Podcasts about pain iasp

Play Episode Listen Later Jan 20, 2022 21:17

In the Lupe, Episode 13 Description on PodBean Patel, Kiran V. "Dorsal Root Ganglion Stimulation for Chronic Pelvic Pain [39T]." Obstetrics & Gynecology 133 (2019): 223S. Abbott Proclaim Implantable Pulse Generator Clinician's Manual. Plano, TX. 2019. *These are the experiences of these patients. Individual experiences, symptoms, situations and results may vary Rx Only Brief Summary: Prior to using these devices, please review the User's Guide for a complete listing of indications, contraindications, warnings, precautions, potential adverse events, and directions for use. The system is intended to be used with leads and associated extensions that are compatible with the system. DRG Indications for Use: US: Spinal column stimulation via epidural and intra-spinal lead access to the dorsal root ganglion as an aid in the management of moderate to severe chronic intractable* pain of the lower limbs in adult patients with Complex Regional Pain Syndrome (CRPS) types I and II.** *Study subjects from the ACCURATE clinical study had failed to achieve adequate pain relief from at least 2 prior pharmacologic treatments from at least 2 different drug classes and continued their pharmacologic therapy during the clinical study. **Please note that in 1994, a consensus group of pain medicine experts gathered by the International Association for the Study of Pain (IASP) reviewed diagnostic criteria and agreed to rename reflex sympathetic dystrophy (RSD) and causalgia, as complex regional pain syndrome (CRPS) types I and II, respectively. CRPS II (causalgia) is defined as a painful condition arising from damage to a nerve. Nerve damage may result from traumatic or surgical nerve injury. Changes secondary to neuropathic pain seen in CRPS I (RSD) may be present, but are not a diagnostic requirement for CRPS II (causalgia). International: Management of chronic intractable pain. Contraindications: US: Patients who are unable to operate the system, who are poor surgical risks. Patients who have failed to receive effective pain relief during trial stimulation. International: Patients who are unable to operate the system, are poor surgical risks, are pregnant, or under the age of 18. Warnings/Precautions: Diathermy therapy, implanted cardiac systems or other active implantable devices, magnetic resonance imaging (MRI), computed tomography (CT), electrosurgery devices, ultrasonic scanning equipment, therapeutic radiation, explosive and flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery, equipment and vehicles, pediatric use, pregnancy, and case damage. Adverse Effects: Unpleasant sensations, changes in stimulation, stimulation in unwanted places, lead or implant migration, epidural hemorrhage, hematoma, infection, spinal cord compression, or paralysis from placement of a lead in the epidural space, cerebrospinal fluid leakage, tissue damage or nerve damage, paralysis, weakness, clumsiness, numbness, sensory loss, or pain below the level of the implant, pain where needle was inserted or at the electrode site or at IPG site, seroma at implant site, headache, allergic or rejection response, battery failure and/or leakage. Clinician's Manual must be reviewed for detailed disclosure. Abbott One St. Jude Medical Dr., St. Paul, MN 55117 USA, Tel: 1 651 756 2000 Neuromodulation.Abbott ™ Indicates a trademark of the Abbott group of companies. ‡ Indicates a third party trademark, which is property of its respective owner. © 2021 Abbott. All Rights Reserved. MAT-2104565 v1.0 | Item is approved for global use.

Pain Manual for Educational Programs | Craig Wassenger

PT Elevated

Play Episode Listen Later Jan 19, 2022 36:08

Welcome back to season 2 of PT Elevated where we are broadening our topics to include more researchers but still focusing on topics that you can use in your clinic every day. On our seventh episode of season 2, Dr. Craig Wassenger, PT, PhD, who currently works in the Tuffs University School of Medicine hybrid DPT Boston program will be telling us about the pain manual that was published by the Pain Special Interest Group within the Academy of Orthopaedic Physical Therapy that he was instrumental in producing. Here are some of the highlights: The pain manual Craig and his colleagues produced is an expansion of the International Association for the Study of Pain (IASP). The IASP has a curricular outline for teaching pain to physical therapists. It has a list of topics that should be included in physical therapist education. Around three years ago Craig and his colleagues led by Mark Shepherd were able to join and make something out of the IASP, the Pain Education Manual for Physical Therapist Professional Degree Programs. “Collectively as healthcare professionals we have learned a ton about pain in the past two decades and I do not think that the content that has been included in physical therapists' education has been able to keep pace with that. As we learn more through psychology and neuroimaging particularly of the brain, we can understand more from a basic science perspective then the application of that content to clinicians treating patients daily and it really has not been done, so this is an attempt to bring those things together as well as an understanding of educators and physical therapists on that topic.” Although the pain manual focuses on education there is a role for clinicians to take content from it. “The way that I look at it from an educator's perspective, is we had this guideline document which was the IASP outline, and it was just a list of stuff telling what you should be teaching. I think of that as if you have a recipe that being your ingredients list, but you didn't really know what to do with it. We tried to take the list of ingredients and add the recipe to it. Here are some things that you can do, here is how you put it together, here are examples of how we have put it together to try to help educators pull that information. If you are an experienced cook for that recipe, like an experienced educator you can take what we offered and then mold it to fit your specific needs, just like the way that an experienced cook would do.” “In addition to just having an extrapolation of the checklist of content from IASP we offer and provide examples of learning activities both active and lecture for educators to incorporate into their classes. The manual is also supported by asynchronous content, so we have partnered with the APTA and the APTA learning center, so the developers of the manual put together lectures to get faculty current on all topics. The document has supported material from an asynchronous learning site so they can see how we present the details as well as opportunities and examples of assignments that could be used within class as homework for students on the educator's side of things.” On pain Craig says, “I think the best way to do it is to have integrated pain content with an additional stand-alone course.” One of the challenges with pain both logistically within the association and from an educational perspective is that it crosses all clinical areas. The pain specialist group is housed within orthopaedics but the course is not only a orthopaedic thing, it is all clinical areas and when you don't have a focus point around it, it gets diluted across a lot of different areas. That is why I think it needs to be integrated across lots of different courses. But have a place where it is centered and have the focus time to evaluate it and study it as a student. Also provide that opportunity to our post graduate students as well, primarily talking about DPTs.” The pain education manual is housed on the Orthopaedic Academy website. We've also partnered with APTA, and have prerecorded lectures for educators and people that are more audio or visual learners. In teaching about pain Craig says, “Pain science is centered around patient education. I use a scaffolded approach to that because it is one of the key things that I cover within the course and one of the main assignments I have with all the universities that I teach this course at. First step is understanding the background information, the research, the content, to substantiate what the education should be centered around, and it comes down to the psychosocial contribution to pain as well as what we understand now around the nociplastic pain and the changes in the central nervous system that are not very well understood by many healthcare providers or the public. The students watch me delivering it to a patient and we watch the interactions and break down the interaction. They then have a practice session with each other. Our training is improving, and this is one step to try to make it better and provide resources but there are still gaps that we recognize. I'm hopeful other healthcare providers do too. There is a role for us to contribute medical, nursing, and pharmacist education and all the other healthcare providers that we and our patients interact with to try to bolster this. I'm hoping there is a shift in the criteria that we are using for our accreditation and or licensure because unless a change is forced it is hard to make people change. Craig's Clinical Pearl: “One thing I wish I knew when I started clinical practice was that I didn't have to have all the answers. You come out of school you've spent so much time studying and learning all this content and you've had expert clinicians and educators telling you all this information and there is so much you must learn. You take your board exam, and you pass it and then you get a patient in front of you, and you don't have the clinical instructor to lean on and you may or may not have a mentor and I just felt like I had to know it all. You certainly do not know it all. You'll never know it all or have all the answers. But that is one thing to not worry about and this will tie back into the pain manual to show that there are resources available for you to help you. My strong recommendation even if it isn't a formal process is to get a mentor and learn much as you can from them. Lastly, it certainly is not all about knowledge it is a whole lot about relationships, people, trust, caring and those other things that are hard to teach but are maybe more important than all the content we talk about in PT education.” Helpful research and training: Advance Therapeutic Neuroscience Education: Focus on Function Therapeutic Neuroscience Education Pain Education Manual for Physical Therapist Professional Degree Programs Ad Info: How many of you are thinking about or preparing to sit for your board-certification exam? Achieving board certification can be a strenuous process, and the right prep course can mean the difference between a passing and failing exam score. PT Elevated sponsor, Evidence In Motion, offers test prep courses for OCS, SCS, and GCS, with over 95% pass rates! As a podcast listener, you can get 5% off a prep course now. Find the promo code and more info in the show notes. You got this! Connect with us on socials: @ZimneyKJ on Twitter @PMintkenDPT on Twitter Craig Wassenger Tufts University Bio

pain phd medicine study academy achieving helpful manual international association collectively ocs scs gcs apta educational programs iasp pain iasp orthopaedic physical therapy evidence in motion

