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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 illness, and insight into compassionate patient and...
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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, and medication prescriber, considers the...
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Ultrasound was started by Karl Dussik in the 1930s and’40s and he was trying to diagnose intracranial tumors. Things have progressed extensively over the last several decades and so ultrasound is now being used to help locate peripheral nerves and to help coordinate injections and to even show some...
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States have tried to respond to the opioid overdose epidemic, and one of the more recent innovations has been a focus on dosage thresholds and subsequent triggers. Once a chronic pain patient, for example, reaches 120 mg morphine equivalency per day, it triggers a particular action or recommendation...
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It’s been said that patients who are on higher doses of morphine equivalence per day are at higher risk of opiate induced respiratory depression and death. But the truth is that patients who are on very high doses of opioids may be very much sicker and they may be at a higher risk of death for other...
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Chronic low back pain doesn’t necessarily have to be just one thing or another; there can be a variety of reasons why people have it Facet-mediated pain is considered one of the more frequent things that we see when it comes to chronic low back pain reasons, accounting for anywhere from 15 to 45...
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A discussion of the keys to correctly diagnosing and treating low back pain: orthopedic conditions that include musculoskeletal, discogenic, osseous, and nerve related entities.
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There’s a robust body of literature on the comorbidity of depression, anxiety and chronic pain. Approximately 50 percent of patients who suffer from chronic nonmalignant pain suffer from some degree of depression. With respect to pain patients and suicidal ideation the prevalence is anywhere between...
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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 modality that shows promise for CRPS and other...
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Why is complex regional pain syndrome so challenging? I think part of the debate is what really constitutes CRPS, because it’s really a difficult diagnosis. You can see flagrant cases of it where you’ll get some atrophy and you’ll get color changes, temperature changes. Typically diagnostic tests...