Pain management

American Society of Anesthesiologists & Padma Gulur, MD

Women may experience more pain than men, but receive less treatment for it

March 12, 2016Mar 12, 20163

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. That men and women are different has been discussed since Adam and Eve. That they experience and cope with pain differently has been consistently described in research studies.…

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

That men and women are different has been discussed since Adam and Eve. That they experience and cope with pain differently has been consistently described in research studies.

It is concerning, however, to learn that women may experience more pain than men, but receive less treatment for it.

In a study of …

It’s time for an honest conversation about pain management

Holly Clowers, MD

March 7, 2016Mar 7, 201623

Psoriatic arthritis can be a debilitating condition. It can lead to painful complications such as neuropathy. Its treatments can lead to complications such as shingles, which can leave a patient with continuing pain. Ehlers-Danlos Syndrome is for most patients a painful condition that leads to spontaneous dislocations, early arthritis, and frequent migraines. My husband and I have decades of experience between us in living with these conditions.

My husband and I …

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The interview before transferring to a new doctor

Hans Duvefelt, MD

February 3, 2016Feb 3, 20169

Today I met a man who wanted to interview me before transferring his records. He was about my age and seemed polite and pleasant enough. He told me his doctor of a dozen years had started to taper him off…

Today I met a man who wanted to interview me before transferring his records.

He was about my age and seemed polite and pleasant enough. He told me his doctor of a dozen years had started to taper him off his long-term narcotics after he reported some of them missing because of theft. He used to take the equivalent of about 1,200 mg of morphine per day for his back pain. …

The critical medical and moral stakes for all patients in pain

Jay Baruch, MD

February 1, 2016Feb 1, 20165

We, as a society, can’t ignore these numbers: over 47,000 human lives lost prematurely in one year from drug overdoses, a 7 percent spike over the previous year, with opioid painkillers and heroin driving much of this tragic surge. If this trend isn’t disturbing enough, four out of five new heroin abusers began their habit by abusing painkillers.

These numbers have faces. Caring for patients who abuse and …

American Society of Anesthesiologists & Anita Gupta, DO, PharmD

How physicians can curb the prescription opioid epidemic

December 31, 2015Dec 31, 201511

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. With the holiday season upon us, there is no better time to reflect on how we as physicians can better serve our patients -- not only in the…

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

With the holiday season upon us, there is no better time to reflect on how we as physicians can better serve our patients — not only in the treatments we provide — but in how we tackle growing health issues such as the overuse and abuse of prescription opioid painkillers.

The problem

The United States is facing …

There may be no bigger mystery than chronic pain

Sridhar Vasudevan, MD

November 27, 2015Nov 27, 20153

An excerpt from Multidisciplinary Management of Chronic Pain: A Practical Guide for Clinicians. In all of medicine there may be no bigger mystery than chronic, nonmalignant pain -- especially to those of us who treat it. Pain usually serves a…

An excerpt from Multidisciplinary Management of Chronic Pain: A Practical Guide for Clinicians.

In all of medicine there may be no bigger mystery than chronic, nonmalignant pain — especially to those of us who treat it. Pain usually serves a biological purpose, yet in chronic pain patients, pain symptoms seems to exist with little biologically useful purpose. We know that pain can be ignored by soldiers and first …

Pain management is personal

Pain management is personal

Val Jones, MD

November 4, 2015Nov 4, 20155

Most of my patients think about pain medicines in terms of the symptoms they treat. “This is my headache medicine, and this is my arthritis medicine,” they often say. Health care providers are more likely to categorize pain medicines by the way they work: some are anti-inflammatory, some affect nerve endings, and others influence how the brain perceives pain. But the truth is that no matter how you classify pain …

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Pain tolerance: A story of two patients

Pain tolerance: A story of two patients

Christopher Stookey, MD

September 21, 2015Sep 21, 201514

One thing I learned early on as a doctor is different people have different tolerances for pain. At one end of the spectrum, for example, I recall a woman who came to the emergency department with a small splinter in her foot. She arrived wailing in pain, and we had to take her back to a treatment room ahead of other patients because her howling was scaring the people in …

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After a drug overdose: Is it malpractice or murder?

Jennifer Gunter, MD

September 15, 2015Sep 15, 201515

Is a doctor guilty of malpractice or murder or is the patient responsible for his or her actions when there is a death by overdose? This is the question that a jury in Los Angeles will have to decide as…

Is a doctor guilty of malpractice or murder or is the patient responsible for his or her actions when there is a death by overdose?

This is the question that a jury in Los Angeles will have to decide as they are presented the facts in the case of Dr. Lisa Tseng.

