Nervous system disease located in nerves or nerve cells
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Podcast Show Notes: Peripheral Vascular Disease in PainManagement Episode Highlights: - Host: Dr. David Rosenblum - Podcast: Pain Exam Podcast - Focus: Peripheral Arterial Disease (PAD) in Pain Management Download the App Key Topics Covered: 1. Peripheral Arterial Disease (PAD) Overview - Definition: Arterial sclerosis condition developing over long term - WHO Definition: Exercise-related pain or ankle-brachial index (ABI) < 0.9 - Prevalence: * 3-4% in 60-65 year olds * Increases to 15-20% in 85-90 year olds * Up to 50% of patients may progress to symptomatic stages 2. Diagnostic Considerations Diagnostic Tests: - Ankle Brachial Index (ABI) - Ultrasound - CT Angiography - Physical examination - Pulse volume recordings - Transcutaneous oximetry ABI Interpretation: - 1.0-1.4: Normal - 0.9-1.0: Acceptable - 0.8-0.9: Some arterial disease - 0.5-0.8: Moderate arterial disease - < 0.5: Severe arterial disease 3. Pain Characteristics Types of Pain: - Intermittent claudication - Chronic limb ischemia - Nociceptive pain - Neuropathic pain - Mixed pain syndrome 4. Pain Management Strategies Pharmacological Approaches: - Mild Pain: Paracetamol, NSAIDs - Neuropathic Pain: Lidocaine patches, gabapentin, duloxetine - Severe Pain: Morphine, fentanyl, ketamine Non-Pharmacological Interventions: - Music therapy - Aromatherapy - Psychotherapy - Massage - Acupuncture - TENS - Intermittent pneumatic compression Upcoming Conferences Mentioned: - ASPN - ASIPP - Pain Week - Latin American Pain Society Additional Resources: - Pain Exam newsletter: painexam.com - Virtual pain fellowship at nrappain.org Disclaimer: Always consult with a healthcare professional for personalized medical advice. Reference Garba Rimamskep Shamaki, Favour Markson, Demilade Soji-Ayoade, Chibuike Charles Agwuegbo, Michael Olaseni Bamgbose, Bob-Manuel Tamunoinemi, Peripheral Artery Disease: A Comprehensive Updated Review, Current Problems in Cardiology, Volume 47, Issue 11, 2022,101082, Maier, J.A.; Andrés, V.; Castiglioni, S.; Giudici, A.; Lau, E.S.; Nemcsik, J.; Seta, F.; Zaninotto, P.; Catalano, M.; Hamburg, N.M. Aging and Vascular Disease: A Multidisciplinary Overview. J. Clin. Med. 2023, 12, 5512. https://doi.org/10.3390/jcm12175512 Maier, J.A.; Andrés, V.; Castiglioni, S.; Giudici, A.; Lau, E.S.; Nemcsik, J.; Seta, F.; Zaninotto, P.; Catalano, M.; Hamburg, N.M. Aging and Vascular Disease: A Multidisciplinary Overview. J. Clin. Med. 2023, 12, 5512. https://doi.org/10.3390/jcm12175512
Podcast Show Notes: Peripheral Vascular Disease in PainManagement Episode Highlights: - Host: Dr. David Rosenblum - Podcast: Pain Exam Podcast - Focus: Peripheral Arterial Disease (PAD) in Pain Management Download the App Key Topics Covered: 1. Peripheral Arterial Disease (PAD) Overview - Definition: Arterial sclerosis condition developing over long term - WHO Definition: Exercise-related pain or ankle-brachial index (ABI) < 0.9 - Prevalence: * 3-4% in 60-65 year olds * Increases to 15-20% in 85-90 year olds * Up to 50% of patients may progress to symptomatic stages 2. Diagnostic Considerations Diagnostic Tests: - Ankle Brachial Index (ABI) - Ultrasound - CT Angiography - Physical examination - Pulse volume recordings - Transcutaneous oximetry ABI Interpretation: - 1.0-1.4: Normal - 0.9-1.0: Acceptable - 0.8-0.9: Some arterial disease - 0.5-0.8: Moderate arterial disease - < 0.5: Severe arterial disease 3. Pain Characteristics Types of Pain: - Intermittent claudication - Chronic limb ischemia - Nociceptive pain - Neuropathic pain - Mixed pain syndrome 4. Pain Management Strategies Pharmacological Approaches: - Mild Pain: Paracetamol, NSAIDs - Neuropathic Pain: Lidocaine patches, gabapentin, duloxetine - Severe Pain: Morphine, fentanyl, ketamine Non-Pharmacological Interventions: - Music therapy - Aromatherapy - Psychotherapy - Massage - Acupuncture - TENS - Intermittent pneumatic compression Upcoming Conferences Mentioned: - ASPN - ASIPP - Pain Week - Latin American Pain Society Additional Resources: - Pain Exam newsletter: painexam.com - Virtual pain fellowship at nrappain.org Disclaimer: Always consult with a healthcare professional for personalized medical advice. Reference Garba Rimamskep Shamaki, Favour Markson, Demilade Soji-Ayoade, Chibuike Charles Agwuegbo, Michael Olaseni Bamgbose, Bob-Manuel Tamunoinemi, Peripheral Artery Disease: A Comprehensive Updated Review, Current Problems in Cardiology, Volume 47, Issue 11, 2022,101082, Maier, J.A.; Andrés, V.; Castiglioni, S.; Giudici, A.; Lau, E.S.; Nemcsik, J.; Seta, F.; Zaninotto, P.; Catalano, M.; Hamburg, N.M. Aging and Vascular Disease: A Multidisciplinary Overview. J. Clin. Med. 2023, 12, 5512. https://doi.org/10.3390/jcm12175512 Maier, J.A.; Andrés, V.; Castiglioni, S.; Giudici, A.; Lau, E.S.; Nemcsik, J.; Seta, F.; Zaninotto, P.; Catalano, M.; Hamburg, N.M. Aging and Vascular Disease: A Multidisciplinary Overview. J. Clin. Med. 2023, 12, 5512. https://doi.org/10.3390/jcm12175512
Podcast Show Notes: Peripheral Vascular Disease in PainManagement Episode Highlights: - Host: Dr. David Rosenblum - Podcast: Pain Exam Podcast - Focus: Peripheral Arterial Disease (PAD) in Pain Management Download the App Key Topics Covered: 1. Peripheral Arterial Disease (PAD) Overview - Definition: Arterial sclerosis condition developing over long term - WHO Definition: Exercise-related pain or ankle-brachial index (ABI) < 0.9 - Prevalence: * 3-4% in 60-65 year olds * Increases to 15-20% in 85-90 year olds * Up to 50% of patients may progress to symptomatic stages 2. Diagnostic Considerations Diagnostic Tests: - Ankle Brachial Index (ABI) - Ultrasound - CT Angiography - Physical examination - Pulse volume recordings - Transcutaneous oximetry ABI Interpretation: - 1.0-1.4: Normal - 0.9-1.0: Acceptable - 0.8-0.9: Some arterial disease - 0.5-0.8: Moderate arterial disease - < 0.5: Severe arterial disease 3. Pain Characteristics Types of Pain: - Intermittent claudication - Chronic limb ischemia - Nociceptive pain - Neuropathic pain - Mixed pain syndrome 4. Pain Management Strategies Pharmacological Approaches: - Mild Pain: Paracetamol, NSAIDs - Neuropathic Pain: Lidocaine patches, gabapentin, duloxetine - Severe Pain: Morphine, fentanyl, ketamine Non-Pharmacological Interventions: - Music therapy - Aromatherapy - Psychotherapy - Massage - Acupuncture - TENS - Intermittent pneumatic compression Upcoming Conferences Mentioned: - ASPN - ASIPP - Pain Week - Latin American Pain Society Additional Resources: - Pain Exam newsletter: painexam.com - Virtual pain fellowship at nrappain.org Disclaimer: Always consult with a healthcare professional for personalized medical advice. Reference Garba Rimamskep Shamaki, Favour Markson, Demilade Soji-Ayoade, Chibuike Charles Agwuegbo, Michael Olaseni Bamgbose, Bob-Manuel Tamunoinemi, Peripheral Artery Disease: A Comprehensive Updated Review, Current Problems in Cardiology, Volume 47, Issue 11, 2022,101082, Maier, J.A.; Andrés, V.; Castiglioni, S.; Giudici, A.; Lau, E.S.; Nemcsik, J.; Seta, F.; Zaninotto, P.; Catalano, M.; Hamburg, N.M. Aging and Vascular Disease: A Multidisciplinary Overview. J. Clin. Med. 2023, 12, 5512. https://doi.org/10.3390/jcm12175512 Maier, J.A.; Andrés, V.; Castiglioni, S.; Giudici, A.; Lau, E.S.; Nemcsik, J.; Seta, F.; Zaninotto, P.; Catalano, M.; Hamburg, N.M. Aging and Vascular Disease: A Multidisciplinary Overview. J. Clin. Med. 2023, 12, 5512. https://doi.org/10.3390/jcm12175512
In this piece we discuss pain medicine with Nadine Attal, a neurologist and pain medicine specialist from France, and Allen Finley, an anesthesiologist and pain medicine specialist from Canada. The episode delves into neuropathic pain and the need to personalize its management, and efforts to standardize the management of paediatric pain in Canada. We talk about the ICD-11 which recognizes chronic pain as a disease, and ChildKind.org which nurtures holistic and responsive support for children or all ages and abilities. Presented by Andy Cumpstey and Kate Leslie on location at the Annual Scientific Meeting of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine in Cairns, Australia, with their guests, Professor Nadine Attal, Director for the Center of Evaluation and Treatment of Pain, Ambroise Paré Hospital, Paris, France, and Professor Allen Finley, Professor of Anesthesia and Psychology at Dalhousie University, and Medical Director of Pediatric Pain Management at IWK Health Centre in Halifax.
OKYO Pharma CEO Gary Jacob joined Steve Darling from Proactive to announce a strategic decision to accelerate the clinical development of urcosimod, its lead candidate for Neuropathic Corneal Pain. CEO Gary Jacob shared the update in an interview with Proactive, highlighting the company's decision to terminate its ongoing Phase 2 trial early in order to access and analyze masked trial data that could inform the next stage of clinical advancement. The Phase 2 trial, being conducted at Tufts Medical Center in Boston, MA, was initially designed as a single-site study to evaluate the safety and efficacy of urcosimod in patients suffering from NCP—a debilitating and poorly understood ocular condition. To date, 17 patients have successfully completed the trial. All of them were diagnosed with chronic, long-term NCP and had failed multiple prior therapies, positioning this cohort as a challenging yet highly relevant population for evaluating urcosimod's potential. According to Jacob, the trial has attracted significant attention from NCP sufferers, reinforcing the high unmet need in this patient population. NCP is characterized by severe ocular pain, light sensitivity, and discomfort that can radiate to the face or head. Its exact etiology remains uncertain but is believed to involve nerve damage and persistent inflammation of the cornea. Currently, no approved therapies exist specifically for NCP, and most patients rely on off-label or palliative treatments with limited success. OKYO's decision to close the trial early reflects a proactive strategic shift, allowing the company to refine its clinical development path and expedite next steps. The company is preparing to launch a multicenter trial, which will include multiple clinical sites and a broader patient population, enhancing the statistical robustness and generalizability of the data. As OKYO prepares for this next clinical phase, the company remains focused on its core mission of delivering innovative therapies for underserved ophthalmic conditions. The accelerated pathway for urcosimod underscores its potential to reshape the treatment landscape for neuropathic eye disorders. #proactiveinvestors #okyopharmalimited #nasdaq #okyo #Urcosimod #NeuropathicCornealPain #BiotechNews #ClinicalTrials #FDAapproval #Ophthalmology #DrugDevelopment #CompassionateUse #EyeHealth
For certain diagnoses and patients who meet clinical criteria, neuromodulation can provide profound, long-lasting relief that significantly improves quality of life. In this episode, Aaron Berkowitz, MD, PhD, FAAN speaks with Prasad Shirvalkar, MD, PhD, author of the article “Neuromodulation for Neuropathic Pain Syndromes,” in the Continuum® October 2024 Pain Management in Neurology issue. Dr. Berkowitz is a Continuum® Audio interviewer and a professor of neurology at the University of California San Francisco in the Department of Neurology and a neurohospitalist, general neurologist, and clinician educator at the San Francisco VA Medical Center at the San Francisco General Hospital in San Francisco, California. Dr. Shirvalkar is an associate professor in the Departments of Anesthesia and Perioperative Care, Neurological Surgery, and Neurology at Weill Institute for Neurosciences at the University of California, San Francisco in San Francisco, California. Additional Resources Read the article: Neuromodulation for Neuropathic Pain Syndromes Subscribe to Continuum: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @AaronLBerkowitz Guest: @PrasadShirvalka Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor in Chief of Continuum, the premier topic-based neurology clinical review and CME journal from the American Academy of Neurology. Thank you for joining us on Continuum Audio, which features conversations with Continuum's guest editors and authors, who are the leading experts in their fields. Subscribers to the Continuum Journal can read the full article or listen to verbatim recordings of the article and have access to exclusive interviews not featured on the podcast. Please visit the link in the episode notes for more information on the article, subscribing to the journal, and how to get CME. Dr Berkowitz: This is Dr Aaron Berkowitz, and today I'm interviewing Dr Prasad Shirvalkar about his article on neuromodulation for painful neuropathic diseases, which appears in the October 2024 Continuum issue on pain management in neurology. Welcome to the podcast, and if you wouldn't mind, please introducing yourself to our listeners. Dr Shirvalkar: Thanks, Aaron. Yes, of course. So, my name is Prasad Shirvalkar. I'm an associate professor in anesthesiology, neurology and neurological surgery at UCSF. I am one of those rare neurologists that's actually a pain physician. Dr Berkowitz: Fantastic. And we're excited to have you here and talk to you more about being a neurologist in in the field of pain. So, you wrote a fascinating article here about current and emerging neuromodulation devices and techniques being used to treat chronic pain. And in our interview today, I'm hoping to learn and for our listeners to learn about these devices and techniques and how to determine which patients may benefit from them. But before we get into some of the clinical aspects here, can you first just give our listeners an overview of the basic principles of how neuromodulation of various regions of the nervous system is thought to reduce pain? Dr Shirvalkar: Yeah, I would love to try. But I will promise you that I will not succeed because I think to a large extent, we don't understand how neuromodulation works to treat pain, to describe or to define neuromodulation. Neuromodulation is often described as using electrical stimuli or a chemical stimuli to alter nervous system activity to really influence local activity, but also kind of distant network activity that might be producing pain. On one level, we don't fully understand how pain arises, specifically how chronic pain arises in the nervous system. It's a huge focus of study from the NIH Heal Initiative and many labs around the world. But acute pain, which is kind of when you stub your toe or you burn your finger, is thought to be quite different from the changes over time and the kind of plasticity that produces emotional, cognitive and sensory dimensions. Really what I think is its own disease, chronic pain, of which there are multiple syndromes when we use neuromodulation, either peripheral nerve stimulation or electrical spinal cord stimulation. One common or predominant theory actually comes from a paper in science from 1967 and people still use it, foundational theory and it's called the gate control theory. Two authors, Melzack and Wall, postulated that at the spinal level, there are, there's a local inhibitory circuit or, you know, there's a local circuit where if you provide input to either peripheral nerves or either spinal cord ascending fibers that to kind of summarize it, there's only so much bandwidth, you know, that nerves can carry. And so that if you literally pass through artificial signals electrically, that you will help gate out or block natural pathological but natural pain signals that might be arising from the periphery or spinal cord. So, you know, one idea is that you are kind of interfering with activity that's arising for chemical neuromodulation. The most common is something known as intrathecal drug infusion drug delivery ITTD for that we quite literally put a catheter in the spinal fluid, you know, at the level of the dorsal horn neurons that we think are responsible for perpetuating or creating the pain. Where's the pain generator? And you really, you can infuse local anesthetic, you can infuse opioids. And what's nice is you avoid a lot of systemic side effects and toxicity because it goes right to the spinal cord, you know, by infusing in the fluid. So there's a couple of modalities, but I will say just, like maybe all of our living experience, pain is in the brain. And so, we don't really understand, I would say, what neuromodulation is doing to the higher spinal or brain levels. Dr Berkowitz: Fascinating topic. And yeah, very interesting to hear both what our current understanding is that some of our current understanding is based on data that's 60 years old and that we're actually probably learning about pain by using these modulation techniques, even though we don't really understand how they might be working. So interesting feedback loop there as well as in as in the as in this land. So, your article very nicely organizes the neuromodulation techniques from peripheral to central. So, encourage our listeners to check out your article. And first before we get into some of the clinical applications, just to give the listeners the lay of the land, can you sort of lay out the devices and techniques available for treating pain at each level of the neuroaxis? We'll get into some of the indications in patient selection in a moment, but just sort of to lay out the landscape. What's available that you and your colleagues can use or implant at different levels when we're thinking of referring patients too? Dr Shirvalkar: Absolutely. So, starting from the least invasive or you know, over the counter patients can purchase themselves a TENS machine. Many folks listening to this have probably tried a TENS machine in the past. And the idea is that you put a couple of pads, at least two. So you have like a dipole or you have a positive and a negative lead and you basically inject some current. So, the pads are attached to a battery and you can put these pads over muscle. If you have areas where myofascial pain or sore muscles, you can put them, frankly, over nerves as well and stimulate nerves that are deeper. Most TENS machines kind of use electrical pulses that occur at different rates. You change the rates, you can change the amplitude and patient can kind of have control for what works best. Then getting slightly more invasive, we can often stimulate electrically peripheral nerves. To do this we implant through a needle, a small wire that consists of anywhere from one electrical contact to four or even eight electrical contact. What I think is particularly cool, like TENS, which is transcutaneous electrical nerve stimulation that goes through the skin. Peripheral nerve stimulation aims to stimulate nerves, but you don't have to be right up against the nerve. So, yeah. We typically do this under an ultrasound and you can visualize a nerve like the sciatic nerve, peroneal nerve, or you know, even if someone has an ulnar or a neuropathy, you know, that's the compression. There's a role obviously for surgery and release, but if they have predominantly pain, it's not related to a mechanical problem per se, you could prevent a wire from a peripheral nerve stimulator as far as one centimeter from a nerve and it'll actually stimulate that that modulated and then, you know, kind of progressing even more deeply. The spinal cord stimulation, SCS, it's probably the most ubiquitous or popular form of neuromodulation for pain. People use it for all kinds of diseases. But what it roughly involves is a trial period, which is a placement of either two cylindrical wires, not directly over the spinal cord, but actually in the epidural space, right? So, it's kind of like when you get an epidural injection or doing labor and delivery, when women get epidural catheters, placing spinal cord stimulator leads in that same potential space outside the dura, and you're stimulating through the dura to actually target the ascending dorsal column fibers. And so, you do a trial period or a test drive where the patients get these wires put in. They're coming out of the skin, they're connected to a battery, and they walk around at home for about a week, take careful notes, check in with them, and they keep a diary or a log about how much it helps. Separately. I will say it's hard to distinguish this, the placebo effect often, but you know, sometimes we want to use the placebo effect in clinical practice, but it is a concern, you know, with such invasive things. But you know, if the trial works well, right, you basically can either keep the leads where they are and place a battery internally. And it's for neurologists. You're familiar with deep brain stimulation. These devices are very similar to DVS devices, but they're specifically made for spinal cord stimulation. And there's now like seven companies that offer manufacturers that offer it, each with their own proprietary algorithm or workflow. But going yet more invasive, there is intrathecal drug delivery, which I mentioned, which involves placement of the spinal catheter and infusion of drug into spinal fluid. You could do a trial for that as well. Keep a patient in the hospital for a few days. You've all probably had experience with lumbar drains. It's something real similar. It just goes the other way. You know, you're infusing drugs, and it could also target peripheral nerves or nerve roots with catheters, and that's often done. And last but not least, there's brain stimulation. Right now, it's all experimental except for some forms of TMS or transcranial magnetic stimulation, which is FDA approved for migraine with aura. There are tens machine type devices, cutaneous like stimulators where you can wear on your head like a crown or with stickers for various sorts of migraines. I don't really talk about them too much in in the article, but if there's a fast field out there for adjunctive therapy as well, Dr Berkowitz: Fantastic. That's a phenomenal overview. Just so we have the lay on the land of these devices. So, from peripheral essentially have peripheral nerve stimulators, spinal cord stimulators, intrathecal drug delivery devices and then techniques we use in other areas of neurology emerging for pain DBS deep brain stimulation and TMS transcranial magnetic stimulation. OK let's get into some clinical applications now. Let's start with spinal cord stimulators, which - correct me if I'm wrong - seem to be probably the most commonly seen in practice. Which patients can benefit from spinal cord stimulators? When should we think about referring a patient to you and your colleagues for consideration of implantation of one of these spinal cord stimulator devices? Dr Shirvalkar: So, you know, it's a great question. I would say it's interesting how to define which patients or diagnosis might be appropriate. Technically, spinal cord stimulators are approved for the treatment of most recently diabetic peripheral neuropathy. And so, I think that's a really great category if you have patients who have been failed by more conservative treatments, physical therapy, etcetera, but more commonly even going back, neuropathic low back pain and neuropathic leg pain. And so, you think about it and it's like, how do you define neuropathic pain. Neuropathic pain is kind of broadly defined as any pain that's caused by injury or some kind of lesion in the somatosensory nervous system. We now broaden that to be more than just somatosensory nervous system, but still, what if you can't find a lesion, but the pain still feels or seems neuropathic. Clinically, if something is neuropathic, we often use certain qualitative descriptors to describe that type of pain burning, stabbing, electric light, shooting radiates. There's often hyperpathia, like it lingers and spreads in space and time as opposed to, you know, arthritis, throbbing dull pain or as opposed to muscle pain might be myofascial pain, but sometimes it's hard to tell. So, there aren't great decision tools, I would say to help decide. One of the most common syndromes that we use spinal cord stimulation for is what used to be called failed back surgery syndrome. We never like to, we now try to shy away from explicitly saying something is someone has failed in their clinical treatment. So, the euphemism is now, you know, post-laminectomy syndrome. But in any case, if someone has had back surgery and they still have a nervy or neuropathic type pain, either shooting down their legs and often there's no evidence on MRI or even EMG that that something is wrong, they might be a good candidate, especially if they're relying on long term medications that have side effects or things like full agonist opioids, you know that that might have side effects or contraindication. So, I would say one, it's not a first line treatment. It's usually after you've gone through physical therapy for sure. So, you've gone through tried some medications. Basically, if chronic pain is still impacting your life and your function in a meaningful way that's restricting the things you want to do, then it it's totally appropriate, I think, to think about spinal cord stimulation. And importantly, I will add a huge predictor of final court stimulation success is psychological composition, you know, making sure the person doesn't have any untreated psychological illness and, and actually making sure their expectations going in are realistic. You're not going to cure anyone's pain. You may and that's, you know, a win, but it's very unlikely. And so, give folks the expectation that we hope to reduce your pain by 50% or we want you to list personally, I like functional goals where you say what is your pain preventing you from doing? We want to see if you can do X,Y, and Z during the trial period. Pharmacostimulation right now. Yeah. Biggest indication low back leg pain, Diabetic peripheral neuropathy. There is also an indication for CRPS, complex regional pain syndrome, a lesser, I'd say less common but also very debilitating pain condition. For better or worse. Tertiary quaternary care centers. You often will see spinal cord stem used off label for neuropathic type pain syndromes that are not explicitly better. That may be for example, like a nerve injury that's peripheral, you know, it's not responding. A lot of this off label use is highly variable and, you know, on the whole at a population level not very successful. And so, I think there's been a lot of mixed