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Category Archives: Chronic Pain

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Not all placebos are created equal

Posted on August 31, 2015 by RMoore

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 →

Posted in Chronic Pain, Medical Practice

Post-traumatic stress disorder and opioid use

Posted on August 11, 2015 by RMoore

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 →

Posted in Chronic Pain, Drug and Substance Abuse, Mental Health Issues

Urine drug screening

Posted on July 28, 2015 by RMoore

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 →

Posted in Chronic Pain, Drug and Substance Abuse, Formulary & Pharmacy Issues, Medical Practice

How often do acute opioids become chronic opioids?

Posted on February 16, 2015 by RMoore

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 →

Posted in Chronic Pain, Drug and Substance Abuse, Medical Practice

Methadone – a complex tool for pain management

Posted on December 22, 2014 by RMoore

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 →

Posted in Chronic Pain, Drug and Substance Abuse, Formulary & Pharmacy Issues, Medical Practice

Oh, my aching back

Posted on December 15, 2014 by RMoore

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 →

Posted in Chronic Pain, Formulary & Pharmacy Issues, Medical Practice

Epidural steroids for back pain

Posted on July 8, 2014 by RMoore

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 →

Posted in Chronic Pain, Medical Practice

Does physical therapy really do anything for knee OA?

Posted on March 20, 2014 by RMoore

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 →

Posted in Chronic Pain, Medical Practice

Follow-up on topical NSAIDs

Posted on December 23, 2013 by RMoore

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 →

Posted in Chronic Pain, Formulary & Pharmacy Issues, Medical Practice

Topical NSAIDs in the treatment of osteoarthritis pain

Posted on December 9, 2013 by RMoore

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 →

Posted in Chronic Pain, Formulary & Pharmacy Issues, Medical Practice

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