It’s Time We Took Chronic Pain in Rheumatology Seriously

HealthDay News For early-career sports medicine candidates, about 40 percent of the procedures they perform may be outside of the sports medicine subspecialty, according to a study published online June 30 in the Journal of Bone & Joint Surgery. Paul M. Inclan, M.D., from Washington University in St. Louis, and colleagues used the American Board of Orthopaedic Surgery Part-II Case List database to examine practice patterns among oral examination candidates and dual fellowship-trained sports medicine candidates. The analysis included 3,298 applicants indicating completion of a sports medicine fellowship between 2003 and 2020. The researchers found that on average, sports medicine-trained candidates submitted 100.6 cases for review during the six-month case collection period: 58.6 percent sports medicine/arthroscopy cases; 29.1 percent trauma/general cases; 4.5 percent adult reconstruction cases; and 7.8 percent “other” cases per candidate. The proportion of sports medicine/arthroscopy cases did not change during the study period. Overall, 10.1 percent of individuals indicated a dual fellowship training. During the study period, the number of dual fellowship-trained candidates pursuing additional fellowship training in pediatrics and adult reconstruction increased, while the number of dual fellowship-trained candidates pursuing additional fellowship training in trauma decreased. “The average young surgeon’s practice is, realistically, that of a generalist surgeon with an emphasis on sports medicine,” the authors write. Abstract/Full Text (subscription or payment may be required)

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Pain – the main manifestation of many rheumatic diseases, but also the most underappreciated, leads to worse disease outcomes and affects the quality of life of patients.

Over the last decade or so, animal models and modern technology have highlighted the complex mechanisms that underlie chronic pain in rheumatology.

To get further insight on the various aspects of chronic pain, we speak with Don L. Goldenberg, MD, about its pathophysiology and diagnostic classification criteria for chronic pain conditions. Deeba Minhas, MD, provides a perspective on addressing implicit biases among patients with rheumatic disease and pain. 

Read the full transcript for this episode here.

Don L. Goldenberg, MD, is emeritus professor of medicine at Tufts University School of Medicine and adjunct faculty at the Departments of Medicine and Nursing at Oregon Health Sciences University in Portland. He was chief of rheumatology at Newton-Wellesley Hospital and professor of medicine at Tufts University School of Medicine from 1988 to 2016.

Dr Goldenberg has more than 150 peer-reviewed publications and has written 5 books on various medical topics. Dr Goldenberg is considered an international expert on fibromyalgia and related rheumatic disorders and has been interviewed in the New York Times, Boston Globe, The New Yorker, and appeared on The Today Show, and Good Morning America. He has been awarded the Marion Ropes Lifetime Achievement Award by the Massachusetts Arthritis Foundation in 2008, and was recognized as a Master by the American College of Rheumatology (ACR) in 2009.

Dr Goldenberg is also a section editor for Up to Date.

Deeba Minhas, MD, is a clinical assistant professor at the University of Michigan. She completed her rheumatology fellowship at Cedars-Sinai Medical Center. Her research focuses on pain mechanisms, nonpharmacologic pain management, and precision medicine approach to chronic pain and fatigue. Dr Minhas has received mindfulness-based stress reduction (MBSR) teacher training and is currently working on projects studying MBSR in back pain and rheumatoid arthritis pain interference. Dr Minhas is also interested in the social determinants of health effects on pain, access to care, opiate use, and cost related nonadherence.

Dr Minhas is also interested in the social determinants of health effects on pain, access to care, opiate use, and cost related nonadherence.

This article originally appeared on Rheumatology Advisor