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Dr. Aljassem: In reviewing the literature with topical opioids, like many things that are kind of outside the box, a lot of it is not standardized. But what we do know is that they are effective in reducing pain and they are minimally absorbed systemically so they do have a high benefit with low...
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In terms of diagnosis and treatment of neuropathic pain, we have a long way to go. Many patients have a component of neuropathic pain to their overall pain experience that is not recognized by those taking care of them. And then often when it is recognized, it’s not treated adequately. An example...
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Individual patient characteristics should guide the treatment plan. One creates a post-surgical treatment plan that is personalized. So it’s patient-specific, patient-centered, patient-focused personalized care plan. We have a world of generic drugs. We have no generic patients. Each patient is...
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Chronic post-surgical pain is a significant problem because it results in decreased activities of daily living, reduced quality of life, and overutilization of medication and healthcare resources, so it’s very costly. The main cause is peripheral stimulation, because of course once a surgeon breaks...
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A new and emerging field in medicine is here and some people call it regenerative medicine; some people call it stem cell treatment. I think it’s important that we define those terms. Regenerative medicine includes this field of medicine where we can hopefully see some regeneration of tissue...
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There are a lot of theories about CRPS. There are theories about glial cell involvement, or dysfunction of the autonomic nervous system. To my mind, there is a hormonal component because 80 percent of my patients are women. There’s a genetic component because I have seen 18 families where more than...
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The Fascial Distortion Model can help guide a practitioner towards treatment selection because the model is based on the patient’s input. The patient is the expert. Patients guide us as practitioners by body language or gestures and their verbal description of their pain. They show us exactly the...
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The Fascial Distortion Model looks at six different types of patterns of gestures that people do when they have an injury. When they show a certain gesture, we’re going to use a certain manual therapy technique that’s going to match. If they indicate with their finger a single spot on the bone, we...
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Failed back surgery syndrome is a problem that affects about 20 to 40 percent of patients who have had back surgery. There are many reasons for this and a lot of it has to do with the peri-operative and pre-operative work up of those patients. For example, studies show that 60% of the time they did...
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Practitioners end up at risk in drug testing because they lack knowledge of the policies that payors put out on medical necessity. They also can get into a lot of trouble if they don’t understand the mechanics of the clinical laboratory regarding presumptive testing and definitive testing. It’s...