570: Dr. Morten Hoegh: Not Everything that Hurts is an Injury

Healthy Wealthy & Smart

Play Episode Listen Later Dec 21, 2021 39:12

In this episode, Specialist Sports Physiotherapist, Morten Hoegh, talks about pain and injury management and research. Today, Morten talks about his workshop on pain, the problems in the research around pain and injuries, and embracing the patient as the expert. What is nociplastic pain? Hear about the injury versus pain narrative, treating the perception of injury during pain, the problem of over-treating pain, and get Morten's advice to his younger self, all on today's episode of The Healthy, Wealthy & Smart Podcast. Key Takeaways “There is a difference between having an injury and being in pain.” “You will have injury and pain on one end, but you will have pain without injury on the other end.” “Just because we know something doesn't mean we know everything.” “Pain prevention is well-intentioned, sometimes unrealistic, and possibly unhelpful.” “All pain is real. It's always experienced as pain.” “People who live their life with pain, they are experts.” “We have different aspects and different competences, and we should bring them together.” “We should definitely try and cure pain from the planet, but maybe not by opioids.” “Things take time to cope with.” “Make sure you stick to good ideas if you think they're good, but also leave them if they're not.” More about Morten Hoegh After qualifying as a clinical physiotherapist (1999) and completing several clinical exams, Morten was granted the title of specialist physiotherapist in musculoskeletal physiotherapy (2005) and sports physiotherapy (2006). It was not until 2010-12 he made an entry to academia when he joined the multidisciplinary Master-of-Science in Pain: Science & Society at King's College London (UK). From 2015-19 Morten did his PhD in Medicine/pain at Center for Neuroplasticity and Pain (CNAP), Aalborg University. He is now an assistant professor. Having spent more than a decade as clinician, teacher, and business developer, he decided to focus on improving national and international pain education based on the International Association for the Study of Pain (IASP). Morten was vice-chair of the European Pain Federation's Educational Committee from 2018-20 and has been involved in the development of the Diploma in Pain Physiotherapy and underlying curriculum, as well as the curricula in nursing and psychology. At a national level, Morten has been appointed to several chairs and committees, including the Danish Medicine and Health Authorities and the Danish Council of Ethics. He has co-authored a textbook on pain, and written several book chapters, clinical commentaries, and peer-reviewed basic science articles on pain and pain modulation. Morten's first book on pain in layman's terms will be published in January 2021. Morten is regarded as a skilled and inspiring speaker, and he has been invited to present in Europe and on the American continent. He is also a prolific debater and advocate of evidence-based and patient-centred approaches to treatment in general. Morten is motivated by his desire to improve management of chronic pain, reduce stigmatisation of people with ‘invisible diseases', and to bridge the gap between clinical practice and neuroscience research in relation to pain. Suggested Keywords Healthy, Wealthy, Smart, Physiotherapy, Neuroscience, Pain, Injury, Rehabilitation, Research, Experience, Treatment, Management, Resources: #IOCprev2021 on Twitter. To learn more, follow Morten at: Website: http://www.videnomsmerter.dk https://p4work.com Twitter: @MH_DK Instagram: @mhdk_drmortenhoegh LinkedIn: Morten Hoegh Subscribe to Healthy, Wealthy & Smart: Website: https://podcast.healthywealthysmart.com Apple Podcasts: https://podcasts.apple.com/us/podcast/healthy-wealthy-smart/id532717264 Spotify: https://open.spotify.com/show/6ELmKwE4mSZXBB8TiQvp73 SoundCloud: https://soundcloud.com/healthywealthysmart Stitcher: https://www.stitcher.com/show/healthy-wealthy-smart iHeart Radio: https://www.iheart.com/podcast/263-healthy-wealthy-smart-27628927 Read the Full Transcript Here: 00:02 Hi, Morten, welcome to the podcast. I'm very excited to have you on. So thanks so much. Thank you for having me, Karen. It's a pleasure to be here. Yeah. And today, we're going to talk about your really wonderful, wonderful workshop at the IOC conference in Monaco. That was just a couple of weeks ago. And you did a great workshop on pain, which is one of my passions. 00:27 But I would, I think 00:30 the best thing for us to do here is to just throw it over to you. And let you give a little background on the talk. And then we'll dive into the talk itself. So go ahead. 00:43 Thank you. And, you know, I'm really happy that you liked it. It was a great pleasure to present that the IRC was my first time there as well. A lovely place to be and very lovely people. And he really well organized conference as well. Well, back to the background. So the tool was, the workshop, as it were, was actually originally something I planned with Dr. Kieran or Sullivan, who is now in Ireland. Unfortunately, he couldn't come due to turn restrictions and all of that for COVID. So we had to change it slightly. But over the period of the last sort of year or so I've been working with colleagues at all university where I'm affiliated and test Denton and Steven George of Adelaide and, and to university respectively. And together with them, we sort of have written up this idea that there is a difference between having an injury and being in pain. And the reason we came about that was because we wanted to try and look into what is actually the sort of narrative definition of a sports injury. And and some one of my colleagues are actually two of my colleagues Kosta, Luke, and Sabine Avista. We're looking into this and trying to sort of find out what the consensus what they came up with, when they were looking at the last 10 years of of sports related research is that the same articles could use injury and pain for the same thing. So it was being used almost as well, not almost, but as sentiment synonymously throughout the program, or the manuscript, and others will stick to pain and others will stick to injury. But if you then try to go down into the methods and find out what is an injury, really, some would have definitions, but there weren't really anything. And definitely, there wasn't a clear distinction between when is the tissue injured. And when is the athlete suffering from pain that is keeping them from not doing what they want to do. 02:50 So we came up with this idea to write an editorial for the BDSM. We couldn't get it accepted as an editorial, we were under the impression that maybe the topic was a bit too narrow. So it really wouldn't have any impact. But we had a we had some some help from from 03:12 sorry, you can cut that bit out. I was just losing her name. Let me just get it here. 03:21 Oh, that's she was such a great help. I'm really sorry for not being able to I definitely think we should put her name in there. 03:32 Oh, here we go. 03:35 So we wanted to do the editorial first. But we were under the impression that we couldn't get the editorial through because the topic, you know, is probably a bit too narrow. But fortunately, Madeline Thorpe, who is working with TAs in Adelaide, she helped us create this infographic that sort of conveyed the message of the difference between what we call a sports related injury and a sports related pain. So after a few revisions, the BJs took it in as an infographic with a short text to describe what we mean. And and it's been. It's been, you know, quite well cited afterwards. So we're very happy with the the attention that this idea has got. And then of course, what we really are trying to do here is to create two new semantic entities as we say, Where where it's clear when we do research, but also when we talk to athletes, are you really injured? Is the tissue injury that needs healing and where you might need you know, specific treatment for that injury versus Are you having pain as a consequence of an injury or even without an injury, which is what we call sports related pain. So that's sort of the broader concept and and I hope I've I've done right with my co authors. 05:00 because they've Of course, been been a huge part of both the development and the writing of these, these, this infographic. 05:09 Yeah. And can we now sort of dive in a little bit deeper? So, injury versus pain? Right. I think a lot of people will think that every time you have an injury, there's pain. So used a really nice example in your talk. So does tendon tissue damage lead to pain? Yeah. But is the pain in the area of the tendon equal to damage to the tendon? 05:38 Maybe not. Yeah. Right. Oh, so yeah. So let's, let's have you kind of dive into this injury versus pain narrative. And if you want to go into those pain mechanisms that you spoke about, we can dive into that as well, because I know that that people had some questions on that on social media. So let's first talk injury versus pain. Yeah, again, my my perspective on this with my background, being a physio and, and sort of a neuroscientist is that I come from it, I would say from a pain, scientist pain mechanistic approach. And what I try to do is to understand what goes on in the human that could explain why they feel pain. And in some instances, and for instance, in low back pain, we we think, in about maybe 80 to 95% of the cases, we don't know what's going on. So we're pretty sure that the risks are mechanism, perhaps are quite complicated. One there has multiple factors that are interrelated, but there's probably something. So that's really difficult to study. Again, consider consider, you know, if you were tasked to, to come up with a, you know, a model where you could study this model would be, for instance, an animal model. So not that I would encourage people to go out and, you know, do bad things to other animals. But just, you know, for the sake of the example, let's imagine that you wanted to do an animal model of low back pain, or even a herniated sorry, a groin injury, you could say, in sports. 07:20 If you know, the most basic thing to do would be to create an injury. If you don't want to create an injury injury, what you could do is induce inflammation, you know, inject capsaicin, or put something under the skin or down into the tissues, and that makes your immune system go, you know, make inflammation. And that inflammation makes your nervous system respond more powerful. We call it sensitization, I think many people have heard of that word by now. 07:49 And that's a really good way to create that sensation of pain in humans as well. So we can inject capsaicin again, and people will usually feel pain. 08:00 In that case, that's what happens or that's how we understand what happens in the case of a tissue injury. So when there's a tissue injury, there's inflammation, and we understand that pain. So when the tissue hit healing period, is sort of crossing from what you could say, the inflammatory phase, into the prolific face, pain should go down. And in most cases, that's what happened. But what when the pain persists after the inflammatory phase. You know, from the science perspective, we don't know that. But we still know that this person is in pain. So whether that be an athlete or non athletes, they're still in pain. And in this in sort of the pain research world, we have a definition of pain that doesn't necessitate any type of injury, not even any activation of those, we call them nociceptors. But nociceptive system you could say. 08:53 So we acknowledge that people can have pain and not be Do not be damaged, not be injured, not have pathology. And that's sort of the idea that we are trying to bring into sports medicine as well, which has been over the you know, many last decades I've you know, I've been in in sports medicine or as a sports physio, for 20 odd years and sort of dominating belief. And also perhaps, trajectory has always been sort of the orthopedic sports related and to some extent, also pharmacological approach, combined with and that's important, combined with a non pharmacological physio, perhaps approach. So there's been this interrelationship collaboration between doctors and physios and other health professionals, which is quite unique. As I see it in the musculoskeletal system. We don't see that to the same extent, for instance, for low back pain or neck pain, but sports has