Roger Chou ’s Undisclosed Conflicts of Interest: How the CDC’s 2016 Guideline for Prescribing Opioids for Chronic Pain Lost Its Clinical and Professional Integrity
by Chad D. Kollas MD, Terri A. Lewis PhD, Beverly Schechtman and Carrie Judy“I ' m present. Uh … I do have a conflict. I receive funding to conduct reviews on opioids, and I ' ll be recusing myself after the um, director ' s, uh, um, um, uh … update.”- Dr. Roger Chou, Center for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control (NCIPC) Board of Scientific Counselors (BSC) Meeting Friday, July 16, 2021.IntroductionFor those familiar with the controversial relationship between the anti-opioid advocacy group, Physicians for Responsible Opioid Prescribing (PROP, recently renamed, He...
Source: Pallimed: A Hospice and Palliative Medicine Blog - September 17, 2021 Category: Palliative Care Tags: CDC judy kollas lewis opioid pain schechtman Source Type: blogs
Roger Chou s Undisclosed Conflicts of Interest: How the CDCs 2016 Guideline for Prescribing Opioids for Chronic Pain Lost Its Clinical and Professional Integrity
by Chad D. Kollas MD, Terri A. Lewis PhD, Beverly Schechtman and Carrie JudyI ' m present. Uh I do have a conflict. I receive funding to conduct reviews on opioids, and I ' ll be recusing myself after the um, director ' s, uh, um, um, uh update.- Dr. Roger Chou, Center for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control (NCIPC) Board of Scientific Counselors (BSC) Meeting Friday, July 16, 2021.IntroductionFor those familiar with the controversial relationship between the anti-opioid advocacy group, Physicians for Responsible Opioid Prescribing (PROP, recently renamed, Health Pro...
Source: Pallimed: A Hospice and Palliative Medicine Blog - September 17, 2021 Category: Palliative Care Tags: CDC judy kollas lewis opioid pain schechtman Source Type: blogs
Adam ’ s slow recovery
Not long ago I wrote about Adam Meakins back pain, and the astonishing response he’s had from fellow clinicians as he’s documented his recovery. Sadly, the polarised views of how therapists should approach a person with low back pain show me just how appallingly badly we adhere to low back pain guidelines… and worse, the kind of language and attitudes shown to a colleague who knows what he’s doing, demonstrates why change is so very slow.
What do I mean? Well, Adam has been following evidence-based low back pain guidelines that haven’t really changed a great deal since the advent of New Zea...
Source: HealthSkills Weblog - August 22, 2021 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Back pain Clinical reasoning Coping strategies Low back pain Occupational therapy Physiotherapy Professional topics Psychology Research Science in practice healthcare pain management Source Type: blogs
When therapists get hurt
“Physician, heal thyself” – usually used to suggest that the person should fix their own problems before trying to fix someone else. And when a therapist gets hurt all the armchair critics (social media proclamists) go off pointing the finger and telling that person what to do – even when the therapist is doing exactly what evidence suggests is the right thing to do.
Adam Meakins has hurt his back while lifting weights in the gym – he’s documenting his progress on social media, which I think is both a very brave thing to do and also something I’d love to see more of. If you want...
Source: HealthSkills Weblog - August 8, 2021 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Back pain Coping strategies Low back pain Pain conditions Professional topics Resilience/Health Science in practice pain management Source Type: blogs
When living with pain is too hard
Living with persistent pain can be really hard, and clinicians, family and the person with pain can be worried about suicidal thoughts and possible actions. There’s good reason to be concerned, too, as a recent study from the 2012 Canadian Community Health Survey shows.
Grocott, Sommer and El-Gabalawy (2021) used the data obtained from this Canadian Health Survey to explore the relationships between pain intensity and suicidality in people with arthritis, migraines and low back pain.
The first question is how many people in the overall population involved in this study had any of the three diagnostic groups &...
Source: HealthSkills Weblog - August 1, 2021 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Coping strategies Low back pain Pain conditions Professional topics Research biopsychosocial Clinical reasoning Health Suicidal thoughts Therapeutic approaches Source Type: blogs
Why I don ’ t trust my clinical reasoning: and why this matters
“See someone experienced” I hear people with pain say. “They’ll know what’s wrong with you.”
Well, based on the research I’ve read, I wouldn’t be so sure. In fact, I’m certain my own clinical reasoning is biased, prone to errors that I don’t notice, and influenced by factors that most clinicians would be horrified to think they, too, were influenced by.
Let me give you a few to ponder:
I’m interested in women and pain – and there’s a lot of evidence showing that women’s pain doesn’t get the same kind of diagnostic and managem...
Source: HealthSkills Weblog - July 11, 2021 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Interdisciplinary teams Occupational therapy Pain conditions Physiotherapy Professional topics Psychology Research Science in practice Chronic pain Clinical reasoning healthcare Source Type: blogs
The stigma of being a woman in pain
Women, it is often thought, must be much tougher than men when it comes to dealing with pain – after all, don’t women have babies without anaesthetic? Don’t men faint at the sight of a needle?
Ummmm, not quite so fast. Now before I begin, in this post I’m referring to cis-gender females, and in the experiments, participants were selected on the basis that they believed that negative gender discrimination was a thing. And as I write this post, I want to be clear that sometimes we have to begin with a very simplified model before research can be conducted on a much more messy cohort – and th...
Source: HealthSkills Weblog - June 20, 2021 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Assessment Coping strategies News Pain Pain conditions Research Science in practice female stigmatism women Source Type: blogs
“Tell Me More”
By HANS DUVEFELT
Words can be misleading. Medical terms work really well when shared between clinicians. But we can’t assume our patients speak the same language we do. If we “run with” whatever key words we pick up from our patient’s chief complaint, we can easily get lost chasing the wrong target.
