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Pain Physicians (pain + physician)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Interpersonal Issues Between Pain Physician and Patient: Strategies to Reduce Conflict

PAIN MEDICINE, Issue 8 2008
Kate Diesfeld BS
ABSTRACT Objective., This article analyzes scholarship on the interpersonal challenges that pain physicians face, with an emphasis on strategies to reduce conflicts within therapeutic relationships. Results., Scholarship on the dilemmas pain physicians face suggests that 1) there are unique and perhaps unrecognized features of pain medicine that generate stress; 2) interpersonal conflict may contribute to stress; and 3) clinicians' biases may interfere with the doctor,patient relationship and with the best practice of pain medicine. Application of a framework based on clinicians' beliefs and Papadimos' reflections on justice and temperance may reduce such conflicts. Conclusion., The challenges of pain medicine may be complicated by the clinician's undisclosed attitudes regarding their roles and their perceptions of pain sufferers. A strategy for physicians to examine their beliefs within a supportive environment may aid physicians caring for people with chronic pain. Papadimos' reflections upon the virtues of justice and tolerance guide this analysis. [source]

Spinal Cord Stimulation Surgical Technique for the Nonsurgically Trained

NEUROMODULATION, Issue 2009
FRCP (C), Marshall D. Bedder MD
ABSTRACT The objective of this paper is to educate physicians who implant spinal cord stimulators in current surgical techniques. Many implanters have not gone through formal surgical residencies and learn their surgical techniques during a one year Fellowship or from proctoring experience. This paper utilizes current concepts from the literature to reinforce appropriate surgical practices, which are applicable to surgeons as well as interventional pain physicians. This should be a valuable resource for all Fellows whether they are in surgical programs or pain fellowship programs. In addition, a more detailed presentation is made at the end of this paper on a proposed simple one-incision surgical technique for implantation of small internal pulse generators. This is the first publication in the literature describing such a technique and may be useful for less-experienced implanters, as well as conferring potential advantages in surgical technique. [source]

Interpersonal Issues Between Pain Physician and Patient: Strategies to Reduce Conflict

Pulsed Radiofrequency: Current Clinical and Biological Literature Available

PAIN MEDICINE, Issue 5 2006
Alex Cahana MD, DAAPM
ABSTRACT Objective., Pulsed radiofrequency, where short bursts of radiofrequency energy are applied to nervous tissue, has been used by pain practitioners as a non- or minimally neurodestructive technique, alternative to radiofrequency heat lesions. Clinical advantages and mechanisms of this treatment remain unclear. The objective of this study was to review current clinical and laboratory data. Design., We systematically searched the MEDLINE database (PubMed) and tables of contents of electronically available pain journals. Reference lists of relevant reports and international scientific pain congress abstract books were also hand searched. Only those reports on pulsed radiofrequency were withheld. Results., The final analysis yielded 58 reports on the clinical use of pulsed radiofrequency in different applications: 33 full publications and 25 abstracts. We also retrieved six basic science reports, five full publications, and one abstract. Conclusions., The accumulation of these data shows that the use of pulsed radiofrequency generates an increasing interest of pain physicians for the management of a variety of pain syndromes. Although the mechanism of action has not been completely elucidated, laboratory reports suggest a genuine neurobiological phenomenon altering the pain signaling, which some have described as neuromodulatory. No side effects related to the pulsed radiofrequency technique were reported to date. Further research in the clinical and biological effects is justified. [source]

The Treating Physician as Expert Witness: Ethical and Pragmatic Considerations

PAIN MEDICINE, Issue 5 2006
Ben A. Rich JD
ABSTRACT Objective., The objective of this analysis is to apprise pain physicians of the ethical concerns and practical considerations that arise when a treating physician is called upon to testify as an expert witness in a legal proceeding involving his or her own patient. The provision of expert testimony in medico-legal proceedings has come under heightened scrutiny in recent years. When a physician testifies as an expert witness, such testimony is considered to be the practice of medicine, and hence subject to the same ethical and professional obligations as patient care. Increasingly, medical professional organizations have promulgated guidelines for such activities, and even implemented oversight mechanisms to review complaints concerning expert testimony by their members. Additional issues are raised when the expert witness is also the treating physician for the patient who is a party to the legal proceeding in which the expert testimony is offered. Conclusions., While it is not categorically unethical or inadvisable for a physician to testify as an expert witness in a medico-legal proceeding involving his or her own patient, such activity raises special issues and concerns. Prospective expert witnesses in such situations should be cognizant of these issues and insure that they have been adequately addressed before and during the testimony. [source]

Management of Pain in Addicted/Illicit and Legal Substance Abusing Patients

PAIN PRACTICE, Issue 1 2005
Aaron B. Rosenblatt MD
Abstract: Approximately one-third of the American population experiences chronic pain. This varies in origin and severity. It also has been documented that billions of dollars are lost yearly because of health care expenses and missed workdays for chronic pain. Addiction is a primary, chronic, neurobiological disease with genetic, psychological and environmental factors influencing its development and manifestations. Addictive disorders occur in 3% to 26% of the general population, 19% to 255 of hospitalized patients and 40% to 60% in patients who sustained major trauma. More specifically 13.9 million of people living in USA over the age of 12 years are currently using illicit drugs. Although patients with chronic pain may be at an increased risk for addiction, the general population has demonstrated similar addiction rates. Unfortunately, patients who have chronic pain and addition will only have one of these aspects addressed. The purpose of this article is to clarify specific definition of substance use, abuse and addiction. As well as examining the role of pain physicians in evaluating and treating the chronic pain patients who have a history of substance abuse, and lastly outline strategy for assessing patients at risks and evaluating the most practical way of dealing with their chronic pain issues. [source]