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Functional pain syndromes (irritable bowel syndrome, fibromyalgia, interstitial cystitis, vulvodynia, etc) are commonly seen in primary care and by pain medicine practitioners. For example, fibromyalgia affects 5 million people and interstitial cystitis 8 million women per year, and the etiologies...
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There is a group of intractable pain patients who have extensively accessed the pain treatment system only to be unable to find satisfactory pain relief. These patients have sought treatment at multiple academic centers and attempted numerous nonmedical, pharmacologic, and invasive interventions...
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Ketamine, known on the street as "special K," is a dissociative anesthetic with hallucinogenic properties and is classified as a controlled substance. Its unique mechanism as an N-methyl-Daspartate (NMDA) receptor antagonist is thought to be responsible for many of the drug's most promising...
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For decades, the concept of morphine equivalent daily dosage (MEDD) or some variant thereof has been routinely utilized clinically (eg, for opioid rotation) as well as in research as a dependent variable. However, recently, the concept has been demonstrated to be a scientifically invalid course...
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Osteoarthritis (OA) is the fastest growing major health condition with symptomatic disease affecting approximately 46 million people in the US. Hyaluronic acid gives synovial fluid the viscous quality that helps to lubricate and absorb shock. Joints affected by OA have poorer quality and less...
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Managing risk is an essential part of medical practice, particularly in light of the reported increase in morbidity and mortality associated with the use of opioids. Recent anecdotal data indicate that as a result of the "opioid crisis," patients are being told by their prescribers that they can no...
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Although many providers have experience in advising their patients to use topical analgesics for treatment of various types of acute and chronic pain conditions, there are new insights into just how important the skin is in evaluating and treating people with chronic pain. In this translational...
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Controversies continue to exist regarding safe and appropriate management of people with chronic pain. The "pendulum has swung in the other direction" with respect to the utility, safety, and efficacy of the use of opioids as a key component of chronic pain treatment. It seems to be unclear to many...
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Counterfeiting is big business. In 2012, counterfeit auto parts accounted for $4 billion in the US and $12 billion globally; electrical parts were $15 billion; personal care $4 billion; aerospace & defense accounted for 520,000 counterfeit parts in the US, and >5% of wine sold on the secondary...
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Fierce debates rage on about chronic pain. These include the utility of chronic opioid therapy, the value proposition of multidisciplinary approaches, reimbursement related issues, risk of aberrant drug related behaviors, along with many other questions related to assessment and treatment...