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Medicine and science builds and grows on the foundations of those who came before. Although pain management discoveries have been at a relative snail’s pace, there have been recent advances in existing medications and analgesic devices, as well as exciting new molecules and formulations on the...
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In the Emperor’s tale, 2 weavers promise an emperor a new suit of clothes that, they say, is invisible to those who are incompetent or unfit for their positions. When the emperor parades before his subjects nude, no one dares to say anything for fear that they will be seen as such. This is a similar...
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Using functional magnetic resonance imaging (fMRI) techniques, we have been able to open windows to the brain, to noninvasively study its structure and function. Pain processing within the central nervous system (CNS), brain and spinal cord, and how it is disrupted in chronic pain has been...
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Washington was one of the first states to legislate prescribing rules for the treatment of chronic pain, a unique model which relied on the use of a dosage trigger and the necessity to calculate morphine equivalency. Following Washington’s lead, other states and the Centers for Disease Control and...
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New paradigms of patient care postsurgery (such as spinal surgery) utilizing both pre- and postoperative multimodal approaches to analgesia, nonopioid medications specifically, will be discussed. Included in the course will be presurgical and immediate postoperative medications, and both acute and...
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Despite high prevalence and seemingly continuous attention, the clinical challenges associated with assessing, treating, and managing patients with chronic pain continue to persist. Many different forces are at play and responsible for this frequently frustrating situation and, as is often the case...
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Most states have passed legislation to honor a type of advanced directive, commonly known as a POLST, for Physician Orders for Life Sustaining Treatment. It is basically a more detailed and specific DNR (do not resuscitate). Patients consistently report preferences to die peacefully at home but all...
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Functional pain syndromes (irritable bowel syndrome, fibromyalgia, interstitial cystitis, vulvodynia, etc) are commonly seen in primary care and by pain medicine practitioners. For example, fibromyalgia affects 5 million people and interstitial cystitis 8 million women per year, and the etiologies...
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There is a group of intractable pain patients who have extensively accessed the pain treatment system only to be unable to find satisfactory pain relief. These patients have sought treatment at multiple academic centers and attempted numerous nonmedical, pharmacologic, and invasive interventions...
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Ketamine, known on the street as "special K," is a dissociative anesthetic with hallucinogenic properties and is classified as a controlled substance. Its unique mechanism as an N-methyl-Daspartate (NMDA) receptor antagonist is thought to be responsible for many of the drug's most promising...