Suspecting that this phenomenon might be the source of my nighttime pain, causing significant REM sleep deprivation, I reasoned that a neuromodulator such as a gabapentinoid might be helpful.
One physician assistant reflects on an important lesson in listening closely to your patients and why it is important to not jump to conclusions when making a diagnosis.
A recent bill passed in the US House of Representatives proposes a number of changes to malpractice liability rules, including a $250,000 cap on non-economic damages.
Aetna will have access to data on pharmaceutical usage patterns that will give the company the opportunity to figure out who is willing to pay more for healthcare. What does this mean for patients?
One physician shares his thoughts on whether wearable fitness technology is benefiting our health.
One physician shares his thoughts on how conscious and unconscious thinking can help making difficult medical decisions.
Decision support systems in clinical settings can dramatically decrease the time and manpower needed to perform a variety of tasks, but are they more harmful than helpful?
From helping patients with opioid addiction to finding pain management programs, one physician shares his experience with chronic pain management in the primary care setting.
Evidence of the streetlight effect can be found across several fields, in which cases investigators draw suspect conclusions from analysis of irrelevant data.
One physician shares his insights on the culture of overprescribing medications and how prescribing habits are reflective of swindling by the pharmaceutical industry
Two physicians offer their opinions on June’s Legal Advisor from Clinical Advisor about a female nurse that was fired for falling asleep while on duty in a hospital.
The natural curiosity provoked by looking at research and clinical care with a sense of wonder may help us find new ways to deal with old problems and, in turn, improve care for our patients.
A physician reflects on an early lesson he learned in humility.
Setting aside time for exercise can make you a better physician by increasing your confidence to counsel patients and your perceived success to do so.
There is a lot you can learn from your patients that was never taught at medical school.
A primary care physician reflects on the advice he has provided patients over the years.
Ingredients in energy drinks are contributing to adverse cardiovascular events, including angina and myocardial infarction.
A physician’s insights on the growing vape market and whether or not vaping is a better option for smoking cessation.
A physician reflects on his past medical missions to Haiti and shares what he could have done differently to make it a more satisfactory trip for him and his patients.
An example of a simple use of technology that not only averted the inconvenience and discomfort for the child of a trip to the ER, but also avoided exposing him to additional illnesses and avoided exposing others to what he had.
The smartphone was made for doctors, and there aren’t enough hours in the day to sing its praises.
The very first thing you learn in surgical residency is that you are not a primary care physician.
Some patients want the doctor with the most knowledge about their diagnosis and they could care less if he plays well with others.
If you want to survive today in primary-care medicine, you must have an extraordinarily low practice overhead.
When it comes to charting our outpatient medical records, I have certainly seen the full-spectrum over the last 25 years.
Over the course of my residency, challenging though it was at times, I was gradually transformed into a real doctor.
Much concern has been voiced regarding legislation allowing the substitution of biosimilars for branded drugs.
Opioid tolerance may be curbed by taking magnesium.
Healthcare reform, in its various permutations, has been a political hot potato since before 1993.
Calling a preoperative evaluation a “clearance,” in fact, belittles the purpose of the assessment, and provides little in terms of meaningful information to the surgeon.
From day one, the residents welcomed me with respect and support.
Patient evaluations performed through teleconferencing may lack the accuracy of an in-person physical exam.
Though there is no law that says patients must be told that the medications they have been prescribed are for an off-label use, and the FDA does not regulate the practice of medicine, I feel it is important to provide at least a brief explanation to my patients.
Katherine A. Roberts, MD, FACE, ECNU, discusses her experience with opting out of Medicare and offers advice to those considering doing the same.
Careful selection of surgical candidates can have an impact on neurologic recovery and quality of life.
While the lidocaine patch is still pharmacologic, it offers a different method of pain relief for patients.
If we invest in providing addiction treatment that is evidence-based and fundamentally invested in the dignity of every person who needs that treatment, a lot more people are going to find themselves ready to seek it out.
An antiviral that targets all the Herpes family virus successfully treated a patient with CFS.
“To write the program off saying it is too complicated or not worth it may be short-sighted,” Dr Shapiro concluded. “Almost anything that is incrementally beneficial to the practice financially becomes important in an era where there is pressure on declining reimbursement.”
“As [a member] of the NIH Task Force on pain, I would say that one of the things that’s important to show is that an interdisciplinary model and a multimodal approach are effective and cost-effective, as they certainly are expensive.”
Promoting public-private partnerships to maximize resources, knowledge-sharing, and expediency in treatment development, as a way to attract emerging and established researchers.
There is a lot of opportunity to improve on what can be offered to patients.
Huma Sheikh, MD, discusses stand-out presentations from the 2016 American Headache Society meeting
Changing the stigma around and frequency of injury in football requires a collaborative, educational effort involving all stakeholders.
