Pain Management

Chronic pain from failed back surgery is notoriously difficult to manage. Might medical marijuana hold promise?

Marijuana can be a valuable therapeutic tool for the nausea and vomiting that accompany chemotherapy, but it also can cause hyperemesis.

Would you consider oral steroids for a patient with acute radiculopathy due to a herniated disc? What's the clinical evidence of benefit?

The 35-year-old man is a new patient for you. He says he was given Vicodin when he had a similar injury a number of years ago. How do you proceed?

The child’s episodic tantrum-like behavior and crying was only briefly soothed. Watch the video-is there a clue here to a diagnosis?

NSAIDs may impair fertility in women with mild musculoskeletal pain. Damage is reversible once NSAIDs are discontinued, according to a new study.

When are antiviral drugs appropriate to treat "shingles" and what is the first-line treatment for post-infection pain?

Is this pruritic lesion just unsightly, or is it indicative of a dangerous condition? Test your acumen in this quiz.

The child is alert and able to speak. Physical examination reveals abdominal contusions and inguinal lacerations. The abdomen is distended and painful to the touch. Watch the video, review the history, and make your diagnosis.

Accompanying vomiting and fever raised suspicion for appendicitis and a CT scan of the abdomen and pelvis was ordered. Watch the ED video, review the history, and make your diagnosis.

Opioids, imaging, and constipation-try this trio of questions on issues related to pain management.

Low back pain is one of the most common reasons patients seek primary care; 3 new studies confirm what most of them don’t want to hear: less treatment is better than more.

Up to 50% of patients taking opioids for an extended period develop constipation. Patient education and basic prevention can help mitigate the side effect.

Brief exposure to a variety of modifiable factors-physical and psychosocial-increases the risk of back pain.

An estimated 10% to 20% of women experience major depression during pregnancy. Opioids could double that trouble.

Good physical and social functioning may help avert insomnia in older people with musculoskeletal pain.

Best practices make a strong case against prescribing benzodiazepines for chronic pain patients taking opioids. But are we following best practices?

Synovitis predates and is associated with the development of radiographic osteoarthritis, new findings suggest. Treating synovitis in knee OA may help reduce disease progression and relieve symptoms. Details here.

While demonstrating his retro dance moves, a 31-year-old injures his knee doing “the Twist.” Now he can barely walk. Would you order an x-ray?

An occult fracture in the knee is most often a nondisplaced lateral tibial plateau fracture.

A new study found that alcohol was involved in more than 20% of both opioid- and benzodiazepine-related deaths reported to the Drug Abuse Warning Network in 2010.

Dyspnea and blood-streaked sputum; severe URI followed by rash; chronic pain; Lemierre syndrome . . . how well will you do on this quiz?

A 62-year-old man has moderate to severe leg pain after playing 36 holes of golf. The pain originates from the lumbar spine and radiates into his lower extremities. What is the best course of treatment?

A 45-year-old man with knee pain has medial osteoarthritis, and you prescribe NSAIDs. He plans to attend tennis camp. Do you recommend he wear a brace?

A 56-year-old woman presents with persistent pain and tenderness in both hands. A workup reveals she has erosive osteoarthritis. Which factors are most strongly associated with increased pain?

Difficulty with sleep is a common problem for people with chronic pain. Plus, it is well known that while pain medications cause sedation, they can also disrupt normal sleep cycles.

Mottled skin; neuropathic pain; syncope . . . test yourself on these and other subjects.

Deaths from opioid overdoses routinely claim headlines but nearly as many fatalities are caused each year by nonsteroidal anti-inflammatory drugs. Who's tracking trouble under the radar?

Chronic pain and psychological interventions, complex regional pain syndrome, spinal fractures and low back pain, acute gouty arthritis, Chiari I malformation, Dengue fever, erythema nodosum-a look at pain in its many shapes, sizes, and locations.

The results of several recent studies on both drug classes may come as a surprise. Will they change the way you prescribe either or both for pain?