Living with pain is social: The Chronic Pain Couple book review
Over the past year or so I’ve kept returning to ‘the social’ part of our multifactorial pain experience.* Pain can be extraordinarily isolating, and our current sociopolitical emphasis maintains a focus on ‘what the individual should do.’ In New Zealand, our accident compensation legislation is a no-fault, 24/7 everywhere, all-the-time innovation but it falls short in critical areas. One is the continued focus on ‘physical findings’ to validate a diagnosis (and to show that the resultant impact on an individual is entirely due to a personal injury caused by accident), and the other...
Source: HealthSkills Weblog - February 25, 2024 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Coping strategies Professional topics Health pain management Therapeutic approaches Source Type: blogs
Beyond opioids: a new hope for chronic pain relief
Opioids work through the mu opiate receptors throughout the body and brain, dampening pain signals being sent through the peripheral nervous system and spinal cord. It also acts on the ventral tegmental area, causing the release of dopamine in the nucleus accumbens, creating a sensation of euphoria. It is this euphoric effect that seems to
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Beyond opioids: a new hope for chronic pain relief originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - February 21, 2024 Category: General Medicine Authors: L. Joseph Parker, MD Tags: Meds Pain Management Source Type: blogs
The difficult balance between evidence-based healthcare … and person-centred self-management
For decades I’ve been an advocate for evidence-based healthcare because the alternative is ’eminence-based healthcare’ (for healthcare, read ‘medicine’ in the original!). Eminence-based healthcare is based on opinion and leverages power based on a hierarchy from within biomedicine (read this for more!). EBHC appealed because in clinical practice I heard the stories of people living with chronic pain who had experienced treatment after treatment of often invasive and typically unhelpful therapies, and EBHC offered a sifting mechanism to filter out the useless from the useful.
Where has EBHC...
Source: HealthSkills Weblog - February 18, 2024 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Clinical reasoning Coping strategies Pain conditions Professional topics Research Science in practice pain management Therapeutic approaches Source Type: blogs
Fight Aging! Newsletter, February 19th 2024
This study aimed to explore the metabolic mechanisms and potential biomarkers associated with declining HGS among older adults. We recruited 15 age- and environment-matched inpatients (age, 77-90 years) with low or normal HGS. Liquid chromatography-mass spectrometry (LC-MS) and 16S ribosomal DNA (rDNA) gene sequencing were performed to analyze the metabolome of serum and stool samples and the gut microbiome composition of stool samples. Spearman's correlation analysis was used to identify the potential serum and fecal metabolites associated with HGS.
We assessed the levels of serum and fecal metabolites belonging to...
Source: Fight Aging! - February 18, 2024 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
The unseen battle: America ’ s veterans and the crisis of chronic pain
Since the Civil War, there have been seventy-four wars and conflicts America has fought in. But as bad as previous wars had been, there has never been anything in American history like the Iraq and Afghanistan wars. While America’s direct intervention against Germany and Japan lasted less than five years, the war on terror went
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The unseen battle: America’s veterans and the crisis of chronic pain originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - February 16, 2024 Category: General Medicine Authors: L. Joseph Parker, MD Tags: Meds Pain Management Source Type: blogs
Monocyte Population Differences with Age Following Bone Fracture
The innate immune system is involved in tissue maintenance and regeneration. That includes populations of monocytes, circulating innate immune cells in the bloodstream that enter damaged tissue to become macrophages. Monocytes are somewhat easier to catalog and study than is the case for macrophages. The former can be found in a blood sample, while the latter require a tissue sample. Researchers tend to follow the incentives attending the cost and availability of data, and thus we have examples like today's open access paper, in which the authors focus on circulating monocytes in the context of bone fracture.
You mi...
Source: Fight Aging! - February 14, 2024 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
Can we finally say goodbye to opioids? There may be new pain relief on the horizon.
In an article I recently wrote about a new calcium channel-blocking medication that could be effective in treating central chronic pain, I mentioned that medications like lidocaine block sodium channels to prevent the transmission of pain through the peripheral nervous system. I also said that these medications have limited use, usually just in the ER,
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Can we finally say goodbye to opioids? There may be new pain relief on the horizon. originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - February 13, 2024 Category: General Medicine Authors: L. Joseph Parker, MD Tags: Meds Pain Management Source Type: blogs
Let ’ s Think of Patient-Centered Care, Not Value-Based Care
This article explores some fundamental changes that could accompany this shift in terminology, revolutionizing how we handle data and patient interventions.
Engagement For Life
We know that maintaining health is an endeavor that takes years, even decades. A successful endeavor must survive the departure of clinicians who have built relationships with the patient, as well as the patient’s own geographic moves, changes of provider, and changes of insurance. Treatment recommendations should also be tailored to the psychology of each patient.
