Alternative Pain Therapy - Research Proposal Example

?Running Head: Proposal on Alternative Pain Therapy Proposal on Alternative Pain Therapy [Institute’s PROPOSAL ON ALTERNATIVE PAIN THERAPY Research Question “Is alternative pain therapy beneficial, safe, and cost effective for chronic orthopaedic pain?” Argument Claim Military patients should be suggested to use alternate pain management methods instead of analgesics to avoid drug dependency. Reasons Individuals involved in warfare are the ones highly susceptible for starting drug dependency / prescription drug addiction. They utilize these drugs to deal with pain due to injury during the combat as well as to handle the emotional suffering of war fatigue or being compelled to observe wartime killings. Evidence Military drug dependency rates have been increasing on an alarming rate during recent years, putting the lives of soldiers at severe risk. Prescription drug abuse has increased among military recruits, having almost tripled from 2008 to 2011.1 A study on military lifestyle revealed that, although the general civilian rates of drug dependency were 6 percent and the rate for the Department of Defense was 15 percent. The level for the Army branch of the military was highest on 23 percent for males of all ages and 22 percent females of all ages.2 Though the level of dependency for civilians decreased sharply following the age of 25 years and carried to decrease as age increased, for all the armed forces branches, the level increases with age. Warrants A comprehensive study revealed a major setback with overmedication of soldiers pulling through combat wound. Overmedication can take the shape of various drugs that cause excessive doses.3 The medicines may be taken for different or the similar situation. The Army is taking steps to rectify the situation by utilizing an automated patient record. Acknowledgement This research will explicate in details the possible alternatives that military soldiers suffering from pain should use in order to have a wide range of choices in their pain management. This information will be beneficial since they will know how to handle themselves better in a safe and cost effective way. Scientific honesty is also regarded as an extremely essential ethical responsibility when conducting research. Dishonest conduct comprises manipulation of design and methods, and manipulation or retention of data. The research will avoid all forms of dishonesty by truthfully recording the facts obtained from the primary, secondary and tertiary sources. Problem Background and Significance “Wars have always brought about significant improvements in medicine that also affect the civilian population”.4 Some early methods of cure are now being included to the treatments and prescriptions that are being used now. The armed forces apply acupuncture as a pain management therapy in the United States as well as in Germany. The objective is to offer a complete, holistic way to pain therapy for armed forces recruits. Acupuncturists are being appointed to practice together with a group of doctors and psychotherapists. Acupuncture is part of conventional Chinese medication. Acupuncture practitioners stimulate particular points on the body - mainly by “inserting thin needles through the skin”5, which normalizes the flow of ‘vital energy’ along pathways called “meridians”.6 This method appears to be safe and effective for chronic orthopedic pain. Recent studies have found that acupuncture offers pain relief and enhances mobility for individuals with osteoarthritis of the knee. There are smaller number side effects linked with acupuncture than with various regular medications (for instance, anti-inflammatory drugs and steroid injections) for curing painful musculoskeletal.7 Another such alternative pain therapy, adopted by armed forces is transcutaneous electrical nerve stimulation (TENS). Although it does have few side effects but it is extremely useful for curing chronic orthopedic pain. Taking into consideration the increase in amputations, nerve injury and other chronic pain conditions in the armed forces, TENS provides them with a pain management method that can be applied both during the war as well as at home. TENS is being employed very often at all levels of care.8 Single factor in the armed forces’ decision to include alternative pain therapies has been the abuse of and dependence on analgesics. Acupuncture, transcutaneous electrical nerve stimulation and the other similar alternate therapies will not substitute drugs and other standard pain management therapies. Instead, these alternative therapies will lessen medication use and offer additional choices for pain relief. Although these initiatives indicate an intense modification within military medicine with respect to approach and delivery, how they are influencing acupuncture and TENS accessibility and utilization across the military is not very clear9; however, several media reports have acknowledged the availability as well as application of these alternate pain management methods throughout the armed forces. Alternative therapies have been used for curing pain in the field of war from around last ten years, and will now be “extended to post-acute care”.10 The military’s plan in using these therapies as an integrative pain management may initiate its use in additional civilian hospitals because they are safe as compared to taking high dosage of drugs, and are more cost-effective. Final Report Outline Research Question 2 Argument 2 Claim 2 Reasons 2 Evidence 2 Warrants 3 Acknowledgement 3 Sources 6 Framework 6 Annotated Bibliography 7 References 10 .... 