Pain Consultations News

Managing pain in primary care

Managing pain in primary care

A FNP reflects on his experiences working with pain management patients prescribed opioids.

Brief intervention may be beneficial for adolescents with chronic pain

Brief intervention may be beneficial for adolescents with chronic pain

A combination of psychoeducation, cognitive-based therapy, visualization, and breathing exercises may represent a tolerable and readily accepted complementary therapeutic approach for adolescent patients with chronic pain.

Opioid use in middle-aged adults

Opioid use in middle-aged adults

Clinicians are in the unique position to educate and counsel middle-aged adults about their opioid use and influence strategies needed to provide effective pain control.

When patients need services that don't exist

When patients need services that don't exist

It can be difficult to care for complex patients when they need services that do not exist.

Pain during IUD insertion reduced with lidocaine nerve block

Pain during IUD insertion reduced with lidocaine nerve block

A 1% paracervical nerve block may be useful for reducing patient-reported pain during IUD insertion.

Opioids and naloxone for pain management

Opioids and naloxone for pain management

Co-prescribing naloxone and opioids in primary care is recommended for patients who have a high risk for opioid overdose.

Effects of cannabis treatment in adult patients with PTSD

Effects of cannabis treatment in adult patients with PTSD

Researchers found that cannabis may alleviate neuropathic pain, but is not associated with benefit for adults with PTSD.

The role of prescription habits in the opioid epidemic

The role of prescription habits in the opioid epidemic

Current surgical and prescribing practices may have a hand in exacerbating the nation's burgeoning opioid epidemic.

Clinicians may be overprescribing gabapentinoids for pain

Clinicians may be overprescribing gabapentinoids for pain

Gabapentinoids may be overprescribed, in part as a response to the opioid epidemic.

NASEM report outlines strategy to combat opioid epidemic

NASEM report outlines strategy to combat opioid epidemic

The FDA commissioned the report to provide an update on current evidence on research, care, and education in the pain field, and to identify actionable measures for the FDA to more adequately address the ongoing opioid epidemic.

CDC: Opioid prescription rate remains high, inconsistent in the United States

CDC: Opioid prescription rate remains high, inconsistent in the United States

However, the number of opioids prescribed decreased between 2010 and 2015.

Majority of opioid prescriptions are written for patients with mental disorders

Majority of opioid prescriptions are written for patients with mental disorders

Among the nearly 40 million Americans who have a mental health condition, about 19% use prescription opioids.

Opioids often prescribed to back pain patients with depression

Opioids often prescribed to back pain patients with depression

Researchers found that back pain patients are also more likely to get higher doses of opioids.

Use of ketamine for pain management and treatment of depression

Use of ketamine for pain management and treatment of depression

Ketamine may alleviate depression, pain, and adverse effects associated with opioid treatment.

Opioid use before TKA causes less pain relief

Opioid use before TKA causes less pain relief

Clinicians should consider limiting pre-TKA opioid prescriptions to optimize the benefits of TKA.

PA programs may need more focus on opioid prescribing practices

PA programs may need more focus on opioid prescribing practices

Many PA students and practicing PAs did not feel that their PA program adequately trained them to screen for opioid abuse.

Corticosteroids for sore throat: a mixed bag of results

Corticosteroids for sore throat: a mixed bag of results

Oral corticosteroids could be an alternative symptomatic treatment for acute sore throat, which is a significant burden in primary care and a source of inappropriate antibiotic prescribing.

Short-term oral corticosteroid use associated with increased risk for sepsis, venous thromboembolism

Short-term oral corticosteroid use associated with increased risk for sepsis, venous thromboembolism

Approximately 1 in 5 American adults use corticosteroids in the short term, which is associated with an increased risk for sepsis, venous thromboembolism, and fracture.

Mindfulness-based stress reduction may improve low back pain

Mindfulness-based stress reduction may improve low back pain

Mindfulness-based stress reduction was associated with short-term benefits for pain intensity and physical functioning.

