A Look at Patient Barriers to Pain Management and Acceptance

The barriers that we face when we tell patients they can learn to live with pain…they’re quite vast. There are some patients who say “I don’t want to live with pain. The pain has taken a lot out of my life and I don’t want to learn to live with it. I just want it gone.” That’s a significant barrier...

The Insurance Climate

When we place a lot of resources upfront, such as employing physicians, psychiatrists, psychologists, physical therapists, yoga instructors, it does have a lot of start-up costs. But what we’re finding is we don’t know the status of our healthcare monetary appropriation. Right now it seems like from...

Common Threads in Pain and Chemical Dependency

This session will explore some of the challenges resulting from the recent “Decade of Pain.” Clearly, the overuse of opioids and, to some extent, the solutions proposed to curtail the misuse of prescription drugs has led to a shift in how we diagnose and how we treat substance use disorders in this...

Lessons From a County Hospital: Pain Management How-To

I think the unique concepts or unique problems that we have at the San Mateo County Medical Center is limitation of resources, first of all. There’s a limitation sometimes in the number of hours that we can have at our clinic, the total number of clinicians we can use, the number of hours in general...

Metabolic Changes and Palliative Care in the Older Adult

There are many changes in the body composition of the older adult that can lead to altered effects of drug therapies. Symptom management in the older adult can be complicated as many of the drugs which we use are amongst those recommended to be avoided in this population. It is critical to...

Sleep Dysfunction and Myofascial Pain

There is a tremendous interplay between sleep and pain and stress and function, adrenal glands, fatigue and healing. We're not as aware of the sleep issues as we need to be. All of our pain patients, with rare exception, have some issue with sleep. When we have pain, pain will wake us up when we...

Pearls and Pitfalls for the Business Aspects of Drug Testing

2016 was not a good year to be on the wrong side of medical necessity when it came to drug testing and ongoing prescribing of controlled medication or substance abuse treatment programs. 2017 is likely to be an expensive year for those who do not proactively take steps to understand medical...

When Health Insurance May Not Be on Our Side

The cost of healthcare of course is a concern. The insurance companies are in the business of providing insurance and healthcare professionals and patients are seeking out quality care. There’s an inherent conflict there because unfortunately pain is a complex biopsychosocial problem. It really does...

Impacting Diverting: It Can Be Done

Jeremy A. Adler, MS, PA-C, of Pacific Pain Medicine Consultants, emphasizes the importance of the patient/practitioner conversation about the importance of drug safety. Communication and safety are key.

The argument that we need to educate providers more is an argument that could always be made...

Back and Spinal Pain--Where do Interventional Procedures Apply?

Spinal pain is very difficult to diagnose, the more so as patients get older. They present with different things on their MRI, different findings on exam, and they’ve had chronic pain for many years. Unfortunately, a lot of the physical exam and history findings are very generalizable, so it’s hard...