1.0 Introduction…………………………………………………………………………… 1.1.0 Background Information………………………………………………………….. 1.2.0 Problem Statement………………………………………………………………... 1.3.0 Objective of Study………………………………………………………………... 1.4.0 Research Questions……………………………………………………………….. 1.5.0 Justification of the Study………………………………………………………..... 1.6.0 Hypothesis (Null/Alternate)……………………………………………………..... 1.7.0 Significance/Rationale of the Study……………………………………………… 1.8.0 Scope of the Study……………………………………………………………….. 1.9.0 Limitations of the Study…………………………………………………………. 1.10.0 Delimitations……………………………………………………………………... 1.11.0 Assumptions……………………………………………………………………… 1.12.0 Conceptual Framework…………………………………………………………… LITERATURE REVIEW……………………………………………………………………... 2.0 Literature Review…………………………………………………………………..... 2.1.0 Introduction…………………………………………………………………........ 2.2.0 Brief Summary of Literature Review…………………………………………..... 2.3.0 Conceptual Framework………………………………………………………….. METHODOLOGY…………………………………………………………………………….. 3.0 Introduction………………………………………………………………………..... 3.1.0 Research Design………………………………………………………………….. 3.2.0 Data Collection……………………………………………………………………. 3.3.0 Data Analysis Procedures………………………………………………………...... DATA ANALYSIS AND PRESENTATION…………………………………………………... DISCUSSION, CONCLUSIONS AND RECOMMENDATIONS…………………………….. REFERENCES………………………………………………………………………………… Sources For this research, data collection will be done by extensively consulting all primary, secondary, and tertiary sources. Journals on alternative pain management and research reports will be consulted as primary sources of data. Next, books and online libraries will be referred as secondary and tertiary sources respectively. Framework It is essential for pain patients to recognize that a “pain-free”11 state is impractical. Practical outcomes for patients with chronic pain consist of considerable reduction in pain, more functional ability, better quality of life, and lesser psychosomatic problems. Patients should be assessed for symptoms of functional disability, for instance, failure to take part in day to day chores. Pain management in patients with drug dependency is a difficult, demanding, and regular issue. Open communication and better assessment are vital factors of caring for army personnel suffering from drug dependency. The research work will emphasize on identifying the problem and provide solutions on how the pain can be managed and reduced for better quality of life. Annotated Bibliography Aldington, D. J. McQuay, H. J., and Moore, R. A. (2011). ‘End-to-end military pain management’. Biological Sciences, 366(1562), 268-275. This paper discusses the changes in armed forces’ pain management techniques and outlines the recent adoption of alternate techniques for curing pain. Aldington, McQuay and Moore (2011) asserts that the past three years have seen considerable changes in the manner in which Defense Medical Services handle and manage trauma pain. Therefore, this paper seeks to clearly outline the changes that have been effected at all levels, beginning from the time the casualty is evacuated from the injury point to rehabilitation and either to medical discharge or continued service in the Defense Forces. However, the research has paid emphasis on the evidence used in intervention for both chronic and acute pain management. It has also highlighted the possible variances in pain management techniques that may exist between military and civilian casualties. Cohen, S. P. Griffith, S. Larkin, T. M. Villena, F. and Larkin, R. (2005). ‘Presentation, diagnoses, and mechanisms of injury, and treatment of soldiers injured in Operation Iraqi Freedom: an epidemiological study conducted at two military pain management centers’. Anesthesia & Analgesia, 101(4), 1098-1103. The paper suggests that the main cause of soldier abrasion in recent military conflicts are not battle injuries, but ordinary causes akin to those experienced in civilian life. Therefore, this paper seeks to find out the conditions that causes pain to soldiers during war. In doing this, the researchers conducted a study on one hundred and sixty two soldiers who were evacuated from Iraqi Freedom Operation and were admitted in two pain treatment centers situated outside their areas of combat. The study revealed that only seventeen percent of the patients were injured at war. It is worth noting that the research found out that apart from the injuries attained at war, the pain conditions of the soldiers seemed to be similar to those experienced in civilian pain clinics. Therefore to enhance the return-to-duty rate, improved