Podcasts about nsaids

The “China Study” is cited as evidence vegetarian diet is best—but big new study shows vegetarians age less well than omnivores; Can a popular men's health supplement ward off prostate cancer? MAHA officials hit pause on looming natural thyroid ban; Can diet alleviate symptoms of lipedema? Precision-engineering your gait can alleviate knee pain better than NSAIDs; After a lifetime of profound depression, novel brain implant enables man to experience joy for the first time.

This week, we kick of a two-week series on the 4 areas of pain:  Analgesia, Activities of Daily Living, Adverse Effects, and Aberrant  Behavior.  In this episode, you'll learn about:—The government-commissioned study that actually concluded the Structure-Function approach to pain was the best way forward…until Big Pharma scuttled it.—How the Structure-Function approach to health care focuses on healing the body and correcting the root cause of the pain, while the Disease Care approach focuses on controlling the symptoms of pain.—The proper short-term or end-of-life role for prescription pain relief like opioids and non-steroidal anti-inflammatory drugs (NSAIDs).—Why proper alignment through Chiropractic Care should be the first place to go when looking for pain relief.  And how Corrective Exercises and Chiropractic work so much better when combined.—How 80% of the first-responders for the 9-11 disaster suffered from PTSD, but only 20% of those first-responders had PTSD if they were treated with Auriculotherapy (Ear Acupuncture). —Why Dr. Prather says his office is "pretty much 100% successful" when treating migraine headaches.—The amazing effectiveness of Acupuncture in immediately relieving pain, including severe abdominal pain associated with polycystic ovaries and menstrual cramps. —The 5 pathways of pain that guide Dr. Prather's approach to pain relief. —The natural products used at Holistic Integration that are more effective than prescription drugs in reducing pain and without the dangerous side-effects.  And how Glucosamine and Chondroitin are more effective than NSAIDs for Osteoarthritis. —How Parkinson's and Dementia patients can see incredible improvements of symptoms through proper alignment of their Atlas and eliminating the forward head posture.http://www.TheVoiceOfHealthRadio.com

#503 Late Season Racing Welcome Welcome to Episode #503 of the 303 Endurance Podcast. We're your hosts Coaches Rich Soares and April Spilde. Thanks for joining us for another week of news, coaching tips and discussion. We're racing Boulder Sunset by BBSC Endurance this weekend. As the name implies, the season is starting to sunset here in Colorado with just about 4 more weeks of triathlon racing. We're talking all things “late season racing” today!. Hey Rich and Lauren, yes, really looking forward to Boulder Sunset tomorrow and racing with Sasha and Hunter as well. This is my second time doing this race and my goal is to beat last year's time of 1:59:05. RaceX is predicting 1:44:48, so let's see what we can do! Lauren - I'll be racing on Sunday with my athlete Veron at the Medford Lakes sprint triathlon.  And my athlete Laura is racing her first Olympic distance at the Chicago Triathlon on Sunday, as well!   Show Sponsor: UCAN UCAN created LIVSTEADY as an alternative to sugar based nutrition products. LIVSTEADY was purposefully designed to work with your body, delivering long-lasting energy you can feel. Whether UCAN Energy Powders, Bars or Gels, LIVSTEADY's unique time-release profile allows your body to access energy consistently throughout the day, unlocking your natural ability to finish stronger and recover more quickly!   In Today's Show Announcements and News: Rich  Ask A Coach: How to Avoid Late Season Burnout Get Gritty Tip: Celebrate Your Wins TriDot Workout of the Week: Mobility Fun Segment: Triathlon Would You Rather—Weird Race Remix!   Announcements and News:   Our Announcements are supported by VESPA Power today. Vespa Power Endurance helps you tap into steady, clean energy—so you stay strong, focused, and in the zone longer. Vespa is not fuel, but a metabolic catalyst that shifts your body to use more fat and less glycogen as your fuel source. Vespa comes in CV-25, Junior and Concentrate.   Less sugar. Higher performance. Faster recovery.  Home of Vespa Power Products | Optimizing Your Fat Metabolism Use discount code - 303endurance20 Grit2Greatness Zoot Store is Open Colorado's Ride Boulder Sunset Saturday Series Registration Now Open for the 2025–2026 Run Denver Series Exclusive Swag Available for Series Registrants DENVER, CO /ENDURANCE SPORTSWIRE/ – The most beloved winter running tradition in the Mile High City is back! Series registration is officially OPEN for the 2025–2026 RunDenver Race Series, a five-race celebration of community, fitness, and fun — all set against the stunning backdrop of Colorado's winter wonderland.   Registration for individual races will open soon, but those looking for the full experience can sign up NOW for the complete five-race series. Series participants will receive themed swag at each event, bonus finisher bling, and additional perks throughout the season.   Each race offers themed swag, fun on-course energy, and a welcoming atmosphere for runners and walkers of all levels.   2025–2026 Run Denver Series Lineup:   Rudolph Ramble 5K Sunday, December 7, 2025, City Park, Denver Polar Bear 5K Sunday, January 18, 2026, Wash Park, Denver Super Bowl 5K Sunday, February 1, 2026, Wash Park, Denver Valentine's Day 4M Sunday, February 8, 2026, Wash Park, Denver That Dam Run Sunday, March 1, 2026, Cherry Creek Dam Road Series registration is now open at: https://secure.getmeregistered.com/get_information.php?event_id=141501   For press inquiries or sponsorship opportunities, please contact: lonnie@halsports.com   Ask A Coach Sponsor: G2G Endurance Triathletes, picture this: it's race day, and you know you've done the exact training your body needed to be ready. That's what Grit2Greatness Endurance and TriDot deliver—smart, targeted workouts backed by powerful analytics. Sign up for a 2-week free trial, then keep leveling up for as little as $14.99/month. Don't just show up to the start line—show up prepared. Click the sign-up link in the show notes to get started today! Website - Grit2Greatness Endurance Coaching Facebook - @grit2greatnessendurance Instagram - @grit2greatness_endurance   Coach April Spilde April.spilde@tridot.com  TriDot Signup - https://app.tridot.com/onboard/sign-up/aprilspilde RunDot Signup - https://app.rundot.com/onboard/sign-up/aprilspilde    Coach Lauren Brown Lauren.brown@tridot.com TriDot Coaching Link - https://app.tridot.com/onboard/sign-up/laurenbrown RunDot Coaching Link - https://app.rundot.com/onboard/sign-up/laurenbrown   Coach Rich Soares Rich.soares@tridot.com  Rich Soares Coaching TriDot Signup - https://app.tridot.com/onboard/sign-up/richsoares RunDot Signup - https://app.rundot.com/onboard/sign-up/richsoares   Ask A Coach: How to avoid late season burnout?  1.  Fatigue Risk: Accumulated physical and mental fatigue from a long season can lead to burnout, poor performance, and loss of motivation. Recommendations: Schedule a mid-season recovery block: Include 5–7 days of reduced volume and intensity. Use HRV and RPE tracking: Monitor recovery and adjust training accordingly. Prioritize sleep and nutrition: Ensure 7–9 hours of sleep and adequate carb/protein intake. Mental reset: Incorporate non-triathlon activities or mindfulness practices to refresh motivation.     2.  Injury Risk: Overuse injuries (e.g., tendinopathy, stress fractures) become more likely with cumulative training stress and racing. Recommendations: Include prehab and mobility work: Focus on hips, glutes, and core stability. Rotate terrain and intensity: Avoid repetitive stress by varying surfaces and workouts. Listen to niggles: Address minor discomfort early with rest, PT, or load adjustments. Strength training: Maintain 1–2 sessions/week of functional strength to support joints and muscles.     3.  Illness Risk: Immune suppression from high training loads, travel, and poor recovery can lead to colds, GI issues, or more serious illness. Recommendations: Support immune health: Prioritize micronutrients (vitamin D, zinc, iron) and hydration. Avoid overtraining: Use tapering and deload weeks strategically. Practice hygiene during travel: Hand washing, mask use in crowded areas, and avoiding shared bottles. Gut health: Use probiotics and avoid unnecessary NSAIDs or antibiotics. Get Gritty Tip: Celebrate Your Wins First, I want to share a personal win from last night. I was part of a Sword Cordon for our SNCO Induction Ceremony here at the academy. We held swords in the air as the 35 inductees walked through with their loved ones and posed for a photo. All eyes were on us, and for me, the win wasn't just leading the formation—it was that I experienced zero anxiety triggers. If you know my history with performance anxiety, you know that's a massive milestone. Here's the lesson: Are you recognizing your wins? In training, in racing, and in life, we often focus on what didn't go perfectly—the missed split, the hard interval, the small mistake. But growth happens when you pause and acknowledge the progress you've made. Every small victory, every moment where you step past fear, doubt, or discomfort, deserves recognition. Action Item: This week, take a moment after each workout, race, or challenging day to identify one thing you did well—no matter how small. Write it down, celebrate it, and let that win fuel your next effort. Remember, victory compounds. The more you recognize them, the more confident, resilient, and unstoppable you become. So give that a try and tell us how it goes. I guarantee with enough practice you will start to experience and appreciate the fruits of your labors which is what this journey is all about. TriDot Workout of the Week: Mobility   Lauren This week's workout of the week is a little different—it's not a swim, bike, or run session. It's actually one of my favorite yoga flows, designed to prepare your whole body for triathlon training in as little as three minutes. This routine is inspired by my own 66-day challenge where I committed to at least three minutes of yoga or mobility work every day. What I've noticed is that when I give myself permission to just do three minutes, it often turns into five or even ten. It's a simple mindset shift that makes consistency much easier. Here's the flow: Start on hands and knees and move between cat and cow for 3–5 breaths. Step back into a plank and press into downward dog. Lift into a three-legged down dog, then step through to a kneeling low lunge and hold. Press back to a kneeling half split, then repeat the sequence on the other side. From down dog, shift forward into high plank, return to tabletop, and thread the needle to each side. From there, flow into broken wing on each side to open the chest and shoulders. Finish by settling into a child's pose to reset. If you have a little more time, you can add some variety: swap the low lunge and half split for lizard pose or pigeon pose, add a twisted three-legged down dog, or include a puppy pose to stretch your lats and shoulders. It's quick, it's restorative, and it's a great way to prep your body for swim, bike, or run—or just to shake out after a long day. So this week, I challenge you to try this 3-minute full-body reset and see if your “just three minutes” turns into more.     Fun Segment: Triathlon Would You Rather – Weird Race Mix! Alright, time for another one of our favorite games—Triathlon Would You Rather? This time, I dig up some of the quirkiest, wildest triathlons on the planet and you have to decide which one you would rather do. From ice skating transitions to swimming past giraffes, these races are proof that triathlon truly has no limits.  Let's dive in and see where we'd land if we had to choose! 1. Would you rather... A) Swim in a fjord, bike across rugged mountains, and run up to a mountain summit—like the Norseman Xtreme Triathlon in Norway? B) Or suit up for a midnight swim, bike and run under headlamp glow in the Starman Portugal night race? 2. Would you rather... A) Lace up your ice skates, run, then ski across frozen terrain in the Winterlude Triathlon in Canada? B) Or race alongside your pup—like in the Tri Dog Canitriathlon in England? 3. Would you rather... A) Swim from cruise ship to island while surrounded by giraffes and cheetahs in Challenge Sir Bani Yas (UAE)? B) Or flip the script and race in reverse order—run, bike, then swim—in the Lander Reverse Triathlon? 4. Would you rather... A) Dive into some of the world's wildest terrain and elevation in the Himalayan Xtri, high in the mountains? B) Or take on a full-distance race tucked inside a snow globe wonderland—like the T24 XTREM Triathlon (ultra and bizarre!)? Article: 7 Weird Triathlon Races We're Totally Signing Up For in 2025 https://www.triathlete.com/culture/news/7-weird-and-unique-triathlons-were-totally-signing-up-for-in-2025/   Well, there you have it—some of the strangest, most creative triathlons out there. Whether you're team mountain summit, team midnight swim, or ready to race alongside your dog, these events remind us that the sport is as much about adventure as it is about endurance. We'll let you keep debating with your training buddies—because let's be real, the arguments are half the fun. Until next time, stay gritty and keep dreaming big!   Closing:   Thanks again for listening this week. Please be sure to follow us @303Triathlon and @grit2greatnessendurance and of course go to iTunes and give us a rating and a comment. We'd really appreciate it! Stay tuned, train informed and enjoy the endurance journey!  

Vilazodone (brand name Viibryd) is an antidepressant with a unique pharmacologic profile compared to most other agents in the SSRI class. While not a first-line choice for every patient, understanding its mechanism, adverse effects, and interaction profile is essential for optimizing therapy and preventing downstream prescribing problems. Mechanism of ActionVilazodone is classified as a selective serotonin reuptake inhibitor (SSRI) and a partial agonist at the 5-HT1A receptor. The SSRI activity increases synaptic serotonin by blocking the serotonin transporter, while partial agonism at 5-HT1A receptors may contribute to antidepressant effects and potentially reduce certain SSRI-associated adverse effects (though clinical evidence for this benefit is mixed). Adverse Effects GI effects – diarrhea, nausea, and vomiting are frequent early in therapy. Taking the medication with food can help minimize these. Insomnia – often dose-related; morning dosing may help. Sexual dysfunction – may be slightly lower than with some SSRIs but still present. Serotonin syndrome – rare but serious, particularly if combined with other serotonergic drugs. Discontinuation syndrome – abrupt cessation can lead to dizziness, irritability, and flu-like symptoms. Drug InteractionsVilazodone is primarily metabolized by CYP3A4. This means: CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin, ritonavir) can increase vilazodone concentrations, potentially worsening side effects—dose reductions may be required. CYP3A4 inducers (e.g., carbamazepine, rifampin, St. John's Wort) can lower drug levels, reducing effectiveness. Other serotonergic agents (e.g., triptans, SNRIs, MAOIs, tramadol, linezolid) increase the risk of serotonin syndrome. Antiplatelets and anticoagulants – SSRIs can impair platelet aggregation, increasing bleeding risk when combined with aspirin, NSAIDs, or warfarin. Prescribing Cascade ExamplesVilazodone's adverse effects can easily lead to unnecessary prescriptions if side effects aren't recognized: GI upset → Acid suppression therapy – Diarrhea or nausea prompts the addition of proton pump inhibitors or antiemetics, instead of adjusting vilazodone dose or timing. Insomnia → Hypnotic initiation – Trouble sleeping results in adding zolpidem or trazodone, without reassessing morning dosing or vilazodone's role. Sexual dysfunction → PDE5 inhibitor prescription – Erectile dysfunction leads to sildenafil use, when the root cause is vilazodone's serotonergic activity. Vilazodone's combination of SSRI and 5-HT1A partial agonist activity makes it somewhat distinct, but its side effect profile and interactions require the same careful monitoring as other antidepressants. Healthcare professionals can play a key role in catching early signs of adverse effects, preventing prescribing cascades, and ensuring drug–drug interactions are managed appropriately.