done that. But maybe there has also kept people within the realms of sort of orthopedic approaches trying to understand what goes on. It's 10:00 tissues, and why did they hurt, and then when you couldn't find out why they hurt, we've just looked deeper into the tissues, which is, of course, a good idea from a scientistic or scientists perspective, because there are definitely things in the tissues that we don't know today, which will, you know, make us become more aware of what goes on, you know, as, as late as in the beginning of October, wasn't it where the Nobel Prizes were given out, there was given a Nobel Prize out for the person, I might do violence to his name, but it's part of Putin, I think he's last name it. 10:36 I didn't, I suppose a Putin or something like that. I do apologize for not being able to pronounce it. But he got the Nobel Prize was shared the Nobel Prize for his work on a peer to two receptors, which is a quite new phenomenon and sort of the longer perspective, but it might learn us over time, why could movement hurt? Which is something we don't know today? So if there's no sensitization, why does it hurt to be moving? And that's really interesting. But again, coming out in the clinic, we don't know enough. So we will have patients in the clinic where we simply do not know why they hurt. 11:14 And you could say that doesn't matter. We can call it anything. But then if you take a clinical look at what goes on what happens again, if you look at the signs, what does it mean, when people are hurting, and they think they're injured? They This is what a percentage again, they seem to be thinking that they're being in pain is the same as being weak. If you're weak, you're not, you know, you're not allowed to be in on the team, you might lose your position. So it has a lot of negative connotations. And I mean, that in itself is wrong. But what if it's based on a misconception that just because you're hurting, you are also injured? And couldn't we help people who are hurting with their pain, 11:59 just as well as we could if they are injured with a tissue injury. So what we are saying is that the two are different. They're both real, they should both be addressed. And they're not, they're not opposite ends of a dichotomy, you will have injury and pain in one end, but you will have pain without injury on the other end. So we need to pay attention to both of them separately. Yeah, it's because sometimes a person has a pain problem 12:29 may not be a specific tissue problem, but they have a pain problem. And so this pain problem may, like you said, cause certainly a an athlete to catastrophize. And to really play out to the point where maybe now they're fearful to get on the pitch or the court or the field. And so where does that leave us as physio therapists when it comes to their care? How do we help manage someone, or I should say, help someone manage their pain in order to play their sport, knowing that their every time they go out and play, they're not compounding, quote, unquote, tissue damage? 13:14 Yeah, and interesting, let's say someone has the perception that their tissues are injured, and every time they move, that's a sign of their tissue injury, or even when they hurt more, the injury is bigger, then that person, I mean, if that's a person like me, I would think that I should do something about that injury so that I don't hurt. But pain is always a symptom of something underlying it. Whereas we know from pain research in for instance, low back pain, that pain can in itself, be the disease, what the ICD 11 is now describing as chronic primary pain. So you can have that in your body, you can have it in your tendons, you can have it all way where your tendons are, you can have it where you know, where the bones are, where the where you feel the muscles are. And it's the pain itself is the problem. So rather than looking specifically at a tissue, which needs strengthening or some sort of treatment, then we can look at the person and say, What is it really that you need? A very, very simple example here, which is unlikely to be, you know, the case for everyone. But let's imagine we have someone with knee pain. And the thing that happens is that when they start running, their knee pain gets worse. But if they've been running for a kilometer, or two kilometer or miles, whatever, you know, whatever metric you use, 14:40 then the pain might be the same. So it sort of comes from nothing to let's say, five in the first mile, and then it stays at five, maybe six, and that person wants to run two miles perhaps. But what's the problem in that? I mean, the problem of course, is if pain in this case is a sign of an injury 15:00 that we should attend to. So we need to understand that it's not an injury. 15:06 Once we've done that, why not help this person, deal with the pain and maybe deal with it when they run, just like we would say to someone, if they have, again, back pain, for instance, and they have pain when they work, but their pain is not necessarily worse when they work, should they not be working? I mean, of course, if, if your pain can go away by two days of rest, and graded exposure, that's fine. But in some cases, and they're not as rare as I think most people believe they are, that we just need to work with that person and help them do what they need or want to do with that pain. And why is that, you know, of course, it's not the optimal it would be much nicer is if we would just kill the pain. Or if they could kill their own pain. But we're not there yet, we are still working to get it. And we're not giving up, there's a lot to do. But currently today, and tomorrow, we need to help people work with their pain, that's the best thing we can do now, and and, you know, giving people that agency to actually manage their pain. So in the case of the runner before, maybe the best thing we can help them do is share with them ideas and make them take agency over their pain by you know, using perhaps a cold pack or heat pack or a rest regime or watching you know, something that takes off their mind of their pain for a minute look at you know, watching dope sick on Disney, whatever they need to do to get their mind off, you know, the pain that they have, so that they can recharge, and they can be as you know, their normal again, before they go out for another run. So all of these things would make absolutely no sense if we didn't acknowledge that pain in itself is the problem, because it's not helping anyone's tissue injury, if there was a such to become better. So again, that's the infographic in its essence is that on one end, you use those inspiration to how to manage pain, what that means and how pain is influenced. And on the other side, you will have tissue injuries, and how to manage that, for instance, loading. In sports medicine loading is a big issue. It's probably the one thing that you know, everyone is doing when you're rehabilitating some someone after an injury or pain. But pain doesn't necessarily necessarily sorry, pain doesn't necessarily respond to loading. So you can have the same pain, whether or not you're loading. But there could be tons of other things such as the way you think about your pain, the way you respond to your pain experiences you've had before the context your work in. So you can run in one context without too many pains or problems. But in a completely different context. For instance, when you do a competition, or if you know, if you need to do something, because that's the bar to get onto the competition you want to do, then pain can be a much, much bigger problem. So we need to understand that context of beliefs and experience really influences pain, whereas loading may not. But it could have caused, but it doesn't have to. So pain is a much larger, much more complex topic of which we still don't know too much. We do know quite a lot. And as long as there's an injury, we understand the pain that goes with it. But when it comes to these pains that are there by themselves, the ICD 11 type chronic primary pain, then that's the type of pain that we you know, we've really, we don't have the sort of blueprints on that. So we can't help everyone. And we can't say this is right for you or wrong for you. We need to do individualized care for all of these people and help them find the best tools to support themselves. Yeah, and I think that was something that people who weren't at the conference and kind of reading through tweets, 19:08 that certainly brought up some questions, one of which was the pay mechanism, no sub plastic pain, where we can't fully explain it. And so then there was a question of, we can't fully explain it, why even bring it up? So I'll throw it over? Yeah. It's, again, it's a good question. And especially if you're a clinician, why would you use it, though, they're basically what they are. They're ways that scientists understand the pain. So again, imagine you're standing at one end of the road and you're looking at the other end by the end of that road, a very long road, you have pain. And then the way the place you're standing at is how you explain how to get to that end point. And if you're standing at a place and you know there's a tissue injury, there's inflammation. We understand that as 20:00 Part of the normal normal nociceptive system. So we would call it nociceptive pain. 20:05 Underneath that there is a range of different changes and modulator modulators of the system that leads to, for instance, peripheral and central sensitization. So they're not unique to anything that is there also in nociceptive pain, but it's induced by, for instance, a tissue injury. 20:24 If you have a different tissue injury, the one that hits your nervous system, we call it a neuropathic pain, so you have a nerve damage, along with pain, we call that a neuropathic pain. So again, you're standing on this long road, but in this case, the road itself is sort of gone wrong. But we still know what's going on. Again, if you want to use the study metaphor, you can, you can design a study, you can just take an animal, and you can compress or do something to the neurons, and you can create this similar pain experience, or at least the behavior that it assimilates this pain experience in animals, other than humans. And then finally, we have this new, we call it a mechanistic descriptor knows a plastic pain, which is much much blurrier. And perhaps it's more like a waste bin. As it is now it's, it's where you would say we acknowledge that people have pain. 21:24 And a lot of things goes into it. So just like in nociceptive, and neuropathic pain, sensitization is definitely part of it. It could also be part of the note of plastic pain. But unlike the other two, you don't have the inflammatory response that could explain it. And you don't have the neuron damage that could explain it. But the person experiencing the pain could have a similar experience. So what is it really? How do we a scientist tried to understand that pain, and that's what most plastic is at the moment. And there is a little bit of debate that whether or not you can actually use algorithms to diagnose or, you know, 22:09 maybe 22:11 justify at least that you yet the person in front of you are experiencing this type of pain mechanism or pain related to this mechanism, we definitely have a very, very, you know, widely embraced algorithm used for neuropathic pain. And some very, you know, high profile researchers has just recently come up with a paper suggesting that the same can be done for noisy plastic, sorry, for noisy plastic pain. But personally, I don't think we should, because unlike so nociceptive and neuropathic pain, they're both well understood by signs and we can separate them, they are different. So you can have both, but you would have different qualities to it, there'll be a nerve damage in one and there wouldn't in the other, for instance. 