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Search results within Expert Opinion Videos for: pain assessment
The fascial distortion model (FDM) allows practitioners to interpret a patient's pain complaints and provide directed manual treatment to correct the fascial distortions. Clinical director Matt Booth and osteopathic physician Todd Capistrant describe this medication-sparing treatment modality and discuss some advantages for both patients and practitioners. ...
Dr. Eleni Romano, a clinical psychologist and health behavior coordinator at the Denver VA, discusses the need for a variety of pain management strategies, and whether or not pain rating systems are useful. ...
There is much controversy around many aspects of pain treatment, and compelling arguments have focused on both sides of the fence regarding legalization of marijuana. There are issues associated with strong positions, although the evidence, when put into practice, is less black and white. Dr. Uritsky discusses medical marijuana, evidence ...
Tanya Uritsky, a clinical pharmacy specialist in pain management and palliative care at the University of Pennsylvania at the hospital of the University of Pennsylvania, discusses opioid treatment in the current climate. ...
Remotely assessing and monitoring pain and its associated symptoms may support individuals in making lifestyle changes needed to improve pain management. For persons with chronic pain and providers who treat them, assessment programs, mobile apps, and activity monitors can help encourage behavioral change. Who can benefit from this technology? Dr. ...
There has been a rise in interest in remotely assessing and monitoring pain and associated symptoms, such as fatigue, as well as in the use of electronic health (eHealth) technology designed to support individuals in making lifestyle changes needed to improve pain management. Consumer demand for remote assessment programs, health ...
Dr. Jennifer Hah on pain as the fifth vital sign, and the pluses of interdisciplinary care. ...
Dr. Mel Pohl discusses the efficacy of opioids and weaning people off them; whether patient goals should be elimination of pain or increased functionality; and the usefulness of pain as the fifth vital sign. ...
Emerging research shows that chronic pain produces a substantial biological burden and can promote cellular aging and produce systemic biological wear and tear. However, there also exists biological resilience factors, and bolstering these may prevent or reverse the biological burden of pain. Afton Hassett, PsyD, discusses building resilience in patients, ...
Focusing on all interventions, not just opioids or the next molecule, will optimize pain management. Jennifer Hah, MD, discusses a "cognitive shift in the right direction." ...
Kathryn A. Schopmeyer, a Physical Therapy Program Coordinator in Pain Management at the San Francisco VA Healthcare System, gives her view on pain as the fifth vital sign. ...
A large body of research supports the use of pain science education--explaining pain from a neurophysiology framework--in conjunction with other treatment interventions for optimal outcomes in patients living with daily pain. What does pain science education mean and how is it delivered? Kate Schopmeyer, PT, DPT, CPE, discusses. ...
Understanding pain can be challenging, and using models or theories can simplify the complex. When treating people who have persistent pain, having a framework to reference is imperative, informative, and supports clinical reasoning. Kate Schopmeyer, a physical therapist specializing in pain management, finds value in knowing the history of pain ...
Dr. Cuevas-Trisan, Chief of the Physical Medicine, Rehabilitiation & Pain Management Service of the West Palm Beach VA in Florida, discusses nonopioid pain treatment options, concerns over healthcare costs, and whether pain scores are helpful. ...
Traditional medical and rehabilitation training programs teach clinicians to frame an explanation of body pain in terms of anatomy and biomechanics. But what is said by practitioners is often not what patients hear. Use of common terms such as "degeneration," "wear and tear," or even "chronic" is associated with worse ...
PsyDs Melissa Fledderjohann and Christian Washburn work at the San Mateo Medical Center Pain Management Clinic in California. In this interview they talk about what makes their work setting, and the programs within it, unique. ...
Dr. Cuevas-Trisan discusses the latest guidelines from the American Academy of Neurology, and talks about what he sees at the VA where he is Chief of the Physical Medicine, Rehabilitiation & Pain Management Service. ...
Edge work is an approach to moving, experimenting with positional sensations such that self-efficacy and recovery expectations are facilitated. Applying pain science and theory to movement related clinical presentations, this type of therapy gives patients an understanding of what they are able to do. Physical therapist Cory Blickenstaff discusses this ...
On a scale of 1 to 10, how crucial are pain scores for the benefit of the patient? What do these numbers impart to the practitioner? What do they mean to the patient? Pharmacists Abigail Brooks and Courtney Kominek weigh the PROs and CONs. ...
Chronic pelvic pain affects many women, some to the extent that they lose work days. What should practitioners know? The causes may be multifactorial, and the treatment must be individualized to give women the care they need. Dr. As-Sanie, from the University of Michigan, discusses. ...
A "resolution of symptoms" is highly possible for pelvic issues such as incontinence. Physical therapist Sandy Hilton explains how biofeedback can help this problem, and other pelvis issues. ...
Does the patient want or expect elimination of their pain? Does the practitioner? What about patient functionality? Drs. Brooks and Kominek offer their opinion and bring into account the importance of exactly who is this patient and what both patient and practitioner can expect. ...
The clinical director of Mount Sinai Beth Israel Louis & Lucille Armstrong Music Therapy Program in New York, John Mondanaro talks about music therapy as a part of integrated, interdisciplinary patient care. ...
Sandy Hilton, a physical therapist at Entropy Physiotherapy, a clinic in Chicago, talks about all too common, all too overlooked of pelvic pain. What practitioners should know, how they can ask, and how patients can get the help they need. ...
Pharmacists Abigail Brooks and Courtney Kominek on health insurance, medication options, and education. How is insurance changing how practitioners treat pain? ...
Two pharmacists give their views on the current climate in pain management. It's not just about the proper treatment, it's about choosing the proper treatment for this particular patient. Drs. Brooks and Kominek discuss patients, medications, and guidelines. ...
Practitioners use pain scores, and the labeling of pain as the 5th vital sign, to access their patient's status. But is that how it should be? Is there a better way? Do HCAHPS scores help the patient? Dr. Jeffrey Fudin offers his take on why pain scores were important, and ...