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https://ivdi.org/inv Ready to elevate your veterinary dentistry skills? Request an invitation to the Veterinary Dental Practitioner Program! -------------------------------- Host: Dr. Brett Beckman, Board Certified Veterinary Dentist In this episode of the Vet Dental Show, Annie Mills, LVT VTS (Dentistry), addresses common questions about electrosurgery for gingival hyperplasia, post-extraction protocols, and pain management, providing practical insights for veterinary professionals. What You'll Learn ✅ The dangers of using electrosurgery for gingival hyperplasia and why a scalpel is preferred. ✅ Proper charging protocols for post-extraction X-rays and regional blocks. ✅ The importance of blood clots in post-extraction sites and when to use hemostatic agents. ✅ Effective pain management strategies, including CRI protocols and take-home medications when NSAIDs are contraindicated. ✅ The limited benefits of fluoride treatments in veterinary dentistry. Key Takeaways ✅ Electrosurgery can cause significant tissue and bone damage due to heat, making a scalpel a safer option for gingival excisions. ✅ Always charge for each post-extraction X-ray and each quadrant receiving a regional block to ensure proper compensation for your services. ✅ A blood clot is the best bone graft for post-extraction sites; avoid routine use of hemostatic agents unless emergent bleeding occurs. ✅ Manage wind-up pain effectively with CRIs of buprenorphine and lidocaine (cats) or hydromorphone, lidocaine, and ketamine (dogs), along with appropriate loading doses. ✅ When NSAIDs are contraindicated, fentanyl and gabapentin can be a powerful combination for pain management. ---------------------------------- Don't miss out on the opportunity to become a leader in veterinary dentistry! Request your invitation to the Veterinary Dental Practitioner Program today: https://ivdi.org/inv What are your experiences with electrosurgery or post-extraction complications? Share your thoughts and questions in the comments below! --------------------------------- Keyword Tags Veterinary Dentistry, Electrosurgery, Gingival Hyperplasia, Tooth Extraction, Post-Extraction Care, Regional Blocks, Pain Management, Veterinary Anesthesia, IVDI, Brett Beckman, Veterinary Dental Practitioner Program, Veterinary Medicine, Dog, Cat, Oral Surgery, Dental Radiography, Hemostatic Agents, Wind-Up Pain, NSAIDs, Fentanyl, Gabapentin, Fluoride Treatments

297: In today's Bite Of Knowledge, I'm talking all about NSAIDs, what they are, the side effects of long term use, as well as how to heal your gut after taking them….We've all taken them at some point in our life and perhaps you even took some today! As always, if you have any questions for the show please email us at digestthispod@gmail.com. And if you like this show, please share it, rate it, review it and subscribe to it on your favorite podcast app.  Sponsored By:  → Bethany's Pantry | Go to bethanyspantry.com and use code PODCAST10 for $10 anything! → Pique Life | Check out piquelife.com/digest for up to 20% OFF and a free starter kit Check Out Bethany: → Bethany's Instagram: @lilsipper → YouTube → Bethany's Website → Discounts & My Favorite Products → My Digestive Support Protein Powder → Gut Reset Book  → Get my Newsletters (Friday Finds) Learn more about your ad choices. Visit megaphone.fm/adchoices

Today's podcast comes from this blog post: Beyond NSAIDs: Natural Inflammation Resolution with SPMs Discover more Christian podcasts at lifeaudio.com and inquire about advertising opportunities at lifeaudio.com/contact-us.

On a prior podcast we talked with Todd Semla and Mike Steinman about the update to the AGS Beers Criteria of potentially inappropriate medications in older adults (Todd and Mike co-chair the AGS Beers Criteria Panel).  One of the questions that came up was - well if we should probably think twice or avoid that medication, what should we do instead? Today we talk with Todd and Mike about their new recommendations of alternative treatments to the AGS Beers Criteria, published recently in JAGS, and also presented at the 2025 AGS conference in Chicago (and available on demand online). We had a lot of fun at the start of the podcast talking about the appropriate analogy for how clinicians should use the AGS Beers Criteria.  In our last podcast, the analogy was a stop sign. You should come to a stop before you prescribe or refill a medication on the Beers list, look around at alternatives, and consider how to proceed.  You might in the end decide to proceed, as there are certainly situations in which it does make sense to start or continue a medication on the Beers list. Today's analogy had somewhat higher stakes, involving a driver, a pothole in the road, and a cyclist on the side who you'd hit if you swerved.  Really upping the anti!!! The podcast is framed around a case Eric crafted of a patient with most of the medications and conditions on the Beers list. We used this as a springboard to discuss the following issues (with links to prior GeriPal podcasts): Insomnia (Doxepin is an alternative, trazodone and melatonin are not?!?) Diabetes management  PPI for GERD Treatments for pain, including NSAIDS, COX2, and gabapentinoids Cannabis Deprescribing,org - terrific Canadian website (no tariff to use) And I hope that the prescribing landscape is indeed getting better (thanks to Kai on guitar)! -Alex Smith  

Robert Yang is a leading expert in digestive wellness, hormone restoration, and performance nutrition with over 27 years of clinical experience. He is an internationally sought-after presenter on a variety of topics on nutrition, gut health, and performance enhancement. He serves as an advisory board member for Titleist Performance Institute, the National Pitching Association, and the USDA's US National Development Program, where he's also the team nutritionist. He consults with elite professional athletes from the XGames, NFL, NHL, MLB, AVP, PGA, LPGA, and European Tour. In this episode of Conversations for Health, we examine the intersection of sports performance and functional nutrition, focusing on both elite and developing athletes. If you work with kids and their parents, you will find this conversation exceptionally valuable. Robert generously shares clinical pearls, information about the labs that he uses with athletes, pre- and post-workout nutrition, traumatic brain injuries, and much more, including the big picture that parents, coaches, and healthcare practitioners need to understand about long-term athletic development for youth athletes.   I'm your host, Evelyne Lambrecht. Thank you for designing a well world with us.   Episode Resources: Robert Yang: robertyang.net Design for Health Resources: Designs for Health - https://www.designsforhealth.com/ Designs for Health Practitioner Exclusive Drug Nutrient Depletion and Interaction Checker - https://www.designsforhealth.com/drug-nutrient-interaction/ Visit the Designs for Health Research and Education Library, which houses medical journals, protocols, webinars, and our blog. https://www.designsforhealth.com/research-and-education/education The Designs for Health Podcast is produced in partnership with Podfly Productions. Chapters: 00:00 Intro. 02:49 Robert Yang's career focuses on sports and performance nutrition and working with elite associations and athletes. 05:54 Key points of long-term athletic development and training for youth.  10:15 Training youth athletes fast throughout growth spurts. 18:07 A foundation of hydration and sodium in training athletes. 24:00 Protein recommendations during training and growth spurts. 29:24 Protein, fat, and fiber for blood sugar control. 30:34 Athletes, GI issues, leaky gut, and inflammation markers. 34:54 Dr. Yang's approach to anti-inflammatories, NSAIDs, and nutrients. 38:33 Lab panels for iron deficiencies and excess storage iron. 41:28 Creatine, amino acid, and other preferred supplements for pre- and post-workout. 49:02 Robert's nutrition strategy and views on intermittent fasting. 56:39 Intra-workout strategies for aging and average patients. 59:25 Post-workout carbohydrates and protein ratio recommendations. 1:04:30 Adaptogens, essential fatty acids, fish oil, and Omega-3 index numbers. 1:10:40 Nutrient recommendations for addressing traumatic brain injuries. 1:17:49 Robert's favorite supplements, favorite health practices, and his changed view on intermittent fasting.

Navigating the fine line between effective pain control and minimizing harm from opioid medications remains one of anesthesiology's greatest challenges. This episode dives deep into the evolving landscape of perioperative pain management, examining how clinicians can achieve the delicate balance required for optimal patient outcomes.Dr. Paul Guillod joins us to share his perspective as both an anesthesiologist and pain management specialist, highlighting how opioid-sparing techniques create opportunities for interdisciplinary collaboration and improved surgical recovery. We examine the substantial risks of traditional opioid-based approaches: respiratory depression, delayed bowel function, delirium, and paradoxically, opioid-induced hyperalgesia.The episode showcases promising research on multimodal analgesia strategies that target multiple pain pathways simultaneously. By combining regional anesthesia techniques with medications like NSAIDs, acetaminophen, ketamine, dexmedetomidine, and newer options like suzetrigine, clinicians can dramatically reduce opioid requirements while maintaining effective pain control. Real-world implementation of these approaches through Enhanced Recovery After Surgery (ERAS) protocols has yielded impressive results: 50% reductions in in-hospital opioid use, shortened hospital stays, and improved pain scores across multiple surgical specialties.Whether you're a clinician seeking to improve your pain management approach or simply interested in understanding how anesthesia care is evolving to address the opioid crisis, this episode offers valuable insights into creating safer, more effective perioperative experiences. Subscribe to the Anesthesia Patient Safety Podcast and join us in our commitment that no one shall be harmed by anesthesia care.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/267-beyond-opioids-revolutionizing-perioperative-pain-control/© 2025, The Anesthesia Patient Safety Foundation

Did you know the humble bottle of extra virgin olive oil in your pantry could be doing more than just making your salad taste good? In this episode, I’m unpacking a game-changing compound found in high quality EVOO – oleocanthal – which behaves just like ibuprofen. We’re talking natural anti-inflammatory power that can help reduce exercise-associated inflammation, support recovery and keep your immune system firing – without wrecking your gut or kidneys like NSAIDs can. You’ll learn: What oleocanthal is and why it’s like nature’s ibuprofen How to spot a good quality EVOO (not all are created equal) Why this simple pantry staple could be a secret weapon in your recovery strategy LINKS: Link to paper