Is there a message in this exhortation for people working with data and healt...
Source: EMR and HIPAA - February 13, 2024 Category: Information Technology Authors: Andy Oram Tags: Analytics/Big Data C-Suite Leadership Communication and Patient Experience Health IT Company Healthcare IT Hospital - Health System Interoperability Chronic Care Management Patient Centered Care Patients Society for Participatory Medic Source Type: blogs
Circling back to supported self-management
I’ve been writing a bit about supported self-management over the last few months. Partly because it’s topical given that medications and exercise offer very small reductions in pain and disability, and people do have lives outside of swallowing a pill and doing 3×10 reps! And partly because it is what we end up doing. It is the bulk of what people living with pain use to have lives.
Self-management refers to a broad range of strategies people with pain use in their daily lives to help them live well. I’m aware of the multiple definitions that exist for self-management, and that the level of agreem...
Source: HealthSkills Weblog - February 11, 2024 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Coping strategies Pain conditions Professional topics Research Science in practice biopsychosocial Health self-management Source Type: blogs
Not all patients are on disability
A recent conversation with my sister inspired me to write this post. She is a physical therapist who often rants about how patients with chronic pain or chronic illness don’t work and are just on disability. I know she’s far from the only health care provider with the same belief. She and her coworkers spend
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Not all patients are on disability originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - February 11, 2024 Category: General Medicine Authors: Benita Talati Tags: Conditions Patients Primary Care Source Type: blogs
Guarding and flow: an observational study
This study is an observational study of physiotherapists watching videos of people with chronic low back pain doing movements. The movements are pretty decontextualised (ie they’re not integrated with everyday life activities) but they are the kinds of movement that people can find difficult. They were: reaching forward with arms horizontal in standing position (reach forward), bending down towards the toes in standing position (forward-bend), standing from sitting stand), and sitting from standing (stand-to-sit). The videos were of 10 people with low back pain, and were chosen from a larger set of 16 people all perf...
Source: HealthSkills Weblog - February 4, 2024 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Assessment Chronic pain Clinical reasoning Coping strategies Low back pain Physiotherapy pain management Research Source Type: blogs
Gene therapies for chronic pain?
Gene therapy is starting to come into its own, and it will change medicine more profoundly than anything that came before. Just like when antibiotics were discovered almost exactly a century ago, we are on the cusp of another revolution in medicine. One that is orders of magnitude greater than antibiotics. Recently, in China, five
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Gene therapies for chronic pain? originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - February 1, 2024 Category: General Medicine Authors: L. Joseph Parker, MD Tags: Meds Medications Source Type: blogs
EMDR therapy: From walk to wonder, unmasking trauma ’ s secrets
In 1987, Francine Shapiro went for a walk and discovered eye movement desensitization reprocessing (EMDR) as a therapeutic technique for traumatic experiences with lasting impact. Some thirty years later, with a substantial body of research confirming its efficacy, the mechanism of action remains a mystery. However, the treatment has expanded to focus on chronic pain,
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EMDR therapy: From walk to wonder, unmasking trauma’s secrets originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - January 31, 2024 Category: General Medicine Authors: Maire Daugharty, MD Tags: Conditions Psychiatry Source Type: blogs
Chest pain, ST Elevation, well-formed Q-waves, and infarction with peak hs troponin I over 1000 ng/L. Is it OMI?
A 60-something male presented stating that he had had chest pain that morning which awoke him from sleep but then resolved after several minutes. He has had similar pain in the past which he attributed to acid reflux. He has a history of untreated hypertension.He is pain free now.His systolic BP was 200.The patient is pain free at the time of this ECG:What do you think?The conventional algorithm said:SINUS RHYTHMANTERIOR MYOCARDIAL INFARCTION , PROBABLY RECENT [40+ ms Q WAVE AND/OR ST/T ABNORMALITY IN V3/V4]***ACUTE MI*** There are well-formed Q-waves in precordial leads. The T-waves are inverted.&nb...
Source: Dr. Smith's ECG Blog - January 31, 2024 Category: Cardiology Authors: Steve Smith Source Type: blogs
Book review: Your Pain Playbook by Helen Roome
There is an enormous missing link in pain management today. That link is, as I see it, how to translate from theory (decontextualised ideas) to daily life. To my life, to your life, to the unique and varied lives people living with pain had before their pain arrived.
Your Pain Playbook is written by Helen Roome, pain occupational therapist living and working in South Africa. The South African vibe runs through her book, giving this Kiwi a lovely taste of Helen’s country via the metaphors she uses – ever heard of the ‘Go-away bird’? It’s a bird that warns impala of impending danger and Hele...
Source: HealthSkills Weblog - January 28, 2024 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Book reviews, site reviews Coping strategies Chronic pain Occupational therapy pain management Source Type: blogs