Opioids have helped countless patients, and opioids have caused pain and addiction as well. The point is they are here, they can reduce suffering, but practitioners must know their patient's needs, and must know all alternatives. Dr. Jeffrey Fudin is a PharmD and a pain management specialist at the Stratton ...
Do patients want or expect elimination of their pain? Or is it all about getting them to function at their best? A practitioner needs to know a patient's goals, and how to help them achieve those goals. Dr. Jeffrey Fudin discusses. ...
Opioids seem to be in the news daily. "They're good" vs "They're bad". If a practitioner wants to use an alternative, will insurance companies cover the cost? Dr. Jeffrey Fudin, a PharmD and a pain management specialist, on if/how health insurance companies have an effect on the opioid epidemic. ...
Dr. Jeffrey Fudin discusses FDA and CDC guidelines for opioid prescribing. Capping may make obtaining opioids harder, which may be good for some and harmful for others. ...
After seeing patients who have failed treatment, or treatments have failed them, David Glick has a different take on the question "Which is the ultimate goal of treatment: elimination of pain or enhancement of functionality?" ...
At PAINWeek we look at topics from all sides. Here, Michael C. Barnes, an attorney who practices law with DCBA Law and Policy in Washington DC, gives his opinion on the opioid controversy, and what practitioners and patients should think about as Plan B. ...
David Glick discusses potential new treatment options, clinical trials, and possibly adjusting the old molecule for patients in need. ...
The opioid controversy is steadily growing. What can practitioners prescribe instead to avoid contributing to the opioid epidemic? Perhaps the first question to ask is how can we re-evaluate the patient's complaint? David Glick discusses the need for better examination of patient's need and nonopioid and nonpharmacologic treatment. ...
Michael C. Barnes, an attorney who practices law with DCBA Law and Policy in Washington DC, discusses the nonadherent patient and recommends what a practitioner should do for the patient, and for themselves. ...
Dr. Gowda is a pain management physician at the San Mateo Medical Center in California, gives his opinion of pain scores and calling pain the 5th vital sign. ...
Health insurance companies shouldn't be averse to spending now when it may save money--and lives--later. Drs. McPherson and McPherson remind that the cliché may be true: stitch in time saves nine. ...
Dr. Gowda is a pain management physician at the San Mateo Medical Center in California, a "safety net" hospital. Here he discusses the opioid controversy and other treatment modalities. ...
What does the patient desire: elimination of pain or restoration of function? What does the practitioner think the patient wants? Pharmacists Lynn McPherson and Alexandra McPherson discuss. ...
The current state of health insurance is a concern for all practitioners and patients. Dr. Gowda, a pain management physician at the San Mateo Medical Center in California, a "safety net" hospital, discusses resources and why it's important to look not just at the now, but also at the future. ...
Practitioners are feeling the pinch of prescribing opioids, but what to do instead? Drs. McPherson and McPherson call out for some good old common sense. ...
Ravi Prasad, a Clinical Associate Professor at Stanford University, discusses the multifactorial dynamic of treatment and psychology as it applies to pain. ...
Dr. Prasad discusses opioids vs nonpharmaceuticals, health costs vs benefits, pain scores vs daily functioning--and keeping the patient's needs uppermost in importance. ...
Sleep quality has long been a concern in the practice of pain management, and evidence suggests a greater significance to sleep issues and apnea than has been generally considered. Dr. Blatman discusses the relationship of sleep fragmentation to head and neck pain, and offers guidance on integrative treatment responses. ...
On a scale of 1 to 10, how crucial are pain scores for the benefit of the patient? What do these numbers impart to the practitioner? Jeremy A. Adler, MS, PA-C, of Pacific Pain Medicine Consultants, talks HCAHPS and fifth vital sign. ...
Dr. Badiola summarizes some of the challenges to accurate diagnosis and pinpointing of spinal pain, and considers some interventional options in the treatment armamentarium as well as where these fit in the multimodal spectrum ...
Multidrug therapy has been part of the chronic pain treatment armamentarium for many years. In this segment, Dr. Argoff reviews the concept and offers guidance on its engagement. ...
The biologic response to stress is a struggle for homeostasis, and a better understanding of the process may inform better decisions in pain management. Dr. Blatman offers some insights, and the beneficial impact of nutritional intervention. ...
Increasing concern over long-term opioid therapy for chronic noncancer pain has prompted interest in opioid sparing alternatives. Is cannabis useful as an opioid sparing approach to pain management? Dr. Badiola considers the evidence. ...
Jeremy A. Adler, MS, PA-C, of Pacific Pain Medicine Consultants, emphasizes the importance of the patient/practitioner conversation about the importance of drug safety. Communication and safety are key. ...
The complex problems that opioid issues bring about are not easily solved. Jeremy A. Adler, MS, PA-C, of Pacific Pain Medicine Consultants, warns against looking for a single solution. ...
What if health insurance companies don't step up to the plate? Jeremy A. Adler, MS, PA-C, of Pacific Pain Medicine Consultants, warns against looking for a single solution. ...
Are clinical treatment guidelines useful in actually treating patients? Dr. Argoff discusses the guideline development process, and why the individual patient sometimes gets "lost in translation". ...
Myelopathies--spinal cord disorders--are associated with multiple medical conditions. Dr. Argoff provides an overview of the causes of myelopathy, and discusses differential diagnosis and options for treatment. ...
Dr. Date works at a county hospital in San Mateo, California, where a lack of practitioners and the limited resources of patients contribute to the pain management difficulties in this setting. ...
Dr. Date works at a county hospital in San Mateo, California, where opioids are just one of the tools in the pain management toolbox. ...
Dr. Date works at a county hospital in San Mateo, California. Although interdisciplinary teams should be the way to go, sometimes a lack of resources, and people, come into play and change the dynamic. ...
Brain neuroimaging techniques have heralded a revolution in our understanding of chronic pain. Dr. Harris discusses how these, and proton magnetic resonance spectroscopy are permitting the noninvasive evaluation of brain structure and function as it relates to pain syndromes. ...
