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Don ’t let the opioid crisis affect the treatment course for your patients

Mrs. Smith is an 81-year-old female. She worked a long time doing very physical work and is now on a fixed income and comes to my office with chronic pain. X-rays show she has degenerative arthritis in her hips, knees and lumbar spine. She has taken Norco twice a day for years and has been able to be very stable on this. She has always been compliant with her medications. She has not lost them or had them stolen. She lives with her husband, and they use a safe where they keep their medications. The patient has done well with acupuncture and massage in the past but is not able to afford these, and her insurance doesn’t cover these services. The main reason she was referred to our clinic is that her primary care provider is refusing to prescribe her medications as they do not want to prescribe long-term opioids. I work in interventional pain management, and we provide a lot of interventional services that can help decrease pain for a lot of patients. We also take care of people who are on chronic pain medications. With the opioid “crisis” there have been a lot of providers who no longer believe in pain. Pain has gone from the fifth vital sign to a non-existent symptom which has left a lot of patients who are in pain to suffer. We’ve come to a point where we have found that there is an issue with opioid medications, but no one wants to come up with a solution. We have options for alternative treatments that have been found to help people with chronic pain...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Meds Pain Management Primary Care Source Type: blogs

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Follow me on Twitter @RobShmerling Ever wonder what other people are wondering about? I know I do. So, here are the top 10 health searches in Google for 2017. And just so you don’t have to look each one up, I’ve provided a brief answer. You’re welcome. 1.  What causes hiccups? I was surprised this one made it to the top 10 list of health searches. Maybe this search is common because hiccups are as mysterious as they are universal. I’ve written about hiccups before, but let’s just say the cause in any individual person is rarely known or knowable. Then again, the reason hiccups stop is als...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Health Source Type: blogs
Publication date: Available online 10 February 2018 Source:Pharmacological Research Author(s): Ádám Horváth, Valéria Tékus, Noémi Bencze, Nikolett Szentes, Bálint Scheich, Kata Bölcskei, Éva Szőke, Attila Mócsai, Éva Tóth-Sarudy, Péter Mátyus, Erika Pintér, Zsuzsanna Helyes Semicarbazide-sensitive amine oxidase (SSAO) produces tissue irritants by deamination of primary amines, which activate transient receptor potential ankyrin 1 (TRPA1) and vanilloid 1 (TRPV1) receptors expressed predominantly on nociceptors. Since the...
Source: Pharmacological Research - Category: Drugs & Pharmacology Source Type: research
(Reuters Health) - A growing number of patients are seeking care from rheumatologists for chronic health problems like arthritis, back pain and osteoporosis, just as the supply of specialists is shrinking, two new studies suggest.
Source: Reuters: Health - Category: Consumer Health News Tags: healthNews Source Type: news
The neuromodulation device industry is enjoying a period of tremendous growth and diversification. A 2016 article by Neurotech Reports estimated the global market for neurotechnology products to be $7.6 billion predicted it will hit $12 billion by 2020. Neuromodulation devices such as neurostimulators targeting the brain, vagus nerve, and spinal cord account for the largest segment and represent some of the most mature applications of neurotechnology for treating diseases such as movement disorders, epilepsy, and pain. However, there are new neuromodulation devices under development aimed at less traditional applicati...
Source: MDDI - Category: Medical Devices Authors: Tags: Electronics Source Type: news
Musculoskeletal conditions (MsCs) are a major burden to the individual, society and the health service. One in five of all general practitioner consultations involves a patient with an MsC. The main consequences of MsCs are chronic pain and physical disability. Back pain is the most common type of musculoskeletal pain. The most common form of inflammatory arthritis is rheumatoid arthritis, and the most common form of non-inflammatory arthritis is osteoarthritis. MsCs can affect individuals of any age and sex.
Source: Medicine - Category: Internal Medicine Authors: Tags: Introduction Source Type: research
Previous estimates for the prevalence of musculoskeletal conditions (MSK) and chronic pain in Australia have been based on self-report. We aimed to determine the prevalence and distribution of arthritis, chron...
Source: BMC Musculoskeletal Disorders - Category: Orthopaedics Authors: Tags: Research article Source Type: research
In this study, we estimated the prevalence of IBP and the subtypes of SpA in a tertiary hospital in Bangladesh. MethodsThis 1 year cross‐sectional study was conducted among 240 CLBP patients in a rheumatology outpatient clinic. Assessment of Spondyloarthritis International Society classification criteria of IBP and predefined recognized classification criteria were followed to define different subtypes of SpA. Means and standard deviations were reported for continuous variables. Descriptive and bi‐variate analyses were accordingly performed. ResultsOf 240 CLBP patients, 60 (25%) had IBP and 180 (75%) had mechanical bac...
Source: APLAR Journal of Rheumatology - Category: Rheumatology Authors: Tags: Original Article Source Type: research
View Original Article Here: Tai Chi For Seniors: Exercises, Benefits, and Tips For The Elderly Tai chi, a form of Chinese martial arts that focuses on slow, controlled movements. It’s low impact and gives people with limited mobility a chance to improve their balance, range of motion and coordination. Research shows that tai chi for seniors can reduce the incidence of falls in elderly and at-risk adults by about 43 percent. With fewer than 34 percent of aging adults getting enough exercise, it’s important for caregivers, older individuals and people who work with seniors to know about this gentle but effective ...
Source: Shield My Senior - Category: Geriatrics Authors: Tags: Senior Safety Source Type: blogs
In this study, we asked people in an open-ended way about their desire for longer life: Would you like to have more time? What age would you like to become? This was something more specific than asking about a preference for survival without reference to any length of time; about one's plans for the future; or whether people see the future as open or limited, as in studies of future time perspective. Our attempt was to discover whether there were preferred temporal spans with which older adults framed their futures and plans. The two-question series about extra years and desired age ("How old would you like to ...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Hey guys, PGY1 here, just finished a rheumatology rotation and noticed a lot of patient with chronic pain that would benefit from interventioinal pain or pharm treatment such as fibro, or inflammatory arthritis that could benefit from geniculat blocks, or chronic neck and back pain. I am interested in pain, do not know all available interventions but noticed the patients were not well controlled at times. How feasible would a rheum/interventional pain clinic be or would it even make sense?
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Source Type: forums
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