Podcast Summary This episode of the Pain Exam Podcast, hosted by Dr. David Rosenblum, discusses an interesting article about Ketorolac injections for musculoskeletal conditions. The podcast covers: Ketorolac is an NSAID that provides analgesic and anti-inflammatory effects through inhibition of prostaglandin synthesis Multiple studies comparing Ketorolac injections to corticosteroids and hyaluronic acid for various conditions Research shows Ketorolac injections are equally effective as corticosteroids for subacromial conditions, adhesive capsulitis, carpal-metacarpal joint issues, and hip/knee osteoarthritis Ketorolac may be a safer alternative to steroids for certain patients, though it has its own contraindications for those with renal, gastrointestinal, or cardiovascular disease Dr. Rosenblum considers the potential of using Ketorolac injections directly at pain sites rather than intramuscularly Upcoming Courses and Conferences Ultrasound courses in New York and Costa Rica (check unwrappedpain.org) Private ultrasound sessions available Dr. Rosenblum will be speaking at Pain Week about ultrasound in pain practice and PRP Presenting at a primary care conference in London Teaching ultrasound at ISPN LAPSES conference in Chile (Dr. Rosenblum won't attend this year) Ketorolac Injections: An Effective Alternative for Musculoskeletal Pain Management Musculoskeletal conditions such as bursitis, adhesive capsulitis, and osteoarthritis affect millions and often require injectable therapies to reduce pain and inflammation. Traditionally, corticosteroid injections have been the mainstay treatment. However, concerns over side effects like tendon rupture, cartilage damage, and systemic hyperglycemia have prompted exploration of alternatives. A recent narrative review by Kiel et al. (2024) highlights ketorolac—a parenteral nonsteroidal anti-inflammatory drug (NSAID)—as a promising substitute for corticosteroids in musculoskeletal injections. Warning: OFF Label use of Ketorolac discussed. Please consult your physician. See full article  for details. Subacromial Ketorolac Injections for Shoulder Pain Subacromial bursitis and impingement syndrome are common causes of shoulder pain and disability. Several randomized controlled trials have shown that subacromial ketorolac injections provide pain relief and functional improvement comparable to corticosteroids: Goyal et al. demonstrated significant reductions in pain scores after subacromial injection of 60 mg ketorolac versus 40 mg methylprednisolone, with no difference in outcomes between groups. Taheri et al. found similar short-term pain relief at 1 and 3 months with either ketorolac or corticosteroid subacromial injections. Kim et al. reported equivalent clinical improvement in rotator cuff syndrome patients receiving ketorolac or triamcinolone injections. Min et al. noted ketorolac led to better forward flexion and patient satisfaction at 4 weeks compared to corticosteroids. These studies support ketorolac as an effective agent for subacromial injection, offering an alternative for patients where corticosteroid use is limited. Intra-articular Ketorolac Injections for Adhesive Capsulitis and Osteoarthritis Adhesive capsulitis (frozen shoulder) and osteoarthritis of the hip, knee, and carpometacarpal joint are often treated with intra-articular corticosteroids. Ketorolac injections have shown comparable efficacy in these conditions: Akhtar et al. found intra-articular ketorolac significantly reduced shoulder pain at 4 weeks in adhesive capsulitis compared to hyaluronic acid. Ahn et al. reported similar pain relief between intra-articular ketorolac and corticosteroid injections in adhesive capsulitis, with ketorolac providing superior shoulder mobility at 3 and 6 months. Koh et al. showed that adding ketorolac to hyaluronic acid injections in carpometacarpal osteoarthritis resulted in faster onset of pain relief compared to hyaluronic acid alone. Park et al. observed equivalent functional improvements with intra-articular ketorolac or corticosteroids in hip osteoarthritis. Jurgensmeier et al. demonstrated similar symptom improvement at 1 and 3 months post-injection for ketorolac and triamcinolone in hip and knee osteoarthritis. Xu et al. and Bellamy et al. confirmed ketorolac's comparable pain relief and functional benefits to corticosteroids for knee osteoarthritis, with ketorolac being more cost-effective. Lee et al. noted quicker pain reduction with intra-articular ketorolac combined with hyaluronic acid versus hyaluronic acid alone in knee osteoarthritis. aSafety and Pharmacologic Considerations Ketorolac's anti-inflammatory action stems from cyclooxygenase inhibition, reducing prostaglandin synthesis. Its half-life is approximately 5.2–5.6 hours, and it is metabolized in the liver. Unlike corticosteroids, ketorolac avoids systemic hyperglycemia and cartilage damage risks. Animal and in vitro studies suggest ketorolac may protect cartilage by inhibiting inflammatory cytokines. While gastrointestinal, renal, and cardiovascular risks associated with NSAIDs remain considerations, localized intra-articular and subacromial ketorolac injections may limit systemic exposure and adverse effects. Mild, transient post-injection pain has been reported but resolves without intervention. Conclusion Ketorolac injections, administered intra-articularly or subacromially, are a safe, effective, and economical alternative to corticosteroids for managing common musculoskeletal conditions. Their comparable efficacy in reducing pain and improving function, combined with a more favorable side effect profile, makes ketorolac an appealing option for clinicians and patients alike. Further research is warranted to fully elucidate long-term safety and optimal dosing strategies. FAQS Ketorolac Injections for Musculoskeletal Conditions: Frequently Asked Questions Musculoskeletal pain from conditions like bursitis, adhesive capsulitis, and osteoarthritis often requires injectable treatments. Ketorolac, a nonsteroidal anti-inflammatory drug (NSAID), is emerging as a promising alternative to corticosteroids. Below are common questions and answers based on a recent narrative review by Kiel et al. (2024). 1. What is ketorolac and how does it work? Ketorolac is a parenteral NSAID that reduces pain and inflammation by inhibiting cyclooxygenase enzymes, which decreases prostaglandin synthesis. It can be administered orally, intramuscularly, intravenously, or by injection directly into joints or around bursae. 2. How effective is ketorolac for musculoskeletal conditions? Studies show ketorolac injections provide significant pain relief and functional improvement comparable to corticosteroids in conditions like: Subacromial bursitis and shoulder impingement (subacromial injections) Adhesive capsulitis (frozen shoulder) (intra-articular injections) Osteoarthritis of the hip, knee, and thumb carpometacarpal joint (intra-articular injections) 3. What evidence supports subacromial ketorolac injections? Randomized controlled trials found: Goyal et al. and Taheri et al. reported similar pain reduction and functional outcomes between ketorolac and corticosteroids for subacromial injections. Kim et al. and Min et al. observed comparable or better patient satisfaction and shoulder mobility with ketorolac versus corticosteroids. 4. How does intra-articular ketorolac compare to corticosteroids for adhesive capsulitis? Akhtar et al. showed ketorolac reduced shoulder pain more than hyaluronic acid. Ahn et al. found ketorolac and corticosteroids equally effective for pain relief, with ketorolac providing better shoulder mobility at 3 and 6 months. 5. What about ketorolac for osteoarthritis? Ketorolac combined with hyaluronic acid provided faster pain relief than hyaluronic acid alone in thumb carpometacarpal joint osteoarthritis (Koh et al.). Intra-articular ketorolac had similar efficacy to corticosteroids in hip (Park et al., Jurgensmeier et al.) and knee osteoarthritis (Bellamy et al., Xu et al.). Ketorolac injections were more cost-effective compared to corticosteroids (Bellamy et al.). 6. Are ketorolac injections safe? Ketorolac's side effects are similar to other NSAIDs, mainly involving gastrointestinal, renal, and cardiovascular risks. However, localized intra-articular and subacromial injections may reduce systemic exposure. Animal studies suggest ketorolac does not harm cartilage and may protect against inflammatory damage. Mild, transient local pain post-injection is possible but usually resolves without treatment. 7. What are the limitations of ketorolac use? Ketorolac is not suitable for patients with: Renal impairment Gastrointestinal ulcers or bleeding risk Cardiovascular disease or hypertension NSAID hypersensitivity, especially in asthma or chronic urticaria patients Clinicians should assess individual risks before choosing ketorolac injections. 8. How does ketorolac's pharmacokinetics affect its use? Ketorolac has a plasma half-life of about 5.2 to 5.6 hours and is metabolized in the liver. Pharmacokinetics for subcutaneous or intra-articular administration are less defined but systemic absorption occurs. Its relatively short half-life supports repeated dosing if needed. 9. Why consider ketorolac over corticosteroids? Ketorolac avoids corticosteroid-associated risks such as tendon rupture, cartilage damage, and steroid-induced hyperglycemia. It is also more cost-effective, making it a favorable option for patients and healthcare systems. 10. What further research is needed? More large-scale, long-term studies are needed to fully understand ketorolac's intra-articular effects, optimal dosing, and safety profile compared to corticosteroids and other treatments. Summary: Ketorolac injections, whether intra-articular or subacromial, offer a safe, effective, and economical alternative to corticosteroids for managing various musculoskeletal conditions. This makes ketorolac an important option in pain management and inflammation control.     Reference: Kiel J, Applewhite AI, Bertasi TGO, Bertasi RAO, Seemann LL, Costa LMC, Helmi H, Pujalte GGA. Ketorolac Injections for Musculoskeletal Conditions: A Narrative Review. Clinical Medicine & Research. 2024;22(1):19-27. DOI: https://doi.org/10.3121/cmr.2024.1847 Disclaimer: This Podcast, website and any content from NRAP Academy (PMRexam.com) otherwise known as Qbazaar.com, LLC is  for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. Professionals should conduct their own fact finding, research, and due diligence to come to their own conclusions for treating patients. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.    

Podcast Summary This episode of the Pain Exam Podcast, hosted by Dr. David Rosenblum, discusses an interesting article about Ketorolac injections for musculoskeletal conditions. The podcast covers: Ketorolac is an NSAID that provides analgesic and anti-inflammatory effects through inhibition of prostaglandin synthesis Multiple studies comparing Ketorolac injections to corticosteroids and hyaluronic acid for various conditions Research shows Ketorolac injections are equally effective as corticosteroids for subacromial conditions, adhesive capsulitis, carpal-metacarpal joint issues, and hip/knee osteoarthritis Ketorolac may be a safer alternative to steroids for certain patients, though it has its own contraindications for those with renal, gastrointestinal, or cardiovascular disease Dr. Rosenblum considers the potential of using Ketorolac injections directly at pain sites rather than intramuscularly Upcoming Courses and Conferences Ultrasound courses in New York and Costa Rica (check unwrappedpain.org) Private ultrasound sessions available Dr. Rosenblum will be speaking at Pain Week about ultrasound in pain practice and PRP Presenting at a primary care conference in London Teaching ultrasound at ISPN LAPS  conference in Chile (Dr. Rosenblum won't attend this year) Ketorolac Injections: An Effective Alternative for Musculoskeletal Pain Management Musculoskeletal conditions such as bursitis, adhesive capsulitis, and osteoarthritis affect millions and often require injectable therapies to reduce pain and inflammation. Traditionally, corticosteroid injections have been the mainstay treatment. However, concerns over side effects like tendon rupture, cartilage damage, and systemic hyperglycemia have prompted exploration of alternatives. A recent narrative review by Kiel et al. (2024) highlights ketorolac—a parenteral nonsteroidal anti-inflammatory drug (NSAID)—as a promising substitute for corticosteroids in musculoskeletal injections. Warning: OFF Label use of Ketorolac discussed. Please consult your physician. See full article  for details. Subacromial Ketorolac Injections for Shoulder Pain Subacromial bursitis and impingement syndrome are common causes of shoulder pain and disability. Several randomized controlled trials have shown that subacromial ketorolac injections provide pain relief and functional improvement comparable to corticosteroids: Goyal et al. demonstrated significant reductions in pain scores after subacromial injection of 60 mg ketorolac versus 40 mg methylprednisolone, with no difference in outcomes between groups. Taheri et al. found similar short-term pain relief at 1 and 3 months with either ketorolac or corticosteroid subacromial injections. Kim et al. reported equivalent clinical improvement in rotator cuff syndrome patients receiving ketorolac or triamcinolone injections. Min et al. noted ketorolac led to better forward flexion and patient satisfaction at 4 weeks compared to corticosteroids. These studies support ketorolac as an effective agent for subacromial injection, offering an alternative for patients where corticosteroid use is limited. Intra-articular Ketorolac Injections for Adhesive Capsulitis and Osteoarthritis Adhesive capsulitis (frozen shoulder) and osteoarthritis of the hip, knee, and carpometacarpal joint are often treated with intra-articular corticosteroids. Ketorolac injections have shown comparable efficacy in these conditions: Akhtar et al. found intra-articular ketorolac significantly reduced shoulder pain at 4 weeks in adhesive capsulitis compared to hyaluronic acid. Ahn et al. reported similar pain relief between intra-articular ketorolac and corticosteroid injections in adhesive capsulitis, with ketorolac providing superior shoulder mobility at 3 and 6 months. Koh et al. showed that adding ketorolac to hyaluronic acid injections in carpometacarpal osteoarthritis resulted in faster onset of pain relief compared to hyaluronic acid alone. Park et al. observed equivalent functional improvements with intra-articular ketorolac or corticosteroids in hip osteoarthritis. Jurgensmeier et al. demonstrated similar symptom improvement at 1 and 3 months post-injection for ketorolac and triamcinolone in hip and knee osteoarthritis. Xu et al. and Bellamy et al. confirmed ketorolac's comparable pain relief and functional benefits to corticosteroids for knee osteoarthritis, with ketorolac being more cost-effective. Lee et al. noted quicker pain reduction with intra-articular ketorolac combined with hyaluronic acid versus hyaluronic acid alone in knee osteoarthritis. aSafety and Pharmacologic Considerations Ketorolac's anti-inflammatory action stems from cyclooxygenase inhibition, reducing prostaglandin synthesis. Its half-life is approximately 5.2–5.6 hours, and it is metabolized in the liver. Unlike corticosteroids, ketorolac avoids systemic hyperglycemia and cartilage damage risks. Animal and in vitro studies suggest ketorolac may protect cartilage by inhibiting inflammatory cytokines. While gastrointestinal, renal, and cardiovascular risks associated with NSAIDs remain considerations, localized intra-articular and subacromial ketorolac injections may limit systemic exposure and adverse effects. Mild, transient post-injection pain has been reported but resolves without intervention. Conclusion Ketorolac injections, administered intra-articularly or subacromially, are a safe, effective, and economical alternative to corticosteroids for managing common musculoskeletal conditions. Their comparable efficacy in reducing pain and improving function, combined with a more favorable side effect profile, makes ketorolac an appealing option for clinicians and patients alike. Further research is warranted to fully elucidate long-term safety and optimal dosing strategies. FAQS Ketorolac Injections for Musculoskeletal Conditions: Frequently Asked Questions Musculoskeletal pain from conditions like bursitis, adhesive capsulitis, and osteoarthritis often requires injectable treatments. Ketorolac, a nonsteroidal anti-inflammatory drug (NSAID), is emerging as a promising alternative to corticosteroids. Below are common questions and answers based on a recent narrative review by Kiel et al. (2024). 1. What is ketorolac and how does it work? Ketorolac is a parenteral NSAID that reduces pain and inflammation by inhibiting cyclooxygenase enzymes, which decreases prostaglandin synthesis. It can be administered orally, intramuscularly, intravenously, or by injection directly into joints or around bursae. 2. How effective is ketorolac for musculoskeletal conditions? Studies show ketorolac injections provide significant pain relief and functional improvement comparable to corticosteroids in conditions like: Subacromial bursitis and shoulder impingement (subacromial injections) Adhesive capsulitis (frozen shoulder) (intra-articular injections) Osteoarthritis of the hip, knee, and thumb carpometacarpal joint (intra-articular injections) 3. What evidence supports subacromial ketorolac injections? Randomized controlled trials found: Goyal et al. and Taheri et al. reported similar pain reduction and functional outcomes between ketorolac and corticosteroids for subacromial injections. Kim et al. and Min et al. observed comparable or better patient satisfaction and shoulder mobility with ketorolac versus corticosteroids. 4. How does intra-articular ketorolac compare to corticosteroids for adhesive capsulitis? Akhtar et al. showed ketorolac reduced shoulder pain more than hyaluronic acid. Ahn et al. found ketorolac and corticosteroids equally effective for pain relief, with ketorolac providing better shoulder mobility at 3 and 6 months. 5. What about ketorolac for osteoarthritis? Ketorolac combined with hyaluronic acid provided faster pain relief than hyaluronic acid alone in thumb carpometacarpal joint osteoarthritis (Koh et al.). Intra-articular ketorolac had similar efficacy to corticosteroids in hip (Park et al., Jurgensmeier et al.) and knee osteoarthritis (Bellamy et al., Xu et al.). Ketorolac injections were more cost-effective compared to corticosteroids (Bellamy et al.). 6. Are ketorolac injections safe? Ketorolac's side effects are similar to other NSAIDs, mainly involving gastrointestinal, renal, and cardiovascular risks. However, localized intra-articular and subacromial injections may reduce systemic exposure. Animal studies suggest ketorolac does not harm cartilage and may protect against inflammatory damage. Mild, transient local pain post-injection is possible but usually resolves without treatment. 7. What are the limitations of ketorolac use? Ketorolac is not suitable for patients with: Renal impairment Gastrointestinal ulcers or bleeding risk Cardiovascular disease or hypertension NSAID hypersensitivity, especially in asthma or chronic urticaria patients Clinicians should assess individual risks before choosing ketorolac injections. 8. How does ketorolac's pharmacokinetics affect its use? Ketorolac has a plasma half-life of about 5.2 to 5.6 hours and is metabolized in the liver. Pharmacokinetics for subcutaneous or intra-articular administration are less defined but systemic absorption occurs. Its relatively short half-life supports repeated dosing if needed. 9. Why consider ketorolac over corticosteroids? Ketorolac avoids corticosteroid-associated risks such as tendon rupture, cartilage damage, and steroid-induced hyperglycemia. It is also more cost-effective, making it a favorable option for patients and healthcare systems. 10. What further research is needed? More large-scale, long-term studies are needed to fully understand ketorolac's intra-articular effects, optimal dosing, and safety profile compared to corticosteroids and other treatments. Summary: Ketorolac injections, whether intra-articular or subacromial, offer a safe, effective, and economical alternative to corticosteroids for managing various musculoskeletal conditions. This makes ketorolac an important option in pain management and inflammation control.     Reference: Kiel J, Applewhite AI, Bertasi TGO, Bertasi RAO, Seemann LL, Costa LMC, Helmi H, Pujalte GGA. Ketorolac Injections for Musculoskeletal Conditions: A Narrative Review. Clinical Medicine & Research. 2024;22(1):19-27. DOI: https://doi.org/10.3121/cmr.2024.1847 Disclaimer: This Podcast, website and any content from NRAP Academy (PMRexam.com) otherwise known as Qbazaar.com, LLC is  for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. Professionals should conduct their own fact finding, research, and due diligence to come to their own conclusions for treating patients. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.  