New insights have been gained in realizing the importance of the skin in assessing and treating people with chronic pain. Drs Rice and Albrecht discuss the role of the skin as a functional organ for neural and vascular system interaction, and of keratinocytes in the development of pain. The clinical ...
Dr. Cuevas-Trisan discusses the emerging role of botulinum toxins as chemical neuromodulators, and their application to the management of chronic intractable pain syndromes. ...
Dr. Napadow discusses some recent advances in neuromodulation that have advanced the utility of the modality for the treatment of chronic pain conditions. Transcutaneous Vagus Nerve Stimulation is one such promising approach that has shown clinical benefit in the treatment of migraine. New wearable technologies are the promise of the ...
Virtual reality (VR) has been in the treatment armamentarium for some decades, but the technology has been cost-prohibitive for many practitioners. Dr. Jones outlines some recent advances that are changing the cost/benefit landscape, and discusses recent clinical evidence for VR in pain management. Reimbursement remains an issue, but VR is ...
A specialist in public policy and bioethics considers the conundrum of gaining insurance coverage for this cost-efficient but expensive paradigm change to prescribing decisions, as well as some of the ethical issues associated with the practice of pharmacogenomic testing. ...
Dr. McPherson considers the question of enhancing the preparedness of practitioners to work effectively in an interprofessional setting. Interprofessional education takes clinicians outside the silos of their own specialties, and equips them to make the most of a team approach to patient care. ...
Can opioids be rationally prescribed for chronic pain? Dr. Stacey considers some of the components of getting there, including strengths and limitations in the current CDC guidelines, the practice of tapering; elements of patient assessment, red flags to watch for, and the proper role of opioids in the multimodal treatment ...
Although recent CDC guidelines have focused on opioids for chronic pain management, little attention has gone to the perioperative setting as a potential contributor to the prescription drug crisis. Dr. Bottros gives his perspective on opioids and other alternatives for postoperative pain. ...
Successful treatment of chronic pain means going beyond the pharmacologic options to embrace self-care, psychological and psychosocial factors, functional restoration, and alternative medicine. Dr. Pohl provides an exploration, and outlines some ideas for primary practitioners to engage. ...
Viscosupplementation, or the injection of a synthetic hyaluronic acid into the affected joint, is thought to improve the viscosity of synovial fluid, therely enhancing movement and reducing pain. Dr. Cuevas-Trisan discusses the approach, and FDA approved and non-approved indications ...
Despite its widespread use as a treatment modality for pain, the results of controlled trials of acupuncture efficacy have returned mixed results. Dr. Harris reviews the evidence including emerging approaches that may help to determine if analgesia from acupuncture derives from placebo or from action on receptor activity and neurotransmitter ...
In addition to other shortcomings, current prescribing guidelines are particularly ill-suited to the needs and challenges of patients already on opioid therapy. Drs. Heit and Gourlay discuss the roots of the problem and the role of primary care as talented amateurs in addiction medicine. ...
Spinal manipulative therapy is far from new, but questions remain over effectiveness in comparison to other treatment options, as well as the patients for whom it may be most beneficial. Dr. George reviews the current research, and what remains to be learned. ...
In judging the outcome of a pain treatment plan, the patient has an important say. Good communication between patient and practitioner is thus an essential element of successful chronic pain management. Dr. Zacharoff discusses the barriers to effective communication, its contribution to patient assessment and treatment plan formulation, and how ...
The recently released CDC prescribing guidelines and recommendations from the National Pain Strategy refer to pain psychology as on the critical path to the management of pain. Drs. Mackey and Darnall discuss this role and what needs to be done to bring this treatment modality within the reach of patients ...
Women with chronic pelvic pain frequently endure long delays in referral to appropriate specialties for diagnosis and care. In this segment, a pain medicine psychologist and a pain medicine specialist outline what primary care should know about the epidemiology, risk factors and etiology of various pelvic pain conditions. ...
The pressures and challenges of managing patients with chronic pain are inciting some practitioners to opt out. Dr. Zacharoff considers some aspects of the professional landscape that are contributing to this condition, and why the "math" concerning pain patients and pain specialists makes it essential that primary care providers stay ...
Chronic pain may centralize in the brain and spinal cord, leading to constant neuropathic pain. Dr. Tennant discusses the mechanism of development, available diagnostic tools, and s why under recognition of neuroinflammation is one of our major problems in pain management. ...
Patients can have control over various realms of their life, leading to less pain and improved quality of life. Dr. James Fricton explains the 7 realms and how they affect pain. ...
Dr. LaPietra engages her expertise in acute pain management to outline some effective treatment modalities for use in the emergency room. She also comments on recently published CDC prescribing guidelines for opioid medications, and how they may refine the practice of pain management. Collaboration between the emergency department and the ...
Integrative medicine is the culture change that the Institute of Medicine has called for in treating pain. Dr. Tick discusses its importance in contrast to today's disease management approach, and considers the special influence of nutrition on chronic pain. The quality and composition of our diet can provoke or alleviate ...
Orofascial pain and its associated disorders are complex and frequently overlooked. Dr. James Fricton discusses why. ...
The pathophysiology of vulvar pain is poorly understood, with the result that less than 2% of affected women are properly diagnosed and treated. The diversity of patient characteristics additionally confounds evaluation and effective treatment. This segment offers guidance on incorporating individual characteristics in the development of better tailored, more effective ...
A pain medicine nurse practitioner looks at the emergence of advanced practice providers as key members of the multidisciplinary team. She also discusses the pros and cons of HCAHPS as a measure of patient satisfaction in the acute care setting ...
Dr. Joshi comments on what primary care practitioners should keep in mind with respect to the common comorbidities of pain, sleep disorders and psychological issues. Considering the whole patient will lead to more successful outcomes. ...
A professor of physical medicine and rehabilitation discusses the treatment of neuropathic pain and what the primary care clinician should know and do. Addressing the whole patient via an interdisciplinary team is the key to better outcomes. Specific points on Fibromyalgia, CRPS, and Ketamine as therapy are also considered. ...