precautionary steps, and vigorous adoption of unconventional pain management techniques is required. Davies, C. Davies, A., and Simons, D. G. (2004). The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. New Harbinger Publications. This book explains acupuncture as a self-care means for easing chronic pain caused by different conditions, such as recurring strain injuries, arthritis, muscle ache, back pain, etc. Trigger pain injections are injections local anesthetic that contain or may not corticosteroid into medically identified myofascial trigger points. Trigger point injections can be repeated when it is medically necessary, and there is a minimum of fifty percent pain relief for not less than six weeks following the injection. It is important to note that repeat trigger point injections applied as isolated treatment modality, those that occur at intervals of less than two months, and those applied more than four sessions per body region annually are most likely to be considered medically unnecessary. Gellman, H. (2002). Acupuncture Treatment for Musculoskeletal Pain: A Textbook for Orthopaedics, Anesthesia, and Rehabilitation. CRC Press. It includes the fundamentals of acupuncture method, describes the principles of Eastern medicine regarding the diagnosis, and cure of musculoskeletal pain - both acute as well as chronic. Gellman (2002) gives orthopedic surgeons, rehabilitation specialists, and anesthesiologist information that is beneficial in the diagnosis and treatment of both arthritis and acute or chronic musculoskeletal pain. This book progresses readers on a journey of healing since it provides vital information regarding the medications and procedure that are currently being used. Gellman has successfully broken down the subject into three main areas: Special Techniques, Basics of Acupuncture, and the Treatment of the Musculoskeletal Acupunture Indications and Points. Osiri, M. and Wells, G. A. (2009). Transcutaneous electrical nerve stimulation for knee osteoarthritis. CRC Press. Authors explain that transcutaneous electrical nerve stimulation (TENS) is a non-invasive modality that is normally applied during physiotherapy for managing both acute as well as chronic pain caused by different conditions. Osiri & Wells (2009) supports the fact that TENS plays an integral role in the treatment of aches in the critical post-operative period, normally within thirty days after surgery. Additionally, they also explain that TENS is considered a secondary treatment alternative for patients suffering from chronic pain as a result of conventional therapies failures. Meta-analysis, systematic reviews and randomly controlled trials have revealed that TENS contributes to a reduction in pain and use of analgesic in treating chronic pain and acute post-operative pain. Peters, L. Simon, E. P. Folen, R. A., and Lagana, L. (2000). ‘The treatment efficacy and medical utilization outcome of a chronic pain management program at a major military hospital’. Military Medicine, 165(12), 954-960. This study deals with the effectiveness of treatment and related benefits of a chronic pain management program within a military hospital. In conducting the study, sixty one non-malignant long-lasting pain patients suffering from heterogeneous syndrome were examined. Multi-dimensional and an all-inclusive outcome criteria comprising relaxation skills, pain ratings, gratification ratings, quality of life, and medical utilization were used. The results revealed that military status does not affect outcome measures outline above. References Aldington, D. J. McQuay, H. J., and Moore, R. A. (2011). ‘End-to-end military pain management’. Biological Sciences, 366(1562), 268-275. Cohen, S. P. Griffith, S. Larkin, T. M. Villena, F. and Larkin, R. (2005). ‘Presentation, diagnoses, mechanisms of injury, and treatment of soldiers injured in Operation Iraqi Freedom: an epidemiological study conducted at two military pain management centers’. Anesthesia & Analgesia, 101(4), 1098-1103. Constant, E. Floris, M. Pitchot, W. Claes, S. and First, M. (2013). ‘Substance use in US active duty military’. Military Psychologists' Desk Reference, 32(3), 221-235. Davies, C. Davies, A., and Simons, D. G. (2004). The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. New Harbinger Publications. Karmakar, M. K. and Anthony, M. (2003). ‘Acute pain management of patients with multiple fractured ribs’. The Journal of Trauma and Acute Care Surgery, 54(3), 615-625. Gellman, H. (2002). Acupuncture Treatment for Musculoskeletal Pain: A Textbook for Orthopaedics, Anesthesia, and Rehabilitation. CRC Press. Jones, I., and Johnson, M. I. (2009). ‘Transcutaneous electrical nerve stimulation’. Continuing Education in Anaesthesia, Critical Care & Pain, 9(4), 130-135. Osiri, M. and Wells, G. A. (2009). Transcutaneous Electrical Nerve Stimulation for Knee Osteoarthritis. CRC Press. Peters, L. Simon, E. P. Folen, R. A., and Lagana, L. (2000). ‘The treatment efficacy and medical utilization outcome of a chronic pain management program at a major military hospital’. Military Medicine, 165(12), 954-960. Read More