Podcast Summary This episode of the Pain Exam Podcast, hosted by Dr. David Rosenblum, discusses an interesting article about Ketorolac injections for musculoskeletal conditions. The podcast covers: Ketorolac is an NSAID that provides analgesic and anti-inflammatory effects through inhibition of prostaglandin synthesis Multiple studies comparing Ketorolac injections to corticosteroids and hyaluronic acid for various conditions Research shows Ketorolac injections are equally effective as corticosteroids for subacromial conditions, adhesive capsulitis, carpal-metacarpal joint issues, and hip/knee osteoarthritis Ketorolac may be a safer alternative to steroids for certain patients, though it has its own contraindications for those with renal, gastrointestinal, or cardiovascular disease Dr. Rosenblum considers the potential of using Ketorolac injections directly at pain sites rather than intramuscularly Upcoming Courses and Conferences Ultrasound courses in New York and Costa Rica (check unwrappedpain.org) Private ultrasound sessions available Dr. Rosenblum will be speaking at Pain Week about ultrasound in pain practice and PRP Presenting at a primary care conference in London Teaching ultrasound at ISPN LAPSES conference in Chile (Dr. Rosenblum won't attend this year) Ketorolac Injections: An Effective Alternative for Musculoskeletal Pain Management Musculoskeletal conditions such as bursitis, adhesive capsulitis, and osteoarthritis affect millions and often require injectable therapies to reduce pain and inflammation. Traditionally, corticosteroid injections have been the mainstay treatment. However, concerns over side effects like tendon rupture, cartilage damage, and systemic hyperglycemia have prompted exploration of alternatives. A recent narrative review by Kiel et al. (2024) highlights ketorolac—a parenteral nonsteroidal anti-inflammatory drug (NSAID)—as a promising substitute for corticosteroids in musculoskeletal injections. Warning: OFF Label use of Ketorolac discussed. Please consult your physician. See full article  for details. Subacromial Ketorolac Injections for Shoulder Pain Subacromial bursitis and impingement syndrome are common causes of shoulder pain and disability. Several randomized controlled trials have shown that subacromial ketorolac injections provide pain relief and functional improvement comparable to corticosteroids: Goyal et al. demonstrated significant reductions in pain scores after subacromial injection of 60 mg ketorolac versus 40 mg methylprednisolone, with no difference in outcomes between groups. Taheri et al. found similar short-term pain relief at 1 and 3 months with either ketorolac or corticosteroid subacromial injections. Kim et al. reported equivalent clinical improvement in rotator cuff syndrome patients receiving ketorolac or triamcinolone injections. Min et al. noted ketorolac led to better forward flexion and patient satisfaction at 4 weeks compared to corticosteroids. These studies support ketorolac as an effective agent for subacromial injection, offering an alternative for patients where corticosteroid use is limited. Intra-articular Ketorolac Injections for Adhesive Capsulitis and Osteoarthritis Adhesive capsulitis (frozen shoulder) and osteoarthritis of the hip, knee, and carpometacarpal joint are often treated with intra-articular corticosteroids. Ketorolac injections have shown comparable efficacy in these conditions: Akhtar et al. found intra-articular ketorolac significantly reduced shoulder pain at 4 weeks in adhesive capsulitis compared to hyaluronic acid. Ahn et al. reported similar pain relief between intra-articular ketorolac and corticosteroid injections in adhesive capsulitis, with ketorolac providing superior shoulder mobility at 3 and 6 months. Koh et al. showed that adding ketorolac to hyaluronic acid injections in carpometacarpal osteoarthritis resulted in faster onset of pain relief compared to hyaluronic acid alone. Park et al. observed equivalent functional improvements with intra-articular ketorolac or corticosteroids in hip osteoarthritis. Jurgensmeier et al. demonstrated similar symptom improvement at 1 and 3 months post-injection for ketorolac and triamcinolone in hip and knee osteoarthritis. Xu et al. and Bellamy et al. confirmed ketorolac's comparable pain relief and functional benefits to corticosteroids for knee osteoarthritis, with ketorolac being more cost-effective. Lee et al. noted quicker pain reduction with intra-articular ketorolac combined with hyaluronic acid versus hyaluronic acid alone in knee osteoarthritis. aSafety and Pharmacologic Considerations Ketorolac's anti-inflammatory action stems from cyclooxygenase inhibition, reducing prostaglandin synthesis. Its half-life is approximately 5.2–5.6 hours, and it is metabolized in the liver. Unlike corticosteroids, ketorolac avoids systemic hyperglycemia and cartilage damage risks. Animal and in vitro studies suggest ketorolac may protect cartilage by inhibiting inflammatory cytokines. While gastrointestinal, renal, and cardiovascular risks associated with NSAIDs remain considerations, localized intra-articular and subacromial ketorolac injections may limit systemic exposure and adverse effects. Mild, transient post-injection pain has been reported but resolves without intervention. Conclusion Ketorolac injections, administered intra-articularly or subacromially, are a safe, effective, and economical alternative to corticosteroids for managing common musculoskeletal conditions. Their comparable efficacy in reducing pain and improving function, combined with a more favorable side effect profile, makes ketorolac an appealing option for clinicians and patients alike. Further research is warranted to fully elucidate long-term safety and optimal dosing strategies. FAQS Ketorolac Injections for Musculoskeletal Conditions: Frequently Asked Questions Musculoskeletal pain from conditions like bursitis, adhesive capsulitis, and osteoarthritis often requires injectable treatments. Ketorolac, a nonsteroidal anti-inflammatory drug (NSAID), is emerging as a promising alternative to corticosteroids. Below are common questions and answers based on a recent narrative review by Kiel et al. (2024). 1. What is ketorolac and how does it work? Ketorolac is a parenteral NSAID that reduces pain and inflammation by inhibiting cyclooxygenase enzymes, which decreases prostaglandin synthesis. It can be administered orally, intramuscularly, intravenously, or by injection directly into joints or around bursae. 2. How effective is ketorolac for musculoskeletal conditions? Studies show ketorolac injections provide significant pain relief and functional improvement comparable to corticosteroids in conditions like: Subacromial bursitis and shoulder impingement (subacromial injections) Adhesive capsulitis (frozen shoulder) (intra-articular injections) Osteoarthritis of the hip, knee, and thumb carpometacarpal joint (intra-articular injections) 3. What evidence supports subacromial ketorolac injections? Randomized controlled trials found: Goyal et al. and Taheri et al. reported similar pain reduction and functional outcomes between ketorolac and corticosteroids for subacromial injections. Kim et al. and Min et al. observed comparable or better patient satisfaction and shoulder mobility with ketorolac versus corticosteroids. 4. How does intra-articular ketorolac compare to corticosteroids for adhesive capsulitis? Akhtar et al. showed ketorolac reduced shoulder pain more than hyaluronic acid. Ahn et al. found ketorolac and corticosteroids equally effective for pain relief, with ketorolac providing better shoulder mobility at 3 and 6 months. 5. What about ketorolac for osteoarthritis? Ketorolac combined with hyaluronic acid provided faster pain relief than hyaluronic acid alone in thumb carpometacarpal joint osteoarthritis (Koh et al.). Intra-articular ketorolac had similar efficacy to corticosteroids in hip (Park et al., Jurgensmeier et al.) and knee osteoarthritis (Bellamy et al., Xu et al.). Ketorolac injections were more cost-effective compared to corticosteroids (Bellamy et al.). 6. Are ketorolac injections safe? Ketorolac's side effects are similar to other NSAIDs, mainly involving gastrointestinal, renal, and cardiovascular risks. However, localized intra-articular and subacromial injections may reduce systemic exposure. Animal studies suggest ketorolac does not harm cartilage and may protect against inflammatory damage. Mild, transient local pain post-injection is possible but usually resolves without treatment. 7. What are the limitations of ketorolac use? Ketorolac is not suitable for patients with: Renal impairment Gastrointestinal ulcers or bleeding risk Cardiovascular disease or hypertension NSAID hypersensitivity, especially in asthma or chronic urticaria patients Clinicians should assess individual risks before choosing ketorolac injections. 8. How does ketorolac's pharmacokinetics affect its use? Ketorolac has a plasma half-life of about 5.2 to 5.6 hours and is metabolized in the liver. Pharmacokinetics for subcutaneous or intra-articular administration are less defined but systemic absorption occurs. Its relatively short half-life supports repeated dosing if needed. 9. Why consider ketorolac over corticosteroids? Ketorolac avoids corticosteroid-associated risks such as tendon rupture, cartilage damage, and steroid-induced hyperglycemia. It is also more cost-effective, making it a favorable option for patients and healthcare systems. 10. What further research is needed? More large-scale, long-term studies are needed to fully understand ketorolac's intra-articular effects, optimal dosing, and safety profile compared to corticosteroids and other treatments. Summary: Ketorolac injections, whether intra-articular or subacromial, offer a safe, effective, and economical alternative to corticosteroids for managing various musculoskeletal conditions. This makes ketorolac an important option in pain management and inflammation control.     Reference: Kiel J, Applewhite AI, Bertasi TGO, Bertasi RAO, Seemann LL, Costa LMC, Helmi H, Pujalte GGA. Ketorolac Injections for Musculoskeletal Conditions: A Narrative Review. Clinical Medicine & Research. 2024;22(1):19-27. DOI: https://doi.org/10.3121/cmr.2024.1847 Disclaimer: This Podcast, website and any content from NRAP Academy (PMRexam.com) otherwise known as Qbazaar.com, LLC is  for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. Professionals should conduct their own fact finding, research, and due diligence to come to their own conclusions for treating patients. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.    

In this episode, YARAL Pharma CEO, Stephen Beckman joins clinical sports pharmacist Jessica Beal, PharmD. to discuss an important topic for athletes and active individuals – the role topical NSAID patches can play in acute pain management. Listeners can visit www.YARALPharma.com to learn more about the company and its products or connect on LinkedIn.    Diclofenac Epolamine Topical System 1.3%    Diclofenac Epolamine Topical System 1.3% is a nonsteroidal anti-inflammatory drug (NSAID) used for treating acute pain from minor strains, sprains, and bruises in adults and children aged 6 and older.     Serious side effects may include increased risk of cardiovascular and gastrointestinal (GI) events. NSAIDs can raise the risk of heart attack, stroke, gastrointestinal bleeding, ulceration, and perforation of the stomach and intestines, which can be fatal. The risk for serious cardiovascular events may occur early in treatment and may increase with duration of use. Elderly patients and those with a history of peptic ulcer disease or GI bleeding are at higher risk for serious GI events.    Do not use in patients who are allergic to diclofenac or any of its ingredients, or have a history of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. Do not use in the setting of coronary artery bypass graft surgery. Avoid use on broken skin. Discontinue immediately if signs of hypersensitivity occur.      Patients should be informed about the warning signs and symptoms of liver problems. Discontinue use if abnormal liver tests persist or worsen or if signs of liver disease develop. Avoid using Diclofenac Epolamine Topical System 1.3% in patients with severe heart failure unless the benefits are expected to outweigh the risks.    The most common side effects include itching, nausea, and headache. Patients should stop use and consult their doctor at the first sign of skin rash or other signs of sensitivity.    Patients should ask their doctor if Diclofenac Epolamine Topical System 1.3% is right for them. For more information and Full Prescribing Information including Boxed Warning and Important Safety Information, visit www.yaralpharma.com   Dr. Beal is not affiliated with YARAL Pharma. All views and opinions regarding pain management are solely her own and are not attributable to YARAL or the Pharmacy Podcast Network. 