Dr. Pryzbylkowski discusses regenerative medicine as an approach to tresptoration and repair of damaged tissue, and specifically focuses on platelet rich plasma and its role in interventional pain management. ...
Opioid induced respiratory depression is associated with over 16,000 deaths in the US each year, and the risks of opioid therapy are not fully understood by many prescribers. Dr. Fudin reviews some of the unanticipated concerns, with a focus on assessing and managing risk for respiratory depression. ...
Drs. Hah and Prasad review the current evidence on long-term opioid therapy for chronic non-cancer pain, and discuss some approaches to achieving a successful transition to pain management without opioids. ...
Dysmenorrhea, or chronic menstrual pain, is the most common gynecological pain condition, affecting from 45% to 95% of menstruating women. But because it is commonly considered a normal aspect of the menstrual cycle, it is often undertreated. Dr. Lamvu considers the consequences of this misperception, and offers guidance on better ...
Central pain conditions are often misdiagnosed and improperly treated. But many, including trigeminal neuralgia, CRPS, phantom limb pain, postherpetic neuralgia, fibromyalgia and others can respond well to ketamine infusions. Dr Joshi discusses the conditions, the infusion, and the results. ...
An experienced pain management nurse practitioner brings some succinct observations on the proper role of electronic health recordkeeping and opioid risk evaluation to guide in coprescription of naloxone. ...
Healthcare provider burnout is notably common in clinicians engaged in pain management. What are the risk factors, and what can practitioners do to improve their resilience and improve quality of life--for themselves and their patients? ...
Recent guidelines from the CDC strongly urge a reduction in opioid prescribing in favor of a multidisciplinary approach for the treatment of chronic pain. Dr. Silverman discusses how frontline practitioners can contextualize this information to help patients achieve better functionality and quality of life. Interventional medicine may be part of ...
The legal landscape for prescribers of controlled medications for pain and addiction is fraught with risk. Attorney Michael Barnes outlines best practices for prescribing clinicians to protect their patients from harm and themselves from criminal and civil liability. ...
Dr. Christo outlines some common procedures used for pain reduction, including a basic description, and the supporting evidence base. Also considered are patient presentations that may be most suited to one or another of these modalities. ...
Chronic pain can lead to inactivity, functional impairment, and reduced quality of life. Dr. Abaci discusses the complex central nervous system changes that can accompany chronic pain syndromes, and how exercise can mitigate these effects. While individual patient presentations differ, the core concepts of rehabilitation can be engaged by every ...
In addition to other shortcomings, current prescribing guidelines are particularly ill-suited to the needs and challenges of patients already on opioid therapy. Drs. Heit and Gourlay discuss the roots of the problem and the role of primary care as talented amateurs in addiction medicine. ...
Public policy reaction to the opioid crisis has significant implications for practitioners and their patients with pain. Attorney Michael Barnes looks at the current federal and state-level regulatory picture, and at some benefits, drawbacks, and unintended consequences of regulatory response. ...
Postoperative acute pain is frequently undertreated and the consequences of suboptimal pain management are numerous. Dr. Argoff outlines some of these and the patients who are at risk, and discusses some better approaches to pain management, using both what is available today, and what may come from emerging research. ...
Dr. Fillingim discusses the evidence suggesting that changes in structure and function of the brain contribute to the pathophysiology of chronic pain. Drawing on a conceptual model of pain as on a continuum of peripheral and central contributors, the tailoring of brain vs body-focused treatment modalities is considered. ...
At PAINWeek 2016, a panel of medical, legal, and pharmacy specialists convened to offer their views on the recently introduced prescribing guidelines for chronic pain from the CDC. In this segment, Dr. Ziegler and Dr. Fudin summarize some of the concerns voiced over the guideline development process, and the utility ...
What does the data say about nonopioid analgesics? Which provide value to what condition? A palliative care services overseer discusses the pros and cons of these treatments, their potential role in pain management, and available data supporting their use. ...
A professor of anesthesiology outlines the mechanisms underlying sensory amplification, and how these may be associated with various central pain states. Pharmacological and nonpharmacological options for treatment are also discussed ...
Undiagnosed low pressure headache can lead to years of patient suffering as a result of misdiagnosis, inappropriate treatment, stigma, and even suspicion of psychogenic pain. Dr. Carroll introduces his patient, Kristen Garnell, in a discussion of what primary care clinicians should know about recognizing and treating the condition. ...
Pharmacotherapy and polypharmacy pose special risks for elderly patients, and the use of interventional strategies is increasingly recognized as important for this population. Dr. Bottros reviews some options to consider. ...
A former Buddist monk and current Chief Zen Officer explains that focusing on pain, but not judging it, can bring a type of awareness that helps pain patients feel more in control. ...
Will recently released prescribing guidelines from the CDC advance the cause of rational opioid therapy? Will they lead to better pain practice and better patient outcomes? Dr. Argoff considers the good, the bad, and the ugly... ...
The challenges of acute pain management and addiction progression can be met. Debra B. Gordon, RN, DNP, FAAN, gives some pointers. ...
A clinical pharmacy specialist turns the spotlight on an option for chronic pain management that many clinicians may not have considered. Buprenorphine offers advantages to patients who are indicated for opioid therapy, but are at risk for adverse effects, While reimbursement is an issue, it remains an option for providers ...
One approach to maintaining the balance between risks and benefits of opioid therapy for chronic pain has been the development of abuse deterrent formulations. A pain management PA provides an overview of abuse deterrent technologies, both existing and emerging.While developments are encouraging, they are but one part of the solution. ...
In 1873, a Harvard gynecologist named Edward H. Clarke in 1873 said that women shouldn't go to college because a woman's "system never does two things well at the same time" and if she did go, she risked "neuralgia, uterine disease, hysteria, and other derangements of the nervous system." Apparently ...
Drs. Hendry and Sheikh, both of whom work in emergency medicine, discuss what has changed and what needs to change in the ED. ...
Pain and depression are complex constructs that involve disease, but also patient vulnerabilities, reinforcements, and outcomes. Dr. Clark discusses the evaluation of patients from these different perspectives with the goal of developing tailored therapies that promote rehabilitation and better quality of life ...
