First, let us address Internet sites that are available for information on pain management. There are many, and it makes sense to divide them into the following categories: advocacy sites for patients in pain, sites to help locate a pain specialist, and sites that provide direct pain management guidance. There is some overlap, but this is a good start. Each site was personally reviewed, and a brief description appears after each Web site listing.
Pain Advocacy Web Sites
This Joint Commission on Accreditation of Healthcare Organizations (JCAHO) was established in a joint effort with the University of Wisconsin Medical School, which has done a great deal of work to improve pain management.
The Pain and Policy Studies Group at the University of Wisconsin facilitates public access to information about pain relief and public policy. It addresses both domestic and international policy issues and is a World Health Organization Collaborating Center for Policy and Communications in Cancer Care.
The University of Iowa informational adult pain site is intended to educate health professionals, patients, and families.
The American Pain Foundation, a somewhat political organization funded by George Soros as an advocacy group, created a Web site primarily focused on relieving pain.
This American Chronic Pain Association developed this site. The organization offers support and information for patients with chronic pain and for their families and support groups.
The National Foundation for the Treatment of Pain (through the American Academy of Pain Medicine, AAPM) is dedicated to providing support for patients who are suffering from intractable pain, their families, friends, and the physicians who treat them.
Purdue Pharma, Inc., which is a pharmaceutical company that manufactures many analgesics and pain-related medications, runs this Web site. It does have many resources and a broad body of information on pain relief for professional and public audiences.
Pain Web Sites That Help Identify Specialists in Pain Management
The Web site developed by the American Academy of Pain Management has a searchable database of medical facilities that have passed the American Academy of Pain Management's Pain Program Accreditation testing and on-site inspection. This site is not recommended if searching for a geriatrician with pain expertise.
The pain.com site is another sponsored by the pharmaceutical industry. It has a searchable list of pain specialists and pain clinics all over the globe. Anyone can enter his or her name and clinic as a specialty pain clinic. Each of the specialists or clinics is listed in postal code order with the complete mailing address. Unfortunately, there is little screening of specialists on the list, and after a search for three specialists who had authored an article on the Web site, their names were not on the list. Nonetheless, there is some useful information and some presentations with continuing medical education (CME) credits for nurses and pharmacists.
Pain Web Sites That Provide Pain Management Guidance
This Web site is a government-run site that catalogs guidelines in many areas. Of more than 825 guidelines indexed, more than 200 are related to pain management. Although some are for seniors, a search as in January 2003 failed to list the American Geriatrics Society's 1998 or 2002 guidelines on chronic or persistent pain.
This site was developed in partnership by the AAPM and the American Pain Society (APS). It provides an impartial consensus in the following position papers: "The Use of Opioids for the Treatment of Chronic Pain," "The Necessity for Early Evaluation and Treatment of the Chronic Pain Patient," and "Quality Care at the End of Life." The site was designed to address inquiries from state legislatures, medical examiners, regulators, and doctors regarding the appropriate use of opioids, among other issues.
The Web site of the APS provides guidelines on pain management, information on upcoming meetings and events, and position statements.
The Department of Pain Medicine and Palliative Care at Beth Israel Medical Center in New York City runs this site, which is dedicated to providing comprehensive care of the highest quality in pain management and palliative care and advancing the educational and research aims of these disciplines.
This Web site has both a public and professional side. It includes articles, an "ask the expert" page, and presentation slides for downloading, as well as sections on resources and public policy.
National Library of Medicine/National Institutes of Health (NLM/ NIH) Resources on Pain links to resources from the National Institutes of Health, the American Geriatrics Society, the Mayo Foundation for Medical Education and Research, the American Society of Anesthesiologists, and more.
Toolkit Instruments to Assess Pain and Physical Symptoms reviews articles from 1983 to 1997 on 40 instruments that assess pain and related symptoms. It includes a detailed review of five of these instruments, applying such criteria as validity, reliability, and interpretability. Unfor tunately, the only measure of "responsiveness" was whether an instrument has been used in a trial.
On the Web site for the Society for Pain Practice Management (SPPM) there is information on upcoming SPPM meetings, pain syndromes, the diagnosis and treatment of pain, new pain management codes, new developments related to billing and legislation, and disability insurance. There is also a directory for people to place information about their pain practice.
Talaria is a resource provide by the APS for health care professionals. It addresses the management of pain in patients with cancer.