Dr. Steven Gundry joins Michael Rubino to reveal why America has never been sicker—and how three major changes from the 1970s triggered a wave of chronic illness we're still battling today. From microbiome damage and leaky gut to mold exposure, glyphosate, and indoor air quality, this episode breaks down what's really driving today's health epidemic.Learn more from Dr. Gundry:▪️ Website: https://drgundry.com▪️ Products: https://gundrymd.com▪️ Telemedicine: https://gundryhealth.comTakeawaysWe've never been sicker than we are today.The best medical system doesn't equate to better health.The microbiome is crucial for our immune system.Leaky gut is a significant health issue.Antibiotics have harmed our gut health.Glyphosate is an antibiotic that affects bacteria.Mold exposure can lead to serious health problems.Restoring the microbiome takes time and effort.Fermentation can help detoxify harmful plant compounds.Hydrogen gas from the microbiome is vital for health.Timestamps:00:00 Introduction to Dr. Steven Gundry01:13 Why we've “never been sicker”02:17 How the 1970s created a health crisis04:36 Mold vs. bacteria: a natural war05:38 Microbiome strength in centenarians06:07 The microbiome destruction from antibiotics08:05 NSAIDs and gut lining damage10:30 Glyphosate's hidden antibiotic role13:28 How crops are sprayed with glyphosate pre-harvest18:33 Leaky gut, autoimmune disease, and inflammation24:23 Traditional food prep that detoxifies plants27:50 How long it actually takes to heal leaky gut31:30 Gundry's mold case study in a patient home34:59 Best spot to place your air purifier36:04 Mold, indoor air, and gut health38:27 Microplastics and hydrogen gas production39:26 Dr. Gundry's hydrogen product and why it matters41:20 Where to find Dr. Gundry and his work

Guest: Abiodun Ologunowa Pediatric sickle cell disease treatment, particularly the use of hydroxyurea, NSAIDs, and opioids, has evolved in response to clinical guidelines and regulatory shifts, but gaps still remain in how children receive essential medications. Joining Dr. Charles Turck to discuss these national prescribing trends, disparities in care, and the implications of evolving treatment guidelines for this population is Dr. Abiodun Ologunowa. Dr. Ologunowa is a doctoral candidate and research assistant in the Department of Pharmacy Practice and Clinical Research at the University of Rhode Island College of Pharmacy.

Story at-a-glance Common medications like NSAIDs, antibiotics, acid blockers, and laxatives quietly damage your kidneys, even when used as directed Kidney symptoms often show up late, so damage is underway before you feel anything, especially if you're older or taking multiple prescriptions NSAIDs reduce blood flow, antibiotics clog, or inflame kidney filters and proton pump inhibitors trigger immune reactions that harm kidney tissue Imaging contrast dyes used in CT or MRI scans sharply reduce kidney function in vulnerable people, particularly those with diabetes or dehydration Reviewing your medications regularly, leading a healthy lifestyle and using natural alternatives help reduce your kidney burden and prevent long-term harm

Send us a message with this link, we would love to hear from you. Standard message rates may apply.We break down the key differences between Tylenol (acetaminophen) and NSAIDs (ibuprofen, naproxen, aspirin) to help you make informed decisions about which pain reliever is right for you. This evidence-based discussion draws from top medical sources to explain how these common medications work differently in your body.• Tylenol works on perception of pain and fever in the brain but doesn't address inflammation• NSAIDs reduce pain, fever AND inflammation by blocking the prostaglandin cascade• Both medications are commonly used for everyday pain including headaches and general discomfort• NSAIDs are usually more effective for inflammatory conditions like sprains, arthritis, and period cramps• Tylenol's main risk is liver damage at high doses (max 4,000mg daily for most adults)• NSAIDs can cause stomach ulcers, GI bleeding, increased blood pressure, and kidney problems• Consider your medical history when choosing—liver issues (caution with Tylenol), stomach/heart/kidney problems (caution with NSAIDs)• Age is a factor—older adults generally face higher risks with NSAIDs• Taking NSAIDs with food can help reduce stomach problems• Always read labels and follow dosing instructions carefullyShare this episode with friends or family who take these medications regularly to help them understand what they're putting in their bodies.Diabetes dialogues podcastDiabetes insights for HCPs. Dexcom's expert-led podcast, Diabetes Dialogues.Listen on: Apple Podcasts SpotifySupport the showSubscribe to Our Newsletter! Production and Content: Edward Delesky, MD & Nicole Aruffo, RNArtwork: Olivia Pawlowski

Are over-the-counter painkillers silently wrecking your liver? Tylenol for a headache. Ibuprofen for sore muscles. PM meds to help you sleep. They're so common we don't think twice… but your liver does. Your liver is one of the hardest-working organs in your body, and when it's overworked or congested, everything suffers—your hormones, your energy, your digestion, even your sleep. The good news? It's also one of the most resilient organs you have. With the right care, you can restore its function and unlock better energy, clearer thinking, and hormonal harmony. In this episode of The Health Made Simple Show, Dr. Bart shares:

On this episode of Vitality Radio, Jared welcomes back naturopathic physician Dr. Lexi Loch from Terry Naturally to uncover two of the most powerful herbs in natural medicine: Boswellia and Curcumin (from Turmeric). While many are familiar with turmeric for inflammation, few realize that Boswellia (also known as frankincense) targets a completely different inflammatory pathway—one that traditional NSAIDs and pain relievers don't touch. Together, these herbs form a potent, well-researched duo for addressing pain and inflammation in the gut, joints, lungs, and beyond. You'll learn about the unique pathway that Boswellia modulates, the advantages of this unique curcumin extract over conventional turmeric extracts, and how combining the two offers faster and longer-lasting support. Whether you're struggling with IBS, asthma, joint pain, or simply want to manage everyday inflammation more naturally, this episode provides evidence-based insight and practical guidance you can trust.Products:Terry Naturally Boswellia & Curcumin ProductsAdditional Information:#524: Maximum Absorption of Nutrients for Energy, Pain, Immune, and Respiratory Challenges with Dr. Lexi LochVisit the podcast website here: VitalityRadio.comYou can follow @vitalitynutritionbountiful and @vitalityradio on Instagram, or Vitality Radio and Vitality Nutrition on Facebook. Join us also in the Vitality Radio Podcast Listener Community on Facebook. Shop the products that Jared mentions at vitalitynutrition.com. Let us know your thoughts about this episode using the hashtag #vitalityradio and please rate and review us on Apple Podcasts. Thank you!Just a reminder that this podcast is for educational purposes only. The FDA has not evaluated the podcast. The information is not intended to diagnose, treat, cure, or prevent any disease. The advice given is not intended to replace the advice of your medical professional.

This episode takes a deep dive into the complex world of inflammation—how it shows up in the body, its essential role in immune response and healing, and what happens when it becomes chronic. Listeners will gain insight into the signs of systemic inflammation, including joint pain, brain fog, skin issues, and digestive symptoms, along with a breakdown of how inflammation can become a driver of chronic disease when left unchecked. We also examine the risks associated with common over-the-counter anti-inflammatory medications like NSAIDs, including their impact on gut integrity and long-term health outcomes. The episode offers evidence-based alternatives for pain and inflammation, including food-as-medicine strategies, targeted supplementation (like omega-3s, curcumin, and boswellia), and lifestyle practices that promote healing and regulate immune function without unwanted side effects. Also in this episode: Preorder Naturally Nourished Kids  What is inflammation? Cellular shifts and the inflammatory cascade Primary inflammatory chemicals Testing markers of inflammation hs-CRP CRP ESR Concerns with antiinflammatory medications Steroids and their side effects Top antiinflammatory supplements Super Turmeric Antioxidant and anti-inflammatory effects of curcumin/turmeric supplementation in adults: A GRADE-assessed systematic review and dose–response meta-analysis of randomized controlled trials EPA DHA Extra Cellular Antiox Anti Inflammatory Bundle Proteolytic Enzymes Inflammazyme What to eliminate to reduce inflammation MRT Test The Best Food Sensitivity Test [Everly, Pinner or MRT]  Food as medicine support Fatty Fish Berries Olive Oil Turmeric Lemon Turmeric Shooter Avocados   Sponsors for this episode:  This episode is sponsored by Wild Foods, a company that puts quality, sustainability, and health first in all of their products. They have everything from coffee to turmeric to medicinal mushrooms, and every single product is painstakingly sourced from small farms around the globe. They take their mission seriously to fix the broken food system, and believe real food is medicine. They've partnered with us to give you guys an exclusive discount, so use the code ALIMILLERRD for 12% off your order at WildFoods.co! 

New study shows mood, attention, brain function improvements after 2-week smartphone “fast”; Natural ways to combat the pain of neuropathy; Solutions for painful swollen lower extremities; Omega-3 reduces depression in bipolar disease; Berberine for blood sugar control; Study demonstrates comprehensive lifestyle program reverses cognitive decline; NSAIDs for knee pain—more is not better; Nighttime pistachio snack curbs pre-diabetes.

 With polypharmacy on the rise, prescribing for older adults can be tricky, leading to increased risks of side effects and drug interactions. In today's episode, we'll explore how you can reduce medication risks in older adults with the Beers Criteria, a tool that helps you safely navigate these challenges and enhance your clinical practice for patients over 65.   In this episode, you'll learn which medications, from antidepressants to NSAIDs, should raise red flags and how the Beers Criteria can guide your decisions. We'll also talk about practical steps for de-prescribing and collaborating with other healthcare professionals to ensure your patients get the safest, most effective treatments.   Get full show notes, transcript, and more information here: https://blog.npreviews.com/reduce-medication-risks-older-adults-beers-criteria

In this episode, Dr. Jockers and Dr. Rob Bello dive into the science behind BPC-157 and why it's different from conventional anti-inflammatories like NSAIDs. You'll hear how this peptide works with your body—not against it—to speed healing and reduce chronic inflammation without halting the recovery process.   You'll also discover the power of stacking BPC-157 with TB-4 Frag, a synergistic combo known as the “Wolverine Stack.” Learn how this potent pair supports tissue repair, collagen production, angiogenesis, and even hormone receptor sensitivity for faster recovery and better performance.   Curious about dosing, delivery methods, or long-term safety? Dr. Bello shares insider insights on oral bioavailability, clinical outcomes, and what makes their formulations uniquely effective—especially for athletes, autoimmune patients, and anyone dealing with chronic pain.   In This Episode: 00:00 Introduction to Inflammation and BPC 03:23 Dr. Jocker's Personal Experience with BPC 157 04:33 Interview with Dr. Rob Bello: Peptides and BPC 157 04:55 The Origin and Benefits of BPC 157 09:48 BPC 157: Mechanisms and Healing Properties 20:14 BPC 157: Dosage and Administration 28:00 Understanding Lip Polysaccharides and Inflammation 28:23 Why Most New Year's Resolutions Fail 30:24 The Role of Endotoxin Labs in Autoimmune Treatment 31:30 Exploring TB 500 and Its Benefits 37:21 The Wolverine Stack: Enhancing Healing and Recovery 46:41 Ensuring Quality and Efficacy in Supplements 51:29 Conclusion and Final Thoughts     Support your heart, brain, and immune system with Paleo Valley's Wild Caught Fish Roe, a whole food source rich in Omega-3s like EPA and DHA. It's more bioavailable and stable than traditional fish oil, offering benefits for cardiovascular health, mood, and brain function. Go to paleovalley.com/jockers for 15% off your order!   Looking to boost your digestion, immunity, and energy? Just Thrive Probiotic is the answer! Unlike most probiotics that get destroyed by stomach acid, Just Thrive is clinically proven to reach your gut 100% alive. This means better digestion, improved immunity, enhanced energy, and easier weight management. Plus, with their industry-leading 100% money-back guarantee, you've got nothing to lose. Start feeling your best today, go to justthrivehealth.com and use code JOCKERS to save 20%.   Turn on your body's ability to heal with Vibrant Blue Oils, particularly their parasympathetic blend. These natural essential oils activate your nervous system, reduce inflammation, enhance digestion, detoxification, and improve brain function. Visit vibrantblueoils.com/jockers to grab a $15 full-size bottle of their Parasympathetic Blend today!"       "BPC-157 doesn't block inflammation. It empowers the healing process by regulating inflammation where it's needed." ~ Dr. Jockers     Subscribe to the podcast on: Apple Podcast Stitcher Spotify PodBean  TuneIn Radio     Resources: Get 15% off Paleovalley Fish Roe: paleovalley.com/jockers – Use code JOCKERS Save 20% on Just Thrive: justthrivehealth.com – Use code JOCKERS Visit vibrantblueoils.com/jockers and save $15 on a full-size bottle today!       Connect with Dr. Rob Bello: Website: https://bellofamilychiropractic.com/   Connect with Dr. Jockers: Instagram – https://www.instagram.com/drjockers/ Facebook – https:/www.facebook.com/DrDavidJockers YouTube – https://www.youtube.com/user/djockers Website – https://drjockers.com/ If you are interested in being a guest on the show, we would love to hear from you! Please contact us here! - https://drjockers.com/join-us-dr-jockers-functional-nutrition-podcast/

Today, we're going to talk about some of the underlying causes of pain, along with the best natural remedies for pain relief. Joint pain and inflammation don't always signify arthritis!t's important to understand that natural joint pain remedies will not work if you continue to consume foods that cause inflammation. To avoid joint pain and inflammation, it's vital to avoid the following foods:•Sugar •High-fructose corn syrup•Seed oils •Gluten •Oxalates•MSG•Maltodextrin•Nightshades (Potatoes, peppers, tomatoes)•Lectins (Beans, peanuts, wheat, soy)Healthy Keto is a great option to help avoid these inflammatory foods! If you're sensitive to oxalates, it may be caused by past antibiotic use. This can make you more susceptible to joint pain, especially when you consume spinach, chocolate, almonds, and Swiss chard. Increasing magnesium intake can help significantly. Add a teaspoon of turmeric to a glass of half water and half coconut milk for the best joint pain remedy. Add a pinch of black pepper to increase absorption by 2000%. You can also add a scoop of collagen powder for even more joint pain relief! This drink is delicious for most people, but you can add a couple drops of liquid stevia if necessary. Drink this daily. It can also be served warm. This drink works anytime, but try drinking it in the morning for pain relief that lasts all day!Turmeric has been shown to have similar effectiveness to ibuprofen and other NSAIDS. If you're taking a turmeric supplement for joint pain relief, take 1000 to 1500 mg daily.Turmeric inhibits at least four major inflammatory pathways. Coconut milk has beneficial properties and also helps with turmeric absorption. Collagen helps build up the joints. Boswellia serrata is also an amazing supplement that research has shown to be as effective as NSAIDS without side effects. Walking is the best exercise for joint pain relief, and it has no side effects. It can also extend your life!Dr. Eric Berg DC Bio:Dr. Berg, age 60, is a chiropractor who specializes in Healthy Ketosis & Intermittent Fasting. He is the author of the best-selling book The Healthy Keto Plan, and is the Director of Dr. Berg Nutritionals. He no longer practices, but focuses on health education through social media.

