Targeting the people who need it most
This study provides some support for using single item questions to identify those who need more in-depth assessment, and those who don’t need this level of attention. I like that! The idea that we can triage those who probably don’t need the whole toolbox hurled at them is a great idea.
Perhaps the New Zealand politicians, as they begin the downhill towards general elections at the end of the year, could be asked to thoughtfully consider rational distribution of healthcare, and a greater emphasis on targeted use of allied health and expensive surgery.
Deyo, R. A., & Mirza, S. K. (2016). Herniated Lu...
Source: HealthSkills Weblog - May 28, 2017 Category: Anesthesiology Authors: adiemusfree Tags: Assessment Back pain Chronic pain Coping strategies Interdisciplinary teams News Pain conditions Professional topics Research biopsychosocial disability healthcare rehabilitation self management treatment Source Type: blogs
There ’s Still Time to Participate in Clinical Decisions:...
There's Still Time to Participate in Clinical Decisions: Management of Sciatica via Now@NEJMPosted oninfosnack. (Source: Kidney Notes)
Source: Kidney Notes - April 3, 2017 Category: Urology & Nephrology Authors: Anonymous Source Type: blogs
New Clinical Decision Article: Management of Sciatica via...
New Clinical Decision Article: Management of Sciatica via Now@NEJMPosted oninfosnack. (Source: Kidney Notes)
Source: Kidney Notes - March 27, 2017 Category: Urology & Nephrology Authors: Anonymous Source Type: blogs
Some medications don ’ t help back pain as much as we thought
This study found that NSAIDs don’t work as well for back pain as many people think. However, it is not true (as stated by some headlines about this study) that NSAIDs were not effective at all. Some people did improve with these medications. The trick is figuring out in advance who is most likely to get better with NSAID therapy. We can’t yet do that very well.
Here’s my suggestion: if you take an NSAID for spinal pain (or just about any other pain), keep track of how you’re feeling. A “pain diary” is one way to do this. If you aren’t clearly better in a week or two, talk to your doctor about adjusting the do...
Source: Harvard Health Blog - March 2, 2017 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Back Pain Drugs and Supplements Pain Management Source Type: blogs
Balance
Managing wrote:This topic has nothing to do with your post I'm attaching it to. Since your experience has been so helpful in offereing some kind of "known" into our lives that follow your blog. . . I wonder if you will consider continuing your blog after your husband passes on?It sounds a little morbid and vouyeristic, but I suffer so greatly in two areas and one of them is I am sure I will never remember my husband as anyone other than who he is now; with all the anger and bad behavior. I don't want to remember him that way. So I wonder as you go through this process, if you discover that his earlier personality...
Source: Wife of a Diabetic - November 15, 2016 Category: Endocrinology Source Type: blogs
iTENS, a Nifty Transcutaneous Electrical Nerve Stimulator to Treat Pain
Transcutaneous electrical nerve stimulation (TENS) devices intended for consumers to use themselves are nothing new anymore. They’ve been even getting a bit stale, often looking similar and relying on pads that are individually connected by wire to the control unit. The iTENS, a product of an Ohio company by the same name, is a rethought and redesigned TENS unit that we took an opportunity to try for ourselves.
Seeing the iTENS for the first time may surprise previous users of similar devices because it’s tiny, has only three buttons on the front, and uses electrode pads that look like wings that clip on to the...
Source: Medgadget - September 6, 2016 Category: Medical Equipment Authors: Editors Tags: Exclusive Neurology Pain Source Type: blogs
Finding Pain Relief When There ’ s Potential for Addiction
I am a woman with a family history of addiction who is also in chronic pain. What if someday I need opioids to manage that pain?
First, two discs in my lower spine degenerated. Then, they herniated, both bulging out and impinging nerves, inciting an excruciating, sciatica-like pain that affected me around the clock. More than a year since my discs were damaged, pain has become my daily reality. I wake up stiff and sore as though I’ve just been hit by a car (having been hit by a car as a kid, I actually know what that feels like). The only thing I struggle with as much as the pain itself is finding the best way to treat i...
Source: World of Psychology - August 14, 2016 Category: Psychiatry & Psychology Authors: Psych Central Staff Tags: Addiction Health-related Personal Publishers The Fix Chronic Pain Drug Addiction drug counseling Epidemic Family History Laura Kiesel Medication Methadone opiods opioid addiction overdoses Pain Relief prescription drug ab Source Type: blogs
An E.R. Kicks the Habit of Opioids for Pain - The New York Times
Brenda Pitts sat stiffly in an emergency room cubicle, her face contorted by pain. An old shoulder injury was radiating fresh agony down to her elbow and up through her neck. She couldn't turn her head. Her right arm had fallen slack.
