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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. ...
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. ...
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 ...
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. ...
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. ...
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. ...
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. ...
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. ...
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. ...
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. ...
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. ...
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 ...
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 ...
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 ...
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. ...
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. ...
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. ...
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. ...
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. ...
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 ...
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. ...
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... ...
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. ...
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. ...
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... ...
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 ...
A specialist in addiction medicine offers guidance in identifying opioid misuse and the appropriate means of withdrawing patients from long term opioid therapy. The longer term management and rehabilitation of these patients is also considered. ...
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. ...
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... ...
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. ...
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... ...
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... ...
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... ...
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... ...
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... ...
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... ...
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... ...
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.... ...
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 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. ...
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. ...
Dr. Schatman critiques the present state of affairs in medical marijuana and illuminates a more promising path for exploration in pain therapy. ...
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. Robeck describes her clinical experience with group interaction in the provision of pain care and addiction management in the VA setting. ...
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... ...
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. ...
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... ...
Medical cannabinoids are legal in several states, yet there is prescriber resistance to their use. This segment examines some reasons, and discusses the MOA and appropriate patient scenarios for this therapy. Recorded at PAINWeek 2013. ...
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. 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. ...
An occupational therapist and attorney explains this experiential tool for pain management and how it integrates into a clinician's therapeutic plan. ...
Observations on the effectiveness of music as an element of pain therapy. ...
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. ...
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. ...
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. ...
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... ...
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 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. ...
Dr. Passik comments on the debate over opioids as appropriate for chronic non-cancer pain, identifying some shortcomings in the arguments from both sides. ...
Dr. Jay discusses some of the issues confronting patients and clinicians in the current environment of cancer pain therapy. ...