NSAIDs can reduce the effectiveness of antihypertensive medications such as ACE inhibitors, ARBs, beta-blockers, and diuretics by promoting sodium and water retention and decreasing renal blood flow. Combining NSAIDs with anticoagulants or antiplatelet agents like warfarin or aspirin significantly increases the risk of gastrointestinal bleeding, due to additive effects on platelet inhibition and mucosal irritation. NSAIDs can elevate lithium levels and increase the risk of toxicity, as they reduce renal clearance of lithium by decreasing renal perfusion. Co-administration of NSAIDs with methotrexate can impair methotrexate elimination, leading to elevated levels and potential toxicity, especially at high methotrexate doses. When NSAIDs are used with corticosteroids, the risk of gastrointestinal ulcers and bleeding is greatly amplified due to synergistic impairment of gastric mucosal protection.

Episode 194: Acute low back pain.  Future Dr. Ibrahim presents a clinical case to explain the essential points in the evaluation of back pain.  Future Dr. Redden adds information about differentiating between a back strain and more serious diseases such as cancer, and Dr. Arreaza shares information about returning to work after back strain.Written by Michael Ibrahim, MSIV. Editing and comments by Jordan Redden, MSIV, and Hector Arreaza, MD.You are listening to 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.Dr. Arreaza:Welcome back, everyone. Today's topic is one that every primary care provider, emergency doctor, and even specialist sees routinely: low back pain. It's so common that studies estimate up to 80% of adults will experience it at some point in their lives. But despite how frequent it is, the challenge is to identify which cases are benign and which demand urgent attention.Jordan:Exactly. Low back pain is usually self-limiting and mechanical in nature, but we always need to keep an eye out for the rare but serious causes: things like infection, malignancy, or neurological compromise. That's why a good history and physical exam are our best tools right out of the gate.Michael:And to ground this in a real example, let me introduce a patient we saw recently. John is a 45-year-old warehouse worker who came in with two weeks of lower back pain that started after lifting a 50-lb box. He describes it as a dull, aching pain that radiates from his lower back down the posterior left thigh into the calf. He says it gets worse with bending or coughing, but he feels better when lying flat. He also mentioned some numbness in his left foot, but he denies any bowel or bladder issues. His vitals are completely normal. On exam, he had lumbar paraspinal tenderness, a positive straight leg-raise at 40 degrees on the left and decreased sensation in the L5 dermatome, though reflexes were still intact.Dr. Arreaza:That's a great case. Let's take a minute and talk about the straight leg raise test. This is a bedside tool we use to assess for lumbar nerve root irritation often caused by a herniated disc. ***Here's how it works: the patient lies supine, and you slowly raise their straight leg. If pain radiates below the knee between 30° and 70°, that suggests radiculopathy, especially involving the L5 or S1 nerve roots. Pain at higher angles is more likely due to hamstring tightness or mechanical strain.Michael:Right. So, stepping back: what do we mean by "low back pain"? Broadly, it's any pain localized to the lumbar spine, but it's often classified by type or cause:Mechanical (like muscle strain or degenerative disc disease), Radicular (nerve root involvement), Referred pain (like from pelvic or abdominal organs), Inflammatory (AS), and Systemic or serious causes like infection or malignancy. Jordan:In John's case, we're thinking radicular pain, most likely from a herniated disc compressing the L5 nerve root. That's supported by the dermatomal numbness, the leg pain, and that positive straight leg test.Dr. Arreaza:Good reasoning. Now, anytime we see back pain, our brains should run a checklist for red flags. These help us pick up more serious causes that require urgent attention. Let's run through the red flags.Michael:Sure. For fracture, we think about major trauma or even minor trauma in the elderly, especially those with osteoporosis or on chronic steroids. Also, anyone over 70 years old.Jordan:Then we have infections, which could include things like discitis, vertebral osteomyelitis, or epidural abscess. Red flags include fever, IV drug use, recent surgery, or immunosuppression.Michael:Malignancy is another critical one, especially if there's a history of breast, prostate, lung, kidney, or thyroid cancer. Clues include unexplained weight loss, night pain, or constant pain not relieved by rest.Jordan:And don't forget about inflammatory back pain, like ankylosing spondylitis, which is often seen in younger patients with morning stiffness that lasts more than 30 minutes and improves with activity.Dr. Arreaza:And of course, we always rule out cauda equina syndrome: a surgical emergency. That's urinary retention or incontinence, saddle anesthesia, bilateral leg weakness, or fecal incontinence. Missing this diagnosis can be catastrophic.Michael:Thankfully, in John's case, we don't see any red flags. His presentation is classic for uncomplicated lumbar radiculopathy. But we must stay vigilant, because sometimes patients don't offer up key symptoms unless we ask directly.Jordan:And that's where associated symptoms help guide us. For example:Radicular symptoms like numbness or weakness follow dermatomal patterns. Constitutional symptoms like fever or weight loss raise red flags. Bladder/bowel changes or saddle anesthesia raise alarms for cauda equina. Pain that wakes patients up at night might point to malignancy. Dr. Arreaza:So when do we order labs or imaging?Michael:Not right away. For most patients with acute low back pain, imaging is not needed unless they have red flags. If infection is suspected, we'd get CBC, ESR, and CRP. For cancer, maybe PSA or serum protein electrophoresis. And if inflammatory back disease is suspected, HLA-B27 can be helpful.Jordan:Yes, imaging should be delayed for at least six weeks unless red flags or significant neurologic deficits are present. When we do image, MRI is our go-to especially for suspected radiculopathy or cauda equina. X-rays can help if we're thinking about fractures, but they won't show soft tissue or nerve root issues.Michael:In the example from our case, since the patient doesn't have red flags, we'd go with conservative management: start NSAIDs and recommend activity modification. As this is the acute setting, physical therapy would not be recommended.Jordan:For the acute phase, research shows no serious difference between those with PT and those without in the long term. However, physical therapy is really the cornerstone of management for chronic back pain. It's not just movement: it's education, body mechanics, and teaching patients how to move safely. And PT can actually reduce opioid use, imaging, and injections down the line for patient struggling with long term back pain.Dr. Arreaza:Yes, and PT is not one-size-fits-all. PT might include McKenzie exercises, manual therapy, postural retraining, or even neuromuscular re-education. The goal is always to build core stability, promote healthy movement patterns, and reduce fear of motion.Jordan:Let's take a minute to talk about the McKenzie Method, a physical therapy approach used to treat lumbar disc herniation by identifying a specific movement, (often spinal extension) that reduces or centralizes pain. A common exercise is the prone press-up, (cobra pose for yoga fans) where the patient lies face down and pushes the upper body upward while keeping the hips on the floor to relieve pressure on the disc. These exercises should be done carefully, ideally under professional guidance, and discontinued if symptoms worsen.Michael:For our case patient, our working diagnosis is mechanical low back pain with L5 radiculopathy. No imaging needed now, no red flags. We'll treat conservatively and educate him about proper lifting, staying active, and recovery expectations.Jordan:We also emphasized to him that bed rest isn't helpful. In fact, bed rest can make things worse. Keeping active while avoiding heavy lifting for now is key.Dr. Arreaza:Return-to-work recommendations should be individualized. For example, an office worker, positioning while working, or work hours may be able to return to work promptly. However, those with physically demanding jobs may need light duty or be off work.Ice: no evidence of benefit. Heat: may reduce pain and disability in pain of less than 3 months, although the benefit was small and short.And we should always teach safe lifting techniques: bend at the knees, keep the load close, avoid twisting. It's basic knowledge, but it is very effective in preventing recurrence.Jordan:Now, if a patient fails to improve after 6 weeks of conservative therapy, or if they develop new neurologic deficits, that's when we think about referral to spine specialists or surgical consultation.Michael:And as previously mentioned: in cases where back pain becomes chronic (lasting more than 12 weeks) a multidisciplinary approach works best. That can include:Physical therapy, Cognitive behavioral therapy (CBT) And sometimes pain management interventions. Jordan:We can't forget the psychological toll either. Chronic back pain is associated with depression, anxiety, and opioid dependence. Increased risk factors include obesity, smoking, sedentary lifestyle, and previous back injuries.Dr. Arreaza:Well said. So, let's summarize. Michael?Michael:Sure! Low back pain is common, and most cases are benign. But we have to know the red flags that point to serious pathology. A focused history and physical exam are more powerful than many people realize. And the first step in treatment is almost always conservative, with a strong emphasis on maintaining physical activity.Jordan:And don't underestimate the value of patient education. Helping patients understand their pain, set realistic expectations, and stay active is often just as important as the medications or therapies we offer.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! _____________________References:Chou, R., Qaseem, A., Snow, V., Casey, D., Cross, J. T., Shekelle, P., & Owens, D. K. (2007). Diagnosis and treatment of low back pain: A joint clinical practice guideline from the American College of Physicians and the American Pain Society. Annals of Internal Medicine, 147(7), 478–491. https://doi.org/10.7326/0003-4819-147-7-200710020-00006Deyo, R. A., Mirza, S. K., Turner, J. A., & Martin, B. I. (2009). Overtreating chronic back pain: Time to back off? Journal of the American Board of Family Medicine, 22(1), 62–68. https://doi.org/10.3122/jabfm.2009.01.080102National Institute for Health and Care Excellence. (2020). Low back pain and sciatica in over 16s: Assessment and management (NICE Guideline No. NG59). https://www.nice.org.uk/guidance/ng59Qaseem, A., Wilt, T. J., McLean, R. M., & Forciea, M. A. (2017). Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 166(7), 514–530. https://doi.org/10.7326/M16-2367UpToDate. (n.d.). Evaluation and treatment of low back pain in adults. Wolters Kluwer. https://www.uptodate.com (Access requires subscription)Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/. 

It's something we all encounter in emergency and prehospital care, probably more than anything else, yet it's a topic we've not given a full episode to… until now! Up to 70% of prehospital patients and 60–90% of ED attendees report pain, with half of all ED presentations having pain as the primary complaint. That's millions of patients across Europe every year and we're not always optimising our approach! In this episode, we're diving deep into acute pain management; from understanding the complex biopsychosocial definition of pain, right through to tailored pharmacological and non-pharmacological strategies, plus everything in between. We'll be looking at how we define and assess pain and the importance of validating patient experience. Then we'll work through management options: from paracetamol to ketamine, NSAIDs to regional anaesthesia, and talk through barriers like bias, opiophobia, and the persistent inequalities in analgesic delivery. We'll also shine a light on special groups;  from paediatrics to chronic pain patients and those with opioid use concerns, finishing with key takeaways on safe discharge planning. This one's about being better at recognising, respecting, and relieving pain. Because pain is an emergency, and we've got the tools to do something about it. Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James

Story at-a-glance Not all sudden chest pain signals a heart attack — less than 6% of emergency room visits for chest pain are life-threatening, according to a 2016 JAMA study Precordial catch syndrome, often triggered by poor posture or growth spurts, causes short, stabbing chest pain but is harmless and usually resolves on its own within minutes Digestive issues like gastritis and gastroesophageal reflux disease (GERD) cause chest discomfort that mimics heart conditions; triggers include spicy food, alcohol, nonsteroidal anti-inflammatory drugs (NSAIDs), and stress Other non-cardiac causes include panic attacks, rib strain, or costochondritis —these are painful but generally self-limiting and improve with rest, posture correction, or over-the-counter medications Life-threatening causes like pulmonary embolism or aortic dissection require urgent care; if chest pain radiates or includes fainting or breathlessness, seek emergency help immediately

We're answering your questions about the impact of various diets on muscle growth, the role of inflammation in exercise recovery, and the effectiveness of blue light glasses. You'll gain insights into how vegan and omnivore diets compare in terms of muscle protein synthesis, and you'll learn about the potential trade-offs of using NSAIDs for pain management. After you listen, you'll understand that the optimal approach to nutrition and recovery doesn't rely on strict rules, but rather on achieving balance and meeting your individual needs.

