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The benefit of Ketamine for acute pain care is decreased opioid consumption immediately in the postoperative period, and over the longer postoperative period as well. A lot has been published about ketamine use for depression or outpatient IV ketamine infusion for chronic pain, but I think this may...
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We don’t have a cure or a fix for chronic pain. It’s very similar to any chronic health condition for which we don’t have a cure. Diabetes, asthma, heart disease—we don’t have a pill or an injection that will make these things go away. So helping a person learn how to live with these conditions and...
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Multidisciplinary care is the use of multiple modalities and multiple disciplines to achieve holistic pain care. That includes psychology or mental health services; physical therapy and body modalities in terms of improvement and physical outcomes, safety, and movement. It includes the use of...
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Dr. Webster and I wrote an article in 2015 about an insurance company’s reluctance to pay for abuse-deterrent formulations of opioids. We continue to opine that insurers would rather see patients with chronic pain, who were expensive to maintain, overdose and die rather than have to pay for...
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When a patient dies from an overdose, the prescriber has some potential liability. It could be a licensing board issue, a licensing board plus malpractice issue, or worse a criminal case. That really depends on the nature of that prescriber’s care. Authorities are looking for things like proper...
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A headache is just a symptom—head pain—and we make the distinction in the headache world between what we call primary headache disorders and secondary headache disorders. A secondary headache disorder is when there is something that’s causing that headache. The most common thing people think about...
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Some emerging trends in acute pain management are multimodal analgesia and trying to combine different medications or modalities to treat the cause of pain. We are in an opioid crisis, and opioids are a very strong pain medication and very necessary. But in patients who have acute inflammatory pain...
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One of the most common complaints that people have with back pain is they feel stiff: “It feels stiff and achy,” “It hurts to move first thing in the morning and it’s hard to get out of bed.” What the literature is showing is that, for individuals who have high levels of perceived stiffness, when...
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A lot of people think that there is no difference between multidisciplinary care and interdisciplinary care or the teams that are multi- or interdisciplinary, and the terms really should not be interchangeable. They mean very different things. The thing they have in common is people from different...
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When you consider where we are with the pharmacotherapy of pain at this current time, I think we are still struggling in the sea of two competing public health crises. Certainly, we still have this enormous cohort of people who suffer with poorly controlled pain, yet, on the other hand, the opioid...