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Pain clinicians are also pain educators, and it’s critically important for them to understand the basic principles of instructional systems development or instructional design. One approach that I like is the ADDIE model, which stands for analysis, design, development, implementation, and evaluation...
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Managing pain in a world without opioids is a scenario that would harm some because there are truly, in my experience, individuals for whom the use of an opioid analgesic on a long-term basis, on a regular basis, made a huge difference in that person’s ability to function comfortably and maximally...
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We have found that even subclinical levels of anxiety and depression can be important in terms of the experience of pain. Another factor that we spend a lot of time investigating in the pain research world is pain-related catastrophizing. It has a pervasive effect on people’s ability to manage pain...
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The cannabinoid system is just beginning to be explored and exploited in the pain world and neuropathic pain is what comes to mind a lot when people think of using medical marijuana. We have good data showing that an inhaled cannabinoid will help with pain, particularly neuropathic pain. It helps...
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Cluster headache is more common in men than women. These patients have absolutely horrible pain to the point where it’s also called a suicide headache. The headache lasts 45 minutes to three hours, whereas migraine goes four hours to 72 typically. Even though it’s a vascular headache it starts from...
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The three treatments that have been studied the most, and have pretty good evidence to support them, are biofeedback, cognitive behavioral treatment, and acceptance and mindfulness-based treatments. We’re starting to think a lot about subgroups of patients that may benefit more from one or another...
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The transdermal formulations of fentanyl and buprenorphine are for patients who have chronic pain. An important distinction is, with transdermal fentanyl the patient has to be opioid tolerant, on the equivalent of 60 mg of oral morphine a day for at least a week, whereas with transdermal...
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Most clinicians are already aware of one of the most common adverse effects, which is that of gastrointestinal side effects with NSAIDS and the importance of monitoring that goes with those medications. Newer concerns have recently arisen as far as the cardiovascular adverse effects of NSAIDS and...
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Autistic individuals often perceive pain differently, either at a greater intensity or lesser intensity. Some autistic individuals are hypersensitive to touch. In a classic encounter, for example, a primary care provider walks in, takes your hand and feels your pulse. They don’t tell you what they...
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Veterans are coming back with a number of key problems that are impacting their pain and their lives. Many patients are coming back with not only chronic pain, but post-traumatic stress disorder. They are coming back with traumatic brain injuries that are related to either direct trauma or exposure...