“Just avoid wine and cheese!”If only it were that simple.Welcome back to The Migraine Heroes Podcast, where we explore the real reasons behind your attacks and how to stop them. Hosted by Diane Ducarme, who's helped over 500 women get their lives back, this podcast blends the best of neuroscience with the deep-rooted wisdom of Traditional Chinese Medicine.In today's episode, we unpack the controversial world of tyramine and histamine—two compounds that hide in your favorite foods and may be secretly fueling your migraine attacks.You'll learn:Why fermented, aged, or even slightly spoiled foods can create a “perfect storm” in your brainWhat tyramine and histamine actually do to your nervous system, and why some bodies just can't process them wellHow medications like NSAIDs, antidepressants, and even common antibiotics can interfere with the body's ability to break down histamine making migraine triggers themselves (!)How to build a path back to food freedom—without fearWhether you've been told to cut all histamine-rich foods or you've noticed wine, cheese, or avocado leave you foggy and drained, this episode is your science-backed, heart-centered guide to understanding why—and what to do next.

In this episode, Dr. David Jockers reveals how common pain relievers like NSAIDs can damage your gut, leading to leaky gut and inflammation. He shares the science behind how these meds worsen long-term gut health.   Antibiotics, often prescribed unnecessarily, disrupt the gut microbiome and cause more harm than good, creating long-term issues like bacterial resistance.   Dr. Jockers also explains how acid-blocking medications prevent nutrient absorption, particularly B12 and magnesium, and why they're more damaging than helpful.     In This Episode:  00:00 Personal Story: The Dangers of Overusing Ibuprofen 00:41 Introduction to the Podcast and Sponsor Message 03:02 Understanding Gut Inflammation and Medications 07:43 The Problem with NSAIDs 09:38 The Risks of Antibiotics 13:40 The Dangers of Acid Blocking Medications 16:56 Issues with Birth Control Pills 17:37 Steroids: Short-Term Relief, Long-Term Harm 18:38 Conclusion and Final Thoughts   Explore the health benefits of C60, a Nobel Prize-winning antioxidant that optimizes mitochondrial function and fights inflammation. Visit shopc60.com and discover how to boost your immune system, detox your body, and increase energy. Use promo code 'Jockers' for 15% off your first order. Start your journey to better health with C60 today!   If you're dealing with blood sugar swings, stubborn fat, or constant cravings, Berberine Breakthrough by BiOptimizers could be the game-changer your body needs. This advanced formula goes beyond standard berberine by combining it with 12 synergistic ingredients like alpha-lipoic acid, chromium, and cinnamon to supercharge your metabolism, stabilize insulin levels, and fuel mitochondrial health. Users report better energy, fewer cravings, and noticeable fat loss — all backed by science. Plus, it comes with a 365-day money-back guarantee, so there's zero risk. Use code JOCKERS at bioptimizers.com/jockers to save 10% and start transforming your health today.     “I ended up taking eight or nine ibuprofen a day to help relieve the soreness in my arm. And I really believe that was one of the triggers for me developing irritable bowel syndrome”  ~ Dr. Jockers     Subscribe to the podcast on: Apple Podcast Stitcher Spotify PodBean TuneIn Radio     Resources: Visit https://shopc60.com/jockers – Use code “JOCKERS” to get 15% off! Visit biOptimizers.com/Jockers   Connect with Dr. Jockers: Instagram – https://www.instagram.com/drjockers/ Facebook – https://www.facebook.com/DrDavidJockers YouTube – https://www.youtube.com/user/djockers Website – https://drjockers.com/ If you are interested in being a guest on the show, we would love to hear from you! Please contact us here! - https://drjockers.com/join-us-dr-jockers-functional-nutrition-podcast/ 

On this podcast episode, I discuss quinapril pharmacology, adverse effects, drug interactions, pharmacokinetics, and much more. Quinapril is a prodrug that is converted in the liver to its active metabolite, quinaprilat, which inhibits ACE, leading to decreased formation of angiotensin II and reduced aldosterone secretion. Hyperkalemia can occur with quinapril use due to decreased aldosterone, leading to potassium retention—especially in patients with renal impairment. Concomitant use of potassium-sparing diuretics or potassium supplements with quinapril increases the risk of hyperkalemia. NSAIDs may reduce the antihypertensive effect of quinapril and increase the risk of nephrotoxicity, especially in patients with preexisting renal dysfunction.

What if the root cause of anxiety, memory loss, or chronic fatigue after a brain injury isn't psychological, but hormonal? Will and Jon sit down with Dr. Mark Gordon, MD a trailblazer in neuroendocrinology, to uncover how traumatic brain injury (TBI) and chronic inflammation disrupt hormonal balance, often mimicking or masking conditions like PTSD. Dr. Gordon explains the science behind hormone therapy, the overlooked role of gut health, and why a 28-point biomarker panel could be the key to reclaiming brain function, especially for veterans.Find out more about Dr. Mark Gordon here - https://tbihelpnow.org/ or here: https://millenniumhealthstore.com/Try NEURISH - Personalized nutrition for your mental health. Get 15% off with Promo Code MTM. Visit https://tinyurl.com/57e68ett to learn more about this incredible daily supplement.Feeling stuck? If you need help getting out of your rut, Will can help. Head to willnotfear.comto learn more about his coaching to get you off the hamster wheel and into better decision-making.More from MTM at: https://mentalkingmindfulness.com/ Timestamps: 00:00 - Introduction02:47 - Neuroendocrinology's Role in Brain and Mood09:16 - CTE and Hormonal Disruption Explained12:03 - Hormonal Feedback Loops and Brain Function13:20 - Hormones, Inflammation, and Brain Health17:00 - Neuroinflammation and Cognitive Impact20:46 - Head Trauma and Long-Term Brain Decline26:29 - Inflammation's Lasting Effects on Healing28:50 - Subconcussive Hits, Gut Health, and the Brain33:31 - Boosting Brain Resilience: Military Lessons37:09 - Blast Exposure and Neurological Damage41:32 - Rethinking TBI and PTSD Treatment Options47:17 - Veteran Brain Health: Science Meets Policy50:18 - Ibogaine Therapy: Success in Alternative Care52:18 - Revisiting Testosterone's Role in Vitality55:28 - NSAIDs, Testosterone, and Better Alternatives58:58 - Nutrition, Selenium, and Hormone Support01:01:42 - NSAIDs, Pregnancy, and Endocrine Disruption01:07:35 - Libido Boosting with Testosterone and PT-14101:11:30 - New Approaches to Testosterone Therapy01:14:18 - Detox and Hormone Optimization01:15:57 - Clomiphene vs. Injectables: What Works?01:17:01 - TRT: Dosing Strategies and Side Effects01:19:02 - Balancing Testosterone and Estradiol01:22:42 - Why Hormone Balance Matters01:28:26 - Biomarker Testing for Brain Injury RecoveryHosted by Ausha. See ausha.co/privacy-policy for more information.

If you're struggling, consider therapy with our sponsor. Visit https://betterhelp.com/almanac for a discount on your first month of therapy.If you have questions about the brand relating to how the therapists are credentialed, their privacy policy, or therapist compensation, here is an overview written by the YouTube creators behind the channel Cinema Therapy that goes into these topics: https://www.reddit.com/r/cinema_therapy/comments/1dpriql/addressing_the_betterhelp_concerns_headon_deep/ Hey Poison Friends! I thought we could use an episode free from prions and other deadly viruses and diseases, so let's talk about some medications that turned out to be toxic. We have discussed how some toxins became useful in the world of medicine, so why not the other way around? While discussing this topic, I thought it would be informative to include some basics on what clinical trials look like (at least here in America).I have had many requests for one drug in particular: Thalidomide. We did briefly discuss this one in a bonus episode, but I dug a little deeper and wanted to include how it affected food and drug acts in the countries it affected. While not approved in America during its time, samples were given out and there were quite a few still affected here. This particular drug led to some horrific birth defects as well as many of miscarriages and stillbirths. Other medications we need to discuss include a couple of NSAIDs (non steroidal anti inflammatory drugs) called Vioxx and Bextra. These caused higher risks of heart attack and stroke, injuring and killing many who had taken them. Bextra was also linked to a higher risk for Stevens-Johnsons Syndrome, a serious skin condition that was painful and could lead to further complications. Lastly, if you grew up in the 90s like we did, you'll remember the influx of amphetamine or caffeine based weight loss drugs. Some were prescribed but some were also over the counter. You could buy some "supplements" like these at any convenient store. One medication prescribed to patients was a combination drug, called Fen-Phen by many, and it caused pulmonary hypertension, proving fatal to some who took it and leaving others with longterm heart valve and respiratory problems. Thank you to all of our listeners and supporters! Please feel free to leave a comment or send us a DM for any questions, suggestions, or just to say, "hi."Support us on Patreon:⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/thepoisonersalmanac⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Merch-⁠⁠⁠https://poisonersalmanac.com/⁠⁠⁠Follow us on socials:The Poisoner's Almanac on IG-⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/poisoners_almanac?utm_source=ig_web_button_share_sheet&igsh=ZDNlZDc0MzIxNw==⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube-⁠⁠⁠https://youtube.com/@thepoisonersalmanac-m5q?si=16JV_ZKhpGaLyM73⁠⁠⁠Also, look for the Poisoner's Almanac TikTok- ⁠⁠⁠⁠https://www.tiktok.com/@poisonersalmanacp?_t=ZT-8wdYQyXhKbm&_r=1⁠⁠⁠⁠Adam-⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.tiktok.com/@studiesshow?is_from_webapp=1&sender_device=pc⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Becca-⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.tiktok.com/@yobec0?is_from_webapp=1&sender_device=pc⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

Story at-a-glance Spinal pain affects millions despite over $134 billion spent annually in the USA alone, with most patients remaining stuck in chronic pain cycles due to treatments that address symptoms rather than root causes Common pain generators are frequently missed, including weak ligaments, tight muscles, structural misalignments, trapped emotions, and inflammatory conditions — leaving patients to cycle through increasingly dangerous interventions without addressing underlying issues Conventional medications create more problems than they solve — NSAIDs are the leading cause of drug-related hospital admissions, Tylenol causes 56,000 ER visits annually from toxicity, and Gabapentin provides minimal benefit while causing cognitive effects such as drowsiness Corticosteroids, despite being "wonder drugs," cause devastating long-term damage, including 5% to 15% yearly bone loss, 70% weight gain rates, and dramatic increases in heart attacks (226%), heart failure (272%), and strokes (73%) Spinal surgeries remain highly profitable but questionable in effectiveness, with significant risks that patients often don't learn about until after complications occur, and no ability to "undo" surgical damage

Send us a textWhat really helps prevent injuries—and what should you do when one inevitably strikes? In this episode, I use my friend Tim's pickleball injury as a jumping-off point to explore what the evidence actually says about ice, rest, NSAIDs, stretching, and more.When Tim skipped his warm-up and pulled a calf muscle, it raised a question many of us face: was it avoidable? While ancient wisdom and modern influencers often shout conflicting advice, this episode sorts through the noise to uncover what's evidence-backed, what's outdated, and what might actually delay healing. For pain, yes, ice works—cooling slows nerve conduction and can help with comfort, as seen in this study of ankle injuries. But does it reduce inflammation in a helpful way? Possibly not. Some research suggests that vasoconstriction may hinder the delivery of reparative cells and removal of waste, as noted in this trial.The evolution from RICE to PEACE to MEAT and even PEACE & LOVE reflects our shifting understanding. A meta-analysis of 22 randomized trials found no conclusive benefit of ice when added to compression or elevation. As for NSAIDs like ibuprofen, the Cochrane Review revealed no significant advantage over acetaminophen in pain relief or swelling reduction—and no clear evidence they speed up recovery.What about rest? Surprisingly, prolonged rest may do more harm than good. The Deyo study and later NEJM data show that continued normal activity (within pain tolerance) results in faster recovery than either bed rest or structured exercises, at least for acute low back pain—offering insights that might extend to other strains or sprains.Can you prevent injuries altogether? Static stretching (think toe touches) doesn't show strong support in RCT reviews, and while a recent meta-analysis found a small reduction in muscle injuries, the impact was modest. Dynamic stretching remains inconclusive according to current evidence.The takeaway? When treatments or prevention strategies are studied over and over yet results remain ambiguous, it likely means any real benefit is small—a principle I call “Dr. Bobby's Law of Many Studies.” Compare that with fall prevention in older adults: 66 RCTs involving 47,000 people showed strength and balance training significantly reduces falls by 20–30%. When something works, it tends to show up clearly and consistently.Takeaways: If you're injured, ice and NSAIDs can ease discomfort—but don't count on them to speed up healing. Resting too much may slow recovery; try gentle movement instead. Stretching might help a bit with prevention, but don't expect miracles. Evidence

