Pain Management
From suffering to healing: the role of trauma in chronic pain
“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 …
The power of listening: a poem from a chronic pain patient to their doctor
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 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]
Pain management beyond prescription pills [PODCAST]
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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 …
How were we duped and what can we do about the opioid overdose crisis?
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 or illicit.
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
“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]
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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 …
Think twice before prescribing opioids as a first-line treatment for pain
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
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
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 …
Back to reality when it comes to pain treatment
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 any other health issues.
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
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 …
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The key to living with less pain is understanding what relieves pain, why it works, and how to achieve it
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 …
It’s time to address pain despite the opioid crisis
Have you ever felt as if your doctor wasn’t really listening to you or was just rushing through your appointment? Have you ever felt as if your doctor didn’t understand the pain you were in or didn’t take it seriously?
Most health care providers are evaluated based on the experience their patients had, and their payment is often based on those patient experience scores. A major component of patient …
How every doctor should address a patient’s pain
From medical school to residency, I’ve worked with colleagues who don’t prescribe pain medications for their patients who truly need them. Or they are just very hesitant about doing so. Some simply don’t believe in them. Others fear the legal implications like being named to a med mal or wrongful death lawsuit. And several avoid pain meds, specifically opioids, like the plague because of possible addiction risk even when their …
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We must disrupt harm
In the mid-1980s, with the AIDS epidemic on the horizon, austere conservative Margaret Thatcher sanctioned the first needle exchanges in the U.K. to prevent the budgetary burden that HIV might otherwise have become on the National Health Service. Nearly forty years later, New York City opened its first supervised injection sites in November of 2021, where intravenous drug users inject their substances of choice under the watchful eye …
Treating pain without medication [PODCAST]
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“In my medical training, we were taught five ways to treat pain: lifestyle modifications, physical therapy, medications, injections, and surgery. Lifestyle modifications are positive changes in diet, exercise, sleep, and stress levels. This is the first-line treatment for painful inflammation. Yet we tend …
Allow patients to continue their opioid of choice while starting microdoses of buprenorphine
Twenty-six hours into the shakes, sweats, crawling anxiety, and gripping nausea of opioid withdrawal, Faye caves in and takes a couple of fentanyl tabs. She knows that she must tough out a couple of days without fentanyl to start Suboxone (buprenorphine/naloxone) through a medication-assisted treatment program, but the sickness gets the better of her. Those couple of tablets reset the clock on her withdrawal.
Starting buprenorphine – an evidence-based …
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Current pain treatments and their deficiencies
An excerpt from The Pain Solution: 5 Steps to Relieve and Prevent Back Pain, Muscle Pain, and Joint Pain without Medication.
The U.S. health care system is designed to handle emergencies. It manages life-threatening heart attacks and acute fractures well. Thankfully, it saves lives. But most ongoing medical conditions …
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