Dr. James Fricton, a professor and senior researcher, describes orofacial pain and its associated disorders and why it can be a complex diagnosis ...
Evidence based biobehavioral therapies, including cognitive behavioral therapy (CBT) and biobehavioral training are indicated for a variety of chronic pain conditions, including fibromyalgia and migraine headache. Dr. Buse, a psychologist, researcher and professor of medicine, outlines what primary care should know about the options, using migraine as a presentation example. ...
Special K is often thought of as a drug of abuse, but it also may be a valid opioid replacement. ...
Common neuropathic conditions such as CRPS, postherpethic neuralgia, and diabetic neuropathy have established diagnostic and treatment paradigms. But what about neuropathic disorders that are less frequently encountered? Drs. Badiola and Yi introduce some of these, and what primary care practitioners should know. ...
We begin the week on The Daily Dose with a special report from the online journal STAT that reviews the dimensions of the crisis in opioid prescribing for patients with chronic pain. While not breaking new ground in the discussion, the report offers a... ...
A former Buddist monk and current Chief Zen Officer brings to light the enormous benefits of mindful meditation. It's not as difficult, or as "out there," as you may think, and may bring people in pain great relief. ...
In an environment of escalating scrutiny over controlled medications, frontline practitioners who prescribe them for pain therapy need to take the appropriate steps to demonstrate "prescribing for a legitimate medical purpose while acting in the usual course of professional practice." Jennifer Bolen, JD, longtime PAINWeek faculty member, and founder of ...
UDT is the preferred tool in patient centered care, and is increasingly important in risk management. Heit and Gourlay discuss how it can offer clinicians insight into patient identification, treatment, and monitoring, and provide objective data for... ...
Dr. Weaver discusses the consequences of alcohol use disorder (AUD) for the development and management of chronic pain syndromes. Techniques for screening for AUD, and motivational interviewing as a therapeutic technique are also considered. ...
Chronic pain patients who fail standard treatments represent a growing problem, and a dilemma for health care providers. A pain specialist and senior PAINWeek faculty member discusses what we know about treatment failure, and outlines some elements... ...
This segment introduces the concept of virtual reality and offers an exploration of its utility in combination with other cognitive behavioral therapies in pain management. ...
Osteoarthritic conditions and resultant pain are common in most clinicians' practice. Dr. Stanos discusses the role of central sensitization in pain causation, and the benefits and risks associated with various pharmacological treatment options. ...
Fibromyalgia remains a challenge to diagnose and to treat. Dr. Stanos discusses some of the complexities of the condition, and some recent insights into etiology. Options for primary care intervention are also considered. ...
The available research provides scant evidence in support of medication or interventional procedures for reducing pain associated with functional impairment. Dr. Pohl outlines the elements of a more comprehensive treatment approach that engages... ...
As mobile technology has become more ubiquitous and widely used by all age groups, its potential for pain management has become more apparent. Dr. Reid reviews the current landscape for devices and apps, and considers some challenges to the adoption... ...
Why is complex regional pain syndrome a frustrating and challenging patient presentation? This segment outlines some of the reasons, and offers some pointers on diagnosis and treatment. ...
Dr. Reid reviews some of the age-related complications of geriatric pain management, and discusses the safety and efficacy of both pharmacologic and alternative treatment modalities. The value of collaborative models of care delivery for this patient... ...
The existence of opioid induced hyperalgesia as a side effect of chronic opioid therapy has been debated. A pain specialist offers his perspective on its reality and manifestations, and what the primary care clinician can do in response. ...
A geriatric psychiatrist discussed the epidemiology and screening process for these frequently comorbid conditions, and why considering these chronic conditions as linked may improve treatment outcomes in older patients. ...
The cost of treating chronic pain now exceeds $500 billion annually, and conventional approaches deliver more failures than successes. Dr. Kaplan discusses why our failure is rooted in a misunderstanding of the problem, and asserts that the... ...
A number of validated risk assessment tools are available to the prescribing clinician, and their use is increasingly important in the current environment for opioid therapy. A clinical psychologist and Certified Pain Educator summarizes what the... ...
Treating Chronic pain often reveals misalignments between patients and healthcare providers, including incongruity of expectations over what constitutes success. Dr. Zacharoff considers why and how the mismatch may arise, and how it might be... ...
Over the last 15 years, more epidural steroid injections are being administered by more providers. Dr. Joshi, an interventional pain physician and anesthesiologist, considers the etiology of musculoskeletal pain, and unravels some of the perceptions... ...
Dr. Jay recounts the case of a patient in pain whose examination was pathophysiologically normal in all respects. Where should the clinician look for clues? Successful treatment may depend on connecting the seemingly unrelated facts. ...
Counterfeit medications are a cause of decreased wellness, increased morbidity, and even death. An anesthesiologist and interventional pain physician reviews the origin of counterfeit medications, describes some anti-counterfeiting technologies and... ...
Doctors Gourlay and Heit, specialists in the arena of pain and addition, explore some of the more common issues confronting the primary care clinician in the management of long-term opioid prescribing. The focus is on the challenges of the inherited... ...
Doctors Gourlay and Heit, specialists in the arena of pain and addition, explore some of the more common issues confronting the primary care clinician in the management of long-term opioid prescribing. The focus is on the challenges of the inherited... ...
Patients with pain often report feeling discounted by health care providers, family, coworkers and caregivers. Dr. Geraghty comments on the etiquette of successful patient communication so that patients feel validated and better treatment outcomes... ...
A professor and department chair of adult and gerontology nursing offers an overview of best practice recommendations for obtaining assessment information from older patients with pain. Different strategies to engage in patients with cognitive... ...
Pain management practices are facing stiffer financial headwinds due to cuts in reimbursement for office visits and procedures, and escalating overhead expenses. Dr. Florente discusses the adoption of nontraditional ancillary services as a creative... ...
Most workers compensation claims involve pain treatment, and most of that therapy involves pharmaceuticals. Dr. Foster overviews the trends and treatment guidelines that primary care practitioners should be aware of, to achieve the best outcomes for... ...
