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In terms of biopsychosocial treatment, providers must know that it’s critically important to look at all the factors that are affecting a patient’s pain condition. Any time we pigeonhole ourselves in any one category--whether it’s the medical piece, the psychological piece, or the physical piece--we...
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Both the central nervous system and the peripheral nervous system are heavily involved in starting and continuing a migraine attack, and are involved before the migraine even starts. If you divide a migraine into premonitory phases–the aura, the migraine phase and then the postdrome, with modern...
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I think we have to go back to before a lot of these scores, before the fifth vital sign was pain management. How did we treat patients before we had all these medications, interventions, surgeries at our disposal that were meant to help pain. I think a lot of what we're applying to chronic pain...
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We're stressed in so many ways and our body tries to compensate for that stress and keep us on an even keel. It compensates in an analogous way as if you were running; your heart beats faster, you prepare yourself for fight or flight, you try to keep your body together and you have many mechanisms...
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I think the resources are not there for us to continue to use the interdisciplinary teams as much as we want to. It's difficult for us sometimes to try to get the interdisciplinary pain program authorized, for example, in an industrial medicine setting. There's been many studies that support the use...
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I think this is a fine kettle of fish we find ourselves in with this opioid controversy. It’s easy to decry the use of opioids if you don’t have Plan B. So I think we’re seeing this in practice all the time, aren’t we?
When we talk about the multimodal therapy, the important thing is I think we...
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Cannabis as a pharmacological agent has been used for centuries. It's been described in China, in Asian countries dating back to well before the BC era. Ultimately it made its way to the United States where it actually was made available to patients until it was outlawed in the 1930s and '40s. And...
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When we run into resistance with biofeedback, usually we first start by explaining exactly what it is. Biofeedback is a term that gets used a lot that either people don't know about or there's a lot of misperceptions or ways it can be represented. The biggest thing I start with is just making sure...
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In my experience, the recognition that disorders of the spinal cord can be associated with chronic pain has often been undervalued or underestimated. It’s become clear that a variety of different disorders that can cause spinal cord dysfunction are present in people who have ongoing pain. We...
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The field of neurochemical imaging in pain is largely in its infancy. Very few studies have used this method to get at neurotransmitter levels or molecular information in the brain. MRI magnets can be used to detect changes in the way that protons behave in different molecules. So protons and the...