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American Family Physician October 15, 2001 Vincent Morelli	Groin Injuries in Athletes Groin injuries comprise 2 to 5 percent of all sports injuries. Early diagnosis and proper treatment are important to prevent these injuries from becoming chronic and potentially career-limiting...
American Family Physician February 15, 2002 David J. Alvarez	Trigger Points: Diagnosis and Management Trigger points are discrete, focal, hyperirritable spots located in a taut band of skeletal muscle. They produce pain locally and in a referred pattern and often accompany chronic musculoskeletal disorders...
Nursing September 2008 Susan Simmons Holcomb	Acute Abdomen: What a Pain! So many things - some life-threatening - can cause abdominal pain. Here's how to capture the clues quickly and accurately.
American Family Physician November 1, 2006 Lyon & Clark	Diagnosis of Acute Abdominal Pain in Older Patients Acute abdominal pain is a common presenting complaint in older patients, but may be difficult to diagnose. Here are some common causes of abdominal pain in old patients and recommendations for treatment.
American Family Physician August 15, 2001 Daisy Arce	Recognizing Spinal Cord Emergencies Physicians who work in primary care settings and emergency departments frequently evaluate patients with neck and back pain. Spinal cord emergencies are uncommon, but injury must be recognized early so that the diagnosis can be quickly confirmed...
American Family Physician June 1, 2003 Leung & Sigalet	Acute Abdominal Pain in Children Acute abdominal pain in children presents a diagnostic dilemma. Although many cases of acute abdominal pain are benign, some require rapid diagnosis and treatment to minimize morbidity. Numerous disorders can cause abdominal pain.
American Family Physician October 1, 2000 Millea & Holloway	Treating Fibromyalgia Fibromyalgia is an extremely common chronic condition that can be challenging to manage...
American Family Physician April 15, 2001 Lori J. Heim	Evaluation and Differential Diagnosis of Dyspareunia Dyspareunia is genital pain associated with sexual intercourse. Although this condition has historically been defined by psychologic theories, the current treatment approach favors an integrated pain model...
Nurse Practitioner May 2009 Yvonne D'Arcy	Is Low Back Pain Getting on Your Nerves? The pain and disability of low back pain are the most common reasons patients seek healthcare. Here are tools for diagnosis and treatment options.
Nurse Practitioner May 2012 Diana L. Wadlund	Meeting the challenge of IBS IBS is the best studied, most common functional GI disorder, and is often characterized by debilitating symptoms without any pathologic findings. The predominant symptoms of IBS are abdominal pain and an alteration in bowel habits with an absence of organic pathology.
American Family Physician June 1, 2002 S. Craig Humphreys	Neuroimaging in Low Back Pain Patients commonly present to family physicians with low back pain. Because the majority of patients fully or partially recover within six weeks, imaging studies are generally not recommended in the first month of acute low back pain.
American Family Physician January 1, 2005 Jerry L. Old et al.	Imaging for Suspected Appendicitis Acute appendicitis is the most common reason for emergency abdominal surgery and must be distinguished from other causes of abdominal pain. Family physicians play a valuable role in the early diagnosis and management of this condition.
Nurse Practitioner November 2010 Ronald Lee Tyson	Diagnosis and treatment of abdominal angina Abdominal angina refers to pain or discomfort in the gut when the blood supply to the tissues and organs of digestion has been compromised in some manner
American Family Physician April 1, 2001 Andrew J. Portis	Diagnosis and Initial Management of Kidney Stones The diagnosis and initial management of urolithiasis have undergone considerable evolution in recent years...
American Family Physician June 1, 2002 Daisy A. Arce	Evaluation of Constipation Constipation is the reason for 2.5 million physician visits per year in the United States, with more than one half of these visits to primary care physicians. The differential diagnosis of constipation and the approach to its evaluation differ in adults and children.
American Family Physician October 1, 2001 Karl E. Miller	Challenges in Pain Management at the End of Life Effective pain management in the terminally ill patient requires an understanding of pain control strategies. Ongoing assessment of pain is crucial and can be accomplished using various forms and scales...