evidence. So, it's something to be aware about. Dr Berkowitz: That's a very helpful framework. So, thinking about referring patients to who have most commonly probably the patients with chronic low back pain have undergone surgery, have undergone physical therapy, are on medications, have undergone treatment for any potential psychological psychiatric comorbidities, and yet remain disabled by this pain and have a reasonable expectation and goals that you think would make them a good candidate for the procedure. Are those similar principles to peripheral nerve stimulation I wasn't familiar with that technique, I'm reading your article, so are the principles similar and if so, which particular conditions would potentially benefit from referral for a trial peripheral nerve stimulation as opposed to spinal cord stimulation? Dr Shirvalkar: Yeah, the principles are similar overall. The peripheral nerve stimulation, you know, neuropathic pain with all the characteristics you listed. Interestingly enough, just like spinal cord stim, most insurances require a psychological evaluation for peripheral nerve stim as well. And we want to make sure again that their expectations are reside, they have good social support and they understand the kind of risks of an invasive device. But also, for peripheral nerve stem, specifically, if someone has a traumatic injury of an individual peripheral nerve, often we will consider it seeing kind of super scapular stimulation. Often with folks who've had shoulder injuries or even sciatic nerve stimulation. I have done a few peroneal nerve stimulations as well as occipital nerve stimulation from migraine, so oxygen nerve stimulation has been studied a lot. So, it's still somewhat controversial, but in the right patient it can actually be really helpful. Dr Berkowitz: Very helpful. So, these are patients who have neuropathic pain, but limited to one peripheral nerve distribution as opposed to the more widespread back associated pains, spine associated pains. Dr Shirvalkar: Yeah, Yeah, that's right. And maybe there's one exception actually to this, which is brachial plexopathy. So, you know, folks who've had something like a brachial plexus avulsion or some kind of traumatic injury to their plexus, there is I think good Class 2 evidence that peripheral nerve stem can work. It falls under the indication. No one is as far as to my knowledge, No one's done an explicit trial, you know PNS randomized controlled trial. Yeah, that's, you know, another area one area where PNS or peripheral nerve stems emerging is actually, believe it or not in myofascial low back pain to actually provide muscle stimulation. There are some, there's a company or two out there that seeks to alter the physiology of the multifidus muscle, one of your spinal stabilizer muscles to really see if that can help low back pain. And they've had some interesting results. Dr Berkowitz: Very interesting. You mentioned TENS units earlier, transcutaneous electrical nerve stimulation as something a patient could get over the counter. When would you encourage a patient to try TENS and when would you consider TENS inadequate and really be thinking about a peripheral nerve stimulator? Dr Shirvalkar: Yeah, you know TENS we think of as really appropriate for myofascial pain. Folks who have muscular pain, have clear trigger points or taught muscle bands can often get relief from TENS If you turn a TENS machine up too high, you'll actually see muscle infection. So, there's an optimal level where you actually can turn it up to induce, like, a gentle vibration. And so folks will feel paresthesia and vibrations, and that's kind of the sweet spot. However, I would say if folks have pain that's limited or temporary in time or after a particular activity, TENS can be really helpful. The unfortunate reality is TENS often has very time-limited benefits - just while you're wearing it, you know? So, it's often not enduring. And so that's one of the limitations. Dr Berkowitz: That's helpful to understand. We've talked about the present landscape in your article, also talk a little bit about the future and you alluded to this earlier. Tell us a little bit about some off label emerging techniques that we may see in future use. Who, which types of patients, which conditions might we be referring to you and your colleagues for deep brain stimulation or transcranial magnetic stimulation or motor cortex stimulation? What's coming down the pipeline here? Dr Shirvalkar: That's a great question. You know, one of my favorite topics is deep brain stimulation. I run the laboratory that studies intracranial signals trying to understand how pain is processed in the brain. But, believe it or not, chronic pain is probably the oldest indication for which DBS has been studied. the first paper came out in 1960, I believe, in France. And you know, the, the original pivotal trials occurred even before the Parkinson's trial and so fell out of favor because in my opinion, I think it was just too hard or too difficult or a problem or too heterogeneous. You know, many things, but there are many central pain syndromes, you know, poststroke pains, there's often pains associated with Parkinson's disease, epilepsy, or other brain disorders for which we just don't have good circuit understanding or good targets. So, I think what's coming down the pipeline is a better personalized target identification, understanding where can we stimulate to actually alleviate pain. The other big trend I think in neuromodulation is using closed loop stimulation which means in contrast to traditional electrical stimulation which is on all the time, you know it's 24/7, set it and forget it. Actually, having stimulation respond or adapt to ongoing physiological signals. So that's something that we're seeing in spinal cord stem, but also trying to develop in deep brain stimulation and noninvasive stimulation. TMS is interestingly approved for neuropathic pain in Europe, but not approved by the FDA in the US. And so I think we may see that coming out of pipeline broader indication. And finally, MR guided focused ultrasound is, is a kind of a brand new technique now. You know, focused ultrasound lesions are being used for essential tremor without even making an incision in the skull or drilling in skull. But there are ways to modulate the brain without lesioning. And, you know, I think a lot of research will be emerging on that in the next five years for, for pain and many other neuronal disorders. Dr Berkowitz: That's fascinating. I didn't know that history that DBS was first studied for pain and now we think of it mostly for Parkinson's and other movement disorders. And now the cycle is coming back around to look at it for pain again. What are some of the targets that are being studied that are thought to have benefit or are being shown by your work and that of others to have benefit as far as DBS targets for, for chronic pain? Dr Shirvalkar: You know, that's a great question. And so, the hard part is finding one target that works for all patients. So, it may actually require personalization and actually understanding what brain circuit phenotypes do you have with regards to your chronic pain and then based on that, what target might we use? But I will say the older targets. Classical targets were periaqueductal gray, which is kind of the opioid center in your brain. You know, it's thought to just release large amounts of endogenous opioids when you stimulate there and then the ventral pusher thalamus, right. So, the sensory ascending system may be through gait control theory interferes with pain, but newer targets the answer singlet there's some interest in in stimulating there again, it doesn't work for everybody. We found some interesting findings with the medial thalamus as well as aspects of the caudate and other basal ganglion nuclei that we hopefully will be publishing soon in a data science paper. Dr Berkowitz: Fantastic. That's exciting to hear and encourage all of our listeners to check out your article. That goes into a lot more depth than we had time to do in this short interview, both about the science and about the clinical indications, pros and cons, risks and benefits of some of these techniques. So again, today I've been interviewing Dr Prasad Shirvalkar, whose article on neuromodulation for painful neuropathic diseases appears in the most recent issue of Continuum on pain management in neurology. Be sure to check out Continuum Audio episodes from this and other issues. And thank you again to our listeners for joining today. Dr Shirvalkar: Thank you for having me. It was an honor. Dr Monteith: This is Dr Teshamae Monteith, associate editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in depth and clinically relevant information important for neurology practitioners. Use this link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/AudioCME. Thank you for listening to Continuum Audio.
OKYO Pharma CEO Gary Jacob joined Steve Darling from Proactive to share news the company is reporting the first patient has been dosed in the Phase 2 trial of OK-101, a topical ocular treatment for neuropathic corneal pain (NCP). This double-masked, randomized, 12-week placebo-controlled trial will enroll 48 patients, all of whom will have their NCP disease confirmed via confocal microscopy. The trial is being conducted at a single center under the leadership of Dr. Pedram Hamrah from Tufts Medical Center, where he serves as Professor and Vice Chair of Research and Academic Programs, and Director of the Center for Translational Ocular Immunology. Dr. Hamrah's expertise will guide the study, which aims to evaluate the effectiveness of OK-101 in alleviating pain caused by corneal nerve damage—a condition with no current FDA-approved treatments. Jacob highlighted that OK-101 is a novel, non-opioid therapeutic specifically designed to target the severe and often debilitating pain associated with NCP. This condition can stem from various sources, including dry eye disease, surgery, or infections, and can significantly affect patients' quality of life. Presently, treatment options for NCP are limited to temporary pain relief strategies that often fall short of providing long-term relief. OKYO Pharma's development of OK-101 is a promising step toward addressing this unmet medical need, potentially offering patients a more effective solution to manage their corneal pain. #proactiveinvestors #okyopharmalimited #nasdaq #okyo #NeuropathicPain #OcularPain #OK101Trial #FDAApproval #Biotech #Pharmaceuticals #ClinicalTrial #DrugDevelopment #HealthInnovation#invest #investing #investment #investor #stockmarket #stocks #stock #stockmarketnews
“Why am I so itchy?” If you have itchy skin without rash, including issues like eczema, psoriasis, or chronic hives, you might have neuropathic itch.Though itch is caused primarily by inflammation, neuropathic itch is actually caused by dysfunction of your nervous system!Put simply, this type of itch has no primary skin rash, so you won't see inflamed dry patches or welts. You'll only feel itchy.It is often localized to certain areas of the body. For example, you could have an itchy scalp, back, or arms. The itchy skin can sometimes be mild, but is unfortunately usually quite intense, leading to scratching, which can damage the skin.And because there's no treatment for neuropathic itch, despite it being very common, you might start to feel like there's no hope. Yes, what's causing this is not yet well understood, but it sounds like experts are digging into this.Joining me to discuss neuropathic itch is returning guest Dr. Shawn Kwatra. He is the Chair of Dermatology at the University of Maryland School of Medicine. He specializes in medical dermatology areas of clinical expertise, including atopic dermatitis, psoriasis, chronic itch of unknown origin and dermatology for ethnic skin. Dr. Kwatra also runs a basic science laboratory and clinical trials unit and is funded by the National Institutes of Health and multiple foundations.He currently serves as the National Secretary/Treasurer of the Skin of Color Society. He is a member of the National Eczema Association's Scientific and Medical Advisory Council.Dr. Kwatra has been an author or co-author on over 200 publications and author of the book Living with Itch.In This Episode:What is neuropathic itch (aka. itchy skin without rash)?How could your brain cause itchy skin without rash?Itch intensity of different examples of neuropathic itchTreatment options for neuropathic itchWhich inflammatory cytokines are involved?Could Low Dose Naltrexone help itchy skin without rash?Alternative therapies for neuropathic itchQuotes“[Neuropathic itch is] initiated or caused by dysfunction of the nervous system…so it actually is caused by the nerves. And the core symptoms here are that you have normal skin, or skin only with some secondary skin changes or signs of scratching, excoriation, and it oftentimes favors a localized distribution. And so the scalp is actually a very common site where folks itch.”“Unfortunately, a lot of the medications we use to treat this condition are very sedating. They're drugs that are focusing on the transmission of itch in the central nervous system and spinal cord like gabapentin or anticonvulsants. So those are the type of drugs that we're giving for this condition.”LinksFind Dr. Shawn Kwatra online here and here | TwitterHealthy Skin Show ep. 275: Why You're So Itchy (HINT: It's Probably Not Histamine) w/ Dr. Shawn KwatraHealthy Skin Show ep. 302: What Is Prurigo Nodularis: Triggers, Body Connections + Crazy Itch w/ Dr. Shawn KwatraHealthy Skin Show ep. 331: Eczema Symptoms-Skin Color Connection: Why Skin Tone May Make Certain Symptoms WORSE w/ Dr. Shawn KwatraHealthy Skin Show ep. 03
This is a great episode I made last year that people got a lot of values from. I wanted to put this one back on just in case you have missed this.This was an amazing interview with one of my most ambitious clients, Larry, who suffered with neck pain that became so bad that he lost strengthen in his dominant arm.The neck has delicate relations to the nerves that go down the arm and control sensation and motor control. So when nerves are pinched acutely or chronically over time, it can lead to temporary but sometimes permanent weakness of your arm.This was Larry's fear, considering how often he used that arm for weight training, exercise, and being at the computer for his job.After weeks of working with him, we were able to eliminate majority of his neck pain, restore function in his arm, and get him back to a state of normalcy.I've been thankful to meet people like Larry who was ambitious enough but brave enough to seek out rehab and coaching outside of traditional means to get him to his health goals.Support the showIf you benefit from episodes like this, hit that ‘Follow' button, and leave a 5-star rating on Spotify or Apple. This would really help this podcast to grow and reach more people who could benefit from living a pain-free life. Interested in working with us? We're looking for healthcare workers, busy parents, and working professionals over 30 who want to eliminate chronic pain from their life so they can enjoy a more active life with their friends & family. We've helped over 550 people find long term success in becoming pain-free. Book a call here to speak with us: https://www.flexwithdoctorjay.co/book Here's a few other places to find me: Join my pain relief support group for busy parents to get weekly live trainings by me and access to my free 6 module pain relief course: http://www.flexwithdoctorjay.online/groupFollow on Instagram: https://instagram.com/flexwithdoctorjayFollow on Tiktok: http://tiktok.com/@flexwithdoctorjaySubscribe on Youtube: http://youtube.com/flexwithdoctorjayCase studies on Yelp: http://flexwithdoctorjay.online/yelpText me anything: 4159656580
In this episode, we review the high-yield topic of Neuropathic Charcot Arthropathy from the MSK section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets
This month Nathalie Dowgray is joined by Clare Rusbridge for part two of their conversation about neuropathic pain in cats. We then join Kelly St Denis and Julien Guillaumen as they discuss recent advances in feline aortic thromboembolism.Our episode begins with Professor Clare Rushbridge sharing her expertise on managing neuropathic pain in cats. We discuss the burdens that caregivers face as well as the various tools and medications that she has found to be helpful with her patients.Dr Kelly St Denis is then joined by Dr Julien Guillaumen to discuss his latest JFMS article ‘Feline Aortic Thromboembolism: Recent Advances and Future Prospects'. Guillaumen provides a historical overview of FATE research, dating back to 1953, and they discuss the delicate balance required in clinical management of these cases, especially concerning hydration and heart failure.For further reading material please visit:Neuropathic pain in cats: Mechanisms and multimodal managementAAFP and ISFM Feline Environmental Needs GuidelinesClare's Youtube ChannelFeline Aortic Thromboembolism: Recent Advances and Future ProspectsFor ISFM members, full recordings of each episode of the podcast is available for you to listen to at portal.icatcare.org. To become an ISFM member, or find out more about our Cat Friendly schemes, visit icatcare.orgHost:Nathalie Dowgray, BVSc, MANZCVS, PgDip, MRCVS, PhD, Head of ISFM, International Society of Feline Medicine, International Cat Care, Tisbury, Wiltshire, UKSpeakers:Clare Rusbridge, BVMS PhD DipECVN FRCVS, RCVS and European Specialist in Veterinary Neurology & JFMS AuthorKelly St Denis, MSc, DVM, DABVP (Feline), 2022 ISFM/AAFP Cat Friendly Veterinary Environment Guidelines Co-Chair, St Denis Veterinary Professional Corporation, Powassan, Ontario, CanadaJulien Guillaumen, Doct Vet, DACVECC, DECVECC, Associate Professor of Emergency and Critical Care at Colorado State University and JFMS Author.
Airing Pain 144: Dilemmas in Pain Research This episode of Airing Pain focuses on the challenges that researchers must overcome when researching pain and developing new treatment approaches. Many questions remain unanswered in the field of pain research. For example, we might know that a treatment works for some people living with pain, but we might not know how it works or why some people benefit and some do not. So, there is a lot of research being done to try to better understand pain. This leads to another problem: how to cope with the amount of new information emerging from research and trials? It is important that new research data is made more accessible for clinicians, healthcare workers, patients, and researchers. Data is no use unless it can be assessed and summarized so that doctors can understand how to use it to benefit their patients. Our contributors for this edition are leaders in this field and they discuss some of the issues they have encountered whilst conducting their research into pain and how to treat it. The interviews were recorded at the British Pain Society's Annual Scientific Meeting, 2023. Contributors: Professor Robert Brownstone, Brain Research UK Chair of Neurosurgery, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology. Dr Neil O'Connell, Reader in Physiotherapy, Brunel University, Chair of the International Association for the Study of Pain (IASP) Methods, Evidence Synthesis and Implementation Special Interest Group. He is an advisor to Pain Concern. Dr Kirsty Bannister, Neuroscientist and Associate Professor at King's College London. Time Stamps: 1:22 Paul introduces Professor Robert Brownstone, Brain Research UK Chair of Neurosurgery at University College London. 1:32 Prof. Brownstone explains what a spinal cord stimulator is, the lack of progress made with this form of treatment, the varied results the treatment gets, and why some people experience long-term pain following back surgery. 7:40 Paul talks about Cochrane, a global independent network of health practitioners, researchers, and patient advocates who review research findings to provide a more precise estimate of the effects of a treatment. 7:54 Paul introduces Dr Neil O'Connell, a Reader at Brunel University who was the Co-ordinating editor of the Cochrane Pain, Palliative and Supportive Care (PaPaS) group. 8:35 Dr O'Connell discusses how Cochrane reviews research and clinical trials, and the complexities involved in gathering and interpreting evidence when developing interventions. 17:04 Paul introduces Dr Kirsty Bannister, a neuroscientist and Associate Professor at King's College London who specialises in neuropharmacology and runs a research group that uses animals to examine the mechanisms of pain processing. 17:22 Dr Bannister talks about why animal models are useful for researching the responses people may have to different pain processes and researching chronic pain by measuring neuronal responses to pain. 21:44 Paul and Dr Bannister discuss the limitations of using animals to research chronic pain. 23:48 Paul and Dr Bannister explore why looking at a patient's experience of pain first can better inform lab research on animal models for understanding and researching pain. 30:03 Prof. Brownstone gives some advice for those considering a spinal cord stimulator as an intervention they want to try. Additional Resources: Cochrane Pain Matters 73: Neuropathic pain issue Pain Matters 79: Navigating pathways to live well with pain Pain Matters 80: What treatment really works Neuropathic Pain If you have any feedback about Airing Pain, you can leave us a review via our Airing Pain survey ______________________________________________________________________________________________
This month our focus is on recognising feline pain. Yaiza Gomez-Meijas is joined by Beatriz Monteiro to discuss the feline grimace scale. Clare Rusbridge then joins Nathalie Dowgray to discuss neuropathic pain in cats.Our episode begins with Yaiza interviewing Beatriz about her findings from a large bilingual global survey assessing if cat caregivers reliably assess acute pain in cats using the Feline Grimace Scale, an innovation that led to Monteiro winning the JFMS Best Resident Paper Award. The method allows both veterinarians and cat caregivers to evaluate pain based on facial expressions, aiming to bridge the gap between professionalveterinary assessments and at-home care for felines.Nathalie is then joined by Professor Clare Rusbridge who shares insights into her recent JFMS article on Neuropathic pain in cats: Mechanisms and multimodal management. She highlights the importance of distinguishing between nociception and pain perception and discusses diagnostic challenges and management strategies for conditions like osteoarthritis and feline hyperesthesia syndrome.For further reading material please visit:Can cat caregivers reliably assess acute pain in cats using the Feline Grimace Scale?The Feline Grimace Scale WebsiteNeuropathic pain in cats: Mechanisms and multimodal managementAAFP and ISFM Feline Environmental Needs GuidelinesClare's Youtube ChannelFor ISFM members, full recordings of each episode of the podcast is available for you to listen to at portal.icatcare.org. To become an ISFM member, or find out more about our Cat Friendly schemes, visit icatcare.orgHost:Nathalie Dowgray, BVSc, MANZCVS, PgDip, MRCVS, PhD, Head of ISFM, International Society of Feline Medicine, International Cat Care, Tisbury, Wiltshire, UKSpeakers:Yaiza Gomez-Mejias, LdaVet MANZCVS (Medicine of Cats) CertAP (SAM-F) Acr AVEPA, ISFM Community Coordinator and Small Animal ClinicianBeatriz Monteiro, DVM, PhD, ISFMAdvCertFB, PgDip, Chair of the World Small Animal Veterinary Association Global Pain Council and Winner of the 2024 JFMS Resident Best Paper AwardClare Rusbridge, BVMS PhD DipECVN FRCVS, RCVS and European Specialist in Veterinary Neurology & JFMS Author
In today's episode, I cover the three primary types of musculoskeletal pain, which include mechanical (nociceptive) pain, neuropathic (nerve) pain and chronic or persistent pain. Understanding what type of pain you have helps determine the best path forward in terms of which treatment options to pursue. In future episodes, I will dive deeper into specific treatment interventions for each type of pain. If you are suffering from pain or an injury, my book has comprehensive rehab programs for the 50 most common injuries and pain issues. Each program guides you through three phases of rehab and has pictures of me doing the exercises. The book is almost 500 pages in length and each body region has its own chapter. It is the type of reference that is intended to help you manage your own pains and injuries. Click the following Amazon LINK to learn more about my book.
Visit nascentmc.com/podcast for full show notes [free course] ChatGPT4 in medical writing and editing at learnAMAstyle.com Nascentmc.com for medical writing assistance for your CME or Medical Communications company. Eplontersen for ATTR-CM Eplontersen received FDA Fast Track designation for treating transthyretin-mediated amyloid cardiomyopathy (ATTR-CM) in adults, aiming to inhibit TTR protein production. Nivolumab for NSCLC The FDA accepted supplemental applications for nivolumab in resectable stage 2A to 3B non-small cell lung cancer (NSCLC) based on the CheckMate-77T trial showing improved survival rates. RSV Vaccine for Adults Aged 50 to 59 The FDA prioritizes review of GSK's Arexvy vaccine for RSV in adults aged 50-59 at risk of complications, expanding from its existing approval for those 60 and older. Spinal Cord Stimulation System The FDA approved Boston Scientific's WaveWriter Spinal Cord Stimulation Systems for chronic low back and leg pain treatment in non-surgery patients, based on the SOLIS trial results. OK-101 for Neuropathic Corneal Pain The FDA approved an IND application for OK-101, a first for treating neuropathic corneal pain (NCP), an Orphan disease, developed by OKYO Pharma Limited. Viz ICH Plus for Brain Bleed The FDA cleared Viz ICH Plus, an AI algorithm by Viz.ai for automating the identification and quantification of brain bleeds and structures in NCCT images. Vepdegestrant for MBC Vepdegestrant received FDA Fast Track designation for treating ER-positive/HER2-negative advanced or metastatic breast cancer in patients previously treated with endocrine therapy. VerTouch Spinal Puncture Device The FDA cleared VerTouch, a handheld imaging tool by IntuiTap Medical, designed to improve the accuracy of spinal punctures by providing a 2D image of lumbar spinal anatomy.
