In the world of pain medicine, compounding pharmacies can be extremely helpful.  Finding the right combination of medications to keep a patient’s pain under control can sometimes only be accomplished by compounding.  But when pharmacies perform this task it needs to be done in a highly regulated environment, as contamination can lead to catastrophic consequences. 

29 lives were lost this year due to fungal contamination of methylprednisolone acetate.  This led to fungal...

Last night I received an email from one of my patients, addressed to myself and a neurosurgeon colleague of mine. She was going back to the hospital. New neurologic findings, both auditory and visual hallucinations, and her pain was severe. Over ten years ago this patient had a bungee jumping accident. Since then she has had multiple cervical spinal fusions and revisions. She has developed Complex regional pain syndrome (CRPS).

CRPS can be a debilitating disease. Let’s get one thing stated...

When it comes to on the job injuries, pain management is a key part of any person’s treatment. There was a very interesting article in the New York Times on June 2^nd about this topic. The California Worker’s Compensation Institute found that workers who received higher doses of opioids for a specific injury stayed out three times longer than those who took the lower dose for a similar injury. The study also found that the overall cost is nine times higher for medical care and disability...

Migraines can be extremely difficult to treat and their physiologic etiology remains unknown.  Many patients suffer from migraines quite often (10 times or more a month).  Here’s the latest direction, evidence based, for choosing migraine medications.

In the April 24^th issue of Neurology, two new reviews were released by the American Academy of Neurology (AAN) regarding the treatment of episodic migraines.  The first reviewed the evidence for prescription strength medications...

The use of prescription opioids for the treatment of acute and chronic pain syndromes has increased significantly over the last 10 years. Abuse of these medications has always been an issue, and there has been increased scrutiny of, and publicity about, the escalation of misuse, abuse, and diversion attending the higher rates of prescription. Recently, the front page of the Wall Street Journal carried an article describing the measures being taken by the federal government in trying to crack...

Back in December of 2011 on the Veterans Affairs Web site, there was a posting about chronic pain. The entry is titled “Chronic Pain and PTSD: a Guide for Patients". It is brief, approximately 8 paragraphs long. It helps to define what chronic pain is, and demonstrates how common it is, stating that approximately one in three Americans suffer chronic pain in their lifetime. The link between PTSD and chronic pain is made with a few interesting statistics:

- 15%-35% of patients with chronic...

The US surgeon general announced the winners for its “Healthy Apps Challenge”, a contest that was first launched in December of 2011 at the mHealth summit. Four winning apps were selected. Specific criteria were used such as usefulness, usability, and a “fun” factor. All were designed to encourage healthy lifestyle changes. They had a diverse group of judges which included:

• Michelle Kwan – Champion figure-skater and a member of the President’s Council on Fitness,...

There are many moving parts when it comes to making changes to healthcare in America that can affect the entire system. In last month’s New England Journal of Medicine, Drs. Pizzo and Clark reiterated a lot of their conclusions from the original Institute of Medicine (IOM) report published in the summer of 2011. Pain, both acute and chronic is undertreated in this country. The total financial costs in the US alone are between $560 and $635 billion dollars. Sixteen specific recommendations...

Today I thought I’d talk about something dear to my heart, because it's something that I see and treat on a regular basis. Kidney stones. Kidney stones are painful, really painful. Most patients may present with classic symptoms with colic and hematuria. The colicky pain is severe, often described as 10 out of 10 and radiating from the flank towards the groin. There is often associated nausea as well. But sometimes there could just be vague abdominal pain with no radiation and no other...

Last week on Dr. Kevin Pho’s blog at http://www.kevinmd.com/blog/, there was a new posting about using a mobile app for chronic pain.  This is a great concept, and is something that is going to become a prominent tool for the management of chronic pain.  This specific app is not available yet, but will be in the near future.  Similar apps already exist and it is interesting to look at what is currently available.

Damon Lynn has a very well designed pain diary that is user...