Who is at risk for transition from acute to chronic pain, and why is this progression difficult to predict? Dr. Zacharoff considers these questions, and outlines some strategies for the clinician to engage to reduce the risk of transition. ...
Beyond its role in treating opioid dependence, methadone has unique benefits that make it a viable option for chronic pain management. But with these come multiple pitfalls, for which the risks of methadone therapy may outweigh its benefits for some... ...
High-quality research on the safety and efficacy of medical cannabinoids as pain therapy has long been impeded by an adverse regulatory environment. Even as the prominence of medical marijuana continues to grow--in part due to the public health... ...
Prescription Drug Monitoring Programs (PDMPs) are widely available, but not yet uniformly used. A clinical pharmacist and associate professor evaluates the current landscape, and what can be improved to enhance their utility in curbing substance... ...
In response to the escalating crisis of opioid abuse and overdose fatalities, states are adopting dosage thresholds as part of their prescribing guidelines. A clinical pharmacist and public policy professor summarize the public health landscape that... ...
A clinical health psychologist discusses the diverse effects of chronic pain on adolescent patients, with consideration for how this phase of life differs from both childhood and adult stages. These differences have implications for the experience of... ...
Stem cell therapy is among the newest innovations in the management of chronic pain and degenerative disease, and offers the most promising outlook in terms of success and prognosis. The technique of stem cell extraction is easy and can be done... ...
Dr. McPherson comments on recent consensus guidelines for methadone prescribing, with background on the properties of this analgesic that render it both an attractive and challenging opioid for pain clinicians. Special considerations for patients... ...
Clinicians involved in pain management face a practice environment that is in constant flux. In this segment, an attorney with deep experience in the medico-legal issues confronting pain practitioners outlines steps that they can take to stay current... ...
A discussion of the challenges of effective patient/provider communications about chronic pain conditions. Drs. Cheatle and Schatman outline how new models of shared decision making and patient mindfulness can help improve the quality of the... ...
Recent technological advances have prompted the increasing use of ultrasound for anatomical visualization during pain management procedures. Dr. Bottros reviews the basics of ultrasound, its application in a range of pain management procedures, and... ...
In patients with advanced illness, pain medication regimens may be inappropriately prolonged, due to clinical inertia or misperceptions over continued benefit. This segment considers the process for evaluating the medication decision in advanced... ...
Although prescription medications are of great benefit to many patients with chronic non-cancer pain, there are significant complications for patients who are either addicted or in recovery. Dr. Durham, a clinical pharmacist, professor of pharmacy,... ...
Although pain affects people of all ages, older adults are at increased risk for chronic pain and resultant disability, as well as for transition from acute to chronic pain. In a "graying" America, it is important for clinicians to understand... ...
Must opioid therapy work for everyone to be a valid part of the treatment armamentarium? Dr. Passik considers some of the consequences of "absolutist thinking" that are leading members of the pain community to unnecessarily harsh self-judgements.... ...
A specialist in pain and substance abuse discusses findings from the research on vulnerable populations in the pain community. Patients with pain and concurrent substance use disorders are particularly at risk for depression and suicidal ideation. To... ...
The enforcement arms of both commercial and government payor plans are focused on reimbursement claims for clinical laboratory services. Ongoing changes to billing and coding for services further complicate the picture for practitioners. Here's... ...
Visceral pain can be debilitating, and can degrade a patient's quality of life. It is often hard to localize, and can refer to other parts of the body. Dr. Christo discusses some aspects that differentiate visceral pain and some options for... ...
Are pain and pleasure part of a neurochemical continuum? Some evidence suggests that the brain's pleasure chemical, dopamine is involved in the response to pain. Research has also examined the relationship between dopamine and endogenous opioids.... ...
A variety of metabolic disorders, such as diabetic peripheral neuropathy, can predispose the patient to peripherial nerve entrapment and lower extremity pain. A podiatric surgeon focusing on lower extremity nerve surgery outlines what clinicians... ...
The role of diet in provoking inflammation and subsequent pain is substantially underappreciated. Dr. Blatman offers pointers to frontline clinicians on what to look for and how to educate patients on the importance of nutrition and dietary selection... ...
A clinical professor of pharmacy offers some insights for primary care on best practice in opioid prescribing. Dr Atayee discusses the importance of risk assessment, competence in dosing and titration, and alternate routes of administration,... ...
A discussion of the keys to correctly diagnosing and treating low back pain: orthopedic conditions that include musculoskeletal, discogenic, osseous, and nerve related entities. ...
Fascia may be the most underappreciated tissue in the body. Dr. Blatman discusses how fresh advances in our understanding of the anatomy are informing our grasp of the causes of myofascial pain, and helping to develop more effective treatments for... ...
Why is chronic regional pain syndrome such a frustrating and challenging patient presentation? Dr. Cheatle considers this question, and outlines a successful algorithm for treating the condition at its onset. He also discusses an emerging treatment... ...
A panel of legal and compliance experts discuss some of the issues confronting prescribers of controlled substances in the management of patients who may be abusing and/or diverting their medications. How should clinicians negotiate the terrain... ...
Dr. Atayee overviews some recently approved medications for treatment of opioid-induced constipation, nausea from chemotherapy, and insomnia. Clinical evidence is scarce, but all bear further investigation. ...
Small fiber neuropathies are becoming better understood, from recognition of their frequency, to more accurate diagnosis and recognition of causal factors. A prominent neurologist overviews this often underappreciated condition and outlines some... ...
A specialist in orthopedic regenerative medicine overviews a therapeutic option for musculoskeletal pain that carries a low risk profile while delivering high success rates. In use for many years, newer advanced forms of prolotherapy are now part of... ...
Dr. Rader is a practicing physician and clinical researcher in lower extremity conditions. Here he offers a synopsis of Morton's Neuralgia, including pathophysiology, diagnosis, and treatment options, including better alternatives to the most... ...
Dr. Mackey summarizes his PAINWeek presentation on the mechanisms and impact of neuropathic pain, with guidance on clinical assessment and approaches to treatment with emphasis on pharmacological options. ...