In this Clinical Insight we take a shallow dive into the Radiculo-Neuropathic Myofascial Pain Model. This model was heavily influenced by Dr. Chan Gunn. It is a very solid model in the evaluation and treatment of chronic pain as it takes into consideration a lot of key components that play a role in the production of chronic pain. We talk through how the combination of Cannon's Law, denervation and other factors play a role in chronic pain based on how this model describes it. At the end we discuss what are some practical recommendations that you can try immediately to see if there is something you can do if you are dealing with chronic pain. Check it out, leave a comment and we will continue the discussion as well as we can to keep helping make the complicated simple. BOOK LINK: Treatment of Chronic Pain (https://amzn.to/3agkT3m) #Podcast #Clinically #Pressed #Wellness #Performance #Nutrition #ComplicatedSimple #Science #fitness #health #strength #athletics #medical #training #exercise #sportsscience #chiropractic #exercisescience #athletictraining #sports #pain #painrelief #weightloss #kettlebells #complicatedsimple #tpdn #rnmp #myofascial #myofascialpain #chronicpain #dryneedling --- Support this podcast: https://podcasters.spotify.com/pod/show/clinicallypressedco/support
Revolutionize your care at Budget Pharmacy (budgetpharmacytexas.com 713 694-3785) in Klein, TX for individuals with diabetes battling excruciating neuropathic nerve pain in their limbs. Focused on wound prevention, this cutting-edge service aims to eliminate the need for medical treatment and potential limb loss. Budget Pharmacy City: Spring Address: 19786 Interstate 45 Website https://www.budgetpharmacytexas.com Phone +1-713-694-3785 Email budgetphcy@gmail.com
Join us as we go through the JEADV Editor's Picks of January 2024: (1) A Treatment with Antineoplastic Potential in Squamous Cell Carcinoma (2) Describing Penile Cancer Carcinogenesis and The Role of HPV (3) Sensitive Skin may be Neuropathic in Nature (4) Urgency of Optimal Imaging in Toxic Epidermal Necrolysis Read the Editor's Picks here: https://onlinelibrary.wiley.com/doi/10.1111/jdv.19624 Link to video version: https://www.youtube.com/playlist?list=PL2DbuyADMP5mFx4sZqS_vQtdTGOGIbwb1 You are invited to participate in our survey to improve the show. Your feedback is valued and appreciated to allow us to better serve our audience: https://eadv.org/eadv-podcast-survey/
Welcome to Season 3, Episode 40 of "Winning Isn't Easy"!
Burning Mouth Syndrome is not a strictly surgical topic, but it's something practitioners will often deal with. During this episode, Dr. Hayley Vatcher returns to the podcast to share her insights on this complex diagnosis and how best to treat it. Tune in as Dr. Vatcher draws on her years of experience to offer guidelines on identifying when patients are struggling with this condition and advising them on how to manage it. Starting with more conservative approaches, we explore different methods of dealing with Burning Mouth and reducing the symptoms, including nutritional and supplementary care, topical solutions, and more. Dr. Vatcher also breaks down key research into causes, management, and more. Thanks for listening in! Key Points From This Episode:Welcome to Oral Medicine Specialist, Dr. Hayley Vatcher.Defining Burning Mouth Syndrome, also referred to as Complex Oral Sensitivity Disorder (COSD).Neuropathic aspects of Burning Mouth Syndrome.How it is managed without surgery.Why Burning Mouth Syndrome is a diagnosis of exclusion.Ruling out the possibility of a vitamin deficiency instead of COSD.Why something that soothes an ordinary mouth will burn someone with COSD.The patient experiences of burning sensations elsewhere on the body or the skin.Treatment options for patients suffering with this condition.Why practitioners regularly start with a more conservative approach to treatment.Optimizing vitamin intake as a supplementary treatment. Noting that the symptoms are not visible to the eye within the mouth. Why the condition is most common in post-menopausal women. The possibility of whether other medicines can cause Burning Mouth. What has led to the lack of surgical intervention for this condition.Historical data that has shown a Vitamin B Complex to reduce symptoms.Research into different nutritional solutions. Why many of these patients have often already seen three to four other practitioners.Links Mentioned in Today's Episode:KLS Martin — https://www.klsmartin.com/en/KLS Martin Promo Code — StuckiFavsKLS Martin Email — usa@klsmartin.comDr. Hayley Vatcher on LinkedIn — https://www.linkedin.com/in/hvatcher/Dr. Hayley Vatcher Email — drvatcher@coafs.comAcademy of Orofacial Pain — https://aaop.org/Burning Mouth Syndrome: A Review and Update — https://onlinelibrary.wiley.com/doi/full/10.1111/jop.12101American Academy of Oral Medicine — https://www.aaom.com/Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/ Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/ Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059
Welcome to Season 3, Episode 38 of "Winning Isn't Easy"!
Budget Pharmacy, Spring, TX (budgetpharmacytexas.com 713 694-3785) is offering a unique advisory service for those with nerve-related skin pain in their hands, arms, legs, and feet, especially diabetics. The goal is to prevent the development of active wounds that could potentially lead to amputation. Budget Pharmacy City: Spring Address: 19786 Interstate 45 Website https://www.budgetpharmacytexas.com Phone +1-713-694-3785 Email budgetphcy@gmail.com
In this episode, we review the high-yield topic of Neuropathic (Charcot) Joint of Shoulder from the Shoulder & Elbow section. Follow Orthobullets on Social Media: Facebook: www.facebook.com/orthobullets Instagram: www.instagram.com/orthobulletsofficial Twitter: www.twitter.com/orthobullets LinkedIn: www.linkedin.com/company/27125689 YouTube: www.youtube.com/channel/UCMZSlD9OhkFG2t25oM14FvQ --- Send in a voice message: https://podcasters.spotify.com/pod/show/orthobullets/message
This was an amazing interview with one of my most ambitious clients, Larry, who suffered with neck pain that became so bad that he lost strengthen in his dominant arm.The neck has delicate relations to the nerves that go down the arm and control sensation and motor control. So when nerves are pinched acutely or chronically over time, it can lead to temporary but sometimes permanent weakness of your arm.This was Larry's fear, considering how often he used that arm for weight training, exercise, and being at the computer for his job.After weeks of working with him, we were able to eliminate majority of his neck pain, restore function in his arm, and get him back to a state of normalcy.I've been thankful to meet people like Larry who was ambitious enough but brave enough to seek out rehab and coaching outside of traditional means to get him to his health goals.Support the showIf you benefit from episodes like this, hit that ‘Follow' button, and leave a 5-star rating on Spotify or Apple. This would really help this podcast to grow and reach more people who could benefit from living a pain-free life. Interested in working with us? We're looking for healthcare workers, busy parents, and working professionals over 30 who want to eliminate chronic pain from their life so they can enjoy a more active life with their friends & family. We've helped over 550 people find long term success in becoming pain-free. Book a call here to speak with us: https://www.flexwithdoctorjay.co/book Here's a few other places to find me: Join my pain relief support group for busy parents to get weekly live trainings by me and access to my free 6 module pain relief course: http://www.flexwithdoctorjay.online/groupFollow on Instagram: https://instagram.com/flexwithdoctorjayFollow on Tiktok: http://tiktok.com/@flexwithdoctorjaySubscribe on Youtube: http://youtube.com/flexwithdoctorjayCase studies on Yelp: http://flexwithdoctorjay.online/yelpText me anything: 4159656580
In this episode of the Psychedelic Medicine Podcast, Dr. Michelle Weiner joins to discuss the research on ketamine assisted psychotherapy for chronic pain conditions. Dr. Weiner is Double board-certified in Interventional Pain Medicine, Physical Medicine and Rehabilitation and the Director of Integrative Pain Management at Spine and Wellness Centers of America. She uses a unique personalized approach to treat the root cause of one's pain using a biopsychosocial model including lifestyle and plant medicine to empower her patients to cultivate health, optimize quality of life and decrease pharmaceuticals. In this conversation, Dr. Weiner discusses her recent research into ketamine therapy for chronic pain and comorbid depression, which compared psychedelic and psycholytic doses of the dissociative. She emphasizes the importance of a biopsychosocial approach to pain treatment and sees the psychotherapy aspect of the ketamine treatments as crucial to their efficacy, as this approach allows doctors to have a better understanding of the complex etiology of the patients pain beyond just what shows up on imaging and empowers patients to actively take ownership of their pain management. While the results from Dr. Weiner's study were very encouraging, she mentions that ketamine therapies typically require maintenance and that more longitudinal research is needed to further understand how durable these changes are. In this episode: The issue of central sensitization in chronic pain The difference between psychedelic and psycholytic doses What led Dr. Weiner to study chronic pain and comorbid depression Neuropathic, nociceptive, and nociplastic forms of pain The influence of trauma and stress on chronic pain The intersection of pain and identity Dr. Weiner's biopsychosocial approach to pain treatment The differences between cannabis and ketamine as pain treatment medications Quotes: “A lot of [patients'] pain is really similar to fear—fear in the brain—and… if we're not able to understand where this fear is coming from we're not able to extinguish their pain. So I really changed the way I practice and use ketamine because I started to think more about how the psychiatrists are using it, in terms of preparation and integration.” [6:59] “What I've seen is that ketamine does require maintenance in the sense that even if we do six sessions, a lot of patients do need to come back after a few weeks or a few months for maintenance treatment with ketamine as well as therapy.” [20:09] “Pain doctors [should try to] be a little bit more aware of the set, setting, and preparation and integration so that we don't need to use benzos and [patients] can actually have this dissociative experience to allow them to have hope or get out of that fight or flight.” [33:04] Links: Dr. Weiner's study: Ketamine-assisted psychotherapy treatment of chronic pain and comorbid depression: a pilot study of two approaches Dr. Weiner's website Dr. Weiner on Instagram PMA webinar with Dr. Weiner: Treating Pain and Functional Neurologic Disorders with Psychedelics Spine and Wellness Centers of America Psychedelic Medicine Association Porangui
This week, we take a look at the practical management of pain and the advancement of science regarding it, with our guest Dr. Dan Clauw. Co-author of the paper: “Identifying and Managing Nociplastic Pain in Individuals With Rheumatic Diseases: A Narrative Review”, Dr. Clauw joins us today to discuss the work to introduce the three types of pain classified by “The International Association for the Study of Pain” and the mechanisms that underlie pain, as it relates to the field of rheumatology.
Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.07.09.548214v1?rss=1 Authors: Crowther, A., Kashem, S., Jewell, M. E., Chang, H. L., Casillas, M. R., Midavaine, E., Rodriguez, S., Braz, J., Kania, A., Basbaum, A. Abstract: Mouse models that combine tetracycline-controlled gene expression systems and conditional genetic activation can tightly regulate transgene expression in discrete cell types and tissues. However, the commonly used Tet-Off variant, tetracycline transactivator (tTA), when overexpressed and fully active, can lead to developmental lethality, disease, or more subtle behavioral phenotypes. Here we describe a profound itch phenotype in mice expressing a genetically encoded tTA that is conditionally activated within the Phox2a lineage. Phox2a; tTA mice develop intense, localized scratching and regional skin lesions that can be controlled by the tTA inhibitor, doxycycline. As gabapentin, but not morphine, completely relieved the scratching, we consider this phenotype to result from chronic neuropathic itch, not pain. In contrast to the Phox2a lineage, mice with tTA activated within the Phox2b lineage, which has many similar areas of recombination within the nervous system, did not recapitulate the scratching phenotype. In Phox2a-Cre mice, but not Phox2b-Cre, intense Cre-dependent reporter expression was found in skin keratinocytes localized to the area of scratching-induced skin lesions. Most interestingly, topical application of the DREADD agonist, CNO, administered repeatedly over two months, which chronically induced Gi signaling in keratinocytes, completely reversed the localized scratching and skin lesions. Furthermore, ablation of TRPV1-expressing, primary afferent neurons reduced the scratching with a time course comparable to that produced by Gi-DREADD inhibition. These temporal properties suggest that the neuropathic itch condition arises not only from localized keratinocyte activation of peripheral nerves but also from a persistent, gabapentin-sensitive state of central sensitization. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC
Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.03.18.533004v1?rss=1 Authors: Raut, N. G., Maile, L. A., Oswalt, L. M., Mitxelena, I., Adlakha, A., Sprague, K. L., Rupert, A. R., Bokros, L., Hofmann, M. C., Patritti-Cram, J., Rizvi, T. A., Queme, L. F., Choi, K., Ratner, N., Jankowski, M. P. Abstract: Pain of unknown etiology is frequent in individuals with the tumor predisposition syndrome Neurofibromatosis 1 (NF1), even when tumors are absent. Schwann cells (SC) were recently shown to play roles in nociceptive processing, and we find that chemogenetic activation of SCs is sufficient to induce afferent and behavioral mechanical hypersensitivity in mice. In mouse models, animals show afferent and behavioral hypersensitivity when SC, but not neurons, lack Nf1. Importantly, hypersensitivity corresponds with SC-specific upregulation of mRNA encoding glial cell line derived neurotrophic factor (GDNF), independent of the presence of tumors. Neuropathic pain-like behaviors in the NF1 mice were inhibited by either chemogenetic silencing of SC calcium or by systemic delivery of GDNF targeting antibodies. Together, these findings suggest that Nf1 loss in SCs causes mechanical pain by influencing adjacent neurons and, data may identify cell-specific treatment strategies to ameliorate pain in individuals with NF1. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC
Dr. Amy Moore is a plastic surgeon at The Ohio State University Wexner Medical Center. She specializes in super microsurgery for peripheral nerve injuries and peripheral neuropathies including complex hand and trauma reconstructive surgery. She regularly performs procedures to reanimate limbs, relieve patients' debilitating pain, and restore sensation for those with nerve injuries.She is one of the few peripheral nerve surgeons in the world, and she has a focus on improving her patients' quality of life. Nerve growth is a years-long process, and she supports her patients the entire way through recuperating and regaining function after surgery.Her research is focused on developing treatments to make nerve regrowth more efficient and faster. She is also exploring strategies for rewiring nerves with the goal of preventing muscle atrophy, restoring motion and relieving pain. She has authored more than 100 peer-reviewed journal articles in addition to other publications.she also leads a federally funded translational scientific research investigation of advanced limb reconstruction.In addition to this she helps to train the next generation of physicians. She is a professor ands serve as the chair of the Department of Plastic and Reconstructive Surgery at The Ohio State University College of Medicine. She is on the scientific advisory board for the International Symposium of Neural Regeneration, the board of the American Association for Hand Surgery and the American Society for Peripheral Nerve.In this episode we discuss:What is a nerve? How does it function?Various ways nerves get damaged and try to heal themselves.The anatomy of nerve regrowth, for better or for worse.Nonsurgical options after nerve injury.Neuropathic pain descriptors.What is Wallerian degeneration? How does it influence timing of nerve testing?Surgical options after nerve injury.Common and uncommon examples.The growing & expanding field of peripheral nerve injury.The podcast episodes drop weekly on Mondays in seasonal chunks. Subscribe to stay up to date, and tune in when you can! Be sure to rate, review, and follow on your favorite podcast app and let me know what other brain & body things you'd like to hear about.For more information about me, check out my website, www.natashamehtamd.com.Follow me on Instagram, Twitter, or Tik Tok @drnatashamehta. Follow Dr. Amy Moore on Instagram @amymooremd.This episode is not sponsored.
In this episode, we review the high-yield topic of Neuropathic (Charcot) Arthropathy from the Orthopedics section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets
Episode 125: Non-opioid Chronic Pain Management Dr. Axelsson and Jesse explain how to treat chronic pain without opioids. Written by Anika Soleyn, MS4, Ross University School of Medicine. Edited by Jesse Lamb, MS3, American University of the Caribbean; Hector Arreaza, MD; and Fiona Axelsson, MD.This is the Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Axelsson:Welcome to the first episode of 2023, Happy new year! Today is January 10, 2023.What is chronic pain?According to the International Association for the Study of Pain, chronic pain is nonstop or reoccurring pain that lasts more than 3 months or beyond the expected clinical course of illness. Chronic pain can adversely affect well-being and quality of life. We used to think of pain as a response to tissue damage, and as the tissue heals, the pain dissipates, but chronic pain is much more complex than that because there may be no evidence of tissue damage, yet the nociceptors keep sending signals to the brain that there is damage.There are 3 options for the management of chronic pain: non-pharmacologic, nonopioid pharmacological and opioid management. CDC recommends a combination of nonpharmacological and non-opioid management for chronic pain. The 7 most common chronic pain conditions are neuropathic pain, fibromyalgia or chronic pain syndrome, osteoarthritis, inflammatory arthritis, low back pain, chronic headache, and sickle cell anemia.Opioids in long-term care facilities.The use of opioids for the treatment of pain is common in the post-acute and long-term care setting. From the AFP Journal, the Choosing Wisely Recommendation states: “Don't provide long-term opioid therapy for chronic non-cancer pain in the absence of clear and documented benefits to functional status and quality of life.” The Society for Post-Acute and Long-Term Care Medicine published a statement in 2018 about the use of opioids. It states that the prescription of opioids should be based on an interprofessional assessment specifying why opioids are needed. When long-term opioids are not being used for cancer, palliative care, or end-of-life care in a long-term facility, a tapering plan must be “individualized and should minimize symptoms of opioid withdrawal while maximizing pain treatment with non-pharmacologic therapies and non-opioid medications”. Long-term opioid prescriptions should be reviewed regularly and take into consideration the potential harms of opioids. Clinicians are encouraged to offer alternatives such as behavioral therapy, non-opioid analgesics, and other non-pharmacologic treatments whenever available and appropriate.Initial assessment: Identify biopsychosocial factors and identify if the source is neuropathic, nociceptive, or central sensitization. This can be a challenging process and it may require several visits to determine the origin of pain. Neuropathic pain is due to nerve damage or irritation while nociceptive pain is due to tissue damage. Central sensitization is an abnormal response of the nociceptive system. There are changes in the nervous system that alter how it responds to sensory input that causes widespread pain with no apparent cause or in response to mild sensory input. Some examples include fibromyalgia, migraines in response to brushing hair, surgical scar pain, etc.Set goals and expectations: It is crucial to set up patient expectations if they have chronic pain. They should understand that pain can be improved to a manageable level but not always eliminated. Patients should have routine follow-up visits with education, and reassurance since they are shown to improve outcomes of pain management. Specific goals such as improved mobility and ability to do certain enjoyable tasks are more reasonable and specific goals than a goal of pain elimination. A good physician-patient relationship and clear communication are essential here. Patients could obviously become deeply upset at the prospect of pain that can't be eliminated, and those who have received opioids for their pain in the past could be even more distraught at the thought of not getting them now or needing to reduce their dose. The physician should be ready to have this discussion with their patients that have chronic pain and be ready to address their concerns appropriately. Reduce catastrophic thinking: Pain is an alarm system letting someone know there is some sort of damage. Because of this, it makes sense that a patient would respond to pain with anxious and catastrophic thinking. Patients who understand their own chronic diseases are more likely to be actively involved in their treatment, so understanding is crucial in the management of pain. Reducing fearful thoughts such as "there must be something wrong," and "hurt means harm'” is an important first step toward pain self-management and making sure the strategies attempted are effective.Rehabilitation: Focused pain clinics often include educational group classes for patients in distress. The programs include explanations for why pain might be present with no pathological factors. It also includes relaxation and mindfulness that help patients soothe themselves during attacks. The brain plays a big role in the experience of pain. Changing how your brain relates physical pain to stress and reducing those psychosocial barriers through self-care helps with pain management. Finding things that make you physically stronger like physical therapy or occupational therapy help, but also increasing mental strength by doing things that make you happy and having a quality social life is a strong determinant of how the brain perceives physical pain. Consistency is key in pain management even after the patient begins to feel better.Non-pharmacologic therapy – Most of what we will talk about today is non-pharmacological treatment. We will discuss the options and goals of different treatments. Chronic pain treatment should start with non-pharmacological approaches and then you can add medications if necessary. Again, these approaches aim to increase functionand reduce progression despite chronic pain. There should be a consistent non-pharmacological regimen, even if medications are added later. The three main approaches will be physical therapy, psychological therapy, and some integrative medicine methods.Physical therapy. The objective of physical therapy is to improve physical function. You should recommend programs that are specific for patients' limitations and the physical therapist should have trained specifically in chronic pain treatment. This ensures they do a proper initial evaluation and select appropriate therapeutic methods such as Therapeutic exercise: Sometimes patients can become so fearful of painful movement that they have deconditioned muscles. In the geriatric population, some patients are so afraid of falling, that they avoid any form of movement whatsoever, therefore almost certainly leading to falls due to deconditioning of those muscles. Adding small amounts of exercise as tolerated can begin to recondition patients and help them build strength. Patients with severe osteoarthritis are more likely to tolerate aquatic exercises. Therapeutic exercise programs may be available at the physical therapy facility or community centers. Patients can even find videos on the internet of tai chi, yoga classes, Pilates, and low-impact fitness programs. Exercise can certainly reduce pain and improve function, with few adverse effects but make sure patients tolerate the exercises and are not pushed beyond their limits. Stretching can also improve range of motion and strength, especially in chronic lower back pain patients. Psychological therapy:Cognitive-behavioral therapy. It is the most researched and recommended psychological treatment for chronic pain. It's normally recommended in conjunction with patient education, physical therapy, and exercise. CBT can be used after introducing meds and/or after surgery. There are 2 components to cognitive behavioral therapy: cognitions and behaviors. CBT addresses the way that patients' thoughts (cognitions) affect their actions and vice versa. This begins with helping patients identify situations and environments that trigger their pain and what they actually experience emotionally, behaviorally, and physically when they have pain.CBT addresses mental responses that may worsen pain, so patients learn to think about how they view their pain. To do this, they use a range of specific behavioral strategies such as relaxation and controlled-breathing exercises, activity pacing, pleasurable activities, improving their sleep, and cognitive reappraisal strategies, such as reframing negative situations to positive or practicing gratefulness.Complementary and integrative health therapies.-Mindfulness-based stress reduction. Mindfulness is the ability to be fully present where we are and what we're doing, and not be overly reactive or overwhelmed by what's going on around us.-Progressive muscle relaxation. For instance, tensing/relaxing muscles throughout the body along with positive imagery and meditation.-Biofeedback. During biofeedback, you're looking at biological signs, and feedback that is being correlated to physical sensations in your body to recognize the correlation between physical signs and symptoms of chronic pain. You're connected to monitors, such as electromyograms or electroencephalograms, to quantify muscle tension, brain waves, heart rate, and blood pressure to see how fluctuations and abnormal numbers physically feel in the body.