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With increased use of technology, like computers and mobile phones, we see a significant increase in carpal tunnel syndrome and tendon problems like tendonitis of the wrist and elbow. The primary care physician should understand what they are dealing with when somebody presents with elbow or hand...
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Here are some tips that may be useful. I’m very fond of an Intensol. These are highly concentrated oral solutions of a medication. Morphine and oxycodone 20 mg/ml, methadone 10 mg/ml, haloperidol, Ativan, and dexamethasone all come as this highly concentrated oral solution. Even if someone is...
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The problem is that the chronic pain patient may make up 10% to 20% of your patient population, but will typically take up 80% to 90% of your staff and your other resources. And while it’s important for that care to continue to be offered by the primary care provider, there has to be some type of...
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Understanding the genetic underpinnings of the disease is really key to developing new drug targets and new therapies. Right now we have at least four autosomal dominant genes that have been identified to account for at least some of the rarest subtypes of migraine, and some genome-wide association...
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Peripheral artery disease in patients who have diabetes tends to have a much more uniform and widespread and a much more aggressive form than those patients who don’t have diabetes. And patients who have diabetes and peripheral artery disease tend to have a higher mortality rate and higher rate of...
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It’s important to start at the beginning and screen patients for indicators that could be suggestive of abuse, misuse, diversion, and unintentional use. We can use actual validated instruments to screen for patients who may have some issues with misuse and abuse and diversion. It is an important...
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Osteoarthritis can affect us as we age. A lot of weightbearing joints like the hip and the knee, for example, are predisposed to osteoarthritis especially in older patients. Therapies can include pharmacologic agents like acetaminophen, but also injectable local anesthetics, and agents like...
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This can be a confusing topic because there are so many formulations out there, and the clinician may see a guideline that says maybe incorporate capsaicin or glucosamine chondroitin, SAMe, avocado, soybean extract, fish oil, or other supplements, but doesn’t offer insight into actually getting the...