Recommended dose of IV acetaminophen may be insufficient for multiple-trauma patients

Recommended dose of IV acetaminophen may be insufficient for multiple-trauma patients

Administration of acetaminophen at the recommended dosage yields serum concentrations below 10 µg/mL due to increased elimination.

Surgery patients may have higher risk of opioid addiction

Surgery patients may have higher risk of opioid addiction

Researchers found that some surgery patients may face a higher risk of becoming dependent on opioids.

Magnesium for patients taking opioids for pain

Magnesium for patients taking opioids for pain

Patients who are taking opioids can manage their tolerance by taking magnesium 500mg.

CDC's opioid guideline prompts clinician concerns

CDC's opioid guideline prompts clinician concerns

The recently released CDC guidelines on opioid prescribing remain a topic of debate.

Radiofrequency treatment effective for refractory chronic joint pain

Radiofrequency treatment effective for refractory chronic joint pain

Radiofrequency treatment is an effective option for treating refractory chronic knee, hip, and shoulder joint pain.

Perioperative care for acute pain management

Perioperative care for acute pain management

Patients with chronic pain who are hospitalized have a higher risk of morbidity and mortality, longer lengths of stay, and more frequent readmissions than patients without chronic pain.

Glucocorticoid injection offers relief for lower back pain

Glucocorticoid injection offers relief for lower back pain

At 1 month after the intervention, the percentage of responders was higher in the GC IDI group than the control group.

Opioid and benzodiazepine combination use significantly increases overdose risk

Opioid and benzodiazepine combination use significantly increases overdose risk

The drug combination significantly contributes to the overall population risk of opioid overdose.

Opioids for chronic pain: a new clinical guideline from the VA and Department of Defense

Opioids for chronic pain: a new clinical guideline from the VA and Department of Defense

The Veterans Administration and Department of Defense issue a clinical practice guideline regarding opioid therapy for chronic pain in veterans.

Could disrupted homeostasis cause headaches?

Could disrupted homeostasis cause headaches?

Dysfunction of the endocrine system may lead to various neurologic manifestations, including headaches.

Noninvasive treatment for low back pain: a new clinical guideline from ACP

Noninvasive treatment for low back pain: a new clinical guideline from ACP

The ACP has released 3 recommendations for the treatment of patients with acute, subacute, and chronic low back pain.

Intravenous lidocaine safe for reducing pain in ICU patients

Intravenous lidocaine safe for reducing pain in ICU patients

Intravenous lidocaine is safe for reducing pain in patients in the ICU with varying degrees of organ dysfunction.

NSAIDs have little effect for spinal pain

NSAIDs have little effect for spinal pain

The researchers estimated that only 1 in 6 patients gained a benefit from taking NSAIDs.

Migraine increases stroke risk in surgical patients

Migraine increases stroke risk in surgical patients

Surgical patients with a history of migraine have an increased risk of perioperative ischemic stroke and a higher 30-day hospital readmission rate.

Psychiatric, behavioral conditions linked to future long-term opioid use

Psychiatric, behavioral conditions linked to future long-term opioid use

Patients diagnosed with a prior psychiatric condition have increased odds of long-term opioid receipt than patients without these conditions.

Crizanlizumab reduces sickle cell-related pain

Crizanlizumab reduces sickle cell-related pain

Treatment with high-dose crizanlizumab resulted in an annual rate of sickle cell-related pain crises that was 45.3% lower compared with placebo.

Shared decision making boosts patients' knowledge of acute coronary syndrome risk

Shared decision making boosts patients' knowledge of acute coronary syndrome risk

The use of a decision aid in patients at risk of acute coronary syndrome increased patient knowledge about their risk.

Chest pain in a woman

Chest pain in a woman

A woman has a myocardial infarction after her chest symptoms are misdiagnosed as acid reflux.

American Chronic Pain Association issues toolkit for clinicians

American Chronic Pain Association issues toolkit for clinicians

The toolkit will provide healthcare professionals with adequate tools to manage their patients' pain.

Increased naloxone prices could affect rates of opioid-related mortality

Increased naloxone prices could affect rates of opioid-related mortality

Researchers identify strategies that could ensure access to naloxone.