-Massage therapy. It can relax painful muscles, tendons, and joints and relieve stress. The effect of pressure in certain areas that are tender causes relaxation and secretion of endorphins that can calm pains. That's why massage therapy can actually be addictive for some people, because of the endorphins. Another benefit of massage therapy is that it can help with improved absorption of medications due to improved circulation.There are many other integrative health therapies including Reiki, hypnosis, therapeutic touch, healing touch, and homeopathy. However, these are not well-researched and can't really be endorsed by evidence-based medicine.If patients are interested in trying complementary, integrative health therapy, you can guide them to practices that are at least safe. Some therapies can end up being harmful, such as herbal remedies or supplements with potential toxicities or known interactions with medications, so those should be taken cautiously. Make sure your med list while taking your history includes supplements and herbs patients might be trying. Shirodhara is an Ayurvedic approach to stress relief that involves having someone pour liquid — usually oil, milk, buttermilk, or water — onto your forehead.Herbal or plant-based treatments have also shown some efficacy in published studies. Ginger, turmeric, St John's Wort, and a handful of others seem like they could have some beneficial effects either on their own merit or as an adjunctive with other non-opioid therapies. Caution should be taken, though, as some of them, particularly St John's Wort, have been shown to have negative impacts on serum levels of opioids when used in combination with them due to their effects on the liver cytochrome system. Data is also rather mixed, with some studies showing reasonable efficacy and others showing almost none. If your patients want to take herbal supplements, it is essential to be diligent about checking their efficacy and interactions with other therapies to ensure safety. The physician should also be clear when discussing current medications to ask specifically if they take herbal supplements of any kind, as many patients don't consider these to be “medications” and will omit them during history. Of note, turmeric has to be taken with black pepper for better GI absorption.Weight reduction: A healthy diet and fitness are always recommended. Online guidelines are helpful on topics such as healthy fats, vegetables, avoiding refined sugar, and more. Obesity is a pro-inflammatory state, but it is important not to blame chronic pain problems solely on obesity since patients may still have pain after losing weight. Weight reduction can be a part of that plan, but we should not promise a cure for chronic pain after a patient reaches an ideal weight. Sleep disturbances: Ironically, sleep improves pain, but pain makes sleep more difficult. If patients complain of sleep disturbances, start with behavioral changes, including improved sleep hygiene (keep a regular sleep schedule, exercise regularly, don't use caffeine and caffeinated beverages, don't eat too late at night) and stimulus control (the bed should only be used for two things: sleep and sex, get out of bed if you can't sleep, wake up at the same time every day, and avoid bright screens before bedtime because they confuse your brain); cognitive behavioral therapy (deal with concerns or worries that may interfere with sleep). Treating sleep disturbance may have a positive effect on the treatment of chronic pain. Acupuncture: It involves the insertion of very thin needles through the skin at specific points on the body. Acupuncture is a key component of traditional Chinese medicine and can be considered in patients with chronic pain. There are significant difficulties in studying acupuncture, but randomized trials suggest that acupuncture and placebo may have similar efficacy, and both are superior to no treatment. Pharmacologic therapy – For patients with inadequate analgesia despite nonpharmacologic therapies, we add carefully selected multi-targeted pharmacological therapies based on the type of pain (i.e., nociceptive, neuropathic, central sensitization) For nociceptive pain, start with non-steroidal anti-inflammatory drugs (NSAIDs) while continuing non-pharmacologic treatments. If that doesn't work add a topical agent such as lidocaine, capsaicin, or topical NSAIDs. Consider opioid treatment if neither of those works. For neuropathic pain, start with antidepressants or antiepileptic drugs: tricyclic antidepressants, SNRIs, pregabalin, gabapentin, or carbamazepine in addition to non-pharmacologic therapy. If those medications do not provide relief of pain, then you can consider adding topical agents and then opioids after weighing the risk and benefits. Side effects can be viewed as harmful, but we can use them for our benefit.Opioids are reserved for people with moderate to severe pain who cannot function. Once you identify a treatment that works for the patient, follow-up visits should be continued to promote behavioral changes, monitor therapeutic response, and treat side effects. A pain contract should also be signed.Follow-up visits – Schedule follow-up visits to continue educating patients and their families and caregivers, to continue motivational interviewing, and to monitor improvement. Refer patients who are not making enough progress, such as not reaching goals of function and quality of life, to comprehensive pain programs that can use additional modalities such as injections.Bottom line: Non-pharmacologic options should be considered in the management of all patients with chronic pain. The main non-pharmacologic strategies include physical therapy, psychological therapy, and complementary and integrative therapy. Remember to treat sleep disturbances and obesity as part of your plan. Add pharmacologic agents such as NSAIDs, antidepressants, and anticonvulsants when non-pharmacologic therapies do not help the patient reach their goals. Consider opioids only in moderate to severe pain with loss of function. Opioid prescription is a complex topic that was addressed in episode 31 of this podcast, more than 2 years ago, it is time for an update. Stay tuned, we will talk about opioids soon.____________________________Conclusion: Now we conclude episode number 125, “Non-opioid Chronic Pain Management.” Non-pharmacologic therapy is proven to be effective in the treatment of chronic pain, especially physical therapy, psychological therapy, and some complementary therapy. Medications can be added to non-pharmacologic therapy, mainly NSAIDs, antidepressants, antiepileptic medications, and more. Opioids can be added in disabling chronic pain, but prescription needs to be done cautiously and watchfully. The treatment of chronic pain may be challenging and daunting at times, but fortunately, we have science to back us up with effective ways to help our patients. So, don't be discouraged and trust science! This week we thank Fiona Axelsson, Jesse Lamb, and Hector Arreaza. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________Links:Tauben, David, Brett R Stacey, Approach to the management of chronic non-cancer pain in adults, UpToDate. Last updated on May 06, 2022. Accessed January 10, 2023. https://www.uptodate.com/contents/approach-to-the-management-of-chronic-non-cancer-pain-in-adults.Choosing Wisely Recommendations: Don't provide long-term opioid therapy for chronic non-cancer pain in the absence of clear and documented benefits to functional status and quality of life, American Family Physician, Collections 460, American Academy of Family Physician. Link: https://www.aafp.org/pubs/afp/collections/choosing-wisely/460.html.What is Mindfulness? Mindful.org. https://www.mindful.org/what-is-mindfulness/.Jahromi B, Pirvulescu I, Candido KD, Knezevic NN. Herbal Medicine for Pain Management: Efficacy and Drug Interactions. Pharmaceutics. 2021; 13(2):251. https://doi.org/10.3390/pharmaceutics13020251.Royalty-free music used for this episode: “Good Vibes - Fashionista." Downloaded on October 13, 2022, from https://www.videvo.net/
0:00 - Introduction5:32 - Importance of lower back pain. Statistics10:07 - What is lower back pain. Discussion around concepts of pain16:07 - What is nociception36:36 - Acute lower back pain57:10 - Manual therapy for acute pain1:10:20 - Recurrent/chronic lower back pain1:15:40 - Specific diagnosis1:17:40 - Neuropathic pain/referred pain1:24:10 - Non-musculoskeletal causes1:42:05 - Manual therapy for chronic pain1:45:15 - Posture1:51:57 - Types of exercise1:54:54 - Core stability2:04:40 - Strategies for decreasing LBP incidence2:06:43 - Lifting2:08:23 - Loaded lumbar flexion abdominal exercises2:18:10 - Spinal position for squat and deadlift2:26:00 - Living with chronic lower back pain2:33:37 - Closing
Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2022.12.18.520924v1?rss=1 Authors: Damo, E., Agarwal, A., Simonetti, M. Abstract: Drugs enhancing the availability of noradrenaline are gaining prominence in the therapy of chronic neuropathic pain. However, underlying mechanisms are not well understood, and research has thus far focused on 2-adrenergic receptors and neuronal excitability. Adrenergic receptors are also expressed on glial cells, but their roles toward antinociception are not well deciphered. This study addresses the contribution of {beta}2-adrenergic receptors ({beta}2-ARs) to the therapeutic modulation of neuropathic pain in mice. We report that selective activation of {beta}2-ARs with Formoterol inhibits pro-inflammatory signaling in microglia ex-vivo and nerve injury-induced structural remodeling and functional activation of microglia in vivo. Systemic delivery of Formoterol inhibits behaviors related to neuropathic pain, such as mechanical hypersensitivity, cold allodynia and the aversive component of pain, and reverses chronically established neuropathic pain. Using conditional gene targeting for microglia-specific deletion of {beta}2-ARs, we demonstrate that the anti-allodynic effects of Formoterol are primarily mediated by microglia. Although Formoterol also reduces astrogliosis at late stages of neuropathic pain, these functions are unrelated to {beta}2-AR signaling in microglia. Our results underline the value of developing microglial {beta}2-AR agonists for relief from neuropathic pain and clarify mechanistic underpinnings. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC
Interview with Scott Hauswirth, OD, FAAO, at the University of Colorado. Join researcher and clinician, Dr. Scott Hauswirth, as he shares his insight on how to manage corneas that “don't feel right.” He presents diagnostic and treatment strategies for corneas that feel “too much” or “too little.”
Not Just a Chiropractor for Stamford, Darien, Norwalk and New Canaan
Neuropathy@CoreHealth551 Post Road Suite 1Darien CT 06820Here is a list of Questions I received recently about peripheral neuropathyis peripheral neuropathy curablecan peripheral neuropathy be reversedis peripheral neuropathy reversiblecan peripheral neuropathy be curedis peripheral neuropathy a disabilitywhat are the symptoms of peripheral neuropathydoes peripheral neuropathy come and gocan peripheral neuropathy go awayis peripheral neuropathy fatalwhat is peripheral neuropathy in diabeteshow long does peripheral neuropathy lastcan peripheral neuropathy kill youis peripheral neuropathy hereditaryis peripheral neuropathy permanentwhat does peripheral neuropathy meanis peripheral neuropathy dangerouscan peripheral neuropathy be caused by a bulging discwhat's peripheral neuropathywho treats peripheral neuropathycan peripheral neuropathy cause itchingcan peripheral neuropathy come and gowhat causes peripheral neuropathy other than diabetesis peripheral neuropathy painfulwhat does peripheral neuropathy feel like redditwhy does peripheral neuropathy cause fatigueperipheral neuropathy when to go to erwhere does neuropathy startwhich statins cause peripheral neuropathyis peripheral neuropathy progressivewhat causes peripheral neuropathy in diabeteswhat makes peripheral neuropathy worsecan peripheral neuropathy cause headachesis peripheral neuropathy seriouscan peripheral neuropathy cause dizzinesswhat helps peripheral neuropathy at nightwhat are the signs of peripheral neuropathyperipheral neuropathy is most likely to be manifested bywill peripheral neuropathy go awayhow does peripheral neuropathy progressdo symptoms of peripheral neuropathy come and gowhat triggers peripheral neuropathywhy peripheral neuropathy in diabeteswhy is peripheral neuropathy dangerouswhy does peripheral neuropathy come and gowhere does peripheral neuropathy starthow long peripheral neuropathy lastwhat are the first signs of peripheral neuropathyhow does peripheral neuropathy affect walkingis vitamin b12 good for peripheral neuropathywill peripheral neuropathy get betterwhy peripheral neuropathyhow peripheral neuropathyhow often peripheral neuropathywill peripheral neuropathy get worseis there a difference between neuropathy and peripheral neuropathyhow common peripheral neuropathywhen does peripheral neuropathy go awayhow can peripheral neuropathy be reversedwhy isoniazid causes peripheral neuropathyhow to get peripheral neuropathywhich cancers cause peripheral neuropathyhow much magnesium for peripheral neuropathyhow many peripheral neuropathy manifest in the patienthow peripheral neuropathy occurshow much alcohol can cause peripheral neuropathywhy does peripheral neuropathy get worsewhy peripheral neuropathy worse at nightwhich doctorThis podcast welcomes your feedback here are several ways to reach out to me. If you have a topic you would like to hear about send me a message. I appreciate your listening. Dr. Brian Mc Kayhttps://twitter.com/DarienChiro/https://www.facebook.com/ChiropractorBrianMckayhttps://chiropractor-darien-dr-brian-mckay.business.sitehttps://podcasts.apple.com/us/podcast/not-just-chiropractor-for-stamford-darien-norwalk-new/id1503674397?uo=4
Episode 184 hosts Dr Rungsima Wanitphakdeedecha, a dermatologist, laser and injectable expert based in Bangkok, Thailand. Rungsima has a wealth of experience using toxins, has led research in the field and has published peer-reviewed journals on the topic. In this series of episodes called 'The Tox Talks', we feature expert injectors who have significant experience in using toxins. Each episode explores our guests experiences and we get special insights into the subtle nuances of getting the best results from toxin products. In Chapter 4 of 'The Tox Talks', we focus on a niche use of toxins most commonly referred to as 'microtoxin treatments'. We explore: - What we mean by microtoxin treatments - Who started doing microtoxin treatments - Why microtoxin treatments are so popular in Asia - The proposed mechanisms by which microtoxin treatments work - Which toxins seem to work best for microtoxin treatments - The main uses, techniques, doses/dilutions of microtoxin treatments including: Skin rejuventation 'Facial lifting' Sebum reduction/acne improvement rosacea Hyperhydrosis (excessive sweating) - Some more unusual uses of microtoxin including: Surgical scar prevention/improvement Hayfever symptom control Neuropathic pain reduction Retractile testicle pain IA Patreons Dr Jake & David hugely appreciate our IA Patreons who have helped support and contribute to the day to day running of the podcast: IA Supporters: Esther Hermann, Sue Arber, Mischell Christmas, Claire Waterworth, Gavin Scriven, Stephen Land, Estelle Kelly, Georgia Rappel, Camilla Phillips, Raquel Campos IA Fans: Ish Goonewardene, Steph Burrows, Zainab Al-Mukhtar, Monica Bahamon, Jacinta King, Hazel Salvedore, Skye Carter, Cathriona Sullivan, Jessica Halliday, Jane Conchie, Natalie Smith IA Super fans: Julie Ann Rogers, Tanya Khan, Martina Lavery, Matt Manton, Stephanie Sirillas, Alexandra Davies, Vanessa Anlezark IA Gold fans: Lori Robertson, Marrisa Dennis, Natasha Keeping, Karim Sayed, Sarah Mowby Want to be an IA Patreon too? You'll be invited into our IA Patreon whatsapp group, get injecting hints & tips, you can also watch our lockdown webinars and learn from injector colleagues aroud the world Follow IA on Instagram Visit our website Subscribe to IA on Apple Podcasts Subscribe to IA on Spotify Contact Dr Jake & David More about Dr Jake Follow Dr Jake on Instagram Follow David on Instagram Follow Rungsima on Instagram
In the second podcast of season 5, Dr. Nima Adimi, a pain and spine specialist at Ridgeview discusses many areas around pain management, including how we evaluate, manage and treat pain and spine patients, the multidisciplinary teamwork involved, current guidelines, new and contemporary management strategies, and what is in the pipeline for the future of pain medicine. Enjoy the podcast. Objectives:Upon completion of this podcast, participants should be able to: Describe the types of tools available for people suffering with chronic pain. Identify ways to get patients access for pain management. Differentiate the diverse and broad nature of treatments available to those suffering from chronic pain. CME credit is only offered to Ridgeview Providers & Allied Health Staff for this podcast activity. Complete and submit the online evaluation form, after viewing the activity. Upon successful completion of the evaluation, you will be e-mailed a certificate of completion within approximately 2 weeks. You may contact the accredited provider with questions regarding this program at Education@ridgeviewmedical.org. To receive continuing education credit for this activity - click the link below, to complete the activity's evaluation. CME Evaluation (**If you are listening to the podcasts through iTunes on your laptop or desktop, it is not possible to link directly with the CME Evaluation for unclear reasons. We are trying to remedy this. You can, however, link to the survey through the Podcasts app on your Apple and other smart devices, as well as through Spotify, Stitcher and other podcast directory apps and on your computer browser at these websites. We apologize for the inconvenience.) DISCLOSURE ANNOUNCEMENT The information provided through this and all Ridgeview podcasts as well as any and all accompanying files, images, videos and documents is/are for CME/CE and other institutional learning and communication purposes only and is/are not meant to substitute for the independent medical judgment of a physician, healthcare provider or other healthcare personnel relative to diagnostic and treatment options of a specific patient's medical condition; and are property/rights of Ridgeview Medical Center & Clinics. Any re-reproduction of any of the materials presented would be infringement of copyright laws. It is Ridgeview's intent that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It is not assumed any potential conflicts will have an adverse impact on these presentations. It remains for the audience to determine whether the speaker's outside interest may reflect a possible bias, either the exposition or the conclusions presented. Ridgeview's CME planning committee members and presenter(s) have disclosed they have no significant financial relationship with a pharmaceutical company and have disclosed that no conflict of interest exists with the presentation/educational event. Thank-you for listening to the podcast. SHOW NOTES: *See the attachment for additional information. In-take process:About 80% of patients referred to Ridgeview's pain center are LBP patients. The first conversation is the usual Goals of Care which are highly important in setting the expectations for the patient, including what type of testing or imaging the patient has received, what treatment modalities have they tried. Neuropathic pain is caused by damage or injury to the nerves that transfer information between the brain and spinal cord from the skin, muscules and other parts of the body. The pain is usually described as a burning sensation and affected areas often sensitive to the touch. Nociplastic pain (a type of pain caused by damage to body tissue. A pain that feels sharp, aching or throbbing) or a type of pain which is mechanically different from the normal nociceptive pain caused by inflammation and tissue damage or the neuropathic pain which results from nerve injury. It may occur in combination with the other types of pain or in isolation. Its location may be generalized or multifocal and it can be more intense than would be expected from associated physical causes. Its causes are not fully understood, but is thought to be a dysfunction of the central nervous system whose processing of pain signals may have become distorted or sensitised. This type of pain typically arises in some chronic pain conditions, with the archetypal condition being fibromyalgia. Opiod Induced HyperalgesiaWhich is a common diagnosis for Dr. Adimi. During this podcast, listeners learn the limitations for further interventions due to hyperalgesia. These interventions will often require opioid titration prior to implementing therapy. Multimodal Treatment Options:Include non-addictive strategies, such as physical therapy, chropractic, fucntional/personal trainer, behavioral health. Discussions continue regarding medications such as gabapentinoids and their side effects, NSAIDs, muscle relaxers, medical cannabis, low dose naltrexone, etc. Interventional StrategiesLeast invasive strategies are discussed, including: trigger point injectsions, epidural, radiofrequency ablation medial branch blocks, facet joint injections, occipital and trigeminal nerve blocks, spinal cord stimulators, peripheral nerve stimulators. During this section of the podcast, Dr. Adimi discusses how spinal cord stimulators are impacting pain with new and exciting modalities, intrathecal pain pumps and their limitations an dhow the use of narcotics, anesthetics and snal poison (ziconotide) are implemented. Dr. Adimi notes that SCS are not effective for mechanical back pain/arthritis patients. Vertiuflex for spinal stenosis patients is discussed, along with the "mild" procedure and minimally invasive lumbar decompression. In wrapping up the podcast, Dr. Adimi discusses the future of pain and the new arena or space the pain specialist will be occupying. New research on SCS for Prakinson, movement disorders, dystonia as well as how it impacts select patient populations like Peripheral Diabetic Neuropathy Study. Thanks for listening.Please check out the additonal show notes for additional resources.
How Peripheral Nerve Stimulation Controls Chronic Pain, With Dr Tim Feldheim On today's episode, Dr. Danko and Dr. Feldheim discuss the rapidly growing and emerging therapy in chronic pain, peripheral nerve stimulation. Dr. Felheim completed his training at The University of Florida and a fellowship at Case Western University. At The Premier Pain Institute they have had positive experiences with peripheral nerve stimulation that they are sharing with the listeners. Tune in for the details! Episode Highlights: Dr. Feldheim explains who peripheral nerve stimulation is good for. They most commonly see peripheral neuropathy characterized by inflammation of the nerves in the lower extremities but can affect the upper; it is usually accompanied by intense burning, numbness, tingling like feeling. What is Reflex Sympathetic Dystrophy (RSD)? Lumbar radiculitis is an extremely common cause of a diseased nerve pain state, a lot of people know this as sciatica. Dr. Feldheim reviews the list of other conditions that cause peripheral nerve pain and damage. Neuropathic pain can be caused by crushing of nerves, lacerations due to trauma or injury, surgical insults, stress injury, small fiber neuropathy and phantom limb pain post amputation. What are the current treatments for peripheral nerve stimulation? Dr. Feldheim reviews the medications that are commonly prescribed as well as topical treatments and therapeutic modalities that may help. What is peripheral nerve stimulation? It does not include FieldSTEM. At PPT, one of their most common is the shoulder, they target the suprascapular nerve. Peripheral nerve stimulation is a very safe and effective option. If you are very active, need routine MRI, or for those who have not had success with spinal cord stimulation, this can have great benefits. Dr. Danko explains how there is a trial with peripheral nerve stimulation and why that is both exciting and important. Multiple imaging modalities can be used to target the nerves. Dr. Danko explains the setup of the devices and how they work. A team of specialists work with the STIMwave technologies on insurance and things of that nature. Dr. Danko asks Dr. Feldheim to share other conditions that he has seen in regards to peripheral nerve stimulation. Are these procedures done in the office or the operating room? How long does the trial last? Dr. Feldheim explains which patients would be best served with spinal cord stimulation and peripheral nerve stimulation. What about knee replacement issues? Needing a battery versus not needing a battery: what are the pros and cons? Dr. Danko explains. How does stimulation compare to the TENS unit? How long does the procedure take and what is the recovery period? 3 Key Points: There are many conditions that can cause issues in peripheral nerves. Dr. Danko and Dr. Feldheim are explaining the common causes and current treatments for this type of pain. The wearable device used for peripheral nerve stimulation is very durable and effective offering freedom to do daily activities and have better quality of life. What is the difference between spinal cord stimulation and peripheral nerve stimulation and what are indicators for one treatment over the other? Resources Mentioned: https://premierpaintreatment.com/ https://www.facebook.com/PremierPainTreatment/ 513-454-7246
On this episode of WOCTalk, we sit down with Phyllis A. Bonham, PhD, MSN, RN, CWOCN, DPNAP, FAAN, WOCN Society Past President, and the Chair of the WOCN Wound Guidelines Task Force. Phyllis joins us to discuss the newest updated clinical guideline, Guideline for Management of Patients with Lower-Extremity Wounds Due to Diabetes Mellitus and/or Neuropathic Disease. Phyllis covers the 14-step process for revisions to the guideline, the updates the task force made to the guideline, and tips for implementing the Guideline for Management of Patients with Lower-Extremity Wounds Due to Diabetes Mellitus and/or Neuropathic Disease at your practice. The WOCN Society's Guideline for Management of Patients with Lower-Extremity Wounds Due to Diabetes Mellitus and/or Neuropathic Disease is the result of a systematic search, review, and synthesis of evidence from literature published from January 2014 through May 2018 with some relevant updates from 2019–2021 during the consensus review process. The target audience for the guideline includes wound, ostomy, and continence (WOC) specialty nurses and other healthcare professionals who specialize in, direct, or provide wound care for patients with/or at risk for lower-extremity (LE) wounds due to diabetes mellitus and/or neuropathic disease (DM/ND).Episode ResourcesClick here to purchase the Guideline for Management of Patients with Lower-Extremity Wounds Due to Diabetes Mellitus and/or Neuropathic DiseaseClick here to purchase the mobile WOCN Clinical Practice Guideline Series.Click here to visit the WOCN BookstoreClick here to read the JWOCN article titled,2021 Guideline for Management of Patients With Lower-Extremity Wounds Due to Diabetes Mellitus and/or Neuropathic Disease: An Executive SummaryClick here to view the WOCNext 2022 session titled, Update on the Guideline for Management of Patients with Lower-Extremity Wounds Due to Diabetes Mellitus and/or Neuropathic DiseaseClick here to view the Lower-Extremity Wounds due to Venous Disease, Arterial Disease, or Diabetes Mellitus and/or Neuropathic Disease: Clinical Resource Guide (2021)
In this episode, we review the high-yield topic of Neuropathic (Charcot) Joint of the Elbow from the Shoulder & Elbow section. Follow Orthobullets on Social Media: Facebook: www.facebook.com/orthobullets Instagram: www.instagram.com/orthobulletsofficial Twitter: www.twitter.com/orthobullets LinkedIn: www.linkedin.com/company/27125689 YouTube: www.youtube.com/channel/UCMZSlD9OhkFG2t25oM14FvQ --- Send in a voice message: https://anchor.fm/orthobullets/message
Today, Doug Pike tells some jokes. He also discusses bartending and opening up clubs. Dr. Sunil Sheth joins the show to talk about neuropathic pain and what to do about it.