23:02 But we don't know about most plastic pain. So it could be changes in your nervous system, it could actually be, you know, increased responsiveness of your immune system in interaction with your nervous system. It could all be all of that. So it could be sensitization, but it could be tons of other things as well. So how can we start when we don't know what the mechanism is? How can we start to clinically differentiate? So I don't personally think we're quite there yet. Although I like the idea that maybe we can at some point, what I'm afraid of, if we start to use these clinical descriptors, sorry, these mechanistic descriptors, as clinical guidelines, is that what happens to the people who are now embraced and validated in their pain experience by scientists saying, Well, we know what you have, it's mostly plastic pain. But what if we made up an algorithm? And we used it for people? What about the people who fall out? Do they need, you know, a fourth descriptor? Are they just weird? Do they have unknown pain? Are they back to the psychogenic pain? So we've come quite a lot of way, embracing the clinical aspects of pain into the pain research world. And I think using you know, these three mechanistic describers, as you know, trying to really differentiate them and create perhaps treatments that is directed at either one. At this point, or especially anatomy is specifically directed at most aplastic point pain. Just because we know something doesn't mean we know everything. 24:34 So yeah, that's that's the issue. There was a bit of off topic. I'm sorry. But it's such an interesting topic. And I think that the most important thing about no plastic pain is that it is a construct that researchers use. It's embraced by the IRS, the world pain Association, the pay Research Association, and it validates that all pain is real. And there's, you know, it's still real even though we can 25:00 not understand it from a science perspective. I think that's important. And I would hate to see that we misuse it. To say that some really has it. And some don't. Because that's just, you know, that'll be I'll be sad. Yeah. And and can't one's pain experience? 25:20 Everybody's pain experiences individualized. But one person's nociceptive pain experience may be exactly like someone's neuropathic pain experience or someone's no support plastic pain experience, because it's in so then to categorize the persons Oh, well, my pain is like this. So it means this, so I can't have this. And I think it can get people a little confused. And when you have more long term or chronic pain, it's like, the the pain is there. Pain is pain. Some people need the the label or categorization, but like you said, Is it is it really helpful? And it kind of leads me to the one of the last slides in your presentation, and it was like pain prevention is well intentioned, yay, thumbs up, sometimes unrealistic, and possibly unhelpful? Yeah. So do you want to expand on that a little bit? And what you meant by that slide? 26:23 Yeah, that's slide was. That was actually the whole idea when, when I started to talk with Dr. Kieran Sullivan about workshop is that we see a lot of people, athletes. So both of us are still clinicians. And we see and we hear stories of a lot of athletes who have been treated and treated and treated again, or assessed and assessed and assessed again. And again, because they have a pain that we cannot objective eyes. So we can't find anything on scans or blood samples or clinical tests. So rather than acknowledging that pain can be there, so let's say nosey plastic pain, those are, there's something going on in your nervous system that gives you this pain, and we don't know what it is, we can't see it, that will be the, I would say the proper thing to do. So rather than doing that, we tend to keep sending people off. And it ends up with too many scans and too many assessments and too much worry. And in that process, we know the athlete is unlikely to be performing optimal during that period of time. Partly, of course, due to the pain, but also due to the insecurity to you know, if nothing is found on the first scan and a second scan that at some point, they probably start to wonder whether or not they're completely broken, or if it's a really rare disease or even if it's gonna kill them. And these are things that we might feed into by overtreating. So, of course, we should try and prevent pain. Statistics suggest that that's quite tricky. And we, you know, it would be great if we could or even perhaps what we can do is give people tools so they can take agency over their pain when it flares up. But having this idea that when you are in pain, you are damaged is very unhelpful. We think. So we really wanted to highlight the fact that sometimes pain is is that it is pain is still disabling. It's that feeling of pain, and nobody can feel whether or not their pain is due to an injury or not, it feels just like pain. But we identify all pain as if there was an injury, when in fact, it's it's quite unlikely that the majority of cases would have an injury attached to it. And just coming back to one thing you said before that it was quite subtle, but I think it's a really important point you made there, which is that all pain is real, it's always experienced as pain, whether that be of any of the descriptors or for any reason, it always feels like pain, and the quality that we attached to it, it's a muscle pain, or it's whatever is something we do it's our perception is our belief about what the pain is. And maybe that's what we need to also address in sports medicine is that disbelief about what your pain is caused by is a potential target for treatment, we call it psychotherapy or psychoeducation. Or, you know, and that doesn't have to be paying neurobiology education that's unlikely to be better than any other good education and listening and embracing. So there's a range of different interventions that are combining or embracing the fact that you need to talk to your athlete or your patient and help them make sense of their pain in a way that gives them empowerment will give them agency over their pain. 29:51 And something that came to my mind as you were saying, oh the pain it's it's in the muscles, the tendons, the bone, it's the joint and can't that all 30:00 So be a coping mechanism of the athlete. So they may say, oh, it's, you know, this is just a muscle strain. It's so it's their way of coping of saying it's nothing I can continue to to move forward. Do you know what I mean? 30:16 Yeah, absolutely and, and I think as long as it empowers them, if you know if you have the pain that you again, think about Dom's, or delete onset onset muscle soreness. That's an empowering pain, isn't it? I mean, I have Dom's, I was doing exercise yesterday. And if you really want to, you know, be good at something, then perhaps Dom's is your sort of reward even, even though it's painful, it should be awful, it might actually feel like a reward. So in that case, you interpret the pain that you are experiencing, as a reward or something you want it to happen. And I definitely think that some would say that this is just a minor thing, again, think about general health and male, you know, older men, like myself, tend to not go into, you know, the GP for what we consider to be minor things, but in fact, that might be killing us. Because we say, no, no, that's nothing, no, that little spot, that's not cancer. And I would say I don't, I don't think it's a lump, it's probably just something that's here this week. So we should be much better at listening to it, and giving it you know, you know, the quality or the, you know, the meaning that it should have. So it's on both ends of the spectrum, sometimes we neglect that pain is there for a reason, and we should listen to it. And sometimes we should understand that the pain is there without anyone really knowing what it is. But it doesn't mean just because we don't have a universal tool that can treat all pain, which is what we say when we say there's no treatment for chronic pain. In fact, there's quite a, you know, a variety of well established evidence based treatments, that can reduce pain, but they need to be targeted, and individualized so that each one find their, you know, their way through their pain. And of course, one way to do it is to go to everyone you know, who has a, you know, any background in health and ask them what to do, probably the best thing to do is to talk to someone who knows about pain, and then get advice about what seems to be working for you. Embracing that the one in this case, the athlete with pain, they have perhaps one or two years experience with their pain, they know much more about their pain than I do. But I can act as a consultant, I can listen to them, I can help them structure, I know what you know, patterns out there. So I can listen for that. And then together, we can try a few things. But over a period of maybe weeks, they should know as much as I do about pain generally, but with their focus on it. And and that should give them you know, with a bit of practice the ability to find out what works and what doesn't. And rather than thinking of pain management, in the case of a sports related pain, as an on off thing, so either it works and the pain is not there, or it doesn't work, it only reduces the pain a bit, we probably should be realistic and say that most people can have reductions in their pain, perhaps 2030, perhaps more percent. But the majority of people will experience from some sort of management of pain reduction. But it doesn't mean that the pain is going to go away. And it doesn't mean that thought is going to be absolutely pain free. But we need to find a balance between the two so that we understand when pain is actually a sign of either injury or possible injury. But also understand when pain is something that might just be part of life. And the best way we can do the most evidence based approach to that would be to find your way through it, you know, in perhaps, together with a 33:56 clinician of some sort? Yeah. And my gosh, I was just gonna say as we wrap things up, would you like to put a bow on it on your talk and at at the IOC conference and to this talk today, and I think you've just done it? I think you'd beat me to the punch. But is there anything else that you'd like to add? 34:18 That, that you want the listeners to take away? 34:22 I think the most the thing that I always want to stress is that people who meet or live their life with pain, they're experts. And we as clinicians, and researchers should embrace that much more. So the patient as an expert, is something I feel deeply about. 34:44 And I think we should be able to understand that as you know, as a scientist, you might know, you know a lot about groups. 34:51 As a clinician, you might know a lot about people who come to you with a similar symptoms, but as a person who have pain, you have two or three years 35:00 perhaps have experience with your own pain. And I think the best way to you know to get all of these together is by everyone being aware that we have different aspects and different competencies, and we should bring them together. And I think that's the best we can do right now. But still, don't give up hope we should definitely try and cure all pain from the planet, but maybe not by opioids. Yes, I would agree with that. And now more and where can people find you if they want to learn more about what you do? Read your research, where can they find you? 35:39 I think the easiest way would probably be to either find me on on Facebook, or go on Twitter. My handle is at MH underscore DK. And I'm also on Instagram. It's at MH DK underscore Dr. Moulton. Whoa. 35:57 Excellent. And one last question. It's a question I asked everyone is what advice would you give to your younger self, knowing where you are now in your life and in your career? 36:09 Remember, things take time to cope with sometimes you have a good idea. And you can't imagine, however, too, you know, you hear something and everyone else knows it. And you're like the only one who doesn't get it. But give it a bit of time. And, you know, I we have a saying that Rome wasn't built in one day. I think it goes in English as well. So give things time and and make sure you stick to good ideas if you think they're good, but also leave them if they're not. 36:37 Excellent advice. So Morton, thank you so much. This was a great conversation. And like I said, your talk at IOC was really wonderful. There's if people want to see his slides, there are tons of tons of tweets with all of his slides and great descriptors. You could go to IOC p r e v 2021. That was the hashtag for the conference. And as you look through, you'll see a lot of tweets from his from Morton's workshops. So thank you so much for coming on and expanding on that for us. I appreciate it. 37:13 Amazing. Thank you. It is a huge pleasure and privilege to be here. Thank you, Karen. Thanks so much. And everyone. Thanks so much for listening, have a great couple of days and stay healthy, wealthy and smart.