Nursing January 2010 Brenner & Krenzer	Understanding acute pancreatitis Mr. White has classic signs and symptoms of acute pancreatitis. The onset is usually abrupt, often occurring after a large meal or excessive alcohol use.
American Family Physician December 1, 2005 Cole, Seto & Gazewood	Plantar Fasciitis: Evidence-Based Review of Diagnosis and Therapy Most interventions used to manage plantar fasciitis have not been studied adequately; however, shoe inserts, stretching exercises, steroid injection, and custom-made night splints may be beneficial.
American Family Physician May 15, 2001 Allan Gottschalk & David S. Smith	New Concepts in Acute Pain Therapy: Preemptive Analgesia Preemptive analgesia, an evolving clinical concept, involves the introduction of an analgesic regimen before the onset of noxious stimuli, with the goal of preventing sensitization of the nervous system to subsequent stimuli that could amplify pain...
American Family Physician October 1, 2005 Salzman & Lillie	Diverticular Disease: Diagnosis and Treatment Although the pathogenic mechanisms of diverticular disease are poorly understood, they are clearly related to complex interactions of colon structure, intestinal motility, diet, and genetic features.
Managed Care May 2005	Microcircuit Devices Deliver Considerable Relief From Chronic Pain Recent advances in pain relief revolve around longer-lasting implantable devices. Can managed care afford not to have a pain management strategy?
Nursing Management March 2012 Yvonne D'Arcy	Pain and obesity It can be a challenge to provide effective pain management for obese patients; however, a multimodal pain management regimen that combines medications and complementary techniques can help increase pain relief.
Nurse Practitioner December 2011	Managing pain in obese patients Obesity-related pain conditions can limit the patient's efforts at increasing activity and limit quality of life. This article will offer information on these conditions and treatment options.
American Family Physician July 1, 2006 Junnila & Cartwright	Chronic Musculoskeletal Pain in Children: Part I. Initial Evaluation Musculoskeletal pain can be difficult for children to characterize. A logical and consistent approach to diagnosis is recommended, with judicious use of laboratory and radiologic testing.
American Family Physician November 1, 2005 Forman, Forman & Rose	A Clinical Approach to Diagnosing Wrist Pain Primary care physicians often are the first to evaluate and treat a patient with wrist pain. A detailed history alone may lead to a specific diagnosis in approximately 70% of patients who have wrist pain.
Nurse Practitioner May 2012 Hammersla & Kapustin	Peripheral Neuropathy: Evidence-based treatment of a complex disorder Peripheral neuropathy is a common and often progressive condition frequently seen in primary care. The chronic pain associated with PN, or neuropathic pain, can significantly diminish patients' quality of life and be challenging to treat.
American Journal of Nursing August 2011 Craft & Prahlow	From Fecal Impaction to Colon Perforation The authors present the case of an elderly, nonverbal nursing home resident with dementia who developed fecal impaction, despite interventions such as enema.
Nursing June 2008 Yvonne D'arcy	Nursing2008 Pain Management Survey Report See how your responses to this survey compare with those of nursing colleagues across the country and beyond.
American Family Physician July 15, 2004 Tracy Aldridge	Diagnosing Heel Pain in Adults A thorough history and a physical examination of the lower extremity should be conducted to locate the pain, define its attributes, and narrow the differential diagnosis.
Nurse Practitioner May 2009 Bradway & Rodgers	Evaluation and Management of Genitourinary Emergencies Primary care NPs are often the first to identify and provide treatment for a variety of genitourinary conditions. These include acute urinary retention; priapism; obstructing renal calculi; and two acute scrotal emergencies - testes torsion and Fournier gangrene.
American Family Physician August 15, 2005 Bellows, Berger & Crass	Management of Gallstones Many patients with gallstones can be managed expectantly. Generally, only persons with symptoms related to the presence of gallstones or complications warrant surgical intervention.
Nursing October 2009 Yvonne D'Arcy	Overturning barriers to pain relief in older adults This article will describe how to lower the barriers to effective pain control in older patients and provide practical tips for helping them receive the full benefit from pharmacologic and nonpharmacologic therapies.
American Family Physician May 15, 2001	Pain Relief After Surgery How will my pain be managed?...How are pain medicines given after surgery?... What should I do to make sure I receive the best possible pain relief?...