How Peripheral Nerve Stimulation Controls Chronic Pain, With Dr Tim Feldheim On today's episode, Dr. Danko and Dr. Feldheim discuss the rapidly growing and emerging therapy in chronic pain, peripheral nerve stimulation. Dr. Felheim completed his training at The University of Florida and a fellowship at Case Western University. At The Premier Pain Institute they have had positive experiences with peripheral nerve stimulation that they are sharing with the listeners. Tune in for the details! Episode Highlights: Dr. Feldheim explains who peripheral nerve stimulation is good for. They most commonly see peripheral neuropathy characterized by inflammation of the nerves in the lower extremities but can affect the upper; it is usually accompanied by intense burning, numbness, tingling like feeling. What is Reflex Sympathetic Dystrophy (RSD)? Lumbar radiculitis is an extremely common cause of a diseased nerve pain state, a lot of people know this as sciatica. Dr. Feldheim reviews the list of other conditions that cause peripheral nerve pain and damage. Neuropathic pain can be caused by crushing of nerves, lacerations due to trauma or injury, surgical insults, stress injury, small fiber neuropathy and phantom limb pain post amputation. What are the current treatments for peripheral nerve stimulation? Dr. Feldheim reviews the medications that are commonly prescribed as well as topical treatments and therapeutic modalities that may help. What is peripheral nerve stimulation? It does not include FieldSTEM. At PPT, one of their most common is the shoulder, they target the suprascapular nerve. Peripheral nerve stimulation is a very safe and effective option. If you are very active, need routine MRI, or for those who have not had success with spinal cord stimulation, this can have great benefits. Dr. Danko explains how there is a trial with peripheral nerve stimulation and why that is both exciting and important. Multiple imaging modalities can be used to target the nerves. Dr. Danko explains the setup of the devices and how they work. A team of specialists work with the STIMwave technologies on insurance and things of that nature. Dr. Danko asks Dr. Feldheim to share other conditions that he has seen in regards to peripheral nerve stimulation. Are these procedures done in the office or the operating room? How long does the trial last? Dr. Feldheim explains which patients would be best served with spinal cord stimulation and peripheral nerve stimulation. What about knee replacement issues? Needing a battery versus not needing a battery: what are the pros and cons? Dr. Danko explains. How does stimulation compare to the TENS unit? How long does the procedure take and what is the recovery period? 3 Key Points: There are many conditions that can cause issues in peripheral nerves. Dr. Danko and Dr. Feldheim are explaining the common causes and current treatments for this type of pain. The wearable device used for peripheral nerve stimulation is very durable and effective offering freedom to do daily activities and have better quality of life. What is the difference between spinal cord stimulation and peripheral nerve stimulation and what are indicators for one treatment over the other? Resources Mentioned: https://premierpaintreatment.com/ https://www.facebook.com/PremierPainTreatment/ 513-454-7246
In this Clinical Insight we take a shallow dive into the Radiculo-Neuropathic Myofascial Pain Model. This model was heavily influenced by Dr. Chan Gunn. It is a very solid model in the evaluation and treatment of chronic pain as it takes into consideration a lot of key components that play a role in the production of chronic pain. We talk through how the combination of Cannon's Law, denervation and other factors play a role in chronic pain based on how this model describes it. At the end we discuss what are some practical recommendations that you can try immediately to see if there is something you can do if you are dealing with chronic pain. Check it out, leave a comment and we will continue the discussion as well as we can to keep helping make the complicated simple. BOOK LINK: Treatment of Chronic Pain (https://amzn.to/3agkT3m) #Podcast #Clinically #Pressed #Wellness #Performance #Nutrition #ComplicatedSimple #Science #fitness #health #strength #athletics #medical #training #exercise #sportsscience #chiropractic #exercisescience #athletictraining #sports #pain #painrelief #weightloss #kettlebells #complicatedsimple #tpdn #rnmp #myofascial #myofascialpain #chronicpain #dryneedling --- Support this podcast: https://anchor.fm/clinicallypressed/support
In this episode, we chat with Gary M. Heri, DMD. An internationally recognized expert in orofacial pain and temporomandibular disorders. He is the director of the Center for Temporomandibular Disorders and Orofacial Pain in the Department of Diagnostic Sciences at Rutgers School of Dental Medicine, which performs research and teaches this advanced field of dentistry focusing on the assessment, diagnosis and treatment of complex chronic orofacial pain disorders. Gary Heir has recently been appointed to the Robert and Susan Carmel Chair in Algesiology at the Rutgers School of Dental Medicine. Over the past decade, Heir played a significant role alongside a committee of national orofacial pain program directors and the American Academy of Orofacial Pain to get orofacial pain recognized as the 12th specialty in dentistry by the American Dental Association in March 2020. He is also the signatory on the application to the National Commission on Recognition of Dental Specialties and Certifying Boards for recognition of the American Board of Orofacial Pain as the official certifying board for the specialty. Currently, Heir directs the center at the dental school, one of only 12 postgraduate orofacial pain programs in the country accredited by the Commission on Dental Accreditation (CODA). He stressed the need for more accredited programs, citing the millions of patients who require treatment but have difficulty finding specialists. In addition to his work at Rutgers, Heir is a highly sought-after lecturer, having delivered nearly 300 presentations on orofacial pain and related subjects in the region, in the country and throughout the world. He has served on the boards of many professional organizations, including as the president of the American Academy of Orofacial Pain and the American Board of Orofacial Pain and as a member of CODA and the Council on Dental Education and Licensure. He was appointed by three of New Jersey's governors for three consecutive terms as a member of New Jersey Governor's Lyme Disease Commission. Heir has published more than 100 peer-reviewed articles, chapters and abstracts on orofacial pain and TMJ disorders. He also serves as the section editor for Orofacial Pain Neuroscience of The Journal of the American Dental Association. (Bio credit, Rutgers.edu) Highlights of this podcast include: Orofacial Pain Musculoskeletal pain Neuropathic pain Neuralgia and palsy Nerve damage and neuropathy Trigeminal neuralgia Migraines Categories of Pain Fear and Pain - psychogenic Placebo and nocebo effects Pain Management / Control Emotional component of pain Diagnosis And So Much More! To learn more about Dr. Heir, please visit rutgershealth.org. This episode is brought to you by Therasage. Use code: STOPCHASINGPAIN at checkout.
Did you know there are different types of pain? In this episode of the Big Questions Podcast, we chat to Dr Lydia Coxon, a researcher in the Nuffield Department of Women's and Reproductive Health at Oxford. Lydia is looking at the mechanisms that cause pain in patients with endometriosis - a common gynaecological condition where tissue that normally grows inside the womb is found outside the womb. Through her research she hopes to better understand the type of pain that endometriosis causes, so that it can be treated more effectively.
What causes different types of face pain and what treatment is available? In this episode of Airing Pain we cover facial pain in its many forms, what treatments are available and how to cope better with your pain. Funded by The Hospital Saturday Fund. In collaboration with UCLH Royal National ENT & Eastman Dental Hospitals. The way our face feels and how we move it is a massive part of our identity. Feeling pain in the face, or not being able to use your face the way you want to, is not only a physical burden on the person suffering, but a heavy psychological load to cope with as well. Issues covered in this programme include: facial pain, unnecessary dental treatments, tooth ache, face and identity, management techniques, trigeminal neuralgia, neuropathic pain, carbamazepine, neurosurgery, pain management programmes, psychology and pain, temporomandibular disorder, burning mouth syndrome, persistent idiopathic facial pain, central sensitisation syndrome, physiotherapy, acceptance & commitment therapy Time Stamps: 01: 54 - Trigeminal neuralgia (TN): what is it and what does it feel like? Dr Joanna Zakrzewska explains. 06:27 - Dr Zakrzewska discusses what treatments are available for TN, including carbamazepine. 10:37 - How can neurosurgery help treat TN? 18:11 - Psychology Pain Management Programmes (PMPs) for sufferers of TN. 19:11 - Susie Holder on the psychological impact of face pain. 21:36 - Dr Roddy McMillan discusses temporomandibular disorder (TMD) as a source of face pain. 22:29 - Burning mouth syndrome and other types of face pain. 25:50 - Treatments available for other types of face pain. 28:30 - TMD and how it is different from other types of face pain (usually neuropathic in origin). 30:00 - What is central sensitisation syndrome? 32:21 - Pain management for chronic pain sufferers. 36:05 - Susie Holder explains what acceptance and commitment therapy (ACT) is. 44:07 - Obstacles to living well with pain, including the coronavirus pandemic. Contributors: Dr Joanna Zakrzewska, consultant in oral medicine specialising in trigeminal neuralgia at the Department or Oral Medicine and Facial Pain at the UCLH NHS Foundation Trust. Susie Holder, clinical psychologist on the facial pain team at the Royal ENT and Eastman Dental Hospitals, UCLH NHS Foundation Trust. Dr Roddy McMillan, consultant in oral medicine and facial pain at the Royal ENT and Eastman Dental Hospitals, UCLH NHS Foundation Trust. More Information: Pain Matters magazine issue 77: face the pain Airing Pain 12: Trigeminal Neuralgia, Pelvic Pain & Cannabis Airing Pain 115: Neuropathic pain 1 of 2, targeted Pain Management Programmes Airing Pain 116: Neuropathic pain 2 of 2, latest research My live well with pain Trigeminal Neuralgia Association UK
On this episode of the PTA Elevation Podcast, host Briana Drapp, PTA, CSCS goes over the important things to know about neuropathic ulcers when studying for the NPTE. At the end of this episode, Briana provides and reviews a sample question that helps students get a feel for how this subject will be asked on the NPTE - PTA. Tune in to learn more! Join our FB group for FREE resources to help you study for the exam! https://www.facebook.com/groups/382310196801103/ If you're interested in the other services we have to offer, please fill out this form below: https://forms.gle/jtFadod1eGBjzc2s7 Follow us on our other platforms! https://linktr.ee/ptaelevation We look forward to serving you!
Expert Guidance for Effective Management and Appropriate Monitoring of Patients With Pain
From Theresa Mallick-Searle, MS, PMGT-BC, ANP-BC, a concise presentation on pain assessment. In this episode, Ms Mallick-Searle provides an overview of the different types of pain before going on to explain how to assess which type of pain your patient is experiencing and how it can affect their life—both physically and emotionally. She then discusses what questions to ask and exams to complete to assess pain levels, including the use of validated pain assessment screening tools. Listen as Ms Mallick-Searle applies these tools and tactics in a standardized patient interview to understand the patient's level of pain and its impact on his life.Presenter:Theresa Mallick-Searle, MS, PMGT-BC, ANP-BCAdult Nurse PractitionerDivision of Pain MedicineStanford Health CareRedwood City, CaliforniaThis activity is supported by an independent educational grant from the Opioid Analgesic REMS Program Companies. Please seehttps://bit.ly/3mgrfb9 for a listing of REMS Program Companies. This activity is intended to be fully compliant with the Opioid Analgesic REMS education requirements issued by the FDA.Provided by Clinical Care Options, LLC, and in partnership with the American Academy of Physical Medicine and Rehabilitation, Practicing Clinicians Exchange, and ProCE.Link to full program:https://bit.ly/3mcDHsi
Don't forget to check out Elizabeth's website, book an appointment with her, and learn about the MS Diet.Make sure you rate and subscribe to My Immune System Hates Me! and follow @myimmunesystempod on Instagram and Facebook for episode updates. You can also email myimmunesystempod@gmail.com if you'd like to get in touch!***Any information discussed in this podcast is strictly my opinion and those of my guests and are for informational purposes only. We are speaking from our personal experiences and you should always consult with your doctor or medical team.
In this episode, we review the topic of Neuropathic (Charcot) Joint of the Shoulder from the Shoulder & Elbow. --- Send in a voice message: https://anchor.fm/orthobullets/message
Nihkil Verma is a medical doctor who specializes in treating and managing spinal health, mobility, chronic pain, and athletic health among others. In this episode, we discuss chronic pain, the various ways chronic pain is managed, transhumanism, muscular tension, and the possible future interventions in managing chronic pain. You can find Nihkil on Twitter at VermaN21 and on Instagram at dr.nvsportandspine. Enjoy! (5:44) What is a notochord? (10:18) What portion of pain is subjective and what portion is objective? How much do we know about each of these components? Nociceptive vs Neuropathic pain. (14:40) What do we know about the memory component of subjective and chronic pain? And why is it so misunderstood? (18:02) Why opioids are terrible widespread methods for treating chronic pain. (19:54) How can we get better in touch with our endogenous opioids? (24:50) Is there such a thing as too much mobility? (26:44) Is there evidence that weightlifting helps manage chronic pain? (29:56) How does the brain create a unitary picture of experience? (33:10) Transhumanism, the ways people apply it to managing chronic back pain, and the problems with it. (41:45) Is there a relationship between muscular tension and chronic pain? Why are float tanks so effective? (48:55) What is the potential of stem cell regeneration for chronic pain? Do psychedelics or ketamines play any role in the future of treating chronic pain? (55:53) Will exoskeletons ever become mainstream? Are there any disadvantages to this?
Neuropathic pain, especially in children can be extremely challenging to recognize and treat. Dr. Alyssa Lebel MD, a dually trained pediatric neurologist and pain physician, provides a step by step explanation of neuropathic pain across the pediatric age groups and provides practical tools for how healthcare professionals can recognize and treat it effectively. Takeaways in This Episode Dr. Lebel's personal connection to and her journey into becoming a pediatric neurologist and pain physician The unique features of pediatric nervous system and neurocognitive development Features distinguishing pediatric neuropathic pain from that among the adults What are functional neurological disorders or pain presentation of these disorders, and the findings on imaging (Hint: it’s not just made up or feigned symptoms) Why and when neonates and infants develop neuropathic or chronic pain Correlation between colic, headache, and/or abdominal pain Ways to prevent the triggering of the central nervous system Guide to an early recognition of neuropathic pain Strategies to treat children's neuropathic pain What the family/patient needs in addition to the treatment options. Links Alyssa Lebel MD FREE Clinicians'Pain Evaluation Toolkit Proactive Pain Solutions About the Guest Speaker Alyssa Lebel MD Dr. Alyssa Lebel is the Co-Director of Headache Program, and a Senior Associate in Pain Medicine in the Department of Anesthesiology, Critical Care and Pain Medicine at Boston Children's Hospital. She's an Associate Professor of Anesthesia at the Harvard Medical School. Dr. Lebel is fellowship trained in pediatric neurology and pain medicine. After her training Dr. Lebel chose to devote her clinical practice primarily to the treatment of patients with significant pain, initially in both adults and children with cancer, and then in patients of all ages with intractable neuropathic pain. Early in her career, she sought additional training in regional anesthesia and rehabilitative medicine to provide a comprehensive service for challenging referrals. Concurrently, she maintained a general pediatric neurology outpatient clinic and served as a teaching attending for the Department of Neurology. In Philadelphia, she continued to work for the Departments of Anesthesiology, Pain Division, and Neurology, on the inpatient and outpatient services as well as within a partial hospital program for pain rehabilitation, ultimately focusing on pediatric care while at Children's Hospital of Philadelphia. Currently, at Boston Children's Hospital, she has increasingly focused on patients with chronic headache. She has written extensively and lectured nationally and internationally on both the mechanisms and treatment of pediatric headache. She established and directs a multidisciplinary pain-management program for patients with chronic head pain. She is recognized by her colleagues as an expert in the comprehensive assessment and management of pediatric and young adult patients with headache and cranial neuralgia.
Skin and Wound Care. Produced by the Emory Nursing Wound Ostomy Continence Nursing Education Center.
