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K - Ameliorate Neuropathic Pain

Outcomes/Assessments Below is a succinct list of some of the more frequently used and appropriately validated tools (*validated in SCI population) for assessment of NeP). It does not include all the possible pain assessment and outcome tools available for the diagnosis of neuropathic pain.13 • DN4 neuropathic pain diagnosis questionnaire, based on history and physical exam • Leeds Assessment for neuropathic symptoms and signs (LANSS)*, based on history and physical exam • Self-report Leeds Assessment for neuropathic symptoms and signs (S-LANSS)*, as above, but based on individual self-assessment. Assessment and Follow Up Evaluation of Pain Severity • Visual Analog Scale (VAS) - Consists of one horizontal or vertical line, usually 10 centimeters in length, anchored with verbal descriptors of “no pain” and “pain as bad as it could be.” The individual with pain marks the line, on the scale, at the point of pain severity. The VAS may also be used as a verbal analog scale, in which the respondent anchors 0 as “no pain”, and 10 or 100 as “worst pain possible” (or other descriptor). • VAS: Faces Pain Scale - As above but presenting facial expressions (ranging from happy to increasing degrees of unhappiness) for the individual to circle, to best reflect pain level. • Numeric Rating Scale (NRS) - A variation of the VAS scale where each 10 millimeters on the scale is given a number, for the individual to rate from 0 (no pain) to 10 (the worst pain experienced). • McGill Pain Questionnaire (MPQ) - Measures different qualities of the subjective pain experience, with three classes of words (a total of 78) that describe the sensory, affective and evaluative aspects of pain; and a five-point pain intensity scale (present pain intensity PPI). A shorter, less time-consuming form of the MPQ also measures different qualities of the subjective pain experience, using 15 words from the original questionnaire: 11 sensory words and four affective words. Assessment and Follow up Evaluation of Pain Severity and Its Impact on Function • Brief Pain Inventory (BPI) - A brief, relatively simple, self-administered questionnaire, to address the relevant aspects of pain: history, intensity, timing, location and quality; as well as the pain’s ability to interfere with the individual’s function. • West Haven-Yale Multidisciplinary Pain Inventory (MPI) - This tool has multiple scales, like the BPI, to measure severity and interference of pain, individual responses to pain, and its impact on daily activities. Current Guidelines Used in Practice • Teasell RW, Mehta S, Aubut J, et al. Pain following spinal cord injury. In: Eng JJ, Teasell RW, Miller WC, et al., eds. Spinal Cord Injury Rehabilitation Evidence. Version 4.0. Vancouver, BC; 2012. (www.scireproject.com) • Multidisciplinary Association of Spinal Cord Injury Professionals. Guidelines for the Management of Neuropathic Pain in Adults Following Spinal Cord Injury. 2nd ed. Middlesex, UK: Spinal Cord Injury Centre, Royal National Orthopaedic Hospital; 2008. http://www.mascip.co.uk/guidelines.aspx. Accessed August 16, 2012. • Kumar, N. WHO Normative Guidelines on Pain Management. Report of a Delphi Study to determine the need for guidelines and to identify the number and topics of guidelines that should be developed by WHO. Geneva, Switzerland: World Health Organization; 2007. • Attal N, Cruccu G, Baron R, et al. EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. Eur J Neurol. 2010;17(9):1113-e88. • Moulin DE, Clark AJ, Gilron I, et al. Pharmacological management of chronic neuropathic pain – Consensus statement and guidelines from the Canadian Pain Society. Pain Res Manage. 2007;12(1):13-21. • Dworkin RH, O’Connor AB, Backonja M, et al. Pharmacologic management of neuropathic pain: Evidence-based recommendations. Pain. 2007;132:237–51. • National Pain Centre. Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain — Part A: Executive Summary and Background, Version 4.5. Canada: National Opioid Use Guideline Group (NOUGG); 2010. http://nationalpaincentre.mcmaster.ca/ opioid/. Accessed August 16, 2012. • National Pain Centre. Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain — Part B: Recommendations for Practice, Version 5.5 Canada: National Opioid Use Guideline Group (NOUGG);2010. http://nationalpaincentre.mcmaster.ca/opioid/. Accessed August 16, 2012. AMELIORATE NEUROPATHIC PAIN | BODY STRUCTURE AND FNUCTION 109


K - Ameliorate Neuropathic Pain
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