Virtual reality game may help relieve phantom limb pain

Virtual reality game may help relieve phantom limb pain

Recent data suggests that a virtual reality game could reduce pain by as much as one-half.

Outpatient program may be effective for pain self-management

Outpatient program may be effective for pain self-management

A program based on cognitive behavioral therapy and physical exercise could improve pain self-management in patients with complex pain.

FDA approves new drug for postmenopausal pain during sex

FDA approves new drug for postmenopausal pain during sex

Intrarosa provides an additional treatment option for women with dyspareunia caused by vulvar and vaginal atrophy.

Lidocaine patches as an alternative pain solution

Lidocaine patches as an alternative pain solution

Lidocaine patches may be effective for patients who are in pain but are looking to avoid drugs that could be addictive.

Quality improvement intervention helps pain management for seniors in the ER

Quality improvement intervention helps pain management for seniors in the ER

Researchers conducted an examination in patients over 65 years with moderate-to-severe pain in an academic emergency department.

More than half of US citizens have a chronic health condition

More than half of US citizens have a chronic health condition

Conditions such as chronic disease, mental illness, or substance abuse commonly overlap with each other and with poverty, which contributes to poor health.

Barriers remain in patients' acceptance of naloxone use in primary care

Barriers remain in patients' acceptance of naloxone use in primary care

Patients would like more thorough conversations with their primary care physician over the use of naloxone.

Comparing treatments for pediatric migraines

Comparing treatments for pediatric migraines

No significant differences were observed among treatments for pediatric migraines.

Treatment costs lower with pregabalin vs gabapentin for peripheral neuropathic pain

Treatment costs lower with pregabalin vs gabapentin for peripheral neuropathic pain

The average total cost was lower for pregabalin treatment due to lower use of concomitant medications, fewer primary care visits, and fewer sick days.

Pain relief during labor may lower risk of postpartum depression

Pain relief during labor may lower risk of postpartum depression

Women who received epidural pain relief during labor had lower scores on the Edinburgh Postnatal Depression Scale.

Placebo treatments may help patients with chronic lower back pain

Placebo treatments may help patients with chronic lower back pain

Patients who knew they were taking a placebo pill still experienced less lower back pain.

DEA reverses plan to ban potential opioid alternative kratom

DEA reverses plan to ban potential opioid alternative kratom

After public opposition, the DEA has withdrawn its plan to classify the kratom plant as a schedule 1 substance.

Complementary health approaches frequently used for musculoskeletal pain disorders

Complementary health approaches frequently used for musculoskeletal pain disorders

Data from the CDC's National Health Statistics Reports show that more than half of adults in the United States have a musculoskeletal pain disorder.

Controversy over CDC guidelines on prescribing opioids for chronic pain

Controversy over CDC guidelines on prescribing opioids for chronic pain

Guidelines created in response to the opioid epidemic in the United States have caused controversy in the medical community.

Nonmedical use of prescription opioids in adolescence leads to substance use disorder symptoms in adulthood

Nonmedical use of prescription opioids in adolescence leads to substance use disorder symptoms in adulthood

Using medical or nonmedical prescribed opioids in adolescence may lead to alcohol, drug, and mental health disorders in adulthood.

Genetic vascular anomaly

Genetic vascular anomaly

A young Caucasian woman presented with complaints of years regarding pain in her feet but did not know the cause.

Massage therapy may be beneficial for surgical pain

Massage therapy may be beneficial for surgical pain

Massage therapy appears to be efficacious for reducing pain and anxiety in patients who are about to undergo or are recovering from surgical procedures.

Platelet-rich plasma SIJ injection cuts low back pain

Platelet-rich plasma SIJ injection cuts low back pain

The researchers found that patients who received the injection had significantly lower intensity of pain at six weeks and at three months compared with patients who didn't.

New treatments relieve pain for patients with cervical disc herniation

New treatments relieve pain for patients with cervical disc herniation

Patients who suffer from cervical disc herniation can find relieve in percutaneous nucleoplasty (PCN) and pulsed radio frequency (PRF).