This site presents a publication of the National Institute of Neurological Disorders and Stroke; it was designed for patients, outlines theories of pain, and discusses treatments.
Web Site That Rates Internet Sites
The www.painandhealth.org site is maintained by the Mayday Pain Project. It provides screened lists of Internet resources. These lists address such subjects as arthritis pain, cancer pain, fibromyalgia, headache pain, and occupational pain. In addition, separate areas of the site cover pharmacology, pain and rehabilitation, hospitals and therapy, and general pain. Other areas focus on senior pain and pediatric pain. As of 2003, the senior pain Internet sites had not been updated for years, which explains the absence in the lists of some of the better senior pain Web sites. Links may produce some unwanted advertising.
Other Web Sites
The American Geriatrics Society provides this site. It includes the guidelines for management of persistent pain in older adults. The executive summary of the guidelines is available now, and the summary may be viewed at http://www.americangeriatrics.org/education/executive_summ.shtml.
This Web Site has the consensus statement, "Symptom Management in Cancer: Pain, Depression and Fatigue."
The International Association for the Study of Pain (IASP) site provides information about continuing education, IASP grants and publications, meetings, and job opportunities.
The site of the American Academy of Hospice and Palliative Medicine is rudimentary, with much of the information out of date. For example, in 2003, the page "Recent Articles of Interest" had not been updated since January 1999.
This site was created by the American Society for Action on Pain, an organization developed by a victim of unrelieved pain. The organization deals with public policy relative to pain management and opioids. The site has an array of articles and guidelines, including the California Board of Registered Nurses "Pain Management Policy," "Opioid Pain Killers Available in the US," and "The Tragedy of Needless Pain."
Web Sites on Diseases for Which Pain Is the Predominant Feature
The Fibromyalgia Alliance of America site, www.fmaa.org/, is a source for information on fibromyalgia; it including lists of health care professionals and support groups specializing in fibromyalgia. The site is in the process of being expanded. The site for the American Fibromyalgia Association Inc. is available at www.afsafund.org.
Sites concerning arthritis are www.arthritis.org (of the Arthritis Foundation) and www.hopkins-arthritis.com (of the Hopkins Arthritis Center), CME, case reports, meeting highlights, "Hear the Lecture Series," "The Role of Opioids for Chronic Pain," and more, plus you can sign up to have news updates delivered via e-mail.
The American Headache Society (AHS; formerly known as the American Association for the Study of Headache) and the American Council for Headache Education (ACHE) have sites regarding headaches. The AHS site (www.ahsnet.org) is for health care professionals, and that of the ACHE (www.achenet.org) is for patients. The AHS site offers CME, headache information, cassettes of scientific meetings, and instructions on how to subscribe to the journal Headache and join the society.
The Web site of MAGNUM (Migraine Awareness Group: A National Understanding for Migraineurs), the National Migraine Association, is available at www.migraines.org.
The article "Heading Off Migraine Pain" by the US Food and Drug Administration's Tamar Nordenberg provides information to consumers on migraine. It is available at www.fda.gov/fdac/features/1998/ 398_pain.html and describes what a migraine is and discusses medications, individual triggers, and the appropriate time to call a physician.
The article "Neuropathic Pain," a "BrainBriefing" from the Society for Neuroscience (www.sfn.org/briefings/neuropathic.html), describes several promising agents under development to provide pain-controlling therapies for patients with neuropathic pain "which results from a nervous system malfunction set off by nerve damage from diseases such as diabetes, trauma or toxic doses of drugs."
Sickle Cell Disease
The Sickle Cell Disease Association of America Inc. oversees the site www.sicklecelldisease.org, which is updated on a regular basis.
The International Pelvic Pain Society runs the www.pelvicpain.org/ site, which has a calendar of events, membership information, a patient booklet, and copies of the society newsletter. According to the site, the society "was incorporated to allow physicians, psychologists, physical therapists and basic scientists to coordinate, collect, and apply" the therapies available for the millions of women with chronic pelvic pain.
The Vulvar Pain Foundation has a Web site at www.vulvarpainfoundation.org. Head and Neck Pain
The American Academy of Head, Neck, and Facial Pain developed their site (www.aahnfp.org) for health care professionals, including dental professionals, for whom it is a source of information on products, educational materials, and more. For the public, it is "a quick and easy way to locate Medical and Dental Professional Members in your area who have specialized knowledge and skills" in the field of head, neck, and facial pain.
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