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This activity is supported by an educational grant from

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Release Date: July 2008

Expiration Date: July 2009

Estimated Time to complete activity: 2 hrs 45 min


Approximately 9 in10 Americans regularly suffer from pain. The most common complaints are acute in nature, including low back pain, postoperative pain, migraine or severe headaches, joint pain, stiffness, or aching. Since most acute pain is treated in the primary care physician’s office, or simply in consultation with a community or long-term care pharmacist, it is imperative that these providers be up-to-date with recent advances and treatment options for this patient population.

Pharmaceutical science has increased the choices for treating acute pain, including broadened selection of non-opioid drugs and new methods of drug administration. In addition, new technologies are under development. It is increasingly challenging for the provider to optimize pharmacologic treatment, while keeping abreast of advances and new treatment options.

Pain and resulting functional impairment are highly prevalent in primary care. Primary care physicians can better relieve pain by understanding the increasing therapeutic arsenal, and correlating pain and functional impairment to treatment. Pharmacists need further education since they routinely monitor analgesic therapy for efficacy and adverse effects, make therapeutic recommendations, and are available to provide vital information to both clinical staff and patients.

This activity will better enable primary care physicians and pharmacists to assess and diagnose mild-to-moderate pain; identify and implement evidence-based treatment plans; and offer insights into emerging treatment options vis-à-vis those currently available.


Bill McCarberg, MD

Founder, Chronic Pain Program
Kaiser Permanente, Escondido, California
Assistant Clinical Professor
University of California School of Medicine
San Diego, California

Robert L. Barkin, MBA, PharmD, FCP
Associate Professor, Faculty
Anesthesiology, Family Medicine, & Pharmacology
Rush Medical College
Rush Pain Center at Rush University Medical Center
The North Shore Pain Center at Rush North Shore, Skokie, Illinois

Leslie Fish, PharmD
Worchester, Massachusetts

Ronald J. Kulich, PhD
Lecturer, Department of Anesthesia & Critical Care
Pain Center, Massachusetts General Hospital
Harvard Medical School
Associate Professor, Tufts School of Dental Medicine
Craniofacial Pain & Headache Center
Boston, Massachusetts

Louis Kuritzky, MD
Clinical Assistant Professor
Department of Community Health and Family Medicine
University of Florida
Gainesville, Florida

Bruce D. Nicholson, MD
Department of Anesthesia
Pennsylvania State University School of Medicine
Director, Division of Pain Medicine
Lehigh Valley Hospital and Health Network
Allentown, Pennsylvania

Joshua Rittenberg, MD
Medical Director, Interventional Spine
Rehabilitation Institute of Chicago
Spine and Sports Rehabilitation Center
Chicago, Illinois

Eugene Viscusi, MD
Acute Pain Management
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania

Arthur L. Weaver, MD, MS, FACP, MACR
Clinical Professor of Medicine Emeritus
Department of Medicine
Division of Rheumatology
University of Nebraska Medical Center
Omaha, Nebraska

  After completing this activity, the participant should be better able to:
  • Describe the diagnosis of patients with acute mild-to-moderate pain.
  • Describe optimal treatment plans based on current guidelines and best evidence.
  • Review current and emerging pharmacologic treatments for acute musculoskeletal pain, including efficacy, mechanisms of action, and adverse effects.
  • Discuss the potential economic implications of inadequate pain management and inappropriate treatment strategies.

Intended Audience
This activity has been designed to meet the educational needs of physicians and community pharmacists involved in the management of patients with mild-to-moderate acute pain.

Physician Continuing Medical Education
Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Postgraduate Institute for Medicine (PIM) and Advanced Studies in Medicine (ASiM). PIM is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation
Postgraduate Institute for Medicine designates this educational activity for a maximum of 2.75 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Pharmacist Continuing Education
acpe logo Accreditation Statement
Postgraduate Institute for Medicine is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Credit Designation
Postgraduate Institute for Medicine (PIM) designates this continuing education activity for 2.8 contact hour(s) (0.28 CEUs) of the Accreditation Council for Pharmacy Education.
(Universal Program Number –809-999-08-112-H01-P.)