The FDA approves first drug for Duchenne muscular dystrophy

The FDA approves first drug for Duchenne muscular dystrophy

Data showed an increase in dystrophin production that could predict clinical benefit among patients with DMD.

Neuropathic pain is reduced by pregabalin

Neuropathic pain is reduced by pregabalin

Pregabalin significantly improves pain irrespective of the time since pain onset.

Using neuroimaging in chronic pain management

Using neuroimaging in chronic pain management

Developments in functional, structural, and neurochemical imaging could help predict individuals with acute pain who are likely to progress to chronic pain.

Oxycodone/naloxone may be beneficial for managing pain after total knee replacement

Oxycodone/naloxone may be beneficial for managing pain after total knee replacement

Oxycodone/naloxone may provide effective analgesia and improve patients' ability to participate in physiotherapy.

Suboxone and methadone—our readers weigh in on the pros and cons

Suboxone and methadone—our readers weigh in on the pros and cons

Research has shown that use of suboxone and methadone, in conjunction with counseling, can be effective addiction treatment.

New guideline for managing kidney stones is released

New guideline for managing kidney stones is released

Guideline from the American Urological Association has been revised to incorporate the management of patients with staghorn renal stones.

Prescribing practices influence opioid dependency

Prescribing practices influence opioid dependency

Patients provided with at least 2 refills were 2.25 times more likely to develop an opioid dependency.

Medicare patients rarely prescribed buprenorphine-naloxone

Medicare patients rarely prescribed buprenorphine-naloxone

Addiction medicine specialists prescribed the most prescriptions for buprenorphine-naloxone.

Sedentary behavior linked to chronic pain in children

Sedentary behavior linked to chronic pain in children

Prepubertal children who regularly engage in sedentary behavior have an increased likelihood of experiencing various pain conditions.

Metamizole may be an acceptable alternative to NSAIDs

Metamizole may be an acceptable alternative to NSAIDs

Metamizole should be considered in patients with contraindications to NSAIDs.

ASCO issues guidelines for chronic pain in patients with a history of adult cancer

ASCO issues guidelines for chronic pain in patients with a history of adult cancer

Screening for pain at every visit is recommended, and management and treatment options are specified.

Alternative treatment options for chronic pain

Alternative treatment options for chronic pain

Ice is among alternative recommendations for treatment of chronic pain.

Appendicitis an important differential diagnosis in the elderly

Appendicitis an important differential diagnosis in the elderly

Older adults presenting with abdominal pain should be screened for appendicitis.

Chronic visceral pain management

Chronic visceral pain management

Pain management specialists may have an important role to play in the treatment of patients with chronic visceral pain.

State restrictions not associated with reduced opioid misuse among disabled adults

State restrictions not associated with reduced opioid misuse among disabled adults

The adoption of various state laws did not affect rates of opioid prescription or strength of dose.

Chest pain in ER patients rarely life threatening

Chest pain in ER patients rarely life threatening

Only 5.5% of ER patients are diagnosed with 1 of 6 life threatening conditions.

Parental management of child's postoperative pain

Parental management of child's postoperative pain

Despite being well-informed, many parents struggled to manage their child's postoperative pain.

Long-acting opioid therapy linked to increased mortality risk

Long-acting opioid therapy linked to increased mortality risk

Patients with chronic, noncancer pain who were treated with long-acting opioid therapy had a 1.6 times greater risk of death.

New opioid use common post-hospital discharge among Medicare beneficiaries

New opioid use common post-hospital discharge among Medicare beneficiaries

After an acute hospitalization, many Medicare beneficiaries submit pharmacy claims for opioid prescriptions.

Smartphone app helps circumvent unnecessary testing for chest pain in ED patients

Smartphone app helps circumvent unnecessary testing for chest pain in ED patients

The HEART pathway app provides doctors in the ED with a digital application an already proven method of assessment.

Naloxone coprescription reduces opioid-related ER visits

Naloxone coprescription reduces opioid-related ER visits

Patients on opioids for chronic pain who were coprescribed naloxone had 47% fewer opioid-related ER visits.

