The placebo effect is a very powerful tool, and an intriguing window into the power of the human brain. This blog offered an illuminating post in the past on the power of placebos. We also carried a post on how placebos can mimic the immunosuppressive effect of cyclosporine. Attempting to use placebos in clinical practice is clearly skating out into the Continue reading
Traumatic stress is common in American life. 80% of adult Americans will experience one or more traumatic events in their lifetimes. Of these, 13% of women and 6% of men will develop post-traumatic stress disorder. Think of trauma as any event where one is Continue reading
Urine drug screens (UDS) are a valuable tool in our management of patients on chronic opioid therapy. However, the results can be misleading and clinical judgment is needed in interpreting results. Continue reading
Each individual who uses chronic opioids was at some point started for the first time on a prescription opioid. Often the problem was an episode of acute pain, such as a twisted ankle. Opioids may also have been newly started for a chronic pain problem, such as Continue reading
Methadone is a valuable tool for patients with chronic benign pain, but it is a medication with a complex pharmacology and potential dangers in prescribing. It is often used for patients who require a long acting pain medication when they have failed or have side Continue reading
A few months ago, I had to undergo an L5-S1 spinal fusion. Before surgery I had a number of epidural injections to try to avoid the surgery and several studies to clearly identify the offending nerve root level. Like most patients, I said “yes” to my doctors’ suggestions Continue reading
Treating chronic low back pain is frustrating. Often, first-line treatments like NSAIDs, physical therapy, hot packs, cold packs or, occasionally, muscle relaxers do not seem to work very well. At least, many of our patients voice frustration with the lack of efficacy of these treatments and want “something more” done to Continue reading
Let’s cut to the chase. Yes, it does.
If you’re having a busy day, feel free to exit out of our primary care blog now and resume your other activities. You’ve read the take-home message and you’re good to go.
If you have a few more minutes, feel free to read on. Continue reading
The following comments are from Bill Hunter, MD, Medical Director of Open Door Community Health Centers, based in Arcata with clinic sites in many Northern California communities:
I was confused by your recent blog post on topical NSAIDs Continue reading
Osteoarthritis pain is one of the more frustrating problems we primary care clinicians have to manage. It is a ubiquitous problem. It is a bothersome complaint. And treatment options are not great. NSAID’s can provide some relief, but Continue reading