covid-19 american spotify english europe disney master science pain phd research management healthy ireland medicine study embracing smart rome treatments vladimir putin ethics injury stitcher dom neuroscience statistics irs hurts gp bdsm nobel prize wealthy monaco rehabilitation international association morton diploma underneath denton dk neuroplasticity morten ioc partly physiotherapy tas mh irc icd moulton kosta bjs key takeaways there aalborg university health authorities research association pain iasp steven george specialist sports physiotherapist

DRG and Chronic Pelvic Pain

Play Episode Listen Later Aug 5, 2021 21:44

Chapman KB, Mogilner AY, Yang AH, et al. Lead migration and fracture rate in dorsal root ganglion stimulation using anchoring and non-anchoring techniques: A multicenter pooled data analysis. Pain Practice : the Official Journal of World Institute of Pain. 2021 Jun. DOI: 10.1111/papr.13052. Rx Only Brief Summary: Prior to using these devices, please review the User's Guide for a complete listing of indications, contraindications, warnings, precautions, potential adverse events, and directions for use. The system is intended to be used with leads and associated extensions that are compatible with the system. DRG Indications for Use: US: Spinal column stimulation via epidural and intra-spinal lead access to the dorsal root ganglion as an aid in the management of moderate to severe chronic intractable* pain of the lower limbs in adult patients with Complex Regional Pain Syndrome (CRPS) types I and II.** *Study subjects from the ACCURATE clinical study had failed to achieve adequate pain relief from at least 2 prior pharmacologic treatments from at least 2 different drug classes and continued their pharmacologic therapy during the clinical study. **Please note that in 1994, a consensus group of pain medicine experts gathered by the International Association for the Study of Pain (IASP) reviewed diagnostic criteria and agreed to rename reflex sympathetic dystrophy (RSD) and causalgia, as complex regional pain syndrome (CRPS) types I and II, respectively. CRPS II (causalgia) is defined as a painful condition arising from damage to a nerve. Nerve damage may result from traumatic or surgical nerve injury. Changes secondary to neuropathic pain seen in CRPS I (RSD) may be present, but are not a diagnostic requirement for CRPS II (causalgia). International: Management of chronic intractable pain. Contraindications: US: Patients who are unable to operate the system, who are poor surgical risks. Patients who have failed to receive effective pain relief during trial stimulation. International: Patients who are unable to operate the system, are poor surgical risks, are pregnant, or under the age of 18. Warnings/Precautions: Diathermy therapy, implanted cardiac systems or other active implantable devices, magnetic resonance imaging (MRI), computed tomography (CT), electrosurgery devices, ultrasonic scanning equipment, therapeutic radiation, explosive and flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery, equipment and vehicles, pediatric use, pregnancy, and case damage. Adverse Effects: Unpleasant sensations, changes in stimulation, stimulation in unwanted places, lead or implant migration, epidural hemorrhage, hematoma, infection, spinal cord compression, or paralysis from placement of a lead in the epidural space, cerebrospinal fluid leakage, tissue damage or nerve damage, paralysis, weakness, clumsiness, numbness, sensory loss, or pain below the level of the implant, pain where needle was inserted or at the electrode site or at IPG site, seroma at implant site, headache, allergic or rejection response, battery failure and/or leakage. Clinician's Manual must be reviewed for detailed disclosure. Abbott One St. Jude Medical Dr., St. Paul, MN 55117 USA, Tel: 1 651 756 2000 Neuromodulation.Abbott ™ Indicates a trademark of the Abbott group of companies. ‡ Indicates a third party trademark, which is property of its respective owner. © 2021 Abbott. All Rights Reserved. MAT-2104565 v1.0 | Item is approved for global use.

128: Back Pain & Pain from a Global Perspective with the International Association for the Study of Pain (IASP)

Awaken To Your Body's Wisdom

Play Episode Listen Later Jun 1, 2021 40:25

Looking into one of the most globally prevalent types of pain, back pain, and exploring different cultural attitudes towards pain. This edition of Airing Pain was created in association with the International Association for the Study of Pain (IASP) and has been funded by the Plum Trust.Back pain is one of the most common types of pain that people report. It can arise due to any number of causative factors and can occur in any part of the back. Lower back pain and Sciatica are particularly common and affect approximately 577 million people globally. In this episode of Airing Pain we have collaborated with the International Association for the Study of Pain (IASP) who are dedicating their global year 2021 to back pain. 2021 Global Year About Back Pain - IASP (iasp-pain.org)We also dedicate a portion of the episode to useful pain management advice that will benefit anybody living with pain, including those with back pain.Time Stamps 2:00 – Pain Patient Advocate Mary Wing from GAPPA speaks: what is GAPPA? 5:25 – IASP Global Year about Back Pain. 6:20 – Physiotherapist Otieno Martin Ong'wen speaks: global attitudes towards pain and therapeutic exercise. 14:00 - Clinical Research Project Assistant Vina Mohabir speaks: Living with long-term pain and attending pain clinics and the ‘3 P Method’. 19:31 – Otieno Martin Ong’wen speaks: on fostering patient empowerment. 22:05 – Vina Mohabir speaks: on communicating your pain and masking pain. 23: 55 – Mary Wing speaks: on her experience with pain, pain psychology and pain management courses. 26:46 - Otieno Martin Ong’wen speaks: on how different cultural approaches impact psychological therapies for the treatment of pain and therapeutic exercise. 39:56 – Final words from Vina Mohabir. Issues covered in this programme include: pain from a global perspective, pain in developing countries, Global Alliance of Partners for Pain Advocacy (GAPPA), chronic condition management, back pain, IASP Global Year about Back Pain, self-management approaches, physiotherapy, therapeutic exercise, pain in rural areas, physical strategies, pharmaceutical strategies, psychological strategies, the ‘3 P Method’, masking pain, pain psychology.Contributors: Mary Wing, Pain Patient Advocate, Global Alliance of Partners for Pain Advocacy (GAPPA), Australia. Otieno Martin Ong’wen, Orthopedic Manual Therapist, Movement Dysfunction Specialist, Physiotherapist, Afyafrica Orthopedic Services, Nairobi. Vina Mohabir, Clinical Research Project Assistant, The Hospital for Sick Children, Toronto. More information: IASP Global Year About Back Pain 2021 With thanks to: IASP, International Association for the Study of Pain – https://www.iasp-pain.org/

australia living pain toronto study hospitals partners lower international association nairobi back pain physiotherapists global perspectives sciatica global alliance sick children p method iasp gappa pain iasp mary wing

