One-Minute Clinician

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Primary care should know that the number of regulatory agencies that are getting involved in the management of chronic pain seems to be growing by the week. Since 2011, the Food and Drug Administration has become really involved with the post-marketing prescribing of opioids, with REMS being...

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Looking at medication options for substance use disorder, there is buprenorphine which is a full mu opioid agonist and also has an affinity to the kappa receptor which is what makes it lower liability in terms of abuse. Buprenorphine has been around for a long time. In the 1980s it was an injectable...

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Dr. Aljassem: In reviewing the literature with topical opioids, like many things that are kind of outside the box, a lot of it is not standardized. But what we do know is that they are effective in reducing pain and they are minimally absorbed systemically so they do have a high benefit with low...

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In terms of diagnosis and treatment of neuropathic pain, we have a long way to go.  Many patients have a component of neuropathic pain to their overall pain experience that is not recognized by those taking care of them. And then often when it is recognized, it’s not treated adequately. An example...

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Individual patient characteristics should guide the treatment plan. One creates a post-surgical treatment plan that is personalized. So it’s patient-specific, patient-centered, patient-focused personalized care plan. We have a world of generic drugs. We have no generic patients. Each patient is...

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Chronic post-surgical pain is a significant problem because it results in decreased activities of daily living, reduced quality of life, and overutilization of medication and healthcare resources, so it’s very costly. The main cause is peripheral stimulation, because of course once a surgeon breaks...

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A new and emerging field in medicine is here and some people call it regenerative medicine; some people call it stem cell treatment.  I think it’s important that we define those terms. Regenerative medicine includes this field of medicine where we can hopefully see some regeneration of tissue,...

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There are a lot of theories about CRPS. There are theories about glial cell involvement, or dysfunction of the autonomic nervous system. To my mind, there is a hormonal component because 80 percent of my patients are women. There’s a genetic component because I have seen 18 families where more than...

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The Fascial Distortion Model can help guide a practitioner towards treatment selection because the model is based on the patient’s input. The patient is the expert. Patients guide us as practitioners by body language or gestures and their verbal description of their pain. They show us exactly the...

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The Fascial Distortion Model looks at six different types of patterns of gestures that people do when they have an injury. When they show a certain gesture, we’re going to use a certain manual therapy technique that’s going to match. If they indicate with their finger a single spot on the bone, we...

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