly neuropathic origin was independently associated with older age, gender, employment (being unable to work), and lower educational attainment. Respondents with this pain type also reported significantly greater pain intensity, higher scores on the NPS, higher levels of expressed need, and longer duration of pain. This is the first estimate of the prevalence and distribution of pain of predominantly neuropathic origin in the general population, using a previously validated and reliable data collection instrument. Chronic pain with neuropathic features appears to be more common in the general population than previously suggested. This type of pain is more severe than other chronic pain but distributed similarly throughout sociodemographic groups.
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            Complementary and alternative medicine use among adults: United States, 2002

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              The Prevalence of Chronic Pain in Canada

              Published population estimates of the prevalence of chronic pain have been highly variable due, in part, to differences in definitions and study methodologies. Designing health care delivery models that address chronic pain and reduce its impact, however, require accurate, up-to-date prevalence data. This article first reviews studies that examined the prevalence of chronic pain both internationally and in Canada. The ensuing sections describe a telephone-based survey of a well-defined population of adults using a detailed and sequential definition of chronic pain, and well-validated and reliable data collection tools for establishing the prevalence of chronic pain in Canada. BACKGROUND: While chronic pain appears to be relatively common, published population prevalence estimates have been highly variable, partly due to differences in the definition of chronic pain and in survey methodologies. OBJECTIVES: To estimate the prevalence of chronic pain in Canada using clear case definitions and a validated survey instrument. METHODS: A telephone survey was administered to a representative sample of adults from across Canada using the same screening questionnaire that had been used in a recent large, multicountry study conducted in Europe. RESULTS: The prevalence of chronic pain prevalence for adults older than 18 years of age was 18.9%. This was comparable with the overall mean reported using identical survey questions and criteria for chronic pain used in the European study. Chronic pain prevalence was greater in older adults, and females had a higher prevalence at older ages compared with males. Approximately one-half of those with chronic pain reported suffering for more than 10 years. Approximately one-third of those reporting chronic pain rated the intensity in the very severe range. The lower back was the most common site of chronic pain, and arthritis was the most frequently named cause. CONCLUSIONS: A consensus is developing that there is a high prevalence of chronic pain within adult populations living in industrialized nations. Recent studies have formulated survey questions carefully and have used large samples. Unfortunately, a substantial proportion of Canadian adults continue to live with chronic pain that is longstanding and severe.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                dolor
                Revista de la Sociedad Española del Dolor
                Rev. Soc. Esp. Dolor
                Sociedad Española del Dolor (Madrid )
                1134-8046
                December 2014
                : 21
                : 6
                : 338-344
                Affiliations
                [1 ] Universidad Pontificia Bolivariana Colombia
                Article
                S1134-80462014000600007
                10.4321/S1134-80462014000600007

                http://creativecommons.org/licenses/by/4.0/

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                Categories
                CRITICAL CARE MEDICINE

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