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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. ...
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. ...
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?" ...
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. ...
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. ...
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. ...
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". ...
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. ...
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. ...
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. ...
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 ...
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. ...
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. ...
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. ...
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 ...
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? ...
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 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. ...
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. ...
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. ...
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 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 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... ...
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... ...
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... ...
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... ...
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... ...
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. ...
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... ...
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,... ...
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 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. 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. ...
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... ...
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... ...
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 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... ...
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. ...
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... ...
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 pharmacist perspective on the pros and cons of opioid treatment agreements ...
Observations on the effectiveness of music as an element of pain therapy. ...
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. ...