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Some further observations on the role of opioids, including advice to the primary clinician as they approach the prescribing decision.
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Managing pain in a world without opioids is a scenario that would harm some because there are truly, in my experience, individuals for whom the use of an opioid analgesic on a long-term basis, on a regular basis, made a huge difference in that person’s ability to function comfortably and maximally...
| Article
We have found that even subclinical levels of anxiety and depression can be important in terms of the experience of pain. Another factor that we spend a lot of time investigating in the pain research world is pain-related catastrophizing. It has a pervasive effect on people’s ability to manage pain...
| Article
Cluster headache is more common in men than women. These patients have absolutely horrible pain to the point where it’s also called a suicide headache. The headache lasts 45 minutes to three hours, whereas migraine goes four hours to 72 typically. Even though it’s a vascular headache it starts from...
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The three treatments that have been studied the most, and have pretty good evidence to support them, are biofeedback, cognitive behavioral treatment, and acceptance and mindfulness-based treatments. We’re starting to think a lot about subgroups of patients that may benefit more from one or another...
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The transdermal formulations of fentanyl and buprenorphine are for patients who have chronic pain. An important distinction is, with transdermal fentanyl the patient has to be opioid tolerant, on the equivalent of 60 mg of oral morphine a day for at least a week, whereas with transdermal...
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Dr. Robeck is a physician with the Veterans Health Administration. This segment examines some comordidites associated with chronic pain among returning veterans.
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Most clinicians are already aware of one of the most common adverse effects, which is that of gastrointestinal side effects with NSAIDS and the importance of monitoring that goes with those medications. Newer concerns have recently arisen as far as the cardiovascular adverse effects of NSAIDS and...
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Observations by a pain management educator and lawyer on some key issues for pain medication prescribers.
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Autistic individuals often perceive pain differently, either at a greater intensity or lesser intensity. Some autistic individuals are hypersensitive to touch. In a classic encounter, for example, a primary care provider walks in, takes your hand and feels your pulse. They don’t tell you what they...