Advances in the Treatment of Pain: Highlights of the 10th World Congress on Pain

Prescott, Lawrence M. PhD

• This article, which presents an overview of some of the major presentations of pharmacologic approaches for the treatment of pain at the 10th World Congress on Pain, was written by Lawrence M. Prescott, PhD.

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D & MD Newsletter 13(11):p 326-331, November 2002.

• A number of anticonvulsants have been shown to be effective in various types of either new-onset or refractory neuropathic pain including peripheral neuropathy, diabetic peripheral neuropathy, trigeminal neuropathy, and post-herpetic neuralgia.

• Extended-release opioids are proving valuable in relieving the severe pain possible in patients with osteoarthritis.

• A transdermal opioid analgesic, used when continuous management of chronic pain is needed, significantly reduces back pain in patients with osteoporosis, leading to a marked improvement in quality of life.

• An acetamide local anesthetic patch offers a targeted peripheral analgesic, relieving pain intensity and reducing pain interference in daily activities in patients with either acute or chronic low back pain.

• Two completely different treatment approaches-one a centrally acting α₂-adrenergic agonist and the other a bacterial toxin-have demonstrated good to excellent pain relief in patients suffering with myofascial pain syndrome, the agonist being useful as a first-line therapy, while the toxin significantly eases refractory pain.

• A novel selective 5-HT_1B/1D agonist effectively relieves acute migraine headache, reducing pain while improving overall function and quality of life in better than two-thirds of the patients treated.

• Two COX-2 inhibitors provide greater overall analgesic efficacy compared to opioid analgesics in patients with acute postoperative dental pain, suggesting their use as an alternative to opioids in the management of acute pain.

• New approaches in the relief of cancer pain show promise, including a novel opioid formulation and the administration of methadone for refractory breakthrough bone pain.