Pain management

Jane Ballantyne, MD & Mark Sullivan, MD

It’s time to replace the 0 to 10 pain intensity scale with a better measure

May 7, 2023May 7, 20235

Adapted from The Right to Pain Relief and Other Deep Roots of the Opioid Epidemic. Published by Oxford University Press in January 2023. The 0-to-10 pain intensity scale that has become a familiar feature of clinical care had its origin…

Adapted from The Right to Pain Relief and Other Deep Roots of the Opioid Epidemic. Published by Oxford University Press in January 2023.

The 0-to-10 pain intensity scale that has become a familiar feature of clinical care had its origin in experimental psychophysics studies that investigated the relationship between noxious stimulus intensity and pain experience. In acute postoperative care, this scale may have improved pain control in the days immediately …

Physician voices

The powerful bond that overcomes the toughest challenges

LaBianca Wright, MD

May 2, 2023May 2, 2023

Towards the end of a busy clinic afternoon, I felt my phone buzz with a page in my jacket pocket. It is rare to receive pages on our phones in the middle of the day because we usually get messages…

Towards the end of a busy clinic afternoon, I felt my phone buzz with a page in my jacket pocket. It is rare to receive pages on our phones in the middle of the day because we usually get messages through the EMR or direct calls to the office. I called back the number to the sound of an exasperated ER doctor who had been trying to reach the PCP …

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Telemedicine in the opioid crisis: a game-changer threatened by DEA regulations

Julie Craig, MD

March 27, 2023Mar 27, 2023

In March 2020, I was directing a federally qualified health center in rural New Mexico when the first flashover of COVID ripped through the state. In two days, the clinics transitioned from an entirely in-person model to a near-total remote model. The transformation was raw and unplanned, trialing mediocre communications platforms in real-time and stumbling through the vagaries of electronic prescribing. As we got our feet under us, unexpected upsides …

The real cause of America’s opioid crisis: Doctors are not to blame

Richard A. Lawhern, PhD

March 22, 2023Mar 22, 202319

We've all heard about America's so-called "opioid epidemic." Nearly 100,000 people died in 2021 of causes that included overdose by one or more narcotic drugs and often alcohol. We also hear assertions from anti-opioid advocates that this epidemic was caused…

We’ve all heard about America’s so-called “opioid epidemic.” Nearly 100,000 people died in 2021 of causes that included overdose by one or more narcotic drugs and often alcohol. We also hear assertions from anti-opioid advocates that this epidemic was caused by doctors “over-prescribing” opioid pain relievers to their patients. These assertions are fundamentally wrong on fact. U.S. national health care policy and law redirections are needed to correct such distortions.

Doctors …

Critical thinking in pain management [PODCAST]

March 7, 2023Mar 7, 2023

In this episode, we welcome special guest Ronald A. Zent, a family physician, to discuss the ongoing opioid crisis. With a fourfold increase in opioid prescriptions and overdose deaths from 1999-2010, Ronald shares his insights on how the medical community…

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From suffering to healing: the role of trauma in chronic pain

Cindy Perlin, LCSW

February 28, 2023Feb 28, 20234

"Trauma is perhaps the most avoided, ignored, belittled, denied, misunderstood and untreated cause of human suffering." - Peter Levine, PhD, Developer of Somatic Experiencing Therapy One frequent cause of treatment-resistant chronic pain is unresolved trauma, yet few health care providers…

“Trauma is perhaps the most avoided, ignored, belittled, denied, misunderstood and untreated cause of human suffering.”
– Peter Levine, PhD, Developer of Somatic Experiencing Therapy

One frequent cause of treatment-resistant chronic pain is unresolved trauma, yet few health care providers and patients are aware of the connection, and, as a result, it is rarely addressed. This leads to considerable unnecessary suffering and misguided attempts at pain treatment that often do more harm …

Physician voices

The power of listening: a poem from a chronic pain patient to their doctor

Aaron Morgenstein, MD

February 25, 2023Feb 25, 2023

Per the CDC, 11 to 40 percent of Americans struggle with chronic pain. All physicians must treat patients with chronic pain, whether they are spine surgeons or primary care physicians. It is a disease we can not escape. We do…

We do not have a one-time pill to fix chronic pain.

Unlike other diseases, we do not necessarily have a cure for chronic pain. In medical school and residency, we are provided with …

Opioid addiction: Understanding the risk factors with a predictive model [PODCAST]

February 11, 2023Feb 11, 2023

In this episode, we're discussing the opioid epidemic and its impact on our society. Our guest is Gary Call, a family physician, who shares the emotional and financial cost on individuals and families caused by opioid addiction and overdoses is…

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In this episode, we’re discussing the opioid epidemic and its impact on our society. Our guest is Gary Call, a family physician, who shares the emotional and financial cost on individuals and families caused by opioid addiction and overdoses is immense and impacts everyone. We’ll also be discussing the latest research …

Pain management beyond prescription pills [PODCAST]

January 31, 2023Jan 31, 20232

In this episode, we welcome Cindy Perlin, a licensed clinical social worker and chronic pain survivor, to discuss the ongoing issue of prescription painkiller abuse and the dangers of relying on medication to treat pain. Research shows that physicians continue…

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How were we duped and what can we do about the opioid overdose crisis?