Prevention and Management of Procedural and Needle Pain and Anxiety Among Children

Pedia Pain Focus

Play Episode Listen Later May 24, 2021 55:42

Every child inevitably would experience pain in the course of their life, but if not addresses appropriately, these experiences can have long-lasting and detrimental effects which carry into adulthood. What's even more remarkable is that healthcare experiences including what we do as part of healthcare as professionals is often a significant part of what causes pain and anxiety for children. Efforts to minimize distress, discomfort, pain and related anxiety should be a priority in healthcare. What can healthcare professionals do to prevent, minimize, and ease a child’s fear, anxiety and pain over the medical procedures that they need to undergo as part of their treatment and care? Join me in this episode as I talk about the prevention and treatment of pain caused by procedures within the hospital and healthcare settings with Stefan Friedrichsdorf, MD, medical director of the Center of Pain, Palliative and Integrative Medicine at the UCSF Benioff Children’s Hospitals in Oakland and San Francisco! Dr. Stefan Friedrichsdorf, MD, FAAP is a Professor of Pediatrics at the University of California at San Francisco (UCSF). Find out about his "Comfort Promise" and 4 simple steps that every healthcare professional should ensure to relieve or decrease pain and anxiety among kids who are undergoing treatment and minor or major procedures. Dr Friedrichsdorf shares his experiences, findings, outcomes, implementation plan and even some of the common barriers as well as ways to address them often overlooked Takeaways In This Episode: How Dr. Stefan got involved in pediatric pain Dr. Stefan talks about the prevention and treatment of pain caused by procedures in our hospital, and the staffs Situations where children in hospitalized settings are experiencing pain and anxiety from their treatment procedures The prevention and treatment of pain and anxiety caused by needles What is the “comfort promise”? The four steps to decrease pain and anxiety caused by vaccinations? How to get past the barrier of having our colleagues recognize that this issue of fear and anxiety brought about by treatment procedures is an important issue? Links Stefan Friedrichsdorf, MD FAAP LinkedIn Twitter His paper Clinicians Pain Evaluation Toolkit Proactive Pain Solutions About the guest: Stefan Friedrichsdorf, MD FAAP Stefan Friedrichsdorf is the medical director of the Center of Pain Medicine, Palliative Care and Integrative Medicine at the UCSF Benioff Children’s Hospitals in Oakland and San Francisco. He's a Professor of Pediatric at the UCSF. Dr. Friedrichsdorf received the 2016 “Elizabeth Narcessian Award for Outstanding Educational Achievements in the Field of Pain” by the American Pain Society and the 2011 “Hastings Center Cunniff-Dixon Physician Award”. He was the medical director of the department of pain medicine, palliative care & integrative medicine at Children’s Minnesota from 2005-2020 and under his leadership the department grew into one of the largest and most comprehensive in the country. It received the “Circle of Life Award” by the American Hospital Association in 2008 and was the 2013 recipient of the “Clinical Centers of Excellence in Pain Management Award” by the American Pain Society and in 2018 the Albert Bandura Influencer Award from VitalSmarts. He was the associate editor of the Journal of Pain and Symptom Management until 2020, the principal investigator of a National Institutes of Health (NIH) / National Cancer Institute (NCI) multisite study on the creation, implementation and evaluation of the Pediatric Palliative Care Curriculum “Education in Palliative and End-of-Life Care (EPEC)-Pediatrics”. In 2008 he founded and since then directs the annual Pediatric Pain Master Class, a unique week-long intensive course for interdisciplinary health professionals. Dr. Friedrichsdorf has presented more than 750 lectures about pediatric pain medicine, palliative care and integrative medicine and has a track record of research and publications in the field, including more than 60 peer-reviewed articles and contributions to more than 25 books on the subject. He is president-elect of the Special Interest Group on Pain in Childhood of the International Association for the Study of Pain (IASP). Dr. Friedrichsdorf received his MD degree from the Medical University of Lübeck, Germany, completed his pediatric residency at the University of Witten/Herdecke, Germany (Children’s Hospital Datteln), and undertook his fellowship in Pediatric Pain Medicine and Palliative Care at the University of Sydney, Australia (Children's Hospital at Westmead). He is double boarded in Pediatrics in Germany and the United States, a Diplomate of the American Board of Pediatrics, and trained in pediatric clinical hypnosis.

Adrianne with Joletta Belton on sharing our stories and being known

Play Episode Listen Later Mar 27, 2021 55:20

Adrianne speaks with Joletta Belton on the importance of sharing our stories and being known. Jo is a storyteller and advocate and for advancing the integration of the lived experience into the study, research, and treatment of pain . She makes sense of her own pain through science and stories on her blog, MyCuppaJo.com. She is Co-chair of the Global Alliance of Partners for Pain Advocacy (GAPPA), a task force of the International Association for the Study of Pain (IASP). She is an author of peer-reviewed articles and book chapters, including the first chapter of 'Yoga and Science in Pain Care: Treating the Person in Pain', and is the first Patient and Public Partnerships Editor for the Journal of Orthopaedic and Sports Physical Therapy. http://www.mycuppajo.com/

science pain meditation wellness study yoga mindfulness patients journal partners international association orthopaedics belton global alliance sharing our stories sports physical therapy pain iasp

Pamela Ressler, founder of Stress Resources.

The Health Design Podcast

Play Episode Listen Later Mar 22, 2021 26:26

Pamela Katz Ressler, RN, MS, HNB-BC is the founder of Stress Resources and an Adjunct Clinical Assistant Professor of Public Health and Community Medicine at Tufts University School of Medicine in Boston, MA. She has served as the only nurse on the Executive Board for Medicine X at Stanford University and as a member of the Consumer Health Council of the Massachusetts Health Quality Partners. Ms. Ressler's work focuses on resilience and communicating the experience of chronic pain and illness through mindfulness based interventions, peer to peer healthcare, and narrative practices. Her research is grounded in the science and the art of wellness and human connection and she has been Her work has earned her the distinction as a thought leader in the field and was selected to co-design The Narrative Playbook: The Strategic Use of Story to Improve Care, Healing and Health (2015). In 2020, Ms. Ressler launched the podcast Raising Resilience which she hosts and produces. Ressler sits on the Board of Directors of ChildKind International, an organization dedicated to improving the quality of pediatric pain care around the world, and was honored to be selected as a 2019-2020 Mayday Pain and Society Fellow. She is a member of the International Association of the Study of Pain (IASP) and serves on the IASP's Global Alliance of Pain Patient Advocates (GAPPA). Her consulting work with businesses, schools, and healthcare organizations is ongoing and expanding as leaders seek strategies of sustainable resilience in our fast paced society.

director founders health healing stress story ms board medicine study public health stanford university rn international association executive board global alliance tufts university school community medicine ressler iasp adjunct clinical assistant professor pain iasp medicine x

