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The evaluation of these patients by providers, physicians, physician assistants, nurse practitioners, and all those who work in a medical team, is a challenge and therefore we need to standardize the approach. We need to recognize that we’re dealing with a chronic illness that requires a team...
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Myofascial pain syndrome is a very common diagnosis in pain clinics. We know that probably 85% of the people seen in a tertiary care pain clinic have myofascial pain syndrome either as a primary or a secondary diagnosis, and pretty much everything that we see, such as radiculopathy and nerve damage...
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Options, Outcomes, Risks, and Complications
The procedures that we do in interventional pain medicine to alleviate pain, improve function and enhance quality of life are sometimes misunderstood and not clearly elaborated to the medical community. There are a range of pain conditions that...
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Avoiding Risks while Preserving Benefits
The current approach to managing pain in a postoperative environment has continued to progress even over the last decade in terms of multimodal analgesia. So after a patient leaves the hospital, after they finish their surgery and had this intensive...
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Constipation happens universally in patients who are prescribed opioids. I’ve met a handful of patients over the years that don’t develop constipation from opioids and I always think the same thing. You’re not taking your drug. That’s how universal constipation is associated with opioids. Just as we...
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Corresponding Responsibilities for Patient Well-Being
Many of the chain pharmacies have implemented policies relating to the know-your-customer policy of the Drug Enforcement Administration and many of the pharmacists are required now to document and corroborate information relating to the...
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Corresponding Responsibilities for Patient Well-Being
In the big picture it may have been a good idea, but the way it was implemented became a problem. Prescribers and pharmacists have little time as it is, and for them to take away their time to engage in a national policy and doing it on each...
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Primary care clinicians need to be very careful about dosing methadone for all sorts of reasons. Most importantly they need to worry about drug interactions and dosing, converting a patient from morphine or an equivalent dose of another opioid to methadone. Even if we could determine what an exact...
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There are several female specific pain conditions, including chronic pelvic pain, which is a particular problem for women, as well as vulvodynia or vaginal pain, and pain after breast cancer treatment which certainly affects exclusively women. It’s important to recognize, though, that pain as a...
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Pain education in the US today unfortunately is warped. Whether coming from industry, whether from the Food and Drug Administration, it ends up being lopsided and very often to opioids, when opioids are just one piece of the management of pain. We need to do more to help it diffuse into the training...