The prosecution’s version is that Dr. Tseng handed out opioids like candy without any regard for standard of care. …

American Society of Anesthesiologists & Edward R. Mariano, MD

Now is the time for acute pain medicine specialists

September 12, 2015Sep 12, 20159

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Since September is Pain Awareness Month, it’s time to recognize that not all pain is equal. Chronic pain can be alleviated, but "acute" pain (sudden onset, brief in…

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

Since September is Pain Awareness Month, it’s time to recognize that not all pain is equal.

Chronic pain can be alleviated, but “acute” pain (sudden onset, brief in duration, often with an identifiable cause) must be eliminated. This requires a systems-based approach led by physicians dedicated to understanding the physiological processes associated with acute pain and investigating new ways to treat …

Is the crusade against pill mills turning into a witch hunt?

Steven Reznick, MD

August 16, 2015Aug 16, 201519

I care for a 65-year-old woman suffering from sarcoidosis affecting her lungs, her skin, her bones, her nerves, her blood chemistries, her kidneys, her colon and her mind. She has gone from an active spouse, mother, grandmother, tearing up the dance floors with her husband, to a home recluse calling friends to drive her to medical and care appointments while ambulating with …

It’s time for pain doctors to step it up

Shirie Leng, MD

July 13, 2015Jul 13, 2015

Fifteen months ago, the Federal Drug Enforcement Agency, or DEA for short, began an investigation in four states: Alabama, Arkansas, Louisiana, and Mississippi. The DEA was looking for illegal drug trafficking, as they do. But they were looking for prescription…

Forty-eight people were arrested, seven of them doctors. DEA …

Managing pain is a focus of medicine today. Here’s why.

Craig Chen, MD

July 11, 2015Jul 11, 201514

The scope of the problem Chronic pain is a health epidemic. Estimates suggest that up to a third of adults or a hundred million Americans live with chronic pain conditions that interfere with their work and life. From back pain…

The scope of the problem

Chronic pain is a health epidemic. Estimates suggest that up to a third of adults or a hundred million Americans live with chronic pain conditions that interfere with their work and life. From back pain to headaches to diabetic neuropathy, chronic pain is widespread and debilitating. These patients suffer tremendously, and societal consequences are significant; back pain is one of the most common causes of missing …

Pain control and abuse prevention: Doctors should take responsibility

James C. Salwitz, MD

June 25, 2015Jun 25, 201516

In the movies, pain is glorious. The runner pushing to the edge. The magic of childbirth. The soldier battles impossible odds to conquer. Pain? “Suck, it up, maggot, pain is nature’s way of telling you that you’re alive.” But, to…

For a patient suffering …

Please forgive us for prescribing controlled drugs to just about everybody

Janice Boughton, MD

May 25, 2015May 25, 20154

Lately I've had the opportunity to work in an outpatient clinic where the regular doctor is out sick for a prolonged period of time. It is a breathtakingly beautiful little community, with green hills and a crystal clear river. It…

Lately I’ve had the opportunity to work in an outpatient clinic where the regular doctor is out sick for a prolonged period of time. It is a breathtakingly beautiful little community, with green hills and a crystal clear river. It is also troubled by methamphetamine and prescription drug abuse.

The little clinic in town is unwittingly a partner in this crime. Like …

Will the pendulum of pain management swing too far?

Elaine Khoong, MD

March 19, 2015Mar 19, 20156

They say that the path to hell is paved with good intentions. Few things in medicine illustrate that as well as how we've approached chronic pain management in the past 10 to 20 years. The advances that we have made…

They say that the path to hell is paved with good intentions. Few things in medicine illustrate that as well as how we’ve approached chronic pain management in the past 10 to 20 years.

The advances that we have made in medicine in the past few decades have been truly remarkable. But, unfortunately, pain is one of the ailments we still do not treat well. One of the difficult aspects of …

Vincent DeGennaro, Jr., MD, MPH

The prescription painkiller epidemic has changed the face of medicine in America

March 8, 2015Mar 8, 201519

“The patient’s pain is still 9/10, doctor. We’ve already given morphine IV and then changed to Dilaudid IV and then we increased the dose of Dilaudid. Can we give it every two hours instead of every three hours?” the nurse asks me over the telephone. I sigh heavily into the receiver, unsure what to do, feeling more like a drug dealer than a doctor. The patient is on horse-sized doses …

How the health care system is making pain patients worse

Sridhar Vasudevan, MD

March 3, 2015Mar 3, 201515

Over 100 million Americans suffer from chronic pain such as spinal disorders (lower back pain, disc disease, pinched nerves and neck pain), complex regional pain syndrome, fibromyalgia and headaches. The cost of chronic pain in human suffering, lost worker productivity…

Yet despite newer, expensive and invasive treatments like spinal fusions and disc surgery, spinal cord stimulators, steroid and painkiller injections, nerve “burning” and of …