Fast relief was a pill away — Percocet, an opioid painkiller — but Dr. Alexis LaPietra did not want to prescribe it. The drug, she explained to Mrs. Pitts, 75, might make her constipated and foggy, and could be addictive. Would Mrs. Pitts be willing to try something different?
Then the doctor massaged Mrs. Pitts's neck, seeking the locus of a muscle spasm, apologizing as the pat...
Source: Psychology of Pain - June 12, 2016 Category: Anesthesiology Source Type: blogs
What Does Genetics Tell Us About Chronic Pain? - Relief: Pain Research News, Insights And Ideas
When the pain comes, Alina Delp retreats to air conditioning as soon as possible. What begins to feel like a mild sunburn will, if left unattended, turn into a raging, burning pain.
"It's this turbulent, violent sensation that feels electric and stinging," Delp says, describing the pain at its worst. "I've run out of the building screaming like a lunatic before because it's been so bad."
Delp has erythromelalgia, a rare condition in which a person's body (typically the feet and the hands, though Delp experiences pain all over) reacts to mild warmth as though it is on fire. Mild exertio...
Source: Psychology of Pain - May 10, 2016 Category: Anesthesiology Source Type: blogs
NICE rejects acupuncture for low back pain
Of all types of alternative medicine, acupuncture is the one that has received the most approval from regular medicine. The benefit of that is that it’s been tested more thoroughly than most others. The result is now clear. It doesn’t work. See the evidence in Acupuncture is a theatrical placebo.
This blog has documented many cases of misreported tests of acupuncture, often from people have a financial interests in selling it. Perhaps the most egregious spin came from the University of Exeter. It was published in a normal journal, and endorsed by the journal’s editor, despite showing clearly that acupunct...
Source: DC's goodscience - March 24, 2016 Category: Science Authors: David Colquhoun Tags: acupuncture Back pain NICE LBP Low back pain NSLBP Source Type: blogs
NICE rejects acupuncture for low back pain
Of all types of alternative medicine, acupuncture is the one that has received the most approval from regular medicine. The benefit of that is that it’s been tested more thoroughly than most others. The result is now clear. It doesn’t work. See the evidence in Acupuncture is a theatrical placebo.
This blog has documented many cases of misreported tests of acupuncture, often from people have a financial interests in selling it. Perhaps the most egregious spin came from the University of Exeter. It was published in a normal journal, and endorsed by the journal’s editor, despite showing clearly that acupunct...
Source: DC's goodscience - March 24, 2016 Category: Science Authors: David Colquhoun Tags: acupuncture Back pain NICE LBP Low back pain NSLBP Source Type: blogs
Why doctors should care where their patients live
In the last month, I have used the ICD-10 codes Z59.0 (homelessness), Z59.1 (inadequate housing) and Z59.9 (unspecified housing or economic problem) far more than I ever would have imagined. Several patients came into my urban clinic with varied chief complaints, including issues with uncontrolled asthma, chest pain, stress, worsening knee pain and sciatica. However, after listening and asking questions, I quickly realized that all of these initial complaints shared a commonality — distress about housing.
My first patient had recently left transitional veteran housing provided by Volunteers of America to get his own...
Source: Kevin, M.D. - Medical Weblog - March 21, 2016 Category: Journals (General) Authors: Venis Wilder, MD Tags: Conditions Primary care Source Type: blogs
NYTimes: Patients in Pain, and a Doctor Who Must Limit Drugs
Susan Kubicka-Welander, a short-order cook, went to her pain checkup appointment straight from the lunch-rush shift. "We were really busy," she told Dr. Robert L. Wergin, trying to smile through deeply etched lines of exhaustion. "Thursdays, it's Philly cheesesteaks."
Her back ached from a compression fracture; a shattered elbow was still mending; her left-hip sciatica was screaming louder than usual. She takes a lot of medication for chronic pain, but today it was just not enough.
Yet rather than increasing her dose, Dr. Wergin was tapering her down. "Susan, we've got to get you to five ...
Source: Psychology of Pain - March 17, 2016 Category: Anesthesiology Source Type: blogs