American Family Physician September 1, 2005 Wilson & Best	Common Overuse Tendon Problems: A Review and Recommendations for Treatment Distinguishing tendinopathy from tendonitis and recommendations on appropriate treatments.
American Family Physician July 1, 2000 Anne D. Walling, M.D.	Family Practice International Depression in Young Adults... Treatment of Pancreatic Cancer... Acute Appendicitis in Pregnancy...
American Journal of Nursing April 2009	Understanding and Managing Burn Pain: Part 1 Despite advances in topical wound care and pharmacology, and a growing emphasis on palliative care, wound care is the main source of the pain associated with burn injury.
Nursing November 2008 Michael W. Day	Fight Back Against Inflammatory Bowel Disease It takes guts to live with Crohn's disease or ulcerative colitis, both of which can take a heavy toll on their victims. Find out how to help your patient tame the attacks.
American Journal of Nursing March 2011 Jablonski et al.	The Use of Algorithms in Assessing and Managing Persistent Pain in Older Adults This article introduces readers to the use of algorithms in guiding the assessment and management of persistent pain in older adults, and provides an illustrative case study.
American Family Physician December 1, 2000	Letters to the Editor Osteopathic Medicine in the Treatment of Low Back Pain...
American Family Physician August 15, 2006 Mounsey, Wilgus & Slawson	Diagnosis and Management of Endometriosis The preferred method for diagnosis of endometriosis is surgical visual inspection of pelvic organs with histologic confirmation. Such diagnosis requires an experienced surgeon because the varied appearance of the disease allows less-obvious lesions to be overlooked.
American Family Physician September 15, 2000 Doris L. Wethers, M.D.	Sickle Cell Disease in Childhood Part II. Diagnosis and Treatment of Major Complications and Recent Advances in Treatment
Nursing July 2008 Held-Warmkessel & Schliech	Responding to 4 Gastrointestinal Complications in Cancer Patients If your patient has cancer, be prepared to help her manage such serious GI complications as bowel obstruction, peritonitis, fistula formation, and intestinal perforation.
Nurse Practitioner April 2012 Firestone et al.	Optimizing fibromyalgia management This article summarizes current information regarding the etiology, pathophysiology, clinical presentation, diagnostic standards, and pharmacologic and non-pharmacologic treatments necessary to successfully manage FM.
American Family Physician July 15, 2002 Dennis A. Cardone & Alfred F. Tallia	Joint and Soft Tissue Injection In this overview, the indications, contraindications, potential side effects, timing, proper technique, necessary materials, pharmaceuticals used and their actions, and post-procedure care of patients are presented.
American Family Physician October 1, 2000 Ronald Schneeweiss, M.B., Ch.B.	Curbside Consultation What is the role of a consultant in the referral process? What constitutes a "good" referral?
American Family Physician February 1, 2005 Maizels & McCarberg	Antidepressants and Antiepileptic Drugs for Chronic Non-Cancer Pain The development of newer classes of antidepressants and second-generation antiepileptic drugs has created unprecedented opportunities for the treatment of chronic pain. These drugs modulate pain transmission by interacting with specific neurotransmitters and ion channels.
American Journal of Nursing December 2010 Baldridge & Andrasek	Pain Assessment in People with Intellectual or Developmental Disabilities Nurses in all settings need to be knowledgeable about alternate pain assessment methods.
American Family Physician March 15, 2006 Cassas Cassettari-Wayhs	Childhood and Adolescent Sports-Related Overuse Injuries Each year in the United States, approximately 30 million children and teenagers participate in organized sports. Youth sports participation carries an inherent risk of injury, including overuse injuries. Here are key recommendations for practices.
American Family Physician February 15, 2002 Miriam Grushka	Burning Mouth Syndrome Burning mouth syndrome is characterized by a burning sensation in the tongue or other oral sites, usually in the absence of clinical and laboratory findings...
American Family Physician November 15, 2005 William E. Cayley	Diagnosing the Cause of Chest Pain Distinguishing between serious and benign causes of chest pain is imperative, and diagnostic and prognostic questions are important in making this determination.