Lead author Nagy Mekhail, MD, PhD discusses the importance of neuromodulation, specifically a closed loop spinal cord stimulation system (SCS), for the management of chronic pain.
Spinal cord stimulation (SCS) with a closed-loop system that uses recorded evoked compound action potentials (ECAPs) is superior to a fixed-output, open-loop system for patients with chronic back and leg pain.
The Science of Cannabis Symposium welcomed both clinicians and legal experts and aimed to provide medical and legal education for healthcare providers who are considering the use of cannabis in their medical practice.
When traditional oral analgesics no longer control pain, some physicians are turning to alternative drug delivery methods that provide pain relief while avoiding systemic adverse effects.
Many patients with craniofacial pain syndromes such as trigeminal neuralgia, cluster headache, and migraine have an adequate response to pharmacologic therapies.
In recent years, the off-label prescription of antidepressants for the treatment of chronic pain has increased, along with evidence of their effectiveness and mechanistic underpinnings when used for this purpose. Depression is a common comorbidity among patients with chronic pain, and the use of these agents may alleviate symptoms of both disorders. Typically, however, significantly…
Interventional pain modalities provide alternative analgesia in patients who are intolerant of pharmacologic agents, have comorbidities that require multiple medications, or have pain refractory to oral medications.
The innovative use of fractionation of laser beam technology in dermatology has led to significant improvements in the treatment of burn scars, regardless of how mature.
Researchers found data that showed, regardless of the number of headaches reported in addition to insomnia that cognitive behavioral therapy is indicated as first-line treatment.
A substantial percentage of patients with primary headache disorders are unresponsive to standard pharmacologic therapies, with pain-free response rates of 45% at 15 minutes and 30% at 2 hours, following the use of rescue medications.1 Such findings, along with the range of side effects associated with these agents, highlight the need for novel treatment options…
A particular challenge in this population is the effective management of migraine during pregnancy and lactation while minimizing the risk for harm to the fetus.
Rates of marijuana use are especially high among men and women of reproductive age. How should physicians advise patients who are trying to conceive about marijuana?
A 2013 Pew Research Center and Internet Life Project report found that 59% of US adults said that they turned to the Internet regarding a health problem during the past year.
As mortality rates associated with admission to the intensive care unit have decreased in recent decades, there has been increasing interest in the long-term negative consequences of critical care.
The American College of Physicians endorses the necessity of a comprehensive process for disclosure of potential conflicts of interest to ensure the integrity of clinical guidelines and guidance statements.
Benjamin Frush MD, a resident in internal medicine-pediatrics at Vanderbilt University Medical Center in Nashville, argues in favor of a role that physicians can play in integrating religion into their clinical practice. Rob Poole MB, FRCPsych, contends that physicians should never incorporate a religious element into clinical practice.
The therapeutic potential of cannabinoids to manage several clinical conditions, including pain, inflammation, sleep disorders, and epilepsy, is finding support through a growing body of evidence.
Chronic pancreatitis stems from a variety of pathogenic entities that result in chronic inflammation, fibrosis, and irreversible damage to the pancreas.
Increasing attention has focused on the use of multidisciplinary approaches that combine pharmacologic and integrative nonpharmacologic therapies for pain management.
Estimates indicate that ~1.4 million people self-identify as transgender in the United States, which is double the initial estimate is made by the Williams Institute in 2011.
The convenience and confidentiality of computer-based and mobile technologies may encourage more individuals with substance use disorders to access treatment.
A particular challenge in this population is the effective management of migraine during pregnancy and lactation while minimizing the risk for harm to the fetus.
As part of current efforts to reduce unnecessary opioid consumption, clinicians have increasingly prescribed gabapentinoids for a range of pain disorders.
The increased opioid use has been associated with a rising incidence of opioid-induced endocrinopathy, most commonly in the form of androgen deficiency.
Researchers found data that showed in patients with rheumatoid arthritis, the delta-tetrahydrocannabinol found in medical cannabis is likely to contribute to an increase in heart rate in patients who are susceptible to atherosclerosis and cardiovascular disease. Medical cannabis was also not found to provide therapeutic effects when comparing it with a combination of cannabinoid type 1 antagonist, fatty acid amide hydrolase inhibitor, and nonpsychotropic cannabidiol.
Researchers found data that in adults who had headaches as children, cognitive and psychomotor ability are compromised. In a Norwegian study, it was found that attention deficits were associated with migraine and nonclassifiable headache in patients aged 15 to 17 years. Metacognitive skills and anxiety, depression, motivation, academic performance, human social interactions, and stress symptoms are common headache triggers that researchers posit can be controlled and monitored by patients.
Researchers found data that support intervention in chronic migraine for both the mother and child as headache frequency in children correlates with that of their mothers.
Researchers found data that showed in patients with rheumatoid arthritis, the delta-tetrahydrocannabinol found in medical cannabis is likely to contribute to an increase in heart rate in patients who are susceptible to atherosclerosis and cardiovascular disease. Medical cannabis was also not found to provide therapeutic effects when comparing it with a combination of cannabinoid type 1 antagonist, fatty acid amide hydrolase inhibitor, and nonpsychotropic cannabidiol.