About the Guest(s): Dr. Chad Woolner is a skilled healthcare professional specializing in chiropractic care and low-level laser therapy. With a deep understanding of chronic diseases and their connection to inflammation, Dr. Woolner has dedicated his career to exploring innovative treatment methodologies that enhance patient care. Focused on practical, non-invasive solutions, he is a co-host of "The Laser Light Show," where he passionately discusses laser therapies' benefits. Dr. Andrew Wells is a seasoned expert in chiropractic health and wellness. With a focus on holistic healthcare approaches, Dr. Wells has extensive experience in managing chronic diseases and inflammation. His expertise spans various integrative health strategies, making him a valuable resource for innovative treatment modalities, including the usage of lasers for immune and musculoskeletal health improvement. Episode Summary: In this enlightening episode of "The Laser Light Show," Dr. Chad Woolner and Dr. Andrew Wells delve into the pervasive issue of inflammation and uncover how low-level laser therapy provides a promising solution. Drawing connections between inflammation and chronic diseases, such as arthritis, heart disease, and depression, they propose an unconventional method not to be ingested but rather utilized through light. The discussion promises to embrace health practitioners and patients alike, offering newfound insights into this therapeutic technique. This episode explores the complex nature of inflammation, emphasizing its dual role as both a healing and harmful force. Dr. Woolner and Dr. Wells discuss how traditional medicinal approaches, such as NSAIDs, often fall short with their adverse side effects, shifting the focus toward laser light therapy as a safe, effective alternative for reducing inflammation. Through highlighting the positive impact on mitochondrial stimulation and oxidative stress reduction, the hosts lay out a compelling case for lasers as a non-invasive method to not only manage inflammation but potentially revolutionize chronic disease treatment. Key Takeaways: Low-level laser therapy offers a powerful, non-invasive tool for addressing inflammation associated with chronic diseases. Chronic inflammation can result from various stimuli and lead to serious health conditions. Laser therapy can modulate inflammation by boosting mitochondrial activity, reducing oxidative stress, and influencing cellular signaling. Safe and effective, Class 2 lasers, such as those from Erchonia, offer significant health benefits without the harmful side effects associated with high-powered lasers or medications. Utilizing lasers, patients can experience increased energy, aiding healthier lifestyle transitions. Notable Quotes: "Every chronic disease, from arthritis to heart disease to depression, has one thing in common, and that is inflammation." - Dr. Chad Woolner "It's equipping your body to be able to manage the insult that's happening, but to reduce the damaging effects." - Dr. Andrew Wells "NSAIDs might help pain today, but they also may be slowly tearing apart your gut lining tomorrow." - Reference from the New England Journal of Medicine "That's the interesting thing, that's what makes it so safe, right. Is it's the body takes in that wavelength and then the body knows what to do with that energy to get back into homeostasis." - Dr. Andrew Wells "Lasers can be used immediately. It doesn't require the same degree of discipline that changing diet oftentimes can for patients." - Dr. Chad Woolner Resources: Follow Dr. Andrew Wells on LinkedIn for insights into holistic chiropractic approaches. Explore more from Dr. Chad Woolner on The Laser Light Show podcast for discussions on low-level laser therapies. Tune in to this episode to discover how laser therapy might just be the innovative, holistic approach necessary to combat inflammation and chronic diseases. Stay connected for more transformative content in the healthcare field from the Laser Light Show!

An episode from The Holistic Navigator. This is not to diagnosis or treat any disease/illness. Consult your physician before taking supplements or medications OR before you stop taking medications. This is for entertainment/informational purposes only! Chronic pain is epidemic and traditional treatments are causing health disasters in this country. The widespread use of NSAIDs (non-steroidal anti-inflammatory drugs) are wreaking havoc on the health of many worldwide and they might not even know it's happening. These are meant to be used for acute pain and short term use, but there are many people that are taking them every day for years. Long term use of these drugs can cause kidney damage, fluid retention, liver stress, create a higher risk of heart disease, and can cause damage to the gut. Are there other options? YES. It's not the norm to be walking around in pain on a daily basis. There are many habits and lifestyles that contribute to this type of pain without you even knowing it. What we eat, our activity levels, our emotions all play a role in our discomfort levels. We're here to say that there is hope and it's possible to live pain free. Topics Discussed What is chronic pain? (1:35) What are the common side effects of NSAIDS? (3:18) What causes chronic pain? (6:42) What is the protocol for addressing chronic pain? (20:25) What is the ideal diet for chronic pain management? (37:12) What about using CBD for pain? (37:47) Key Takeaways Chronic Pain is affecting 1.5 billion people worldwide. (2:05) There's nothing wrong with three to seven days of these drugs. What's wrong is that six months and beyond is where the damage is occurring. (5:19) If you have too much omega-6 in your diet you will have issues with pain. (23:03) Glucosamine helps put moisture back in the cartilage. (30:32) Be very picky when selecting a curcumin product. (33:18) Please consider leaving us a review on Apple and giving us a share to your friends!

In this episode of the Friends of NPACE Podcast we are joined by Richard Petruschke the Director of US Medical & Scientific Affairs, Pain Relief at Haleon to have a conversation about the use of NSAIDs as first-line treatment and highlighting important CDC guidelines. Tune in every other Wednesday for new episodes of the Friends of NPACE Podcast on your favorite streaming platform (Spotify, Apple Music, YouTube, and Amazon Music). View the Haleon resources below: • Haleon HealthPartners: https://www.haleonhealthpartner.com/en-us/pain-relief/ • Haleon Free Samples: https://www.haleonhealthpartner.com/en-us/samples/ • HCP Resources: https://www.haleonhealthpartner.com/en-us/learning-lab/educational-resources/#pain-relief • Patient Resources: https://www.haleonhealthpartner.com/en-us/patient-care-resources/#pain-relief • Nonopioid Pain Management portal: https://www.haleonhealthpartner.com/en-us/pain-relief/conditions/nonopioid-pain-management/overview/ • Continuing Education: https://www.haleonhealthpartner.com/en-us/news-events/#pain-relief • Pain Portfolio Product Pages: https://www.haleonhealthpartner.com/en-us/pain-relief/brands/ • Pain Relief Coupon: https://www.haleonhealthpartner.com/en-us/patient-care-resources/pain-relief-coupon-handout/

Contributor: Aaron Lessen, MD Educational Pearls: How do we take care of kids in severe pain? There are many non-pharmacologic options for pain (i.e. ice, elevation) as well as more conventional medication options (i.e. acetaminophen, NSAIDS) but in severe pain stronger medications might be indicated. These stronger medications include options such as IV morphine, a subdissociative dose of ketamine, as well as intranasal fentanyl. Intranasal fentanyl has many advantages: Studies have shown it might be more effective early on in controlling pain, as in the first 15-20 minutes after administration, and then becomes equivalent to other pain control options Total adverse effects were also lower with IN fentanyl, including low rates of nausea and vomiting To administer, use the IV formulation with an atomizer and spray into the nose; therefore, you do not need an IV line Dose is 1-2 micrograms per kilogram, can be redosed once at 10 minutes.  Don't forget about gabapentinoids for neuropathic pain, muscle relaxants for muscle spasms, and nerve blocks when appropriate. (Disclaimer: muscle relaxers have not been well studied in children) References Alsabri M, Hafez AH, Singer E, Elhady MM, Waqar M, Gill P. Efficacy and Safety of Intranasal Fentanyl in Pediatric Emergencies: A Systematic Review and Meta-analysis. Pediatr Emerg Care. 2024 Oct 1;40(10):748-752. doi: 10.1097/PEC.0000000000003187. Epub 2024 Apr 11. PMID: 38713846. Bailey B, Trottier ED. Managing Pediatric Pain in the Emergency Department. Paediatr Drugs. 2016 Aug;18(4):287-301. doi: 10.1007/s40272-016-0181-5. PMID: 27260499. Hadland SE, Agarwal R, Raman SR, Smith MJ, Bryl A, Michel J, Kelley-Quon LI, Raval MV, Renny MH, Larson-Steckler B, Wexelblatt S, Wilder RT, Flinn SK. Opioid Prescribing for Acute Pain Management in Children and Adolescents in Outpatient Settings: Clinical Practice Guideline. Pediatrics. 2024 Sep 30:e2024068752. doi: 10.1542/peds.2024-068752. Epub ahead of print. PMID: 39344439. Summarized by Jeffrey Olson, MS4 | Edited by Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/

Story at-a-glance Many common medications contain hidden gluten and soy in their "inactive" ingredients, which trigger reactions in sensitive individuals A study found 44.4% of pain relievers contained gluten and 14% of NSAIDs contained soy-based additives, with poor labeling making identification difficult Solid oral medications most commonly contain gluten, while liquids and suppositories more frequently contain soy derivatives Exposure to these hidden allergens causes serious health consequences ranging from digestive issues to permanent damage in those with sensitivities Focus on leading a healthy lifestyle to reduce your reliance on medications that contain hidden allergens; this includes optimizing sun exposure, avoiding processed foods, eating enough healthy carbs and prioritizing daily movement

View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter Sean Mackey is a professor of pain medicine at Stanford University and the director of the Stanford Systems Neuroscience and Pain Lab, where his research explores the neural mechanisms of pain and the development of novel treatments for chronic pain. In this episode, Sean joins Peter for a wide-ranging discussion on the multifaceted nature of pain—as both a sensory and emotional experience—and its evolutionary purpose as a critical survival mechanism. He dives into how pain is transmitted through the nervous system, the different types of pain, and why different individuals perceive pain so differently. Sean shares insights into pain management strategies ranging from medications like NSAIDs and opioids to neuromodulation techniques such as transcutaneous electrical nerve stimulation (TENS). Additionally, this episode explores the interplay between sleep and chronic pain and the psychological and emotional dimensions of pain, and it includes a personal story from Peter about his own experience with pain and how Sean's expertise helped him more than two decades ago. We discuss: The definition of pain, and how our understanding of pain has evolved from a simplistic body-mind separation to a nuanced biopsychosocial model [2:30]; The biological mechanisms behind how we perceive pain [9:30]; The role of consciousness in the perception of pain, and how nociception functions during unconscious states [14:30]; The four types of pain [22:00]; Using fMRI to identify objective biomarkers of pain in the brain [31:30]; The evolutionary role of pain in human behavior and survival [36:00]; How the brain processes and modulates pain signals, Gate Control Theory, the variability in individuals' pain perception, and effectiveness of neuromodulation techniques like TENS [41:00]; The brain's influence on pain: the role of emotion, beliefs, sleep, and individual differences in perception and tolerance [53:45]; Peter's personal journey with chronic back pain, and how the emotional consequences of pain can be more distressing than the pain itself [1:04:30]; The pharmacology of common pain medications—NSAIDs, COX-2 inhibitors, and acetaminophen [1:09:30]; Muscle relaxants: benefits, drawbacks, and personalized strategies [1:20:30]; The definition of chronic pain [1:29:15]; The role of antidepressants in pain management [1:30:15]; Opioids: their controversial and nuanced role in pain management [1:33:45]; Alternative therapies: acupuncture and cannabis [1:54:15]; Fibromyalgia and chronic pain: clinical features, brain mechanisms, and emerging treatments like low-dose naltrexone [2:01:00]; Possible brain benefits of low-dose naltrexone (LDN) for people with mild cognitive impairment [2:15:00]; Peter's recovery from severe chronic pain—how he went from immobility and high-dose opioids to full functionality [2:20:15]; Breaking the pain cycle: how physical rehabilitation and psychological recovery work together in chronic pain treatment [2:30:45]; Sean's struggle with cluster headaches, and the value of knowledge, preparation, and empathy in both managing chronic pain and caring for patients [2:39:15]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

Ethan Suplee is thrilled to sit down with Dr. Stephen Gundry on the American Glutton Podcast to explore the alarming decline in America's health since the 1970s. Together, they dive into the gut microbiome's crucial role in regulating hunger and supporting weight loss, examining how antibiotics, glyphosate, and processed foods have severely disrupted this delicate system. Dr. Gundry offers practical solutions—such as incorporating prebiotic fiber and fermented foods—to help restore balance. The conversation also tackles the downsides of quick-fix drugs like Ozempic. This eye-opening episode challenges conventional health wisdom and offers real hope for sustainable change.SHOW HIGHLIGHTS00:00 - Introduction to Dr. Stephen Gundry 01:11 - The Health Decline Since the 1970s 02:25 - Ultra-Processed Foods and Their Origins 03:06 - Impact of Broad-Spectrum Antibiotics 04:22 - Glyphosate's Effect on the Microbiome 05:39 - Dangers of NSAIDs like Advil 07:34 - Obesity Trends and High Fructose Corn Syrup 08:01 - Restoring the Gut Microbiome 12:21 - Three Steps to a Healthy Microbiome 19:07 - Gut-Centric Theory of Hunger 23:35 - Challenges of Getting Enough Fiber 25:23 - Efficiency and Modern Food Access 27:47 - Weight Loss Drugs and Their Risks 33:38 - Importance of Fermented Foods 36:11 - Reintroducing Beneficial Bacteria 40:48 - Overcoming Bacteriophobia 43:20 - Final Thoughts and Takeaways Hosted on Acast. See acast.com/privacy for more information.

In this Huberman Lab Essentials episode, I discuss how to build muscle strength and size (hypertrophy) and cover key training principles to enhance athletic performance and offset age-related muscle decline. I explain how the nervous system drives muscle movement, the key differences between training for hypertrophy or strength, and resistance training protocols to build muscle for performance and healthy aging. Additionally, I discuss tools for assessing recovery and the role of key nutrients—such as creatine and electrolytes—in supporting muscle development and performance. This episode provides actionable, science-backed strategies to enhance movement, preserve strength with age, and boost energy levels. Read the episode show notes at hubermanlab.com. Timestamps 00:00:00 Huberman Lab Essentials; Muscle 00:02:02 Muscle & Nervous System 00:03:24 Sponsors: Eight Sleep & LMNT 00:06:03 Strength & Aging, Henneman's Size Principle, Use Heavy Weights? 00:10:09 3 Stimuli, Muscle Strength vs Muscle Growth (Hypertrophy) 00:12:11 Tool: Resistance Training Protocol, Increase Muscle Strength 00:15:55 Sponsor: AG1 00:17:50 Tool: Advanced Resistance Training & Volume; Speed, Rest 00:21:12 Testing for Recovery, Heart Rate Variability, Grip Strength 00:24:29 Sponsor: Function 00:26:16 Testing for Recovery, Carbon Dioxide Tolerance 00:29:20 Ice Bath Timing; NSAIDs & Exercise 00:30:34 Salt & Electrolytes; Creatine; Leucine Disclaimer & Disclosures