Constipation as a diagnosis can be dangerous, mainly because it is a powerful anchor in our medical decision-making. Chances are, you’d be right to chalk up the pain to functional constipation — 90% of pediatric constipation is functional, multifactorial, and mostly benign — as long as it is addressed. We’re not here for “chances are“; we’re here for “why isn’t it?“ Ask yourself, could it be: Anatomic malformations: anal stenosis, anterior displaced anus, sacral hematoma Metabolic: hypothyroidism, hypercalcemia, hypokalemia, cystic fibrosis, diabetes mellitus, gluten enteropathy Neuropathic: spinal cord abnormalities, trauma, tethered cord Neuromuscular: Hirschprung disease, intestinal neuronal dysplasia, myopathies, Down syndrome, prune belly syndrome Connective tissue disorders: scleroderma, SLE, Ehlers-Danlos syndrome Drugs: opioids, antacids, antihypertensives, anticholinergics, antidepressants, sympathomimetics Ingestions: heavy metals, vitamin D overload, botulism, cow’s milk protein intolerance Red Flags Failure to thrive Abdominal distention Lack of lumbosacral curve Midline pigmentation abnormalities of the lower spine Tight, empty rectum in presence of a palpable fecal mass Gush of fluid or air from rectum on withdrawal of finger Absent anal wink You gotta push the boat out of the mud before you pray for rain. — Coach Medications for disimpaction (do this first!) Polyethylene Glycol (PEG) 3350 (Miralax): 1 to 1.5 g/kg PO daily for 3 to 6 consecutive days. Maximum daily dose: 100 g/day PO. Follow-up with maintenance dose (below) for at least 2 months (usually 6 months) Lactulose: 1.33 g/kg/dose (2 mL/kg) PO twice daily for 7 days Mineral Oil (school-aged children): 3 mL/kg PO twice daily for 7 days Medications for Maintenance (do this after disimpaction!) Polyethylene Glycol (PEG) 3350 (Miralax): 0.2 to 0.8 g/kg/day PO. Maximum daily dose: 17 g/day. Maintenance dosing for Miralax may need to be tailored; up to 1 g/day maintenance. Lactulose: 1 to 2 g/kg/day (1.5 to 3 mL/kg/day)PO divided once or twice daily. Maximum daily dose: 60 mL/day in adults. Mineral Oil: 1 to 3 mL/kg/day PO divided in 1 to 2 doses; maximum daily dose: 90 mL/day Docusate (Colace): 5 mg/kg/day PO divided QD, BID, or TID (typical adult dose 100 mg BID) Senna, Bisocodyl — complicated regimens; use your local reference Enemas Are you sure? Have you tried oral disimpaction over days? No phosphate enemas for children less than 2. Saline enemas are generally safe for all ages Be careful with the specific dose — please use your local reference Selected References Freedman SB et al. Pediatric Constipation in the Emergency Department: Evaluation, Treatment, and Outcomes. JPGN 2014;59: 327–333. North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. Clinical Practice Guideline: Evaluation and Treatment of Constipation in Infants and Children. JPGN 2006; 43:e1-e13. Tabbers MM et al. Evaluation and Treatment of Functional Constipation in Infants and Children: Evidence-Based Recommendations From ESPGHAN and NASPGHAN. JPGN 2014;58: 258–274. Audio Player 00:00 00:0
Gary takes on the real issues that the mainstream media is afraid to tackle. Tune in to find out the latest about health news, healing, politics, and the economy. Study shows that mindfulness can help ease the pain of breast cancer survivors University of Ottawa (Canada), January 6, 2021 A study led by University of Ottawa researchers provides empirical evidence that mindfulness has a significant impact on the brain of women suffering from neuropathic pain related to breast cancer treatment. The researchers showed that mindfulness-based stress reduction (MBSR) helps modulate neuropathic pain. Their findings could make a difference in the lives of many women. In Canada, over a quarter of a million women are expected to be diagnosed with breast cancer - the most diagnosed cancer among women worldwide - in 2020. In addition to the psychological impacts of breast cancer, approximately 20 to 50 percent of survivors report experiencing chronic neuropathic pain following treatment. We talked to senior author Dr. Andra Smith, Full Professor at the uOttawa School of Psychology, to learn more about the most recent findings published in the journal Mindfulness. Why did you and your team decide to look at mindfulness to improve pain-related problems? "Neuropathic pain is a very common side effect of chemotherapy and other breast cancer treatments. Pain killers do not always work and quality of life, cognitive abilities, and overall well-being can be reduced due to this pain. Due to these negative effects and the complexity of treatment for this type of pain following breast cancer treatment, it is important to provide adjunct treatment and management options. We have heard a lot about mindfulness over the past few years, about how it helps people relax and feel better. If mindfulness, a non-pharmacological tool, can be used to help with neuropathic pain, women will feel better and might not experience such disruptive pain. Pain is a subjective experience and mindfulness is often dismissed as a "buzz word." But our research provides objective, empirical evidence of a significant impact of mindfulness on the brain of these women." How was the research conducted? "We investigated the impact of an 8-week mindfulness-based stress reduction (MBSR) program on emotional reactivity among a sample of breast cancer survivors with chronic neuropathic pain. We used state-of-the-art brain imaging at The Ottawa Hospital, on their 3T MRI scanner and collected data on white matter health, brain activity during emotional pain related word processing and during resting state. Women with neuropathic pain were imaged before and after an MBSR program, or treatment as usual. Pain, quality of life, and imaging were compared between the two groups and within the MBSR group pre- and post-MBSR." What did you find? "We observed major reductions in brain activity following mindfulness-based stress reduction in regions related to pain, emotional regulation, and cognitive processing. Both pain severity and pain interference, for the MBSR group, were significantly reduced after the 8-week training. Our results show a significant improvement in brain health as well as in pain perception. There are many anecdotal reports of how this or that made a person "feel better" but the really exciting results here are that we can see that there are actual changes in the brain and the way a person can alter their response to pain." Why is it important? "This research provides hope for a non-invasive method of easing the struggle of chronic neuropathic pain in women following breast cancer treatment. Pain is something that people fear, and many people run into significant secondary problems because of their pain medication use, including drug misuse and mental health issues. Mindfulness has a neurophysiological effect that can alter one's perception of pain. This research shows that there are adjunctive treatment options. If used properly, the information we have published can improve health outcomes for the people involved and could potentially also reduce health costs, as well as some of the related problems - particularly those related to mental health." Who worked on this research? "Dr. Patricia Poulin, at The Ottawa Hospital, was the clinical principal investigator with her research team of Heather Romanow, Yaad Shergill, Emily Tennant, and Eve-Ling Khoo. This included recruitment of the women and all clinical assessments. My lab performed the scanning component of the study, including my imaging team of Dr. Taylor Hatchard, Ola Mioduszewski and Dr. Lydia Fang. The data was collected over two years, from 2017 to 2019, funded by both Canadian Institutes of Health Research (CIHR) and Canadian Breast Cancer Foundation grants. We published three articles on our research in the last four months. The latest, "Reduced Emotional Reactivity in Breast Cancer Survivors with Chronic Neuropathic Pain Following Mindfulness-Based Stress Reduction (MBSR): an fMRI Pilot Investigation" was published in November 2020 in the journal Mindfulness." Moderate calcium intake, supplementation associated with reduced mortality risk during up to two decades of follow-up University of Aberdeen (UK), January 6 2021. A study and meta-analysis reported on December 31, 2020 in the European Journal of Epidemiology found a lower risk of premature mortality from any cause among men and women who consumed moderate amounts of calcium. Supplementing with calcium was associated with a lower risk of mortality from all causes among women. Tiberiu A. Pana and colleagues conducted a study that examined the effects of calcium among 17,968 participants in the European Prospective Investigation of Cancer, Norfolk (EPIC-Norfolk). The results were then included in a meta-analysis of 26 studies with a total of 1,828,149 subjects that evaluated the association between calcium intake and all-cause mortality, cardiovascular mortality, and incident cardiovascular disease, aortic stenosis, heart failure, myocardial infarction, peripheral vascular disease and stroke. When divided into fifths according to amount of their calcium intake, EPIC-Norfolk participants whose intake of calcium was between 771 mg and 926 mg per day had a 9% lower risk of dying from any cause and participants whose intake was 1074 mg to 1254 mg had a 15% lower risk in comparison with subjects whose intake was among the lowest fifth at less than 770 mg. Cardiovascular disease mortality was also reduced in these groups. A moderate intake of calcium was associated with a significantly lower risk of stroke, while the reduction in risk associated with an intake of more than 1255 mg per day failed to reach significance. The meta-analysis found a lower risk of all-cause mortality in association with higher calcium intake compared to lower intake. Calcium supplementation was associated with lower all-cause mortality among women, while no significant association was observed among men. “Moderate dietary calcium intake may protect against cardiovascular and all-cause mortality and incident stroke,” the authors concluded. Health benefits of replacing wheat flour with chickpea flour Kings College London and Quadram Institute, January 11, 2021 Researchers from the Quadram Institute and King's College London have shown that replacing wheat flour with a new ingredient derived from chickpeas improved the glycaemic response of people eating white bread. The ingredient uses specially developed milling and drying processes that preserves cellular structure, making its starch more resistant to digestion. Developing food products that contain more of this resistant starch would help to control blood glucose levels and reduce risk of type 2 diabetes. Starch from wheat is a major source of dietary carbohydrate, but in bread and many other processed foods it is quickly digested to glucose in the body, causing a large spike in blood glucose levels. There is a large body of evidence that links long-term consumption of foods that provoke high glycaemic responses to the development of Type II diabetes. With this condition on the rise, along with obesity and other metabolic disorders, providing foods and ingredients that help consumers better manage blood glucose could help combat these challenges to health. Many pulses, such as chickpeas, peas, beans and lentils naturally contain high amounts of resistant starch, which is digested slowly and avoids potentially damaging blood glucose spikes. But most of this beneficial resistance is lost, rendering the starch highly digestible, when these crops are milled to flour and processed into a food product. For this reason, the scientists invented an alternative milling process, which preserves the plant cell wall structures (dietary fiber) that surround the starch. This 'Type 1' resistant starch is the same as that found in wholefoods, but this new ingredient can be used in a form that potentially allows it to be incorporated into a wider range of foods. Funding from the Biotechnology and Biological Sciences Research Council (BBSRC), part of UKRI, was used to develop the commercial potential of this novel ingredient, referred to as PulseON, and expands the possibilities for including large amounts of resistant starch in processed foods to improve nutritional quality. And now, in a new study published in the journal Food Hydrocolloids, the research team shows for the first time that the resistant property of the starch is retained during bread making, and that people who ate bread rolls where some wheat flourwas replaced by PulseON had lower blood glucose responses. In a double blind randomized cross over study, the scientists replaced 0%, 30% or 60% of the wheat flour in a standard white wheat bread recipe with PulseON. Healthy human participants consumed each type of bread roll type for breakfast in random order on separate days, with no knowledge of which type of roll they were eating. Their glucose levels were recorded using continuous glucose monitors. Blood glucose responses to the PulseON enriched breads were on average 40% lower than after eating the control breads. All bread rolls contained similar amounts of starch and wheat protein (gluten) per serving, so the different blood glucose responses reflect the carbohydrate quality. These results raise the possibility of using such foods for improving the dietary management of diabetes, which needs to be evaluated in future studies. The digestion of starch in each bread type was also studied in a laboratory using biochemical and microscopy techniques. These experiments showed that after two hours of digestion, the wheat starch had been digested, but the type-1-resistant starch remained. This confirms that the lower glucose response to PulseON enriched breads was due to the resistant starch enclosed in the chickpea ingredient not being digested. "Incorporating our new type of flour into bread and other staple foods provides an opportunity to develop the next generation of low glycaemic food products to support public health measures to improve health through better diets" said Dr. Cathrina Edwards from the Quadram Institute. "Consumers replacing wheat bread with PulseON enriched bread would benefit not only from the type 1 resistant starch, but also from the higher fiber and protein content." For widespread acceptance, the qualities of the products such as their taste, texture and appearance need to match those that are so popular with consumers. Participants gave the PulseON enriched breads similar scores for texture and taste as the white bread. Quality tests indicated that any effects on bread quality (texture, appearance) were subtle and most noticeable when large amounts of PulseON were used. The sensory properties need to be confirmed with a broader consumer group in a non-clinical setting, but are very encouraging for efforts to produce healthier white bread without adverse effect on product quality. The technology is patent-protected and the group are looking at commercial exploitation. Previous research from the same group has shown that the same milling process may be applied to other beans, lentils and pulses, resulting in cellular powders high in resistant starch, but with different colors and flavors. The researchers are now exploring ingredient applications in a broader range of foodproducts, and planning further trials involving those with prediabetes and type 2 diabetes. Traditional Chinese water-only fasting associated with reduced thrombosis risk Soochow University School of Medicine (China), January 4, 2021 According to news reporting based on a preprint abstract, our journalists obtained the following quote sourced from medrxiv.org: “Beego is a traditional Chinese complete water-only fasting practice initially developed for spiritual purposes, later extending to physical fitness purposes. Beego notably includes a psychological induction component that includes meditation and abdominal breathing, light body exercise, and ends with a specific gradual refeeding program before returning to a normal diet. Beego has regained its popularity in recent decades in China as a strategy for helping people in subhealthy conditions or with metabolic syndrome, but we are unaware of any studies examining the biological effects of this practice. “To address this, we here performed a longitudinal study of beego comprising fasting (7 and 14 day cohorts) and a 7-day programmed refeeding phase. “In addition to detecting improvements in cardiovascular physiology and selective reduction of blood pressure in hypertensive subjects, we observed that beego decreased blood triacylglycerol (TG) selectively in TG-high subjects and increased cholesterol in all subjects during fasting; however, the cholesterol levels were normalized after completion of the refeeding program. Strikingly, beego reduced platelet formation, activation, aggregation, and degranulation, resulting in an alleviated thrombosis risk, yet maintained hemostasis by sustaining levels of coagulation factors and other hemostatic proteins. Mechanistically, we speculate that downregulation of G6B and MYL9 may influence the observed beego-mediated reduction in platelets. Fundamentally, our study supports that supervised beego reduces thrombosis risk without compromising hemostasis capacity. Moreover, our results support that beego under medical supervision can be implemented as noninvasive intervention for reducing thrombosis risk, and suggest several lines of intriguing inquiry for future studies about this fasting practice Assessing the antimicrobial activity of flaxseed NGH Institute of Dental Sciences & Research Centre (India), January 5, 2021 Researchers in India evaluated the antimicrobial activity of flaxseed against known periodontal pathogens. They reported their findings in an article published in the International Journal of Herbal Medicine. Research suggests that the use of antibiotics is beneficial in the management of periodontitis. However, antibiotic resistance has now become a major global issue, and it is believed to have stemmed from the misuse of antibiotics. Many researchers now see herbal interventions as therapeutic strategies that deserve more research and attention. Flaxseed, a popular superfood rich in omega-3 fatty acids, has demonstrated potent antimicrobial and anti-biofilm activities in several studies. To further explore its potential, the researchers conducted an in vitro study that aims to assess the antimicrobial activity of flaxseed against periodontal pathogens. They prepared an ethanolic extract from flaxseed powder and determined its minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) against Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitansand Tannerella forsythia. The researchers reported that the flaxseed extract exhibited bacteriostatic activities against all three pathogens. At 100 microliters (uL)/milliliter (mL), the extract exerted bactericidal effects against P. gingivalis. Based on these findings, the researchers concluded that flaxseed can be used as a natural adjunct to periodontal therapy because of its bactericidal effects against P. gingivalis. Vitamin B3 may benefit those with Parkinson's disease University of Leicester, January 11, 2021 Individuals with a specific type of Parkinson's disease (PD) could gain from increasing vitamin B3 (niacin) content in their diet, say British investigators. The findings point to niacin’s ability to increase levels of a compound responsible for energy generation and DNA repair. These factors — if left unattended — result in faulty mitochondria function that contributes to the progression of the neuro-degenerative disorder. "This study strengthens the therapeutic potential for Vitamin B3/niacin-based dietary interventions in the treatment of Parkinson's disease," said Dr Miguel Martins, lead study author and programme leader of the MRC Toxicology Unit at the University of Leicester. Niacin or Vitamin B3 is found in a number of foods, including liver, chicken, beef, fish, cereal, peanuts, and legumes. It can also be made from tryptophan, an essential amino acid found in most forms of protein. The team began by looking at studying fruit flies, specifically bred with a mutation that mimics PD. These flies specifically had a mutated form of the PINK1 gene that normally protects cells from stress-induced mitochondrial malfunction. Flies were then fed food supplemented with niacin, which is made into the compound NAD inside the body. With this additional source of NAD, the researchers found flies had a lower number of faulty mitochondria than their mutant cohorts fed a regular diet. In addition, niacin also prevented the flies from losing existing neurons. “Mutations in PINK1 prevent cells from clearing out the defective powerhouses. When they accumulate, neurons can't get enough energy and die. The faulty mitochondria also release toxic molecules that damage their genes encoded by DNA,” said Dr Martins. “With all the mitochondrial damage going on, we wondered if in cases of Parkinson's the NAD compound ends up in short supply." The team also found that stopping DNA repair from depleting NAD kept mitochondria healthy and neurons alive, as well as enhance the flies' strength, mobility and lifespan. "The results suggest that in familial Parkinson's, available NAD is critical for keeping mitochondria in shape and the disease at bay,” said Dr Martins. While drug treatments exist that block NAD-consumption during the DNA repair process, Dr Martins thought increasing dietary niacin could provide certain benefits. "While neither of these would be cures, they would expand treatment options for Parkinson's patients with faulty mitochondria,” he added. excluded Study finds unfavorable intestinal microflora levels associated with the development of postmenopausal osteoporosis Fujin University (China), December 27, 2020 According to news reporting originating from Fujian, People’s Republic of China, research stated, “We aimed to investigate the intestinal microecology and fibroblast growth factor (FGF) expression in women with postmenopausal osteoporosis (PMO) and their clinical value in the diagnosis of PMO. A total of 214 postmenopausal women were analyzed retrospectively.” Our news editors obtained a quote from the research from the Department of Orthopedics, “The women were divided into the abnormal group (103 cases) and the normal group (111 cases) according to their bone mineral density (BMD). The levels of intestinal microflora and serum FGF-21, FGF-23, alpha-klotho, and beta-klotho were compared between the two groups, and the correlations of intestinal microflora, FGF-23, alpha-klotho, and beta-klotho with BMD were analyzed. The women in the abnormal group were further divided into the osteoporosis subgroup (59 cases) and the osteopenia subgroup (44 cases) for comparison. Receiver operating characteristic (ROC) curve was plotted to analyze the diagnostic value of intestinal microflora, FGF-23, alpha-klotho and beta-klotho for PMO. Compared with the normal group, the abnormal group had lower levels of bifidobacterium, lactobacillus, alpha-klotho, and beta-klotho and higher levels of enterococcus and FGF-23 (all P
Do you ever get overwhelmed with all the ED analgesic options? Dr. Sergey Motov from Maimonides Medical Center in the Bronx helps breaks down ED pain management. We cover everything from topical NSAIDs to ketamine infusions. Curious which opioid to go with or what dosing? Look no further. Key Points: Remember to set appropriate pain management expectations. The goal is to make the pain tolerable, not to eliminate it. The more you include your patient in your decision making, the more in control they will feel. NSAIDs are a go-to first option. If a patient doesn’t respond to one class, try another. And don’t forget about topical NSAIDs like diclofenac! Reasons to avoid this class would be history of GI bleed or CAD. Ketamine is a great option for acute pain. 0.3mg/kg in a bolus over 30 minutes followed by 0.1mg/kg/hr during their ED stay. Use these slow infusions to avoid dysphoric reactions. Don’t be afraid to use ketamine in combination with other analgesics for optimal pain management. Neuropathic pain is difficult to manage. Options include antidepressants, lidocaine infusion, gabapentin. Nerve blocks are amazing. From a greater occipital nerve block for migraine to serratus anterior block for rib fractures. There are so many more applications. “If there is a nerve, it can be blocked.” Shout out to my favorite: a hematoma block! Opioids are dangerous but they have a definite role in acute pain management. Morphine is less associated with euphoria and is a good start if choosing to treat with opioids. Oxycodone and hydromorphone are weaker alternatives and have a higher risk of substance abuse; avoid them if possible. Resources and References: https://www.emra.org/books/pain-management/painmgtguide/ http://www.painfree-ed.com/
In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves want to stay pink past October- they are continuing breast cancer awareness month and discussing one of the overlapping diagnoses: Post-Mastectomy Pain Syndrome (PMPS). Breast cancer is the most frequently diagnosed life threatening cancer in women. There are many different approaches to the treatment of breast cancer, and surgical resection often plays an important role in the management. One potential complication after surgical resection is chronic pain, specifically referred to as PMPS. The definition of PMPS according to the International Association for the Study of Pain (IASP) is: persistent pain soon after mastectomy/lumpectomy affecting the anterior thorax, axilla, and/or medial arm; typically described as burning, stabbing, pulling sensation. PMPS is a growing concern, and epidemiologic studies demonstrate that it can affect 20-68% of breast cancers after surgical intervention. Risk factors for development of PMPS include: younger age (35 years old or younger), type of surgery (total mastectomy and axillary lymph node dissection having increased risk), prior history of chronic pain. The treatment of PMPS, similar to other chronic neuropathic disease processes, is challenging. As always it is important to think about the treatment algorithm: -lifestyle modifications (including diet, exercise, weight optimization (especially considering BMI can be a risk factor for PMPS)) -physical therapy (including desensitization techniques) -medications (including topical medications, and potentially compounded topical meds) -procedures (including the Erector Spinae Block) -minimally invasive surgical techniques (including Peripheral Nerve Stimulation and Dorsal Column Spinal Cord Stimulation) -and stay vigilant for monitoring for recurrence / progression of the cancer itself This podcast is for information and educational purposes only, it is not meant to be medical or career advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, the may not represent the views of Spine & Nerve. Neuropathic pain podcast episode: https://anchor.fm/spine/episodes/Narcissistic-nerves---what-exactly-is-peripheral-neuropathy-and-why-you-should-care-e4njhf References: 1. Gong, Youwei MM; Tan, Qixing MD; Qin, Qinghong MD; Wei, Changyuan PhD. Prevalence of postmastectomy pain syndrome and associated risk factors, Medicine: May 15, 2020 - Volume 99 - Issue 20. 2. Mainkar, O., Sollo, C.A., Chen, G., Legler, A. and Gulati, A. (2020), Pilot Study in Temporary Peripheral Nerve Stimulation in Oncologic Pain. Neuromodulation: Technology at the Neural Interface, 23: 819-826.
All about health and the importance of healthy bodies to improve business performance
Managing a chronic condition like multiple sclerosis can be complicated. In the second part of Astrid’s story, we hear about her experiences with disease symptoms and complications, treatment, supportive therapies, lifestyle changes, and support networks, all of which play a part in helping her and others with MS live well. We’ll again hear from Dr. John Parratt about what it’s like managing the condition, including explanations of treatment types and strategies for getting the support you need as a person living with MS. This episode is kindly supported by MS Australia and is sponsored by Roche Australia (Sydney). Material number EC-AU-9437, prepared Apr2020. Episode References: MS Australia. Symptoms. Available at: https://www.msaustralia.org.au/about-ms/symptoms. Accessed April 2020. MedicineNet. Medical Definition of Proprioception. Available at: https://www.medicinenet.com/script/main/art.asp?articlekey=6393. Accessed April 2020. International Association for the study of pain. IASP Terminology – Neuropathic pain. Available at: https://www.iasp-pain.org/terminology?navItemNumber=576#Neuropathicpain. Accessed April 2020. WebMD. What Are the Side Effects of Pain Medication? Available at: https://www.webmd.com/pain-management/pain-medication-side-effects#2. Accessed April 2020. MS Australia. Medications & Treatments. Available at: https://www.msaustralia.org.au/about-ms/medications-treatments. Accessed April 2020. MS Australia. Understanding Multiple Sclerosis – An Introductory Guide. Available at: https://www.msaustralia.org.au/publications/understanding-ms-introductory-guide. Accessed March 2020. MS Australia. Diet & Nutrition. Available at: https://www.msaustralia.org.au/wellbeing-ms/diet-nutrition. Accessed April 2020. Exercise is Medicine Australia Factsheet. Available at: http://exerciseismedicine.com.au/wp-content/uploads/2019/12/Factsheet-MS-BRIEF-VERSION-2014.pdf. Accessed April 2020. Chwastiak LA, Ehde DM. Psychiatric issues in multiple sclerosis. Psychiatr Clin North Am. 2007;30(4):803–817. MS Research Australia. MS Treatments. Available at: https://msra.org.au/treatments/. Accessed April 2020. Broadley SA, Barnett MH, Boggild M, Brew BJ, Butzkueven H, Heard R, Hodgkinson S, Kermode AG, Lechner-Scott J, Macdonell RA, Marriott M, Mason DF, Parratt J, Reddel SW, Shaw CP, Slee M, Spies JM, Taylor BV, Carroll WM, Kilpatrick TJ, King J, McCombe PA, Pollard JD, Willoughby E. A new era in the treatment of multiple sclerosis. Medical Journal of Australia 2015; 203(3): 139-141. Clanet MC, Wolinsky JS, Ashton RJ, Hartung HP, Reingold SC. Risk evaluation and monitoring in multiple sclerosis therapeutics. Mult Scler 2014; 20(10): 1306-1311. Halabchi F, Alizadeh Z, Sahraian MA, Abolhasani M. Exercise prescription for patients with multiple sclerosis; potential benefits and practical recommendations. BMC Neurol 2017; 17(1): 185. Klotz L, Havla J, Schwab N, Hohlfeld R, Barnett M, Reddel S, Wiendl H. Risks and risk management in modern multiple sclerosis immunotherapeutic treatment. Ther Adv Neurol Disord 2019; 12: 1756286419836571. Mokhtarzade M, Ranjbar R, Majdinasab N, Patel D, Molanouri Shamsi M. Effect of aerobic interval training on serum IL-10, TNFalpha, and adipokines levels in women with multiple sclerosis: possible relations with fatigue and quality of life. Endocrine 2017; 57(2): 262-271. Tintore M, Vidal-Jordana A, Sastre-Garriga J. Treatment of multiple sclerosis - success from bench to bedside. Nat Rev Neurol 2019; 15(1): 53-58. Zimmer P, Bloch W, Schenk A, Oberste M, Riedel S, Kool J, Langdon D, Dalgas U, Kesselring J, Bansi J. High-intensity interval exercise improves cognitive performance and reduces matrix metalloproteinases-2 serum levels in persons with multiple sclerosis: A randomized controlled trial. Mult Scler 2018; 24(12): 1635-1644.
