Naloxone: Silver Bullet or Tool in the Shed?

Is naloxone the silver bullet? Well maybe the silver bullet du jour. I think the biggest challenges with respect to naloxone are the educational hurdles because unlike the EpiPen, naloxone is intended to be administered by someone else not the patient. So that means that the burden of determining an...

A Look at Patient Barriers to Pain Management and Acceptance

The barriers that we face when we tell patients they can learn to live with pain…they’re quite vast. There are some patients who say “I don’t want to live with pain. The pain has taken a lot out of my life and I don’t want to learn to live with it. I just want it gone.” That’s a significant barrier...

The Insurance Climate

When we place a lot of resources upfront, such as employing physicians, psychiatrists, psychologists, physical therapists, yoga instructors, it does have a lot of start-up costs. But what we’re finding is we don’t know the status of our healthcare monetary appropriation. Right now it seems like from...

Lessons From a County Hospital: Pain Management How-To

I think the unique concepts or unique problems that we have at the San Mateo County Medical Center is limitation of resources, first of all. There’s a limitation sometimes in the number of hours that we can have at our clinic, the total number of clinicians we can use, the number of hours in general...

Denouncing Opioid Use...but What to Use Instead?

The hot topic with respect to practitioner groups is there seems to be a lot of denouncing of the fact that there’s too much opioid use and everyone is looking for ideas to minimize these opioids. But one of the top suggestions that people will consider is maybe nonopioid and nonpharmacologic...

Sleep Dysfunction and Myofascial Pain

There is a tremendous interplay between sleep and pain and stress and function, adrenal glands, fatigue and healing. We're not as aware of the sleep issues as we need to be. All of our pain patients, with rare exception, have some issue with sleep. When we have pain, pain will wake us up when we...

When Health Insurance May Not Be on Our Side

The cost of healthcare of course is a concern. The insurance companies are in the business of providing insurance and healthcare professionals and patients are seeking out quality care. There’s an inherent conflict there because unfortunately pain is a complex biopsychosocial problem. It really does...

Clinical Treatment Guidelines and Patients in Pain

Although one of the goals of clinical guideline development is to aid the provider with information to help make important treatment decisions, what’s not completely divulged is that clinical treatment guidelines can’t make a good treatment decision per se for an individual patient. Guidelines that...

Impacting Diverting: It Can Be Done

Jeremy A. Adler, MS, PA-C, of Pacific Pain Medicine Consultants, emphasizes the importance of the patient/practitioner conversation about the importance of drug safety. Communication and safety are key.

The argument that we need to educate providers more is an argument that could always be made...

Back and Spinal Pain--Where do Interventional Procedures Apply?

Spinal pain is very difficult to diagnose, the more so as patients get older. They present with different things on their MRI, different findings on exam, and they’ve had chronic pain for many years. Unfortunately, a lot of the physical exam and history findings are very generalizable, so it’s hard...