Where I work, along the Canadian border, “Valley French” expressions tripped me up when I first arrived. The flu, or in French le flu (if that is how you spell it – I’ve never seen it in writing) is the word people use for diarrhea. Mal au cœur (heart pain) doesn’t mean angina or che...
Source: The Health Care Blog - May 17, 2021 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Patients Physicians Primary Care Hans Duvefelt health communication Source Type: blogs
Are antidepressants also pain relievers?
Did you know that antidepressant medications are often prescribed for people without depression?
It’s true. Antidepressants are frequently prescribed for chronic pain, especially pain related to nerve disease (called neuropathic pain), chronic low back or neck pain, and certain types of arthritis.
In fact, some guidelines for the treatment of chronic low back pain and osteoarthritis (the most common type of arthritis) include antidepressants. One antidepressant in particular, duloxetine (Cymbalta), is FDA-approved for these conditions.
Just how antidepressants reduce pain is not well understood. One possibility is they a...
Source: Harvard Health Blog - April 16, 2021 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Back Pain Bones and joints Health Osteoarthritis Pain Management Source Type: blogs
Tunable Vibrations Could be Key to Reducing Lower Back Pain
Researchers at the Nagoya Institute of Technology in Japan have developed a device that can diagnose and help to correct postural instability leading to back pain. The technique involves using vibration to stimulate sensory receptors that help the brain to perceive the position of the body in space, which is known as proprioception. The approach is based on the hypothesis that poor proprioception leads to postural instability and subsequent lower back pain.
Lower back pain is a very common affliction, particularly among older people, and can often seem unavoidable. The pain can be caused by postural instabi...
Source: Medgadget - April 13, 2021 Category: Medical Devices Authors: Conn Hastings Tags: Neurology Orthopedic Surgery Pain Management Rehab Sports Medicine Source Type: blogs
AppliedVR raises $29M to help make virtual reality the standard of care for treating chronic pain
AppliedVR Raises $29 Million for Immersive Headsets (LA Business Journal):
Century City-based AppliedVR, Inc. announced March 23 that it has raised $29 million in Series A funding that will be used to continue development of an immersive headset to help patients with chronic pain.
… The company is building a headset called EaseVRx that will display immersive environments like campfires, mountains and other animated nature scenes to help patients dealing with chronic pain, including fibromyalgia and chronic intractable lower back pain…
AppliedVR Chief Executive and co-founder Matthew Stoudt said that the pandemic h...
Source: SharpBrains - March 24, 2021 Category: Neuroscience Authors: SharpBrains Tags: Brain/ Mental Health Technology & Innovation AppliedVR chronic pain cognitive behavioral therapies FDA fibromyalgia headset mindfulness exercises pain treatment virtual-reality Source Type: blogs
Does pain change your brain?
I consult on many patients because they are suffering from pain. In fact, their pain is so severe that they are considering spinal surgery. More than 100,000 Americans decide to undergo surgery, and millions more have invasive procedures for low back pain or sciatica every year. You almost certainly know someone who has struggled with […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - March 21, 2021 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/marc-arginteanu" rel="tag" > Marc Arginteanu, MD < /a > < /span > Tags: Conditions Neurology Source Type: blogs
Modifying pain behaviour (2)
Two concepts that receive limited attention in the allied health literature are nomothetic and idiographic approaches. I’m discussing these concepts here because when we’re considering pain behaviour, I think we can focus much more on “generic” (nomothetic) concepts than we do idiographic ones – and yet we say we’re about the unique person in front of us.
Firstly, this site offers a good summary of the difference between nomothetic and idiographic – click
Essentially, nomothetic approaches focus on underlying generalities, perhaps traits, and are a solid part of the science o...
Source: HealthSkills Weblog - March 14, 2021 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Assessment Back pain Chronic pain Coping strategies Low back pain Motivation Professional topics Science in practice behavioral pain behavior rehabilitation relational frame theory Source Type: blogs
Hidden Anxiety Symptoms and How to Handle Them
You probably think of anxiety as a mental disorder, and it is. However, psychological distress might not be your first symptom. This condition has a habit of manifesting in sneaky ways.
Therefore, you need to use your mindfulness skills to recognize when things aren’t quite right. Here are six hidden anxiety symptoms and how to cope so you can get relief.
1. Intestinal Upset
Are you plagued with frequent stomach upset? If so, your fight-or-flight response might be the culprit. When you face danger, your sympathetic nervous system increases blood flow to your heart and muscles and away from your intestines as it ...
Source: PickTheBrain | Motivation and Self Improvement - March 2, 2021 Category: Consumer Health News Authors: Kara Reynolds Tags: depression featured happiness health and fitness psychology self-improvement anxiety mental health mental illness pickthebrain Source Type: blogs
Pain model – helping to target change
In my recent post on behavioural approaches to pain management, I had a number of commentators ask why do it, why not focus on pain intensity, and aren’t I invalidating a person’s experience if I target a person’s response to their experience. Today’s post will explore some of these points.
I suppose my first point needs to distinguish between pain as an experience, and pain behaviour – or what we do when we experience pain. I like to use a pretty old “model” or diagram to help untangle these concepts. It’s drawn from Loeser’s “Onion ring” model, and he w...
Source: HealthSkills Weblog - February 28, 2021 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Clinical reasoning Coping strategies Pain Pain conditions Therapeutic approaches models pain models Source Type: blogs