History of Radio Frequency

FIRSTAR Let's chAT: an Athletic Therapy podcast

Play Episode Listen Later Feb 9, 2021 20:56

Join Drs. Jason Pope and Timothy Lubenow for a new episode of Abbott Virtual Scientific Forum Podcast In the Lupe: History of Radiofrequency. List to our esteemed faculty discuss the history and importance of utilizing Radiofrequency in your practice day to day. Cohen SP, Bhaskar A, Bhatia A, et al. Consensus practice guidelines on interventions for lumbar facet joint pain from a multispecialty, international working group. Reg Anesth Pain Med. 2020;45(6):424‐467. doi:10.1136/rapm-2019-101243Juch, J., Maas, E. T., Ostelo, R., Groeneweg, J. G., Kallewaard, J. W., Koes, B. W., Verhagen, A. P., van Dongen, J. M., Huygen, F., & van Tulder, M. W. (2017). Effect of Radiofrequency Denervation on Pain Intensity Among Patients With Chronic Low Back Pain: The Mint Randomized Clinical Trials. JAMA, 318(1), 68–81. https://doi.org/10.1001/jama.2017.7918Manchikanti L. et al. A systematic review and best evidence synthesis of effectiveness of therapeutic facet joint interventions in managing chronic spinal pain. Pain physician. 2015 Jul;18:E535-82. Rx OnlyBrief Summary: Prior to using these devices, please review the User’s Guide for a complete listing of indications, contraindications, warnings, precautions, potential adverse events, and directions for use. The system is intended to be used with leads and associated extensions that are compatible with the system.DRGIndications for Use: US: Spinal column stimulation via epidural and intra-spinal lead access to the dorsal root ganglion as an aid in the management of moderate to severe chronic intractable* pain of the lower limbs in adult patients with Complex Regional Pain Syndrome (CRPS) types I and II.***Study subjects from the ACCURATE clinical study had failed to achieve adequate pain relief from at least 2 prior pharmacologic treatments from at least 2 different drug classes and continued their pharmacologic therapy during the clinical study.**Please note that in 1994, a consensus group of pain medicine experts gathered by the International Association for the Study of Pain (IASP) reviewed diagnostic criteria and agreed to rename reflex sympathetic dystrophy (RSD) and causalgia, as complex regional pain syndrome (CRPS) types I and II, respectively. CRPS II (causalgia) is defined as a painful condition arising from damage to a nerve. Nerve damage may result from traumatic or surgical nerve injury. Changes secondary to neuropathic pain seen in CRPS I (RSD) may be present, but are not a diagnostic requirement for CRPS II (causalgia).International: Management of chronic intractable pain.Contraindications: US: Patients who are unable to operate the system, who are poor surgical risks. Patients who have failed to receive effective pain relief during trial stimulation.International: Patients who are unable to operate the system, are poor surgical risks, are pregnant, or under the age of 18.Warnings/Precautions: Diathermy therapy, implanted cardiac systems or other active implantable devices, magnetic resonance imaging (MRI), computed tomography (CT), electrosurgery devices, ultrasonic scanning equipment, therapeutic radiation, explosive and flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery, equipment and vehicles, pediatric use, pregnancy, and case damage.Adverse Effects: Unpleasant sensations, changes in stimulation, stimulation in unwanted places, lead or implant migration, epidural hemorrhage, hematoma, infection, spinal cord compression, or paralysis from placement of a lead in the epidural space, cerebrospinal fluid leakage, tissue damage or nerve damage, paralysis, weakness, clumsiness, numbness, sensory loss, or pain below the level of the implant, pain where needle was inserted or at the electrode site or at IPG site, seroma at implant site, headache, allergic or rejection response, battery failure and/or leakage. Clinician’s Manual must be reviewed for detailed disclosure.SCSIndications for Use: Spinal cord stimulation as an aid in the management of chronic, intractable pain of the trunk and/or limbs, including unilateral or bilateral pain associated with the following: failed back surgery syndrome and intractable low back and leg pain.Contraindications: Patients who are unable to operate the system or who have failed to receive effective pain relief during trial stimulation.Warnings/Precautions: Diathermy therapy, implanted cardiac systems or other active implanted devices, magnetic resonance imaging (MRI), electrosurgery, explosive and flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery, equipment and vehicles, pediatric use, pregnancy, and case damage. Patients who are poor surgical risks, with multiple illnesses, or with active general infections should not be implanted.Adverse Effects: Unpleasant sensations, changes in stimulation, stimulation in unwanted places, lead or implant migration, epidural hemorrhage, hematoma, infection, spinal cord compression, or paralysis from placement of a lead in the epidural space, cerebrospinal fluid leakage, paralysis, weakness, clumsiness, numbness, sensory loss, or pain below the level of the implant, pain at the electrode or IPG site, seroma at IPG site, allergic or rejection response, battery failure. Clinician’s Manual must be reviewed for detailed disclosure.RFAIndications for Use: The NT2000iXTM generator is intended for lesioning neural tissue. The NT2000iXTM generator is intended to be used for pain management. The NT2000iXTM generator is to be used only with separately cleared/approved lesion/temperature probes (NeuroTherm radiofrequency probes and SPINECATHTM and ACUTHERMTM catheters). The NT2000iXTM generator is indicated for use in the peripheral nervous system. Warnings/Precautions: Hazardous electrical output, electric shock hazard, explosion hazard, fire hazard, pooling hazard, ignition hazard, fuse replacement, risk of RF burns to patient, interference with active implants, interference with other equipment, probes. User’s Guide must be reviewed for detailed disclosure. Indications for Use: US: The IonicRF™ Generator, in combination with approved compatible electrodes and cannulae, is indicated as an aid in the management of pain in the nervous system. Examples include facet denervation, trigeminal rhizotomy, and related functional neurosurgical procedures.International: The IonicRF™ Generator, in combination with approved compatible electrodes and cannulae, is indicated as an aid in the management of pain in the nervous system. Examples include, but are not limited to, facet denervation, rhizotomy, and related functional neurosurgical procedures.Contraindications: The use of this device is contraindicated in patients with systemic infection or local infection in the area of the procedure.Warnings/Precautions: Hazardous electrical output, electric shock hazard, equipment failure, explosion hazard, fire hazard, pooling hazard, ignition hazard, risk of RF burns and unintended stimulation, risk of RF burns to patient, interference with active implants, redirection of high-frequency currents, interference with other equipment, shortwave or microwave equipment, apparent low output or failure of equipment, risk of patient injury, proper device use, non-sterile, accessories, continuity monitoring, inspection, mechanical damage, electrode positioning, use of fluids, dispersive connections, cleaning the generator, emergency stop.Adverse Effects: Damage to surrounding tissue through iatrogenic injury; nerve injury, including thermal injury, or puncture of the spinal cord or nerve roots, potentially resulting in radiculopathy, paresis, and paralysis; pain, pulmonary embolism, hemothorax or pneumothorax, infection, unintended puncture wound, including vascular puncture and dural tear, hemorrhage, and hematoma. User’s Guide must be reviewed for detailed disclosure.Simplicity™ III Disposable Radiofrequency ElectrodePRESCRIPTION AND SAFETY INFORMATIONRead this section to gather important prescription and safety information.INDICATION FOR USEThe Abbott Medical Simplicity™ III Disposable Radiofrequency Electrode is intended for use in the treatment of chronic pain by the ablation of neural tissue.DESCRIPTIONThe Simplicity III electrode is a disposable radiofrequency (RF) device consisting of three isolated electrodes along the shaft. Radiopaque markers are located between the distal and the middle electrodes, between the middle and the proximal electrodes, and below the proximal electrode. These radiopaque markers clearly show the separation of the three electrodes under X-ray. The Simplicity III electrode needs to be connected to an Abbott Medical RF generator using an Abbott Medical adapter cable.WARNINGSSharp; handle carefully.Do not proceed unless all electrodes read body temperature when connected and inserted into the patient.Stop if heat is felt at site of the grounding pad.When the Simplicity III electrode is used to perform lesion procedures in the sacral region, always ensure that the electrode does not enter any of the sacral foramen and that the electrode does not proceed inferior to the inferior border of the sacrum.Do not use the electrode if the package has been opened or damaged.Ensure the most proximal contact on the electrode is not too close to the dermis to prevent skin burn.Use of general anesthesia is not recommended during the procedure. It is advised to use local anesthesia or conscious sedation so patient interaction is possible.The electrode should only be used by physicians trained in the use of the device.The electrode is intended for single-use only. This device is not intended for bilateral use.The electrode should only be used with an Abbott Medical RF generator.During treatment with the Simplicity III electrode, the patient should continuously be monitored and evaluated for any unexpected symptoms.Before starting any thermal treatment with the electrode, ensure no motor nerves are in the vicinity of the electrode.Do not move the electrode while it is activated.Do not use the electrode if any damage is observed.Do not bend or reshape the electrode; this can cause permanent mechanical damage.Use minimal force and torque when manipulating the electrode; the handle has been designed to release if too much torque is applied.Reuse of single-use devices creates a potential risk of patient or user infections. Contamination of the device may lead to injury, illness, or death of the patient.Reprocessing may compromise the structural integrity of the device and/or lead to device failure.Cleaning, disinfection, and sterilization may compromise essential material and design characteristics, leading to device failure.AbbottOne St. Jude Medical Dr., St. Paul, MN 55117 USA, Tel: 1 651 756 2000Neuromodulation.Abbott™ Indicates a trademark of the Abbott group of companies.‡ Indicates a third party trademark, which is property of its respective owner.© 2020 Abbott. All Rights Reserved.MAT-2012132 v1.0| Item is approved for global use.