Interventional pain therapies continue to play an important role for patients with chronic pain.
Psychologists have much to offer medicine as a profession, and pain medicine in particular.
Does your pain clinic currently allow the use of cannabis in combination with opioid medication? If so, has a maximum THC threshold been identified? How have your patients responded to such treatment?
This case study highlights discrepancies between physical and radiologic findings and physical limitations in a patient with cervical and lumbar pain complaints.
The correlation between mental health and how well chronic pain is controlled has been well established, and this particular case appears to demonstrate this relationship quite well.
Dr Conidi discusses some of the major points addressed in the blockbuster film that could impact clinical practice.
Gratitude can help people to become more social and develop deeper and healthier relationships, which in turn can improve their emotional health.
Keeping opioid prescribing to 200 mg/d morphine equivalent or less may provide a measure of safety.
The 2015 ASRA guidelines categorize procedures depending on their risk: high risk, intermediate risk, and low risk.
A patient with debilitating chronic pain experiences an altered level of consciousness following a bout of the flu. Could his high-dose opioid regimen be to blame?
Medical practitioners should always treat patients with respect, no matter how stressed or annoyed they are.
The tendency to overprescribe opioids and undertreat pain will swing back and forth until generalists and pain specialists can come to a common understanding about controlled substances and opioids.
Low back pain is one of the most common pain syndromes. In fact, about 69% of adults in the United States will have low back pain at some point in their lifetime.
The FDA approval of a pediatric indication for Oxycontin creates a safer situation for terminally ill children.
Clearing a patient for surgery is a clinician’s attempt to mitigate any side effects from occurring as a result of a surgical procedure
Two major symptoms of the function of TMJ problems are pain and dysfunction.
PAs and NPs often receive several job offers after graduation, but there is more to consider than just salary.
When forced to re-evaluate your career, forewarned is forearmed.
Videotaping becomes a problem when the intent is punitive.
Even though movement causing exacerbation of pain can happen with both somatic and visceral abdominal pain, asking patients to do a sit-up or a twister can identify trigger points in the rectus muscles and the obliques
Steven Croft, MD, lays down his reasons why ICD-10 will do more bad than good for physician and patient communities.
Finishing a fellowship means it’s now time to find the right job. Not every practice model is the the perfect fit for everybody, so it’s rather important for physicians to understand which structure will work best for them.
Many patients with back pain stop treatment due to dissatisfaction with treatment.
Postherpetic neuralgia is defined as pain persisting for more than three months after zoster’s onset.
There are key factors to consider when determining the best treatment strategy for pain in patients with cancer.
It is important to review the most recent data available before performing some of these options to make sure these techniques are not out of date.
There are many ways to assess pain in patients.
Welwyn Ardsley and the Cosmic Ninjas are on a quest to help you ease your pediatric patients’ fears of surgery.
Cocaine, heroin and marijuana are the most popular illegal drugs abused among seniors.
In one study of 3,000 twins, after adjusting for variables, twins who were overweight were more likely to report painful conditions.
Many of the pending codes are orthopedic in nature, which holds significance for clinicians dealing with patients with pain.
Although flouroscopy is still key, ultrasound has its place,
When dealing with a patient with a previous iodinated contrast agent reaction, pretreatment should be considered.
Investing in a “good chair” for the clinic, that encourages good posture, could help you avoid painful back problems.
Most of these systems have online videos, which can be very educational.
Opioid use in women of reproductive-age has been a hot topic in the news of late.
Take a closer look at your work, exercise, rest, and stress factors during a typical work week.
Study investigating treatment to improve sleep and address pain related to fibromyalgia and PTSD.
Patients who remain cheerful, despite personal drama, deserved to be recognized.
An essential part of our job as health care practitioners as one of bridge building; encouraging our patients to shorten the distance between the world of the ill and world of the well by enhancing connection.
Advancements in mobile detection technology allow immediate assessment, but can’t replace a medical professional’s diagnosis.
Since pain is a subjective experience for which there are no accurate objective measurements, patient-derived information regarding their pain experience is important to analyze
Perspective-taking is a way to help foster empathic feelings in observers and to help people when they are experiencing pain.
Ease pediatric patients’ anxiety about needles by talking with them about what to expect.
Concussions resulting from contact sports injuries can impact cognition, behavior and mood.
All too often, physicians, coaches, and athletes are swayed into making a quick conclusion after a hard hit.
Key features include: concise daily news, drug monographs, full length clinical features, continuing medical education courses, and coverage from major conferences.
Many medical centers are now developing multi-professional teams who will identify patients likely to have post-op problems.
Oral malignancies can be associated with increased pain, but current research suggests that a cannabis-based medication may reduce this morbidity.
A night with inadequate sleep may result in increased pain the next day, which may disrupt sleep even further. Learn how to help patients break this detrimental cycle.