A gynecologic pain specialist discusses vulvodynia in the context of other women's pain conditions, with guidance on pain mechanisms and differential diagnosis. With a prevalence of 8% to 20% of the patient population, vaginal pain is deserving of... ...
An occupational therapist and practicing attorney discusses the power of engagement as a means to improving outcomes in patients with chronic pain conditions--and why this approach is good public policy as well. ...
Integrative Pain Management is a multidimensional approach that combines interventional medicine with behavioral modalities. This segment discusses the concept and its benefits. ...
Has The Decade of Pain had a positive impact on the caliber of pain education in the US? A prominent pain educator and practitioner offers an assessment of pain education today, including lessons learned from the past that may guide future... ...
By advancing from a problem/solution perspective to a holistic life coaching approach in the management of chronic pain, both clinician and patient can achieve better, more satisfying, longer lasting outcomes. ...
When patients are taught about the physiology of their pain, their treatment outcomes improve. Dr. Schopmeyer discusses the role of Therapeutic Neuroscience Education in promoting an understanding of the role of the brain in producing pain. ...
Dr. Schatman critiques the present state of affairs in medical marijuana and illuminates a more promising path for exploration in pain therapy. ...
Dr. Saenger advocates for the inclusion of CAM therapies in the pain treatment decision, and discusses the evidence supporting several modalities ...
Dr. Mackey is Division Chief for Pain Medicine at Stanford University, and is the current President of the American Academy of Pain Medicine. Here, he summarizes his PAINWeek 2014 lecture on the neurophysiology of pain transmission, with a focus on... ...
A professor of occupational therapy discusses VTE and the various reasons why the clinician may overlook the diagnosis when patients present with the classic symptoms of pain. ...
Dr. Zacharoff sketches the background history of Prescription Drug Monitoring Programs, and offers an assessment of how well they are performing and how they can be improved. Watch the segment for recommendations on what you need to know to... ...
A podiatrist offers a review of some painful foot and ankle conditions that are commonly seen in private clinical practice. ...
Dr. Robeck describes her clinical experience with group interaction in the provision of pain care and addiction management in the VA setting. ...
A nurse practitioner and Certified Pain Educator discusses some of the changes in the healthcare landscape and complexities of medical practice that confront nurse practitioners as part of the pain management team. ...
An epidemiologist looks at opioid therapy from the perspective of dose vs risk relationships, and comments on how communities can better harness local initiative and interest to combat overdose events. ...
Drs. Carter and Schatman consider the consequences that would accrue from the removal of opioids from the therapeutic options for chronic pain. The segment also discusses the characteristics of a "better" opioid, and the research understanding... ...
Drs. Carter and Schatman consider the consequences that would accrue from the removal of opioids from the therapeutic options for chronic pain. The segment also discusses the characteristics of a "better" opioid, and the research understanding... ...
Diabetes is associated with various changes in the gastrointestinal tract that are discussed here. Dr. Bottros also covers some recent advances in understanding the pathogenesis, and offers some options for treatment of GI pain. ...
An attorney discusses the role and importance of laboratory test reports in a medical legal proceeding, and gives examples of how they are used to indicate compliance/noncompliance. ...
Some further observations on the role of opioids, including advice to the primary clinician as they approach the prescribing decision. ...
A discussion of the research breakthroughs that have occurred in the understanding of centralized pain, and an outline of approaches to pain management.   ...
Dr. Argoff comments on the appropriate role of opioid analgesics as part of therapy for chronic noncancer pain, with observations on protecting legitimate access while preventing abuse. ...
Many chronic pain conditions can be treated successfully and efficiently with office-based procedures. This segment discusses the rationale for performing these and outlines some common practices. ...
The conclusion of a 2-part discussion. Some specific limitations of UTD as a clinical tool are examined. Drs. Gourlay and Heit also consider the role of opioids in chronic pain management, with balanced regard for the risks of pain and addiction. ...
An examination of the prominent musculoskeletal pain conditions in women through different stages of life, including some strategies for treatment. ...
What would the world be like without opioids? Dr. Clark hypothesizes on the implications for patients with pain, and on what the characteristics of a "better" opioid might include. ...
A consideration of the relationship between pain, depression and suicide ideation, with practitioner insights into mitigating the risk of suicide in patients with chronic pain conditions. Recorded at PAINWeek 2013. ...
In this 2-part segment, Dr. Passik discusses some of the lessons learned during and following the Decade of Pain Control and Research, and implications for the appropriate engagement of opioid therapy in chronic noncancer pain management. Click... ...
In this 2-part segment, Dr. Passik discusses some of the lessons learned during and following the Decade of Pain Control and Research, and implications for the appropriate engagement of opioid therapy in chronic noncancer pain management. Click... ...
Are you prepared to deal successfully with this frequently encountered, yet poorly studied condition? This discussion defines the phenomenon of chronic postsurgical pain, explores the causes of transition from acute to chronic pain, and examines some... ...
A review of obesity-related pain, including links and comorbidities, assessment measures, and techniques for initiating the patient discussion about the conditions. Dr. Bonakdar offers valuable insight into the current understanding of the condition... ...
Proper documentation is both an ethical and legal duty of healthcare providers, particularly with respect to opioid therapy. Attorney Bolen discusses critical documentation skills, and outlines common mistakes that clinicians may make in maintaining... ...
There's much that you can do to help your patients with postherpetic neuralgia--including how you manage referrals. In this segment, a professor of neurology offers insights for primary care clinicians on diagnosing and managing postherpetic... ...
Quantitative Sensory Testing can provide clinically useful information on potential mechanisms that may contribute to a patient's pain. Dr. Fillingim discusses the methodology and its application to patient evaluation and treatment selection. ...
Dr. Fitzgerald discusses the different kinds of urogenital pain that are commonly encountered, and examines present and emerging approached to treatment, including an assessment of the effectiveness of opioids. ...
A prominent psychiatrist and pain educator discusses the challenge of managing patients with chronic pain who also suffer with borderline personality disorder and depression, including the special difficulties associated with demanding, noncompliant,... ...
