This guideline replaces the earlier CG88 i.e. Early management of persistent non-specific low back pain. Here, low back pain and sciatica has been estimated and managed in people aged 16 and over alongwith the physical, psychological, pharmacological and surgical treatments for the same. It is pivoted to improve people's quality of life, encouraging the most effective forms of care for low back pain and sciatica.
Gout involves problem with the purine metabolism. In this disease, the uric acid levels are increased (hyperuricemia) and urate crystals accumulates in joints and tissues of the body. This deposition of urate crystals causes acute, recurrent and painful attacks of gouty arthritis in the joints, usually the foot (especially the big toe), knee, hand or wrist. Chronic gout occurs when joints are affected by subcutaneous concentrations of urate crystals (nodular tophi).
Syndesmotic injuries at the ankle joint are injuries to the ligaments that connect the tibia and fibula. They are the most severe ligament injuries to the ankle, and occur either in isolation or at the same time as an ankle fracture. External rotation and/or hyperdorsiflexion are the most common mechanisms causing syndesmotic injuries. These injuries can occur during activities like sports or dancing, and any other fall. Patients with syndesmotic injuries like acute ankle sprains experience acute ankle instability, pain & functional problems.
Fibromyalgia is a syndrome which is indicated by chronic widespread pain. It was first described more than 100 years ago with the first official diagnostic guidelines being published in 1990 by the American College of Rheumatology (ACR). Fifteen years later, the first treatment guidelines were published by the American Pain Society (APS). From then, many controversies have surrounded both diagnosis and management of fibromyalgia syndrome. Rheumatologists most often see these patients.
This guideline is an updated version on the drug treatment options for post-shingles pain. It was based on the review of the recent literature and the modified by the author.
Post-herpetic neuralgia (PHN):
Most oftenly, an acute attack of shingles induces pain and the pain mostly terminates when the shingles rash clears up. But, sometimes it may be persistent after the shingles has resolved and it is then elucidated as PHN. In half of patients with shingles over the age of 70, this condition is common and it's frequency increases with age.
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