Treat the Patient, Not the Label: A Pain Neuroscience Update
When dealing with chronic pain, it is often not possible for clinicians to provide adequate answers to their patients about what might be wrong, and why they continue to have their pain. This has led to greater use of diagnostic “labels” for conditions such as fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, chronic Lyme disease, and many others. Assigning such “labels” to patients with chronic pain has far-reaching consequences for all stakeholders. The aim of this clinical commentary is to highlight some of the common threads among 4 particular conditions common to women—fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and chronic Lyme disease—when it comes to the underlying neurobiology and its consequences for the patient and treating clinicians. By taking a “big picture” view of pain as a multiple system output activated in response to threat, we discuss how the various output systems activated can lead to clusters of symptoms that may predispose patients to one or other of these 4 diagnostic conditions. There is now emerging evidence that during the biological response to threat, one output system may be more affected than the others and dominate the clinical picture, hence manifesting as a particular diagnostic condition. We propose that ultimately, these conditions essentially mean the same thing, that the patient has chronic pain, and we advocate for treatment of the patient, not the co...
We describe the most highly recommended generic and disease-specific PRO tools in SCD and discuss the challenges of incorporating them in clinical practice. EXPERT OPINION: PRO measures are essential to incorporate into SCD clinical trials either as primary or secondary outcomes. The use of PRO measures in SCD facilitates a patient-centered approach, which is likely to lead to improved outcomes. Significant challenges remain in adapting PRO tools to routine clinical use and in developing countries. PMID: 33034214 [PubMed - as supplied by publisher]
Currently in fellowship doing bread/butter procedures (MBB, epidurals, PNB, few SCS/PNS trials, etc.) and just interviewed at a private practice spot where they do a lot of procedures that I will have not done any training in prior to graduating (e.g. IT pump, SI fusion, Vertiflex, Kypho, MILD, Discectomy, lots of SCS/PNS trials etc) and significant amount of "OR pain procedures" at a very busy practice seeing 30-40 pts/day - how many of you are commonly performing these procedures and are... private practice concern
Publication date: October 2020Source: Brain, Behavior, and Immunity, Volume 89Author(s): Fernando Lopes, Fernando A. Vicentini, Nina L. Cluny, Alexander J. Mathews, Benjamin H. Lee, Wagdi A. Almishri, Lateece Griffin, William Gonçalves, Vanessa Pinho, Derek M. McKay, Simon A. Hirota, Mark G. Swain, Quentin J. Pittman, Keith A. Sharkey
BEST supplements to relieve joint pain: Is your arthritis playing up? The wetter and colder months could partially be to blame. These two pills may help.
Authors: Kim H, Lim YM, Lee EJ, Kim HW, Ahn HS, Kim KK PMID: 33029979 [PubMed]
CONCLUSIONS: More than half of the iIONP patients had an enhanced oculomotor nerve in MRI. A few of them also had elevated CSF IgG synthesis rate, but no further evidence for inflammation was found. The administration of steroids seemed to have no benefit other than increasing the blood glucose level. PMID: 33029972 [PubMed]
Publication date: Available online 10 October 2020Source: Journal of Acupuncture and Meridian StudiesAuthor(s): Natália Freire Valente, Eliezer de Sousa Cardoso, Juliana Alencar da Silva Resende, Jeferson Antônio Santos
CONCLUSION: When gastroenterologists encounter NAFLD/NASH patients, serum CK should be verified. If hyperCKemia, frontal baldness, a hatched face, history of cataract surgery, and grip myotonia are noted, the possibility of MD may be considered. PMID: 33033573 [PubMed]
Authors: Kim MS, Moon JS, Kim MJ, Seong MW, Park SS, Ko JS Abstract Hereditary fructose intolerance (HFI) is an autosomal recessive disorder caused by a mutation in the aldolase B gene. HFI patients exhibit nausea, vomiting, abdominal pain, hypoglycemia, and elevated liver enzymes after dietary fructose exposure. Chronic exposure might lead to failure to thrive, liver failure, renal failure, and, eventually, death. HFI usually manifests in infants when they are being weaned off of breastmilk. Because HFI has an excellent prognosis when patients maintain a strict restrictive diet, some patients remain undiagnosed du...