Disclosure of Conflicts of Interest
Postgraduate Institute for Medicine (PIM) assesses conflict of interest with its instructors, planners, managers, and other individuals who are in a position to control the content of CE activities. All relevant conflicts of interest that are identified are thoroughly vetted by PIM for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. PIM is committed to providing its learners with high quality CE activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CE activity:

Dr McCarberg reports serving on the speakers’ bureau for Alpharma Inc, Abbott Laboratories, Cephalon, Inc, Eli Lilly and Company, Endo Pharmaceuticals, Forest Laboratories, King Pharmaceuticals, Inc, Ligand, Merck & Co, Inc, Mylan Inc, Pfizer Inc, Pricara, and Purdue Pharma LP.

Dr Barkin reports serving on the speakers’ bureau for Alpharma Inc, Endo Pharmaceuticals, Pricara, Sanofi-Aventis, and Wyeth; and holding other financial relationships with Abbott Laboratories, Dominion, Eli Lilly and Company, and King Pharmaceuticals, Inc.

Dr Fish reports having no significant financial relationship with any commercial entity related to this activity.

Dr Kulich reports receiving grants/research support from Endo Pharmaceuticals; and serving on the speakers’ bureau for Merck & Co, Inc.

Dr Kuritzky reports serving as a consultant for Eli Lilly and Company, Endo Pharmaceuticals, and Schering-Plough Corporation.

Dr Nicholson reports having no significant financial relationship with any commercial entity related to this activity.

Dr Rittenberg reports having no significant financial relationship with any commercial entity related to this activity.

Dr Viscusi reports serving as a consultant for Adolor Corporation, Anesiva, Inc, Cadence Pharmaceuticals, Ortho-McNeil/Pricara, Xanodyne Pharmaceuticals Inc, and YM BioSciences Inc; receiving fees for non-CME services received directly from EKR Therapeutics; and doing contracted research for Anesiva, Inc, Cadence Pharmaceuticals, Johnson & Johnson, and Wyeth.

Dr Weaver reports serving on the Board of Directors for Azano Pharmaceuticals, Inc, and Corrona; and serving as a consultant and on medical advisory boards and speakers’ bureaus for Abbott Laboratories, Alpharma Inc, Amgen Inc, Aventis, Azano Pharmaceuticals, Inc, Biogen Idec, Bristol-Myers Squibb Company, Centocor, Inc, Cypress Bioscience, Inc, Fujisawa Pharmaceutical Co, Genentech, Inc, Horizon Therapeutics, Human Genome Sciences, Merck & Co, Inc, Mylan Inc, Novartis Pharmaceuticals Corporation, Pfizer Inc, Primus Pharmaceuticals, Inc, Savient Pharmaceuticals, Inc, TAP Pharmaceutical Products Inc, Takeda Pharmaceuticals North America, Inc, TheraQuest Biosciences, and Wyeth.

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CE activity:

The PIM Clinical Reviewers, including Jan Hixon, RN, Trace Hutchison, PharmD, and Linda Graham, RN, report having no real or apparent conflicts of interest related to this activity.

iM Managers, Stacey JP Ullman, MHS, and Laura Cuzzocrea, report having no real or apparent conflicts of interest related to this activity.

Method of Participation
There are no fees for participating and receiving CE credit for this activity. During the period July 2008 through July 2009, participants must 1) read the learning objectives and faculty disclosures; 2) study the educational activity; 3) complete the post-test by recording the best answer to each question in the answer key on the evaluation form; 4) complete the evaluation form; and 5) mail or fax the evaluation form with answer key to Postgraduate Institute for Medicine.

A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed posttest with a score of 70% or better. Your statement of credit will be mailed to you within 3 weeks.


Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Postgraduate Institute for Medicine (PIM) and ASiM do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of PIM and ASiM. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

System Requirements

  • DSL, cable, or faster Internet connection
  • At least 256Kbps of dedicated bandwidth per connection on program day
  • Internet Explorer 5.0 or newer Web Browser
  • Adobe Flash Player
  • 16-bit sound card
  • 24-bit true color video card
  • Windows 98 or newer
    Pentium or AMD Athlon K6 266 MHz processor or faster
  • Mac OS 9 or later
    PowerPC G3 233MHz processor or faster
  • 128 MB RAM

Post-test and Evaluation Form

Click here for the Post-test and Evaluation Form

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