Many patients lack knowledge about NSAIDs and their risks

Many patients lack knowledge about NSAIDs and their risks

Despite the widespread use of NSAIDs to treat pain, many patients lack knowledge about these medications and their risks.

IV lidocaine plus amitriptyline has no impact in fibromyalgia

IV lidocaine plus amitriptyline has no impact in fibromyalgia

No difference was recorded between patients treated with lidocaine plus amitriptyline versus patients treated with acetaminophen and tramadol.

Chronic migraines may be linked to vitamin deficiencies

Chronic migraines may be linked to vitamin deficiencies

Researchers examined a possible link between vitamin D, riboflavin, coenzyme Q10, and chronic migraines.

For chronic low back pain, opioids only moderately effective

For chronic low back pain, opioids only moderately effective

For patients with chronic low back pain, opioids may provide some short-term relief but are unlikely to be effective within recommended doses.

Acceptance and commitment therapy effectively treats chronic pain

Acceptance and commitment therapy effectively treats chronic pain

Acceptance and commitment therapy can have positive outcomes in adults with chronic pain.

Chronic pain management in veterans

Chronic pain management in veterans

Chronic pain in veterans has been linked to mental health conditions and high use of healthcare resources.

Cannabinoids may provide moderate benefit for rheumatic conditions

Cannabinoids may provide moderate benefit for rheumatic conditions

Researchers found no serious adverse events related to treatment with cannabinoids.

Migraines may increase CVD risk in women

Migraines may increase CVD risk in women

Women who experience migraines had a 50% greater risk for developing major CVD.

FDA approves buprenorphine implant for opioid dependence

FDA approves buprenorphine implant for opioid dependence

Probuphine is the first buprenorphine implant approved for the maintenance treatment of opioid dependence.

Probiotics improve clinical, metabolic status in rheumatoid arthritis

Probiotics improve clinical, metabolic status in rheumatoid arthritis

After 8 weeks, patients with rheumatoid arthritis who took probiotics showed improvements in disease activity and metabolic health.

Pain complexities in rheumatoid arthritis

Pain complexities in rheumatoid arthritis

Nearly 12% of patients in remission from RA still experience clinically significant pain.

Migraine medications not linked to stroke risk

Migraine medications not linked to stroke risk

For patients with basilar or hemiplegic migraines, two common migraine medications do not increase the risk of stroke and cardiovascular events.

Effective strategies to prescribe opioids, provide pain relief in hospital settings urgently needed

Effective strategies to prescribe opioids, provide pain relief in hospital settings urgently needed

Clinicians in hospital settings need strategies in place to safely provide opioid pain relief to hospitalized patients.

Hospitalizations due to opioid abuse, dependence increasing significantly

Hospitalizations due to opioid abuse, dependence increasing significantly

Since 2002, the number of hospitalizations due to opioid abuse and dependence has increased by 72%.

Salivary duct stone

Salivary duct stone

After 36 hours, a patient with a salivary duct stone shows limited improvement.

Benefit of spinal manipulation not clinically meaningful

Benefit of spinal manipulation not clinically meaningful

Spinal manipulation patients experienced statistically, but not clinically significant, reductions in pain and disability.

Slippery elm: an effective anti-inflammatory agent

Slippery elm: an effective anti-inflammatory agent

Slippery elm may be beneficial for patients with GI complaints.

High fatigue common in psoriatic arthritis

High fatigue common in psoriatic arthritis

Nearly 50% of patients with psoriatic arthritis report elevated levels of fatigue.

Readers weigh in on non-narcotic treatment options for patients with musculoskeletal pain

Readers weigh in on non-narcotic treatment options for patients with musculoskeletal pain


Readers provide more suggestions for treating musculoskeletal pain.

Osteoarthritis: conservative treatment options

Osteoarthritis: conservative treatment options

Osteoarthritis is one of the most common problems encountered in primary care, and conservative treatment can improve patients' quality of life.

Non-narcotic analgesics for musculoskeletal pain

Non-narcotic analgesics for musculoskeletal pain

Which non-narcotic analgesics are best for treating musculoskeletal pain?

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