Ronald A. Zent, MD

January 13, 2023Jan 13, 20232

Who among us as physicians and prescribers, not to mention the millions of families who have been affected and suffered deep personal loss due to the current crisis and record overdose deaths, regardless of whether the opioid was legally written…

Let’s take a step back in time and review. As physicians, how have we been duped? Now the CDC has come up with recent new guidelines on opioid prescribing …

The promises and limits of a fentanyl vaccine

Julie Craig, MD

December 18, 2022Dec 18, 20222

"Fentanyl Vaccine a Potential 'Game Changer' for Opioid Crisis," declares a Medscape headline. "Fentanyl Vaccine Delivers Promising Results in Trial," reports an industry website. "A Vaccine Against Deadly Fentanyl Might Be Near," promises US News & World Report. Only the…

“Fentanyl Vaccine a Potential ‘Game Changer’ for Opioid Crisis,” declares a Medscape headline.

“Fentanyl Vaccine Delivers Promising Results in Trial,” reports an industry website.

“A Vaccine Against Deadly Fentanyl Might Be Near,” promises US News & World Report.

Only the fourth headline I encounter puts the news into proper perspective: “New Fentanyl Vaccine

…

Nutrition’s impact on pain and obesity [PODCAST]

December 15, 2022Dec 15, 2022

"Both pain and obesity can have a multitude of causes. Therefore, reducing pain and body weight should be approached in a multifactorial way; nutritionally, physically, mentally, and emotionally. Failure to do so may result in short-term success but long-term failure."…

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“Both pain and obesity can have a multitude of causes. Therefore, reducing pain and body weight should be approached in a multifactorial way; nutritionally, physically, mentally, and emotionally. Failure to do so may result in short-term success but long-term failure.”

Francisco M. Torres is an interventional …

Think twice before prescribing opioids as a first-line treatment for pain

Gary Call, MD

November 22, 2022Nov 22, 20224

Everyone knows the terrible toll the opioid epidemic takes on our society. It doesn't matter where you live and how wealthy or educated you are, no one is immune. I watched as a colleague tried to help a child struggling…

Everyone knows the terrible toll the opioid epidemic takes on our society. It doesn’t matter where you live and how wealthy or educated you are, no one is immune. I watched as a colleague tried to help a child struggling with addiction, spending countless hours of worry and thousands of dollars, only to have the child succumb to an accidental opioid overdose. The emotional and financial cost on individuals and …

It’s time for a reckoning in pain medicine

Cindy Perlin, LCSW

November 17, 2022Nov 17, 20222

More than a million Americans have died since the late 1990s from drug overdoses, with the vast majority dying from an opioid overdose. This trend started with the heavy marketing of opioids to physicians as nonaddictive and effective. The number of deaths from overdose has escalated significantly in the past few years. Although many of the recent opioid-related deaths are from fentanyl, substance abuse treatment providers report that …

We cannot ignore nutrition’s impact on both pain and obesity

Francisco M. Torres, MD

October 9, 2022Oct 9, 2022

An excerpt from Epigenetics and the Psychology of Weight Loss: How to Lose More Weight with Less Effort. We know that people with chronic pain are more likely to be obese; but does this happen because people with chronic pain…

An excerpt from Epigenetics and the Psychology of Weight Loss: How to Lose More Weight with Less Effort.

We know that people with chronic pain are more likely to be obese; but does this happen because people with chronic pain struggle to exercise and suffer from a high load of stress hormones which promote stress eating, or does it happen because obesity causes more wear and tear on joints, which …

Back to reality when it comes to pain treatment

Curtis G. Graham, MD

October 3, 2022Oct 3, 20227

Back in the 1980s, I had a longtime patient, age about 30, that came to my office for severe back pain. She previously had some mild back pain and had no orthopedic evaluation. Otherwise, she was in good health without…

She could barely walk upright, so I sent her to the orthopedic physician I normally referred my patients to the same day. He sent her back to …

We need to get real about chronic pain solutions

Ivica Ducic, MD, PhD

September 9, 2022Sep 9, 20222

For all the time and attention that's placed on whether opioids should be prescribed or even removed from the market, we must put equal – if not greater – emphasis on enhancing access to non-opioid pain treatments. Not prescribing opioids…

For all the time and attention that’s placed on whether opioids should be prescribed or even removed from the market, we must put equal – if not greater – emphasis on enhancing access to non-opioid pain treatments. Not prescribing opioids doesn’t solve or eliminate the root issue and reason many people are on painkillers to begin with—chronic pain.

Fifty million Americans live in chronic, debilitating pain. For many, their pain …

The key to living with less pain is understanding what relieves pain, why it works, and how to achieve it

Saloni Sharma, MD

September 1, 2022Sep 1, 2022

An excerpt from The Pain Solution: 5 Steps to Relieve and Prevent Back Pain, Muscle Pain, and Joint Pain without Medication. In a one-year period, more than 54 percent of Americans report musculoskeletal pain, including arthritis pain, low back pain,…

An excerpt from The Pain Solution: 5 Steps to Relieve and Prevent Back Pain, Muscle Pain, and Joint Pain without Medication.

In a one-year period, more than 54 percent of Americans report musculoskeletal pain, including arthritis pain, low back pain, and neck pain. The search for relief has created a different kind of epidemic. The opioids frequently prescribed for pain relief have created a crisis …