The epidemic of opioid use disorder has led to substantial increases in new cases of HCV and HIV infection, as well as hospitalizations for other OUD-related infections.
Researchers found data that showed, after consultation with an expert, optimal prevention of migraine headaches for patients who present in the emergency department includes both antiseizure medications, specifically, divalproex sodium, sodium valproate, or topiramate, and β-blockers, namely, metoprolol, propranolol, and timolol. In addition, triptans are suggested, as well as antidepressants, amitriptyline, and venlafaxine.
Approximately half of the 14% of Americans who have severe headache and migraine report having tried interventions such as meditation, yoga, and deep breathing exercises.
As rates of physician burnout continue to climb, a diverse group of researchers weigh in on enhancing resilience and particularly emphasize enlightening educators about how resilience develops during residency.
Researchers found that intranasal lidocaine is effective in the treatment of acute migraine and cluster headache because of its ability to block the sphenopalatine ganglion, which is associated with facial pain from the trigeminal nerve.
When politicians attempt to make changes to health policy based on sentiments rather than on evidence-based conclusions, physicians often find themselves trying to meet unrealistic expectations.
A team of investigators from both Brigham and Women’s Hospital and the Massachusetts Institute of Technology analyzed data on thousands of inactive ingredients in approved medications to further characterize them and enhance our knowledge of their safety.
In an interview with Neurology Advisor, Robert Cowan, MD, FAAN explains how thunderclap headache may be the only early warning sign of vascular changes or brain injury.
In 2015, 1 in 20 adults in the United States experienced a diagnostic error every year; yet by the beginning of 2019, nothing had been done to improve the situation.
An estimated 25% of children and adolescents report having pain that persists for more than 3 months, with severe and disabling pain affecting 8% of this population.
In a draft report issued December 28, 2018 by the US Department of Health and Human Services-sponsored Pain Management Best Practices Inter-Agency Task Force, recommendations for a multidisciplinary approach to pain management were formulated.
Although it is estimated that more than 166 million Americans use dietary supplements, many healthcare providers are unfamiliar with how these substances are regulated by the US Food and Drug Administration.
Considering individual patient factors, effects of aging, and using online tools for drug interactions will aid in treatment of migraines in the elderly.
Conventional approaches to treatment of opioid-induced constipation include the use of treatment modalities that address non-opioid-related constipation as well as new medications that target the OIC mechanism of action.
This rise in prescribing of prescription opioids in the last 2 decades of the 20th century occurred at a time during which medical professionals were urged to resort to prescription opioids to manage untreated and chronic noncancer pain.
To shed light on issues of cybersecurity in medical practices, MPR spoke to Michael J Sacopulos, JD, CEO of Medical Risk Institute (MRI), a firm that provides “proactive counsel” to the healthcare community to identify where liability risks originate and to reduce or remove those risks.
There are many procedural treatments for migraine that are effective and safe, including peripheral nerve blocks, trigger point injections, botulinum toxin injections, and sphenopalatine ganglion blocks.
The use of neuroimaging as a diagnostic tool remains at the discretion of the clinician, necessitating more research to improve clinical understanding of primary and secondary headaches.
A study by the National Survey of Drug Use and Health (NSDUH) found that from 2002-2014 the proportion of adults aged 50 to 64 who reported cannabis use in the past year more than tripled from 2.9% to 9.0%. Among adults age 65 or older, there was more than a ten-fold increase (from 0.2% to 2.1%).
The continued observation of this delayed headache syndrome may point to a different pathophysiology from tension-type headache or acute poststroke headache.
The guideline formulated by the Centers for Disease Control and Prevention in an effort to curb opioid overdose-related deaths included a recommendation for steep reductions in opioid doses for patients taking high doses of the drug for chronic pain.
Big data has enabled public health authorities to identify doctor-shopping patients and those who needed treatment for opioid abuse. The trade-off, however, could be patient and provider privacy.
The opioid system is responsible for social pain and reward in the brain; therefore, understanding its underpinnings may help clinicians manage patients with depression and suicidal ideation.
When alcohol and opioid addiction occur together, managing them concomitantly becomes challenging. Whereas some patients may not need medication for alcohol addiction, opioid abuse does require pharmacotherapy.
The perioperative management of pain in patients with opioid use disorders presents multiple challenges to clinicians. A recent review offered clinical guidance for various subgroups of these individuals.
Up to 85% of amputees experience phantom limb pain: sensations in the missing limb that patients may describe as burning, cramping, tingling, itching, stabbing, throbbing, or a feeling of “pins and needles.”
Data in children do support an association between pediatric obesity and headache disorders in general, but more research is needed to confirm the association specifically with pediatric migraine.
Emerging evidence indicates that the placebo effect can in some instances reduce patients’ pain. The current debate is whether clinicians need to disclose to patients that they are using placebos instead of active ingredients.
Bipolar disorder is often comorbid with substance use disorders, with alcohol being the top substance. Clinicians should take a thorough history to uncover substance use disorder because it will guide the management of both disorders.
Chronic, noninflammatory pain in children and adolescents encompasses a wide range of pain syndromes. Clinicians need to consider not only the physical manifestations of pain but also the psychosocial and academic impact of the child’s pain and impairment.
