The Victoria Work Cover Authority Back Campaign Australia 19971999

In 1997 the Victoria WorkCover Authority (VWA), the manager of the workers ' compensation system in the Australian state of Victoria, began a state-wide public health campaign aimed at shifting the general population' s attitudes and beliefs about back pain (henceforth called the VWA Back Campaign). The VWA Back Campaign was developed according to messages in The Back Book, an educational booklet for patients based on the biopsychosocial model 42 . Various unambiguous messages were included,...

Mass Media Campaigns for Back Pain

A summary of the key campaign elements and evaluation strategies of four back pain mass media campaigns are shown in Table 21.1 and are described below. Back pain, don't take it lying down Working backs Scotland Back It Active back Back pain, don't take it lying down Working backs Scotland Back It Active back Vestfold and Aust-Agder counties (325 000) Healthcare provision for the general population Dual system of universal healthcare (Medicare) and private health insurance Dual system of...

Two Jurisdictions That Have Prioritized Management of Chronic Pain

Jurisdictions (i.e. countries, states provinces or specific health systems) differ with regard to how they administer and finance services for patients with chronic pain. In the following section we provide a description of the commitment made to the management of chronic pain in the two example jurisdictions, selected because (i) they have made a clear commitment to chronic pain health services and their quality control (ii) they provide services to all members of a specific region or group...

The Prevalence of Psychopathology with Chronic Pain

Pain is both an emotional and a physical experience, and a range of expected emotional responses to chronic pain may arise, including anxiety, depressed mood, anger, bereavement, frustration, irritation, and isolation. These symptoms may or may not reach the threshold for the diagnosis of a mental disorder. There are a variety of characteristics of patients with chronic pain 7 2. Strong and ambivalent dependency needs 3. Feelings of isolation and loneliness 5. Inability to take care of self...

Surgical Factors Associated with CPSP

CPSP is more likely to develop in certain circumstances. Long operations 24, 25 , operations performed in centres with a low annual procedure volume 22 , open vs. laparoscopic procedures 26 and operations involving nerve damage 5, 26 are known to pose a greater risk. There are also specific surgical techniques that increase the risk 26, 27 . All of these factors appear to be associated with heightened surgical trauma and particularly with intraoperative nerve injury. Nerve injury is likely a...

Topical Tricyclic Antidepressants and Ketamine

There are preliminary data regarding the effectiveness of topically applied antidepressants for pain. Two randomized controlled trials demonstrated topical doxepin 3-5 is analgesic in a mixed group of patients with neuropathic pain 73, 74 . In a 3 week randomized placebo controlled trial, the concentration of amitriptyline 2 ketamine 1 was not better than placebo 75 however a higher concentration of amitriptyline 4 ketamine 2 was significantly better than placebo in post herpetic neuralgia 76 .

Cannabinoids

The potent anti- nociceptive and antihyperalgesic effects of cannabinoid agonists in animal models of acute and chronic pain, the presence of cannabinoid receptors in pain- processing areas of the brain, spinal cord and periphery and evidence supporting endogenous modulation of pain systems by cannabinoids, provide support that cannabinoids exhibit significant potential as analgesics. Fifteen of eighteen randomized controlled trials examining cannabinoids in the treatment of pain have...