Neuropathic pain is a pain condition that’s usually chronic. It’s usually caused by chronic, progressive nerve disease, and it can also occur as the result of injury or infection. If you have chronic neuropathic pain, it can flare up at any time without an obvious pain-inducing event or factor. Acute neuropathic pain, while uncommon, can occur as well. Typically, non-neuropathic pain (nociceptive pain) is due to an injury or illness. For example, if you drop a heavy book on your foot, your nervous system sends signals of pain immediately after the book hits. With neuropathic pain, the pain isn’t typically triggered by an event or injury. Instead, the body just sends pain signals to your brain unprompted. People with this pain condition may experience shooting, burning pain. The pain may be constant, or may occur intermittently. A feeling of numbness or a loss of sensation is common, too. Neuropathic pain tends to get worse over time.Doc Morris Also Covers other types of Pain and the Management of various types of Pain. He also discusses the use of Medical Marijuana for Pain Management. Morris Medical CenterWeight Loss Physician & Family Practitioner located in Fort Myers, FL & LaBelle, FLMorris Medical Center is a physician-owned and operated medical facility in Fort Myers, Florida. Led by Dr. Dareld Morris, the tight-knit team of health professionals at Morris Medical Center strives to provide each patient with high-quality, individualized care. Dr. Morris and his team enjoy supporting their patients with the expertise and guidance they need to improve their health, and believe that thoughtful, one-on-one medical care is an essential part of becoming healthy and staying that way. They offer a wide range of convenient, on-site services, including:Find Out More about Doc Morris and his Practice at www.morrismedicalcenter.com or Email askdocmorris@morrismedicalcenter.com or Call 239-201-2465
Listen In: Digging In Drilling Down helping others with Upfront Very Real Conversations around Personal Development striking prolific change and then comes affirmation. Health Happens, Life Happens, Current Events Happen. We are here to answer the call. Get The Answers, Hear The Research. Help you to optimize your health and wellness journey, Teaching you the benefit of nutrition today. So Many areas to cover. The Benefits of Cannabinoid Molecules (CBD). Backed by science, teaching you the benefits of plant-based foods and critical nutrients our bodies need from them. Your Mental Checkup in getting you to that which is greater in your life events. - The Transformation and then comes the Affirmation of Self. Teaching preparedness for life events and how to rise to the occasion of purpose. Let's get to it together. Let's make it happen. Tune In Every Monday Start your week off with food for thought and food for life. Launching The First Monday In August Early Morning Drivetime. The Auspicious Experience. Our Podcast The Evolution From Ordinary To Extraordinary Invited Guest Physicians, Doctors, Wholistic Providers, and Neuropathic other Health and Life Coaches and Their Niche and Perspective.Listed on Apple Podcasts, Spotify, Google Podcasts, Stitcher, iHeart Radio, TuneIn, Alexa, Overcast, PocketCasts, Castro, Castbox, and Podchaser.Disclaimer: The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition.Listen to all episodes in season 1 here https://auspiciouswellness.com/pages/auspicious-wellness-podcast-evolution-from-ordinary-to-extraordinaryIf you would like to opt-in and stay connected to the Auspicious Wellness Coaching Circle, feel free to click the link below and signup. Sign up and stay up today as we release new coaching products, freebies, recipe demonstrations, announcements, and more. Click the link and submit the signup form. Let's stay motivated together. See you then https://forms.aweber.com/form/33/5949233.htm #podcaster #podcaster #DebraSmithTorrence #AuspiciousWelnessPodcast #BestPodcastonSpotify #WellnessPodcast #WomensHealthPodcast #SelfImprovementPodcast #wellness #Mindfullfess #anxiety #Stress #MotivationalPodcast Contact: 833-287-7424 Ext 700 Debbie Smith-Torrenceto
In this episode, we review the high-yield topic of Neuropathic (Charcot) Joint of Shoulder. --- Send in a voice message: https://anchor.fm/orthobullets/message
Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.07.01.181917v1?rss=1 Authors: Coxon, L., Wiech, K., Vincent, K. Abstract: Background: Pain is one of the primary symptoms of endometriosis, a chronic inflammatory condition characterised by the presence of endometrial tissue outside the uterus. Endometriosis-associated pain is commonly considered as nociceptive in nature but its clinical presentation suggests that it might have neuropathic-like properties in a subgroup of patients. Methods: This is a cross sectional study using an online survey. The survey was distributed by patient support websites. The survey was composed of validated questionnaires assessing pain symptoms, psychological measures and questions about number of surgeries. Main results and the role of chance: We had 1417 responses which met the inclusion criteria. Using standard painDETECT cut-off scores, we found that pain was classified as neuropathic in 40% of patients and as mixed neuropathic/nociceptive in a further 35%. In line with observations in other neuropathic conditions, the neuropathic subgroup reported higher pain intensities, greater psychological distress and cognitive impairment. Neuropathic pain was also more likely in those with more surgeries to the abdomen and a longer history of pain. As revealed by a cluster analysis, those with a neuropathic pain component could further be divided into two subgroups based on their sensory profile. Conclusions: The data presented here indicate that endometriosis-associated pain includes a neuropathic-like component in a substantial proportion of women. Although further investigation is required, our finding challenges the current conceptualisation of endometriosis-associated pain as nociceptive and advocates for a new perspective on this type of pain, which is so debilitating to a large number of women. Copy rights belong to original authors. Visit the link for more info
Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.05.11.089425v1?rss=1 Authors: Chen, W., Marvizon, J. C. G. Abstract: Latent sensitization is a model of chronic pain in which a persistent state of pain hypersensitivity is suppressed by opioid receptors, as evidenced by the ability of opioid antagonists to induce a period of mechanical allodynia. Our objective was to determine if substance P and its neurokinin 1 receptor (NK1R) mediate the maintenance of latent sensitization. Latent sensitization was induced by injecting rats in the hindpaw with complete Freund's adjuvant (CFA), or by spared nerve injury (SNI). When responses to von Frey filaments returned to baseline (day 28), the rats were injected intrathecally with saline or the NK1R antagonist RP67580, followed 15 min later by intrathecal naltrexone. In both pain models, the saline-injected rats developed allodynia for 2 h after naltrexone, but not the RP67580-injected rats. Saline or RP67580 were injected daily for two more days. Five days later (day 35), naltrexone was injected intrathecally. Again, the saline-injected rats, but not the RP67580-injected rats, developed allodynia in response to naltrexone. To determine if there is sustained activation of NK1Rs during latent sensitization, NK1R internalization was measured in lamina I neurons in rats injected in the paw with saline or CFA, and then injected intrathecally with saline or naltrexone on day 28. The rats injected with CFA had a small amount of NK1R internalization that was significantly higher than in the saline-injected rats. Naltrexone increased NK1R internalization in the CFA-injected rats but nor in the saline-injected rats. Therefore, sustained activation of NK1Rs maintains pain hypersensitivity during latent sensitization. Copy rights belong to original authors. Visit the link for more info
In this episode, Dr. Cox continues his discussion on the influence of the vagus nerve in health and healing. He also shares a paper on mechanobiology, that is, how the cells of the body are constantly remodeling and adapting to their ever-changing mechanical environment. He concludes with a paper that goes beyond the 5 senses of sight, hearing, touch, smell, and taste to the newly described seventh sense. James M. Cox, DC, DACBR, FICC, Hon.D.Litt., FACO(H) Dr. Cox is the developer of Cox® Technic Flexion Distraction Manipulation and the proud participant in the on-going federal research projects involving the Keiser University, National University of Health Sciences, Palmer College of Chiropractic Research Center, Loyola Stritch School of Medicine, University of Illinois, University of Iowa, Auburn University, etc. He is a member of the postgraduate faculty of the National University of Health Sciences and has been privileged to speak throughout the world. Resources: About Dr. Cox curriculum vitae More about Cox Technic Find a Back Doctor The Cox 8 Table by Haven Medical References: HHS Public Access Author manuscript Brain Behav Immun . Author manuscript; available in PMC 2019 January 04. Published in final edited form as: Brain Behav Immun . 2018 October ; 73: 441–449. doi:10.1016/j.bbi.2018.06.005. Joanna L. Ng, Mariana E. Kersh, Sharon Kilbreath and M. Knothe Tate. Establishing the Basis for Mechanobiology-Based Physical Therapy Protocols to Potentiate Cellular Healing and Tissue Regeneration. Front.physiol.,06 June 2017 https://doi.org/10.3389/fphys.2017.00303 Kevin P. Cheng, Sarah K. Brodnick, Stephan L. Blanz, Weifeng Zeng, Jack Kegel, Jane A. Pisaniello, Jared P. Ness, Erika Ross, View ORCID ProfileEvan N. Nicolai, Megan L. Settell, Is Vagus Nerve Stimulation Brain Washing? doi: https://doi.org/10.1101/733410 Cuoco J, Fnnie C, Cheriyan G: Hypothetical Link Between Osteopathic Suboccipital Decompression and Neuroimmunomodulation. J Neurol Neurosci. 2016, 7: S3. Christopher Bergland. Vagus Nerve Stimulation Dramatically Reduces Inflammation: Stimulating the vagus nerve reduces inflammation and the symptoms of arthritis. PSYCHOLOGY TODAY, posted July 6, 2016 Stanley Rosenberg: Accessing The Healing Power Of The Vagus Nerve. North Atlantic Books, Berkeley, CA Berrueta L, Muskaj I, Olenich S, Butler T, Badger GJ, Colas RA, Spite M, Serhan CN, Langevin HM. Stretching Impacts Inflammation Resolution in Connective Tissue. J Cell Physiol. 2015 Nov 20. doi: 10.1002/jcp.25263. [Epub ahead of print] Teodorczyk-Injeyan JA1, Triano JJ1, Injeyan HS2. Non-specific Low Back Pain: Inflammatory Profiles of Patients with Acute and Chronic Pain. Clin J Pain. 2019 Jul 5. doi: 10.1097/AJP.0000000000000745. [Epub ahead of print] Song XJ, Huang ZJ, Song WB, Song XS, Fuhr AF, Rosner AL, Ndtan H, Rupert RL. Attenuation Effect of Spinal Manipulation on Neuropathic and Postoperative Pain Through Activating Endogenous Anti-Inflammatory Cytokine Interleukin 10 in Rat Spinal Cord. J Manipulative Physiol Ther. 2016 Jan 30. pii: S0161-4754(15)00211-0. doi: 10.1016/j.jmpt.2015.12.004. Compiled by James M. Cox, DC, DACBR
Discussion on overall health and wellness ,music and Coronavirus with the black community --- Support this podcast: https://anchor.fm/lekeya/support
Well we are at the starting line of a new decade, so welcome to 2020 and Season 2 of The Holistic Savage Podcast my savage friends This month we have the pleasure of hearing from Dr. Jolene Brighten, is a women’s health naturopathic medical doctor and author of Beyond the Pill a book meant for any woman 1970’s and upward. Aside from being a prominent leader in the emerging sciences of women’s health. Jolene is also an international speaker, clinical educator, medical advisor within the tech community, and considered the leading authority in women’s health. Dr. Brighten is also a part of the Mind Body Green Collective and a faculty member of the American Academy of Antiaging Medicine. Speaking from my perspective, being a son, brother, someday a husband, a father, and A Functional Practitioner. I appreciate that Dr. Brighten has a passion for empowering women worldwide to take control and their health and hormones. In this episode we will talk about the book, what causes a hormone imbalance, post birth control syndrome, the effects on the brain, mitocondria, fertility and how our body thrives and learns to heal without traditional medication and much more. So lock yourself in and get ready for an amazing episode with Dr. Jolene Brighten. Episode Guide [0:02:24] Birth Control & Post-birth Control Syndrome Men & Relating To Women’s Medicine, Having A Place & Taboo Talk, Taking A Seat At The Table & Being A Part Of The Discussion. How Birth Control Is Being Distributed, The New Generation Of Women For Space Reasons For Birth Control; Pms, Pmdd, Pcos, Cystic Acne, Hair Loss [0:10:15] Birth Control’s Disruption Of The Maturation Cycle & The Brain's Job Teens, Chemical Castration, & Depression Heavy Periods & Diarrhea Birth Control Temporary Fix But Not Getting To The Root Cause [0:18:00] Pharmaceuticals, Birth Control, Depression, & Practitioners Immune System Learning & Letting Yourself Get Sick & Orthorexia Where Healing Happens, The Sandwich Shop, & The Ice Cream Shop Get A Badass Conventional, Neuropathic, Functional Medicine Team [0:30:33] Fears of Functional Medicine Service Is Becoming A Luxury Service. Beyond The Pill - The Manual/Roadmap Meant For All Ages & Your Role, Daily Practices Towards Well Versus Ill The Doomsday Period, Forgetting What A Normal. It’s Like, & Pcos Effects Of Birth Control, Rigidness, & Getting On The Right Side Of History [0:40:30] Testing & Study Ethics, Your Eggs, Birth Control, & The Medical Industry Ego When Drug Trials Start, Gen Pop, Hormone Earrings To Myths Versus The Reality Of Birth Control, Binding Goblin, Testosterone, Athletic Performance, & Pelvic Floor Dysfunction Keeping A Symptom Diary, Questions For Your Next Medical Visit, Gaslighting & Deprogramming [0:54:58] There Is No Weaker Sex, Going Together Like Salt & Pepper, Dietary Myths Mao Gene, Enzymes, & Genetics Game Of Thrones Analogy, The Stress Hormone, & The Brain [1:06:18] Aura Ring, Cycle Tracking, Biohacking, & Experimentation. Adrenal Calm, & Melatonin. Blue Light The Disruption Of The Menstrual Cycle, The Moon Phases, Untethering The Brain Menstruation As A Tribe & Your User Manual. Empowering Your Health Journey, Sherpas, & Curiosity Find out more about Dr. Brighton at www.drbrighten.com or Order Beyond the Pill at: https://drbrighten.com/beyond-the-pill/ --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/holisticsavagepodcast/message
Turmeric, active ingredients are turmerone oil and water-soluble curcuminoids, among which curcumin has been the focus of researchNative to south AsiaOrange colour used in cosmetics and as a food colouring agentAbsorption is poor and it’s metabolised rapidly. Absorption can be improved if taken with pepper (piperine) or fat, but this depends on if you have a therapeutic goal. A meta-analysis of randomized clinical trials revealed that curcumin is effective in decreasing the concentration of tumor necrosis factor-alpha, a key mediator in many inflammatory diseases.Gut Turmeric may help alleviate symptoms of irritable bowel syndrome or ulcerative colitis,JointsTurmeric extract was found to be safe and equally effective as a non-steroidal anti-inflammatory drug for the treatment of osteoarthritis of the knee. Need to absorb it so take with piperine/fat. CancerCurcumin has been studied to have anticancer properties through really the 3 main pathways of cancer development: 1. It’s antioxidant properties and protection against DNA mutations and cell damage2. It’s antiproliferative properties that reduce tumour growth and spread including inducing apoptosis (programmed cell death) and 3.Curcumin has shown ability to kill cancer cells directly by activating “execution enzymes” that destroy cancer cells from within. As an added benefit, curcumin seems to focus on the cancer cells and leave our healthy cells alone, unlike chemotherapy and RT that can’t distinguish between malignant and healthy cells.Several animal studies suggest that turmeric helps to prevent colon, stomach, and skin cancers in rats exposed to carcinogens. Human studies are underway to validate these findings in humansWhat’s interesting is that while curcumin shows benefit in breast cancer, pancreatic cancer, colon cancer, multiple myeloma, myelogenous leukaemia and skin, kidney and colorectal cancer, turmeric as a whole food has in some cases been shown to be even more effective!In fact, a study was undertaken with turmeric where they removed the active component curcumin, and it was found to be just as effective!!Topical turmeric-based cream has shown some ability to reduce radiotherapy-induced dermatitis in patients with head and neck cancer; and oral mucositisCan interfere with some chemotherapy agents OtherMay improve concentrations of liver enzymesSome but insufficient evidence for treatment of kidney stones and reduction in stomach and intestinal gasWhen it’s not a good ideaCan interfere with many drugs, blood thinners and chemo agents when taken as a supplement. One study - These findings support the hypothesis that dietary curcumin can inhibit chemotherapy-induced apoptosis through inhibition of ROS generation and blockade of JNK function, and suggest that additional studies are needed to determine whether breast cancer patients undergoing chemotherapy should avoid curcumin supplementation, and possibly even limit their exposure to curcumin-containing foods. https://www.ncbi.nlm.nih.gov/pubmed/12097302Other spices with similar impact It’s not the only option...Other anti-inflammatory and health promoting spicesCuminMay improve digestion by increasing activity of digestive enzymes and increase release of bile from liver. May assist IBS - a low level study explored cumin essential oil and found it reduced abdominal pain, bloating, fecal urgency and presence of mucus discharge during and after treatment with Cumin extract.May improve BG control in Diabetes - still unclear the exact mechanisms or exactly how much is required to obtain the desired therapeutic outcomes.Some studies suggest that supplementation may improve chol profileThe salicylic acid and other phenolic acids may have a anti-inflammatory and free-radical reducing properties to reduce cancer risk https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210012/https://www.sciencedirect.com/science/article/pii/S0308814608002483https://www.ncbi.nlm.nih.gov/pubmed/24829694https://www.ncbi.nlm.nih.gov/pubmed/25766448https://www.ncbi.nlm.nih.gov/pubmed/27664636https://nutritionfacts.org/2019/12/26/the-foods-with-the-highest-aspirin-content/?utm_source=NutritionFacts.org&utm_campaign=b4e7d340b4-RSS_BLOG_DAILY&utm_medium=email&utm_term=0_40f9e497d1-b4e7d340b4-26955981&mc_cid=b4e7d340b4&mc_eid=b327dd2e50Cinnamon - coined gift fit for kingsAnti-inflammatory properties similar to that of turmeric - high concentration of antioxidants (polyphenols). Reduce insulin resistance - Cinnamon has shown to be able to improve insulin sensitivity, which means better able to reduce our BGLS.Cinnamon contains contains enzymes which work in our GIT which slowing down the breakdown of CHO’s. This reduces the amount of glucose in our blood after a meal.120mg per day can reduce total chol, LDL, TGs May help protect neurons, normalize neurotransmitter levels and improve motor function - researchers interested for Alzheimer'. Human studies are lacking, however watch this space..https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003790/https://www.ncbi.nlm.nih.gov/pubmed/14633804https://www.ncbi.nlm.nih.gov/pubmed/24019277https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901047/https://www.ncbi.nlm.nih.gov/pubmed/19433898https://www.ncbi.nlm.nih.gov/pubmed/23531502https://www.ncbi.nlm.nih.gov/pubmed/24349472GingerGinger root contains compounds that may help relieve or prevent nausea and vomiting. These substances can increase the flow of saliva and digestive juices and may also help calm the stomach and intestines. Some studies have found ginger may help nausea caused by chemotherapy, but larger studies are needed to confirm these effects.Eating fresh ginger in high doses can have blood-thinning effects by preventing platelets from sticking together. Laboratory studies suggest that ginger can protect brain cells from the plaques that cause Alzheimer’s disease, but this effect has not been studied in humans.Some data in OA and RA May reduce BGL May reduce drug dependence! May improve digestive health - reduce diarrhoea, gas and bloatingSupplemental doses can interfere with warfarin or blood thinners, NSAIDs, insulin, during pregnancy or pre-surgery. Stick to the real food! https://www.mskcc.org/cancer-care/integrative-medicine/herbs/gingerAshwaghandha (Indian or asian Ginseng)May assist with angina, T2DM management, immune function and…Sexual dysfunction benefits for erectile dysfunction Some reports of manic and psychotic episodes with supplements - stick to the food! Make into a tea or add to asian soups https://www.mskcc.org/cancer-care/integrative-medicine/herbs/ginseng-asianSupplemental doses of many of these spices can interfere with warfarin or blood thinners, NSAIDs, insulin, during pregnancy or pre-surgery or cause nasty side effects so stick to the real food! ChiliWhat is it: Capsaicin is the active ingredient in chilli, cayenne pepper, capsicum What for: Neuropathic pain and neuropathy, OA pain, weight loss, psoriasis, cluster headaches Caution: GIT lining, reflux Health benefits of capsaicin Weight loss: There is evidence to suggest intake of chilis (containing capsaicin) can enhance fat burning potential and reduce appetite, which of course can assist with weight loss. As always the literature suggested that regular ingestion of capsaicin compounds in conjunction with a healthy diet & lifestyle showed the most promising outcomes.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257466/Pain management: There is some low level evidence to support that Capsaicin has the ability to bind to pain receptors to reduce the pain sensation. However these were small studies and effects were not lasting.Be cautious of:GIT upset (abdominal pain/cramping or diarrhoea) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4102147/Cancer: There is some suggestion of chemoprotective effects however the evidence of safety vs risk is mixed regarding chili consumption. As mentioned, adding too much chili may have the ability to burn the lining of our GIT and this has been seen in some observational studies.Long term topical use may increase risk of skin cancer - eat don’t rub it Look out for capsaicin as active ingredient in some topical creams and nasal sprays. It is also available in a prescription-strength patch. https://academic.oup.com/aje/article-abstract/139/3/263/63603?redirectedFrom=fulltexthttps://www.mskcc.org/cancer-care/integrative-medicine/herbs/capsaicinIn summary: See what agrees with your body! If you love chilli, enjoy it! If you don’t moderate the amounts you eat.Eat your spicesAdd cinnamon and turmeric to oats - try our carrot cake bircher or make this into balls with some dates. Add yoghurt if you need to absorb it. Ginger tea or water, stir fry, bliss balls, Chilli, cumin, paprika, turmeric to your evening meals - veg chilli con carne, dhal or curry Ginseng tea or add to your soup TO DO: buy minced chilli, garlic, ginger, dried cumin, paprika, chilli, turmeric
In this Clinical Insight we take a shallow dive into the Radiculo-Neuropathic Myofascial Pain Model. This model was heavily influenced by Dr. Chan Gunn. It is a very solid model in the evaluation and treatment of chronic pain as it takes into consideration a lot of key components that play a role in the production of chronic pain. We talk through how the combination of Cannon’s Law, denervation and other factors play a role in chronic pain based on how this model describes it. At the end we discuss what are some practical recommendations that you can try immediately to see if there is something you can do if you are dealing with chronic pain. Check it out, leave a comment and we will continue the discussion as well as we can to keep helping make the complicated simple. BOOK LINK: Treatment of Chronic Pain (https://amzn.to/3agkT3m) #Podcast #Clinically #Pressed #Wellness #Performance #Nutrition #ComplicatedSimple #Science #fitness #health #strength #athletics #medical #training #exercise #sportsscience #chiropractic #exercisescience #athletictraining #sports #pain #painrelief #weightloss #kettlebells #complicatedsimple #tpdn #rnmp #myofascial #myofascialpain #chronicpain
Lasik and neuropathic pain – is there a connection? There is if you’re Garry Mason, one of a rare handful of less fortunate patients who traded in better vision for a host of other issues. In this episode, we discuss Garry’s struggles with corneal hyperalgesia, meibomian gland dysfunction (MGD), and blepharitis – otherwise known as a whole lot of pain for one corrective surgery. Sign up for our newsletter: www.friendswithdeficitspodcast.com Support Friends With Deficits! www.patreon.com/friendswithdeficits
Half a century worth of research exists on neuropathic pain but what are the latest developments? With the previous edition of Airing Pain focussing on the ‘psycho’ and ‘social’ of the bio-psycho-social model, this programme tackles the ‘bio’ component. In this second instalment in a mini-series on neuropathic pain, Paul Evans delves into the latest scientific developments on the condition and the ways in which the gap between research and treatments could be bridged. Following on from Airing Pain 115, which concentrated on targeted Pain Management Programmes, this edition discusses the ‘bio’ element on dealing with neuropathic pain. Speaking to Professor Srinivasa Raja, Paul discusses what exactly is going on in the brain with neuropathic pain. Professor Raja provides a valuable explanation of the science behind the condition. Patrick M. Dougherty, Professor at the Department of Pain Medicine at The University of Texas MD Anderson Cancer Centre then shares with Paul the latest advances in neuropathic pain research. He examines the link between cancer treatments and the condition as well as the potential for treatments such as immunotherapy to combat neuropathic pain in the future. Contributors: Patrick M. Dougherty, Professor at the Department of Pain Medicine, Division of Anaesthesiology and Critical Care, The University of Texas MD Anderson Cancer Centre, Houston Professor Srinivasa Raja (John Hopkins School of Medicine, USA). More information: Neuropathic pain fact sheets and support, IASP https://www.iasp-pain.org/GlobalYear/NeuropathicPain News, information and support at RELIEF, IASP Pain Research Forum https://relief.news/ The University of Texas MD Anderson Cancer Centre https://www.mdanderson.org/?_ga=2.205594646.486343381.1563359882-181156349.1563359882 Neuropathic Pain information, National Institute for Health and Care Excellence (NICE), https://www.nice.org.uk/search?q=Neuropathic+pain.
