Comorbid Conditions
- Acute and Post-Operative Pain
- Cancer-related Pain
- Chronic Noncancer Pain
- Comorbid Conditions
- Fibromyalgia
- Headache
- Interventional Modalites
- Low Back Pain
- Medico-Legal-Ethical Issues
- Neuropathic Pain
- Nonopioid Pharmacotherapy
- Nonpharmacologic Treatment
- Opioid Pharmacotherapy
- Osteoarthritis
- Palliative Care
- Risk Management
- Scientific Perspectives
- Special Patient Populations
Journals
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Section Editor
Srinivas R. Nalamachu, MD
User Activity
Srinivas R. Nalamachu, MD
President and Medical Director
International Clinical Research Institute, Inc.
Co-Director
Pain Management Institute
Overland Park, Kansas
View AllPublications
Chronic opioid therapy and preventive services in rural primary care: an Oregon rural practice-based research network study.
A different kind of co-morbidity: Understanding posttraumatic stress disorder and chronic pain
Chronic low back pain, sleep disturbance, and interleukin-6.
Cognitive-behavioral therapy for sleep abnormalities of chronic pain patients.
Effect of telecare management on pain and depression in patients with cancer: a randomized trial.
Buckley DI, Calvert JF, Lapidus JA, et al.
Ann Fam Med. 2010;8(3):237-44.
PURPOSE:...
Ann Fam Med. 2010;8(3):237-44.
PURPOSE:...
A different kind of co-morbidity: Understanding posttraumatic stress disorder and chronic pain
Beck JG, Clapp JD.
Psychol Trauma. 2011 Jun;3(2):101-108.
Many traumatic events leave...
Psychol Trauma. 2011 Jun;3(2):101-108.
Many traumatic events leave...
Chronic low back pain, sleep disturbance, and interleukin-6.
Heffner KL, France CR, Trost Z. et al.
Clin J Pain. 2011 Jan;27(1):35-41.
OBJECTIVES:...
Clin J Pain. 2011 Jan;27(1):35-41.
OBJECTIVES:...
Cognitive-behavioral therapy for sleep abnormalities of chronic pain patients.
Tang NK.
Curr Rheumatol Rep. 2009 Dec;11(6):451-60.
Chronic pain and insomnia often...
Curr Rheumatol Rep. 2009 Dec;11(6):451-60.
Chronic pain and insomnia often...
Effect of telecare management on pain and depression in patients with cancer: a randomized trial.
Kroenke K, Theobald D, Wu J et al.
JAMA. 2010 Jul 14;304(2):163-71.
CONTEXT: Pain and...
JAMA. 2010 Jul 14;304(2):163-71.
CONTEXT: Pain and...







Some fraction of opioid-treated patients with chronic pain will engage in aberrant substance use, including compulsive drug seeking and addiction.
An individual’s perception and experience of chronic pain result from complex interplay among multiple biological, psychological, and social factors.
Chronic pain is often comorbid with affective symptomatology.
Chronic pain is a biopsychosocial condition that adversely affects multiple domains, including sleep. In fact, most chronic pain patients report fragmented or poor quality sleep. Moreover, studies suggest that pain onset often precedes the development of clinical insomnia, and pain intensity correlates with the degree of sleep disturbance.
Chronic pain is frequency accompanied by profound physical deconditioning, resulting in decreased tolerance to exercise, increased fatigue, and greater healthcare costs.
Many screening and monitoring tools – including the Opioid Risk Tool (ORT) and the Current Opioid Misuse Measure (COMM) – exist to assess and monitor the risk that a pain patient will engage in aberrant or problematic use of his/her pain medication.
Although chronic pain produces well-documented negative consequences for affected individuals and society as a whole, little is known about the interactions between chronic pain and other comorbid chronic conditions.
Patients with chronic pain often present with comorbid psychiatric disorders.
In addition to pain, patients with fibromyalgia often report sleep disturbances. Studies have shown that abnormal sleep patterns in fibromyalgia are characterized by delayed onset, decreased efficiency, and reduced slow wave and rapid eye movement sleep
In appropriately selected patient populations, opioid medications can provide significant pain relief and improve patient function.