Some further observations on the role of opioids, including advice to the primary clinician as they approach the prescribing decision. ...
Dr. Argoff comments on the appropriate role of opioid analgesics as part of therapy for chronic noncancer pain, with observations on protecting legitimate access while preventing abuse. ...
Some observations on pain mechanisms, diagnostic testing and back pain that underlie an effective clinical approach to management and treatment. ...
Observations on the challenges confronting both patients and practitioners in underserved rural areas. ...
Dr. Robeck is a physician with the Veterans Health Administration.  This segment examines some comordidites associated with chronic pain among returning veterans. ...
An occupational therapist and attorney explains this experiential tool for pain management and how it integrates into a clinician's therapeutic plan. ...
Some observations in 2 parts on the state of pain education by PAINWeek 2012 Keynote Speaker Daniel Carr; where it is today, and what can be improved. ...
Observations by a pain management educator and lawyer on some key issues for pain medication prescribers. ...
A discussion of spinal cord stimulation- description, appropriate pain conditions, considerations of patient selection and management of patient expectations. ...
Dr. Walker is an assistant professor of pharmacy practice, and a practitioner in palliative care. This segment discusses topical and transdermal medications, indications for use, and their role in the therapeutic plan. ...
Dr. Blatman discusses some of the health and pain concerns that women confront at mid-life, and offers some non-pharmacologic options for treatment ...
Some observations on pain mechanisms, diagnostic testing and back pain that underlie an effective clinical approach to management and treatment. ...
Dr. McPherson is an acclaimed professor of pharmacy, primary care practitioner and consultant in hospice and palliative care. Here, she discusses some of the issues surrounding medical marijuana. ...
Observations by a pain management educator and lawyer on some key issues for pain medication prescribers. ...
Observations on the effectiveness of music as an element of pain therapy. ...
Dr. Blatman offers insights into the role of nutrition in pain management, including foods that may increase pain and inflammation, and foods that assist in their modulation. ...
Exploring strategies for balancing the needs of patients, physicians and other stakeholders in pain management. ...
Pelvic pain affects one-quarter of reproductive age women. Dr. Fitzgerald discusses the impact of pregnancy on pelvic pain, and the role of rehabilitation strategies in treatment. ...
Some observations on pain mechanisms, diagnostic testing and back pain that underlie an effective clinical approach to management and treatment. ...
Some observations in 2 parts on the state of pain education by PAINWeek 2012 Keynote Speaker Daniel Carr; where it is today, and what can be improved. ...
An examination of intrathecal drug therapy- the benefits, and clinical considerations of patient selection and managing treatment expectations. ...
A summary of acupuncture and auricular therapies as alternative medicine techniques, and the role of stress and anxiety in pain progression. ...
Observations by a pain management educator and lawyer on some key issues for pain medication prescribers. ...
Dr. McPherson discusses what the primary care clinician should know about initiating methadone therapy, including an outline of some of the precautions that should be considered with this opioid. ...
Dr. McPherson is an acclaimed professor of pharmacy, primary care practitioner and consultant in hospice and palliative care. This segment explores topical and transdermal pain relievers. ...
Chronic pain can be significantly influenced by psychological factors, and proper recognition and treatment can contribute to clinical success. ...
An occupational therapist and attorney discusses some of the special challenges presented by individuals with autism, for pain educators and clinicians dealing with pain. ...
Dr. Robeck is a physician with the Veterans Health Administration.  This discussion introduces the Primary Care Medical Home and its applicability to non-VA clinical settings. ...
A 2-part discussion of chronic headache; differential diagnosis and treatment approaches. ...
An examination of common pain presentations, their diagnosis, and options for treatment. ...
Awareness and engagement of instructional design methodologies can be of significant benefit to clinicians engaged in pain management. Pain education is a critical component of pain therapy, and Dr. McPherson discusses how these principles can... ...
A discussion of CAM therapies that are now being incorporated into pain treatment guidelines, the clinical indications for their use, and a spotlight on evidence-based dietary supplements for pain conditions ...
An examination of some of the gender based differences in the experience of pain, and in response to treatment modalities. ...
A 2- part examination of some of the chronic pain syndromes that are common in older adults, and the special considerations relating to pharmacology that arise from the physiology of older patients. ...
A 2- part examination of some of the chronic pain syndromes that are common in older adults, and the special considerations relating to pharmacology that arise from the physiology of older patients. ...
An in-depth, 4- part examination of opioid risk assessment in the primary care setting; the need, the tools; the clinician responsibilities. ...
An in-depth, 4- part examination of opioid risk assessment in the primary care setting; the need, the tools; the clinician responsibilities. ...
An in-depth, 4- part examination of opioid risk assessment in the primary care setting; the need, the tools; the clinician responsibilities. ...
An in-depth, 4- part examination of opioid risk assessment in the primary care setting; the need, the tools; the clinician responsibilities. ...
A discussion of medical marijuana in the arsenal of treatment options for pain, including clinical indications and practical legal considerations associated with the use of cannabinoids. ...
Dr. Jay discusses some of the issues confronting patients and clinicians in the current environment of cancer pain therapy. ...
Diabetes can lead to a variety of pain-inducing changes in the gastrointestinal tract. Dr. Bottros outlines some of these, and discusses options for treatment. ...
Studies indicate that various neuromuscular disorders are often accompanied by chronic pain. Dr Carter discusses this relationship and some options for treatment that are available. ...
Dr. Passik comments on the debate over opioids as appropriate for chronic non-cancer pain, identifying some shortcomings in the arguments from both sides. ...
A discussion of the role of adjuvants and co-analgesics in pain management, focusing on awareness and management of adverse effects of these therapies. ...
Dr. Herndon shares insights from the implementation of a chronic pain management program within a large family medicine program. ...
Peripheral Artery Disease (PAD) is a common comorbidity in diabetics, and can be very painful. Dr. Bottros discusses how PAD differs in diabetic and non diabetic patients, how to diagnose it, and some options for treatment. ...