VHA/DoD Clinical Practice Guideline for the Management of Medically Unexplained Symptoms: Chronic Pain and Fatigue

2001 ◽  
Keyword(s):  
Chronic Pain ◽  
Clinical Practice ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Medically Unexplained Symptoms ◽  
Medically Unexplained ◽  
Unexplained Symptoms

scholarly journals 2017 HIVMA of IDSA Clinical Practice Guideline for the Management of Chronic Pain in Patients Living With HIV

2017 ◽  
Vol 65 (10) ◽  
pp. e1-e37 ◽  
Author(s):  
R Douglas Bruce ◽  
Jessica Merlin ◽  
Paula J Lum ◽  
Ebtesam Ahmed ◽  
Carla Alexander ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Clinical Practice ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Living With Hiv

scholarly journals Encouraging clinicians to work effectively with people with medically unexplained symptoms - is a change in underlying attitudes required?

2017 ◽  
Vol 5 (3) ◽  
pp. 389
Author(s):  
Marta J Buszewicz
Keyword(s):  
Clinical Practice ◽  
Health Service ◽  
Secondary Care ◽  
Medically Unexplained Symptoms ◽  
Physical Symptoms ◽  
Normal Function ◽  
Negative Consequences ◽  
Postgraduate Level ◽  
Medically Unexplained ◽  
Unexplained Symptoms

Medically unexplained symptoms are defined as physical symptoms for which there is no clear diagnosis of organic pathology, including after relevant investigations. Several other terms are also used to describe such symptoms and will be briefly described, although none is ideal. The present paper summarizes the current research, illustrating how patients consulting clinicians in both primary and secondary care often present with symptoms which, while undoubtedly distressing for the patient, do not link with any clear organic pathology. This raises difficult issues for clinicians in terms of how much they should investigate and how to manage the patient’s problems in a way which will be helpful and mean they will feel their symptoms have been appropriately recognised and addressed. Failure to do this can lead to many negative consequences, including a breakdown in trust between patients and clinicians, over-investigation or inappropriate treatments, a loss of normal function for the patient and significant costs to the health service and economy. Despite this, the evidence is that doctors receive very little if any training about how to manage such symptoms at either the undergraduate or postgraduate level. This paper will focus on the attitudes of both junior and more senior doctors across a range of specialities to working with people with unexplained symptoms and how these may affect their management. The implications for clinical practice and recommendations for future training will be discussed and in particular the need to consider the psychosocial as well as the biomedical aspects of patients’ presentations from the outset.

Disability, Chronic Pain, and Medically Unexplained Symptoms

2021 ◽  
pp. 55-71
Author(s):  
David Beaumont
Keyword(s):  
Chronic Pain ◽  
Central Sensitization ◽  
Medically Unexplained Symptoms ◽  
Pain Syndrome ◽  
Chronic Fatigue ◽  
Case Examples ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
Irritable Bowel ◽  
Definition Of

The concept of disability (including the WHO definition). Case example: disability cf ‘challenge’. Chronic pain, chronic fatigue, and spina bifida, Author’s keynote speech to New Zealand Disability Support Network. The experience of 100 people with different disabilities: system failure and ‘all some doctors see is my disability’. Author’s personal experience of disability resulting from osteoarthritis in both hips. Effect of aquajogging and gentle walking in easing pain, losing weight, and lifting mood. The experience of pain. Chronic pain syndrome and Professor Clifford Woolf’s (Harvard Medical School) 1983 definition of central sensitization. The role of the brain in the experience of pain. Central sensitization and case examples of carpal tunnel syndrome and low back pain. Regional pain syndrome, pain medication and the patient’s expertise with gabapentin. Number needed to treat of gabapentin is 6–8. Effectiveness of paracetamol. Medically unexplained symptoms explained, the example of fibromyalgia, irritable bowel syndrome. The concept of ‘curing’ compared with ‘healing’. The concept of homeostasis. The WHO’s ICD-11 (2018) and the new overarching concept of bodily distress disorder.

Sign in / Sign up

Export Citation Format

Share Document