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Smartphone technology has been rapidly emerging and now there are about 44,000 health-related applications out on the market. A substantial proportion are directed at improving outcomes in people who suffer from pain. For older patients who live alone, they can be important clinical eyes and ears; a...
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The existence of opioid induced hyperalgesia has been debated, but I believe that it does. It’s when a patient uses an opioid and over time develops not just tolerance but super tolerance. Tolerance is normal. You take a medicine, your body adjusts to that dose. The side effects will usually go away...
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One of the things to keep in mind about good communication is really being in the room with your patient--really listening. I know that can be quite difficult for some specialties these days especially with mandated reporting on computers and such, but it is so important especially for teenagers to...
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There’s a new oral formulation for opioid induced constipation and it falls under the class of the PAMORAs which are the peripherally acting mu-opioid receptor antagonists.
So far on the market we have methylnaltrexone which is subcutaneous, we have alvimopan which is oral but it causes heart...
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When we think about the reward circuits in the brain, heavily dependent on dopamine and now more evidence to suggest the involvement of endogenous opioids, you can begin to recognize that from an evolutionary standpoint, we really do need those circuits. We need to be motivated to seek out things...
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Visceral pain relates to pain in the organs of the body, so it could be the chest, or more likely, the abdomen or the pelvis. It is somewhat unlike other pain syndromes in a sense that visceral pain activates the autonomic nervous system, specifically the parasympathetic nervous system or the...
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A specialist in addiction medicine offers guidance in identifying opioid misuse and the appropriate means of withdrawing patients from long term opioid therapy. The longer term management and rehabilitation of these patients is also considered.
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Dr. Weaver discusses the consequences of alcohol use disorder (AUD) for the development and management of chronic pain syndromes. Techniques for screening for AUD, and motivational interviewing as a therapeutic technique are also considered.
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Chronic pain patients who fail standard treatments represent a growing problem, and a dilemma for health care providers. A pain specialist and senior PAINWeek faculty member discusses what we know about treatment failure, and outlines some elements of a successful treatment approach.
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Fibromyalgia remains a challenge to diagnose and to treat. Dr. Stanos discusses some of the complexities of the condition, and some recent insights into etiology. Options for primary care intervention are also considered.