When your patient has heel pain with their first few steps in the morning, after sitting for a while or at the start of a run, a diagnosis of plantar heel pain (PHP) or plantar fasciopathy might jump straight to the top of your list. How will you treat your patients with PHP? How long will it take? How can you explain PHP, the rehab and recovery to your patients? In this podcast with Henrik Riel (Physiotherapist, researcher and PhD candidate at Aalborg University) we take a deep dive into PHP, and how you can treat it, including: How to describe plantar heel pain to your patients How to explain to your patient why they developed PHP, recovery timeframes and rehab Plantar fasciitis, plantar fasciopathy, plantar heel pain? What's the most appropriate terminology? Differential diagnosis for PHP including Neuropathic pain Fat pad irritation, contusion or atrophy Calcaneal stress fracture Other diagnoses How to systematically perform an objective assessment and diagnose PHP Assessment tests to identify factors contributing to your patients pain Whether your patients require imaging How long PHP takes to recover What factors affect your patients prognosis and recovery times How to differentiate your treatment for active or sedentary patients Whether your patients can continue to run with PHP Factors that may hinder the recovery of your sedentary patients, and how to address these Whether your patients should include stretching in their rehab Types of strengthening to include in your rehab - isometric, isotonic or otherwise How many sets and reps should your patients perform of their strengthening exercises Whether orthotics are useful Corticosteroid injections - do they help or increase the risk of plantar fascia rupture? Links associated with this episode: Download and subscribe to the podcast on iTunes Download the podcast now using my favourite podcast app - Overcast Improve your confidence and plantar fasciopathy results with a free trial Clinical Edge membership, and get access to the 3 part webinar series on PHP with Henrik Riel Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Twitter - @Henrik_Riel Research Gate - Henrik Riel Articles associated with this episode: Alshami et al. 2008. A review of plantar heel pain of neural origin: differential diagnosis and management. Chimutengwende-Gordon et al. 2010. Magnetic resonance imaging in plantar heel pain. Dakin et al. 2018. Chronic inflammation is a feature of Achilles tendinopathy and rupture. David et al. 2017. Injected corticosteroids for treating plantar heel pain in adults. Digiovanni et al. 2006. Plantar fascia-specific stretching exercise improves outcomes in patients with chronic plantar fasciitis. A prospective clinical trial with two-year follow-up. Hansen et al. 2018. Long-Term Prognosis of Plantar Fasciitis: A 5- to 15-Year Follow-up Study of 174 Patients With Ultrasound Examination. Lemont et al. 2003. Plantar fasciitis: a degenerative process (fasciosis) without inflammation. Rathleff et al. 2015. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Riel et al. 2017. Is ‘plantar heel pain’ a more appropriate term than ‘plantar fasciitis’? Time to move on. Riel et al. 2018. The effect of isometric exercise on pain in individuals with plantar fasciopathy: A randomized crossover trial. Riel et al. 2019. Self-dosed and pre-determined progressive heavy-slow resistance training have similar effects in people with plantar fasciopathy: a randomised trial. Other Episodes of Interest: PE 062 - How to treat plantar fasciopathy in runners with Tom Goom PE 061 - How to assess and diagnose plantar fasciopathy in runners with Tom Goom PE 060 - Plantar fasciopathy in runners with Tom Goom PE 038 - Plantar fasciopathy loading programs with Michael Rathleff PE 012 - Plantar Fascia, Achilles Tendinopathy And Nerve Entrapments With Russell Wright
In this week's episode of the Spine & Nerve podcast, Dr. Karvelas and Dr. Joves discuss peripheral neuropathy. Neuropathic pain is defined as a process that affects the somatosensory nervous system. When the nerves that are affected lie outside of the central nervous system (brain and spinal cord), it is considered peripheral neuropathy. Painful peripheral neuropathy has been identified in up to 3% of the general population, but provides a much greater challenge in patients with diabetes where as many as 25-50% of patients experience symptoms. Numbness, burning, and weakness are characteristic of peripheral neuropathy, and these symptoms can have devastating consequences on a person's quality of life and daily function. Listen in as we dive deeper... Follow our practice on Facebook at Spine & Nerve Diagnostic Center. Please leave us a comment or review- these help us to improve and provide value to more people. This podcast is for information and educational purposes only, it is not meant to be medical advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, they may not represent the views of Spine & Nerve.
The 2019 annual Internal Medicine meeting of the American College of Physicians took place beginning April 10 in Philadelphia. MDedge Podcast host and producer Nick Andrews joined Internal Medicine News editor Katie Lennon to discuss a few of the biggest topics. ACP 2019 highlights: Telemedicine update. Neuropathic pain update. Negotiating a strong contract. ACP launches quality improvement tools. You can contact the MDedge Daily news by emailing podcasts@mdedge.com or by following us on Twitter at @MDedgeTweets.
Researchers at the University of Maryland recently announced a potential breakthrough in the fight against "neuropathic" pain—that is, pain that results from malfunctioning or damaged nerves.Neuropathic pain afflicts 100 million Americans and costs the nation over half a trillion dollars every year. WIRED OPINION ABOUT KurtAmsler, Ph.D., is a professor of biomedical sciences at the New York Institute of Technology's College of Osteopathic Medicine.
Dr. Rosenblum reviews the latest on neuropathic pain definition and treatment guidelines Subscribe to our mailing list * indicates required Email Address * References Aust Prescr. 2018 Jun; 41(3): 60–63. Published online 2018 Jun 1. doi: [10.18773/austprescr.2018.022] PMCID: PMC6003018 PMID: 29921999 Neuropathic pain: current definition and review of drug treatment Bridin P Murnion, Senior clinical lecturer1 and Senior staff specialist2 AnesthesiaExam Podcast App For iPhone and Android DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. You should regularly consult a physician in matters relating to yours or another’s health. You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. Copyright © 2018 QBazaar.com, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.
Is our American diet affecting us? We know that it's affecting our weight, our metabolic syndrome. We know that it's leading to diseases such as diabetes and prediabetes. However, it's also effecting neuropathic pain. Neuropathic pain is pain caused by damage or disease affecting the somatosensory nervous system, a part of the sensory nervous system. No wonder out diet is called SAD or the standard American diet. Almost everything about the western diet or the standard American diet leaves you feeling not well. It’s linked to chronic pain type syndromes, brain fog, anxiety, depression, and many other things. Learn how to retrain your brain and body so you can live the joy-filled and pain-free life you deserve. Dr. Tatta talks about neuropathic pain and shares some tips and strategies that you can use to either treat your neuropathic pain or, if you're a practitioner, what you can do as far as neuropathic pain when it comes to nutrition. Sign up for the latest episode at www.drjoetatta.com/podcasts. Love the show? Subscribe, rate, review, and share! Here’s How » Join the Healing Pain Podcast Community today: drjoetatta.com Healing Pain Podcast Facebook Healing Pain Podcast Twitter Healing Pain Podcast YouTube Healing Pain Podcast LinkedIn
Recorded in the Birdman Media Studios. In this episode, Birdman talks with Jeromy Cronin, Director of Wound Care and Hyperbarics Center with Summit Healthcare. Video @ https://youtu.be/OFUynUYkdNI About Jeromy Cronin: Jeromy is an Arizona native who grew up in San Manuel, AZ. He enlisted in the Navy in 1993 and served as a Deep Sea Diving Independent Duty Corpsman and Command Master Chief. After 23 years in the Navy, he retired from the Navy and returned home. Jeromy holds a degree in Healthcare Management and has worked in healthcare for more than 20 years with experience in Hyperbaric Therapy, Dialysis, Veterans Affairs, and Outpatient Medicine. Jeromy has four children; he and his wife Breanna enjoy spending their free time outdoors hiking, camping, and traveling. Summit Healthcare Wound Care Center Summit Healthcare Regional Medical Center is home to a specialized Wound Care and Hyperbaric Center. The advanced medical center houses two (2) hyperbaric chambers and is the only rural hospital in northeastern Arizona to offer this service. This addition is part of our goal to provide a complete system of medical and professional care to our patients. Summit Healthcare’s Wound Care and Hyperbaric Center is an outpatient, hospital-based program. The medical center is designed to complement the services offered by patients’ primary care physicians–in fact; we should think of it an extension of a physician’s practice. Patients receive outstanding, professional, and courteous attention in a timely fashion, and are returned to the referring physician once the healing is satisfactory. The program operates by appointment and requires a referral from the primary care physician. Conditions We Treat Our Wound Care and Hyperbaric Center allows the hospital to offer a more comprehensive wound care program to manage chronic or non-healing wounds caused by diabetes, circulatory problems, and other conditions. The following are types of wounds Summit Healthcare’s Wound Care & Hyperbaric Center can treat. Burns Diabetic ulcers Ischemic ulcers Neuropathic ulcers Peristomal skin irritations Pressure ulcers Surgical wounds Traumatic wounds Vasculitis Venous insufficiency Other chronic, non-healing wounds Hyperbaric Oxygen Therapy Treatments Hyperbaric Oxygen Therapy (HBO2) is a safe and evidence-based treatment proven to speed the healing process in certain types of wounds. During the treatments, the patient breathes 100 percent oxygen inside a pressurized chamber, quickly increasing the concentration of oxygen in the bloodstream. Then, the oxygen is delivered to a patient’s wound site for faster healing. Essentially, HBO2 helps heal the wound from the inside out. This therapy can help reduce swelling, fight infection, improve circulation, build new blood vessels, and ultimately help produce healthy tissue. The following are types of Hyperbaric Oxygen Therapy treatment that we offer at Summit Healthcare. Actinomycosis Acute peripheral arterial insufficiency Brown recluse spider bites Chronic refractory osteomyelitis Compromised skin grafts and flaps Crush injury Diabetic ulcer of the lower extremities Late-stage radiation injury Osteomyelitis Progressive necrotizing infection Soft tissue radio-necrosis Learn More For more information about Summit Healthcare’s Wound Care & Hyperbaric Center call 928.537.6820.
Pat Tomasulo is a funny man on a serious mission. Mayor Emanuel sat down with the sportscaster, stand-up comic, and host of WGN’s “Man of the People” who’s also fighting to fund research and raise awareness for people suffering from neuropathic disorders—people like Pat’s wife.
On this episode, Dr. Schwartz and Dr. Rosenblum discuss Pain Management in a patient with Buerger's Disease. On the second half, Dr. Rosenblum finds a letter sent by an internist for validation. The letter was a fake with his name at the end. Check out the podcast as the drama unfolds... Subscribe to our mailing list * indicates required Email Address * AnesthesiaExam Podcast App For iPhone and Android DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. You should regularly consult a physician in matters relating to yours or another’s health. You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. Copyright © 2018 QBazaar.com, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.
21 July 2017: Annalise Abiodun of OHSU Interviews Sonja Staender of the University of Muenster about the Mechanisms and Treatment of Neuropathic Itch
Neuropathic pain can be debilitating for many individuals living with a spinal cord injury. In this episode, we talk with two guests about how exercise can temporarily reduce the neuropathic pain associated with such injuries, as well as how it can be used as part of a larger self-management strategy. PhD student Kendra Todd provides insight on her current research on this topic, and her colleague Robert Shaw shares his unique perspective from living with a spinal cord injury as the result of a diving accident in 2011.
Many people in the wellness world are turning to cannabidiol, commonly referred to as CBD, for its powerful anti-inflammatory and anti-anxiety effects. But as its popularity grows so doesn’t the confusion and misconceptions about this plant-based oil. About a year ago I decided to take a long hard look at CBD oil and its health benefits. I must admit in the beginning I was skeptical because I didn’t see enough sound scientific proof. Well, a lot has changed in a year, and there are now many more studies and compelling personal stories about the health benefits of CBD. In today’s podcast, we break down what exactly is cannabidiol is, the health claims and the vast difference between the hemp plant and the marijuana plant. You will learn how cannabidiol (CBD) works in the human body and the surprising ways it affects the human anatomy. We will also discuss many of the studies linking CBD oil as a potential treatment for epilepsy, inflammation, neuropathic pain, migraines and anxiety disorders like panic disorder, anxiety, obsessive-compulsive disorder, depression and post-traumatic stress disorder. Thanks for joining us today. I am deeply passionate about providing all the information you need to live a long and healthy life. If you enjoyed today’s podcast, please subscribe in iTunes , and if you get a minute, please write a review. You can find all my recipes and podcasts on Ordinaryvegan.net. Just getting started on a plant-based diet? Here is a free downloadable list of delicious vegan protein and visit Ordinaryvegan.net for every vegan essential you will need for your journey. Safe, effective, vegan, seed to table, 3rd party tested, non-GMO, gluten-free CBD Oil is now available from Ordinary Vegan. Click here. Studies and resources cited: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604171/ https://www.ncbi.nlm.nih.gov/pubmed/20829306 http://www.jneurosci.org/content/33/37/14869 http://www.thelancet.com/journals/laneur/article/PIIS1474-4422(15)00379-8/abstract http://www.thelancet.com/journals/laneur/article/PIIS1474-4422(16)00002-8/abstract http://www.cnn.com/2013/08/07/health/charlotte-child-medical-marijuana/index.html https://www.ncbi.nlm.nih.gov/pubmed/22716160 https://www.medicalnewstoday.com/articles/317221.php http://file.scirp.org/pdf/PP_2015021016351567.pdf
Welcome Introduction: Hello and welcome to Episode 5 of Hotdish: The Just Food Co-op podcast. I’m Vicki, your host, and I am very excited to bring you the latests news from your community at the co-op. The purpose of this podcast is to keep the conversation going beyond the walls of our building. Just Food Co-op aims to be a meeting place for community and friends, where our stories can be heard and shared. Where there is an open line of communication about your food, where that food comes from, and how it is being used to nourish our town and its members. Announcements: There is a Wellness Fair going on on Saturday, October 28th from 10am-1pm featuring various healthcare professionals from around the area. There will be samples, free massages, and chatting with professionals. Segment 1 - Story: Gina, our Wellness Manager talks to us about the Wellness Fair which she spearheaded. Segment 2 - Julia, owner of Fine Fettle and a Naturopathic Practitioner who just moved her office to Bridge Square. She talks about what a Naturopath does, and invites you to come talk to her at the Wellness Fair. http://www.finefettle.store/ Cooperative Principal of the Week: Principle #5: Education, Training, and Information Cooperatives provide education and training for members, elected representatives, managers and employees so they can contribute effectively to the development of their cooperative. Members also inform the general public about the nature and benefits of cooperatives. Happenings/Next Week: An Overview of The Upcoming Events in November - Coffee With the Board - November 4, 10am-12pm Holiday Sample Day - November 11, 10am-1pm Holiday Entertaining Sample Day - November 18, 10am-1pm Turkey Pick-up Day - November 20th sign up sheet is up, sign up before November 19th. Thanksgiving Day - November 23, Store Closed Black Friday - November 24, Store Open Normal Hours 7am-9pm For More Information about Happenings at Just Food Co-op as well as up-to-date information about your local cooperative grocer you can. Go to our website www.justfood.coop. This is where you’ll find the hotbar menu. Follow us on Facebook Follow us on Twitter & Instagram Look at our favorite recipes and food-related hacks on Pinterest Our Bi-monthly newsletter is available on our website, and physical copies are available in our store. We also have a weekly email newsletter which you can sign up for by simply emailing your name and the email address you would like to use to info@justfood.coop. If you have any questions or comments for the podcast please email them to social@justfood.coop. Also if you have any suggestions for segments or would like to be a guest on the podcast, please email Vicki at social@justfood.coop with your ideas. She would love to hear from you. Thank you for listening to this Episode of of HotDish, The Just Food Co-op Podcast. Talk to you next time. Outro. : Just Food Co-op nourishes a Just, Healthy and Sustainable Community.
Thanks Ross.Listener question. Neuropathic pain, Multiple Sclerosis, Meds.
This episode covers Chapter 70 of Rosen’s Emergency Medicine. How are teeth traditionally numbered? Describe the classification and management of tooth fractures Describe the method for reducing a jaw dislocation? What is the usual direction of the dislocation? Explain Ludwig’s Angina and its management List 3 complications of maxillary (eg canine) tooth infection? Describe management of Dental Caries vs Periapical abscess Describe your approach to Acute Necrotising Ulcerative Gingivitis what is Vincent’s Angina? what is cancrum oris? Rapid Fire treatment for the following: Post root canal pain Cracked Tooth or Split root syndromes Maxillary Sinusitis Atypical Odontalgia Post extraction pain Neuropathic pain Temporomandibular Myofascial Pain Dysfunction Syndrome Pericoronitis Apthous Stomatitis WiseCracks Spot diagnosis
This episode covers Chapter 70 of Rosen’s Emergency Medicine. How are teeth traditionally numbered? Describe the classification and management of tooth fractures Describe the method for reducing a jaw dislocation? What is the usual direction of the dislocation? Explain Ludwig’s Angina and its management List 3 complications of maxillary (eg canine) tooth infection? Describe management of Dental Caries vs Periapical abscess Describe your approach to Acute Necrotising Ulcerative Gingivitis what is Vincent’s Angina? what is cancrum oris? Rapid Fire treatment for the following: Post root canal pain Cracked Tooth or Split root syndromes Maxillary Sinusitis Atypical Odontalgia Post extraction pain Neuropathic pain Temporomandibular Myofascial Pain Dysfunction Syndrome Pericoronitis Apthous Stomatitis WiseCracks Spot diagnosis
This weeks Question & Answer Session with Christina Rendon interviewing Ronnie Landis involves topics Wild Food Nutrition, Investigating Natural Diets of Indigenous Cultures, Cardiovascular Disease & Heart Nutrients, Heavy Metal Cleansing, Detox Products, Elemental Nutrition involving Earth, Water, Air, Earth, Diabetes & Neuropathic Conditions, Calcification & Bio-Film Infections, And So Much More! Ronnie Landis: http://www.ronnie-landis.com The Holistic Health Mastery Program: http://www.holistichealthmastery.com
This weeks Question & Answer Session with Christina Rendon interviewing Ronnie Landis involves topics Wild Food Nutrition, Investigating Natural Diets of Indigenous Cultures, Cardiovascular Disease & Heart Nutrients, Heavy Metal Cleansing, Detox Products, Elemental Nutrition involving Earth, Water, Air, Earth, Diabetes & Neuropathic Conditions, Calcification & Bio-Film Infections, And So Much More! Ronnie Landis: http://www.ronnie-landis.com The Holistic Health Mastery Program: http://www.holistichealthmastery.com
Free Hypnosis | Hypnotherapy | Self help | Life coaching with Kim Little
Podcast 14: Chronic pain management with hypnotherapy. Looking at how hypnotherapy can help you manage the symptoms of chronic pain. There will also be a free hypnotherapyaudio at the end of this podcast that you can enjoy, keep and come back to time and time again. Why do we feel pain? Pain is a signal that tells us something needs addressing. Our bodies can only communicate with us through sensations. This includes telling us where the pain is, is it continuous or varying and can range from mild pain to excruciating agony. We have many different word to describe pain and discomfort this might be sharp, dull, throbbing, nagging, it could be a burning sensation or itchy, an ache, a numb or pins and needles type feeling. Pain can be an indicator of many different things so it’s important you don’t self diagnose. Get checked out by your GP and make sure you follow any advice they give you. Chronic pain can be a mild inconvenience or totally incapacitating. Acute pain, this starts suddenly and is usually short-term. Neuropathic or nerve pain that can come and go. Visceral pain is felt when organs or tissues are damaged. Psychological pain or mental pain, this is an unpleasant feeling (a suffering) of a psychological, non-physical, origin. This isn’t to say it’s “all in your head” or that you’re making it up this means there is a psychological reason for your pain, your brain is sending signals down to your body that cause you to experience physical discomfort. Chronic pain is felt over a longer period of time, usually defined as chronic after 12 weeks of discomfort. We need to address psychological as well as the physical aspects of a pain condition. Taking painkillers is a good, short term solution but what are the underlying causes? Is stress a factor? It usually is in some shape or form, being in pain is a huge stressor which you can improve and reduce with relaxation techniques like hypnotherapy. Pain doesn’t usually exist alone, it might also cause Insomnia or disruption to your sleeping pattern. It’s hard to get comfortable enough to sleep when you’re in pain. Fatigue, it’s exhausting being in chronic pain. It can take all your energy to do the most basic jobs. Generalised discomfort. Withdrawal from activity and an increased need to rest. Not being able to socialise or visit loved ones. Weakened immune system. Changes in your mood. Physical disability. Today’s podcast will include techniques you can use to build the resources you will need to manage chronic pain effectively. There are numerous techniques that can help you manage chronic pain so if you find you need more help visit www.altptherapies.co.uk to have a bespoke recording made for you with your challenges in mind.
For the Full Version, Subscribe to our Premium Subscription via our App, or Download the Full Lecture Library at PainExam.com PainExam Podcast For Board Review and Practice Management Updates TEXT the word PAINEXAM to the number 33444 Download our iphone App! Download our Android App! For more information on Pain Management Topics and keywords Go to PainExam.com David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com 718 436 7246 DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. You should regularly consult a physician in matters relating to yours or another's health. You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. Copyright © 2015 QBazaar.com, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author. References http://emedicine.medscape.com/article/1819950-overview#a2 http://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/basics/symptoms/con-20022540
Dr. Rosenblum discusses the management of Phantom Limb Pain For the Full Version, subscribe to the Premium Episode PainExam Podcast For Board Review and Practice Management Updates TEXT the word PAINEXAM to the number 33444 Download our iphone App! Download our Android App! For more information on Pain Management Topics and keywords Go to PainExam.com David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com 718 436 7246 Reference: Benzon, HT, et al. Essentials of Pain Medicine and Regional Anesthesia. Second Edition. 2005. p. 394-398 DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. You should regularly consult a physician in matters relating to yours or another's health. You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. Copyright © 2015 QBazaar.com, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.
Dr. Rosenblum Reviews Non-neuropathic Orofacial Pain and the treatment of TMJ, Trigeminal Neuralgia Free Version Discussed in the Full Version of this Podcast: TMJ Syndrome Cracked tooth syndrome Carotidynia Glossodynia Atypical Odontalgia Burning Mouth Syndrome PainExam Podcast Download our App! For the Full Version Click Here For more information on Pain Management Topics and keywords Go to PainExam.com David Rosenblum, MD specializes in Pain Management and is the Director of Pain Management at Maimonides Medical Center and AABP Pain Managment For evaluation and treatment of a Painful Disorder, go to www.AABPPain.com 718 436 7246 DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. You should regularly consult a physician in matters relating to yours or another's health. You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. Copyright © 2015 QBazaar.com, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author. References Benzon, HT. Essentionals of Pain Management and Regional Anesthesia. Second ed. page 301-310
Acute pain, Chronic post-surgical pain, Neuropathic pain
In this episode of the eLife podcast we hear about neuropathic pain, gene therapy, insulin production, ageing in worms, and how flatworms grow new body parts. Get the references and the transcripts for this programme from the Naked Scientists website
Are vegetables intelligent? Is Pi a "normal" number? Are humans the only picky eaters? We take on your science questions, including why women generally don't go bald and how fingers can feel cold even though they're warm to the touch. Plus, we're joined by Matt Parker, the Stand Up Mathematician, who takes on your mathematical brain teasers, and explains how a simple mathematical trick can let you predict the numbers on a barcode! Like this podcast? Please help us by supporting the Naked Scientists
Are vegetables intelligent? Is Pi a "normal" number? Are humans the only picky eaters? We take on your science questions, including why women generally don't go bald and how fingers can feel cold even though they're warm to the touch. Plus, we're joined by Matt Parker, the Stand Up Mathematician, who takes on your mathematical brain teasers, and explains how a simple mathematical trick can let you predict the numbers on a barcode! Like this podcast? Please help us by supporting the Naked Scientists
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