Session 57 (Jan 24 2021): Nikos Apostolopolous Founder & Creator, Microstretching TREAT THE WHOLE, NOT THE SUM OF THE PARTS

Play Episode Play 50 sec Highlight Listen Later Jan 25, 2021 76:57

Nikos Apostolopolous Founder & Creator, Microstretching TREAT THE WHOLE, NOT THE SUM OF THE PARTSNikos Apostolopoulos is the Founder and Developer of microStretching® and Stretch Therapy®. This recovery regeneration technique, based on functional-clinical anatomy, has been used to treat many professional, elite, amateur, and Paralympic athletes, internationally as well as individuals suffering from numerous musculoskeletal disorders. Nikos is a member of both the International Association for the Study of Pain (IASP), and the International Society for Exercise and Immunology (ISEI). He serves as Chief Science Officer (CSO) for several biotechnology companies focused on psychedelic research and endocannabinoids focused on inflammation and the body.

founders creator study exercise treat developers paralympics international association international society nikos stretch therapy pain iasp

Fellow's Tour

Play Episode Listen Later Dec 1, 2020 14:07

Join Dr. Lubenow and Dr. Pope for the Abbott Virtual Scientific Forum Podcast, "In the Lupe: Fellow's Tour" where they discuss how Abbott is leading the way in training and education with how Abbott is training fellows on the road this year.Rx OnlyBrief Summary: Prior to using these devices, please review the User’s Guide for a complete listing of indications, contraindications, warnings, precautions, potential adverse events, and directions for use. The system is intended to be used with leads and associated extensions that are compatible with the system.DRGIndications for Use: US: Spinal column stimulation via epidural and intra-spinal lead access to the dorsal root ganglion as an aid in the management of moderate to severe chronic intractable* pain of the lower limbs in adult patients with Complex Regional Pain Syndrome (CRPS) types I and II.***Study subjects from the ACCURATE clinical study had failed to achieve adequate pain relief from at least 2 prior pharmacologic treatments from at least 2 different drug classes and continued their pharmacologic therapy during the clinical study.**Please note that in 1994, a consensus group of pain medicine experts gathered by the International Association for the Study of Pain (IASP) reviewed diagnostic criteria and agreed to rename reflex sympathetic dystrophy (RSD) and causalgia, as complex regional pain syndrome (CRPS) types I and II, respectively. CRPS II (causalgia) is defined as a painful condition arising from damage to a nerve. Nerve damage may result from traumatic or surgical nerve injury. Changes secondary to neuropathic pain seen in CRPS I (RSD) may be present, but are not a diagnostic requirement for CRPS II (causalgia).International: Management of chronic intractable pain.Contraindications: US: Patients who are unable to operate the system, who are poor surgical risks. Patients who have failed to receive effective pain relief during trial stimulation.International: Patients who are unable to operate the system, are poor surgical risks, are pregnant, or under the age of 18.Warnings/Precautions: Diathermy therapy, implanted cardiac systems or other active implantable devices, magnetic resonance imaging (MRI), computed tomography (CT), electrosurgery devices, ultrasonic scanning equipment, therapeutic radiation, explosive and flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery, equipment and vehicles, pediatric use, pregnancy, and case damage.Adverse Effects: Unpleasant sensations, changes in stimulation, stimulation in unwanted places, lead or implant migration, epidural hemorrhage, hematoma, infection, spinal cord compression, or paralysis from placement of a lead in the epidural space, cerebrospinal fluid leakage, tissue damage or nerve damage, paralysis, weakness, clumsiness, numbness, sensory loss, or pain below the level of the implant, pain where needle was inserted or at the electrode site or at IPG site, seroma at implant site, headache, allergic or rejection response, battery failure and/or leakage. Clinician’s Manual must be reviewed for detailed disclosure.SCSIndications for Use: Spinal cord stimulation as an aid in the management of chronic, intractable pain of the trunk and/or limbs, including unilateral or bilateral pain associated with the following: failed back surgery syndrome and intractable low back and leg pain.Contraindications: Patients who are unable to operate the system or who have failed to receive effective pain relief during trial stimulation.Warnings/Precautions: Diathermy therapy, implanted cardiac systems or other active implanted devices, magnetic resonance imaging (MRI), electrosurgery, explosive and flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery, equipment and vehicles, pediatric use, pregnancy, and case damage. Patients who are poor surgical risks, with multiple illnesses, or with active general infections should not be implanted.Adverse Effects: Unpleasant sensations, changes in stimulation, stimulation in unwanted places, lead or implant migration, epidural hemorrhage, hematoma, infection, spinal cord compression, or paralysis from placement of a lead in the epidural space, cerebrospinal fluid leakage, paralysis, weakness, clumsiness, numbness, sensory loss, or pain below the level of the implant, pain at the electrode or IPG site, seroma at IPG site, allergic or rejection response, battery failure. Clinician’s Manual must be reviewed for detailed disclosure.AbbottOne St. Jude Medical Dr., St. Paul, MN 55117 USA, Tel: 1 651 756 2000Neuromodulation.Abbott™ Indicates a trademark of the Abbott group of companies.‡ Indicates a third party trademark, which is property of its respective owner.© 2020 Abbott. All Rights Reserved.MAT-2010795 | Item is approved for global use.

Pink Past October - Treating breast cancer survivors with post mastectomy pain syndrome

Spine and Nerve podcast

Play Episode Listen Later Nov 8, 2020 26:01

In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves want to stay pink past October- they are continuing breast cancer awareness month and discussing one of the overlapping diagnoses: Post-Mastectomy Pain Syndrome (PMPS). Breast cancer is the most frequently diagnosed life threatening cancer in women. There are many different approaches to the treatment of breast cancer, and surgical resection often plays an important role in the management. One potential complication after surgical resection is chronic pain, specifically referred to as PMPS. The definition of PMPS according to the International Association for the Study of Pain (IASP) is: persistent pain soon after mastectomy/lumpectomy affecting the anterior thorax, axilla, and/or medial arm; typically described as burning, stabbing, pulling sensation. PMPS is a growing concern, and epidemiologic studies demonstrate that it can affect 20-68% of breast cancers after surgical intervention. Risk factors for development of PMPS include: younger age (35 years old or younger), type of surgery (total mastectomy and axillary lymph node dissection having increased risk), prior history of chronic pain. The treatment of PMPS, similar to other chronic neuropathic disease processes, is challenging. As always it is important to think about the treatment algorithm: -lifestyle modifications (including diet, exercise, weight optimization (especially considering BMI can be a risk factor for PMPS)) -physical therapy (including desensitization techniques) -medications (including topical medications, and potentially compounded topical meds) -procedures (including the Erector Spinae Block) -minimally invasive surgical techniques (including Peripheral Nerve Stimulation and Dorsal Column Spinal Cord Stimulation) -and stay vigilant for monitoring for recurrence / progression of the cancer itself This podcast is for information and educational purposes only, it is not meant to be medical or career advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, the may not represent the views of Spine & Nerve. Neuropathic pain podcast episode: https://anchor.fm/spine/episodes/Narcissistic-nerves---what-exactly-is-peripheral-neuropathy-and-why-you-should-care-e4njhf References: 1. Gong, Youwei MM; Tan, Qixing MD; Qin, Qinghong MD; Wei, Changyuan PhD. Prevalence of postmastectomy pain syndrome and associated risk factors, Medicine: May 15, 2020 - Volume 99 - Issue 20. 2. Mainkar, O., Sollo, C.A., Chen, G., Legler, A. and Gulati, A. (2020), Pilot Study in Temporary Peripheral Nerve Stimulation in Oncologic Pain. Neuromodulation: Technology at the Neural Interface, 23: 819-826.

Industry Partnership

Play Episode Listen Later Oct 8, 2020 27:18

Join Dr. Lubenow and Dr. Pope for the Abbott Virtual Scientific Forum Podcast, "In the Lupe: Industry Partnership" where they discuss the importance on partnering with Industry especially during the educational part of your fellowship. ReferencesProclaim™ DRG Neurostimulation System Clinician’s Manual. Plano, TX. 2018.Deer TR, Patterson DG, Baksh J, et al. Novel Intermittent Dosing Burst Paradigm in Spinal Cord Stimulation. Neuromodulation. Published online March 23, 2020. doi:10.1111/ner.13143. PMID: 32202044Diwan, Sudhir, and Timothy R. Deer. Advanced Procedures for Pain Management. Springer International Publishing:, 2018. https://www.springer.com/gp/book/9783319688398Rx OnlyBrief Summary: Prior to using these devices, please review the User’s Guide for a complete listing of indications, contraindications, warnings, precautions, potential adverse events, and directions for use. The system is intended to be used with needles and electrodes that are compatible with the system.Indications for Use: The NT2000iX™ generator is intended for lesioning neural tissue. The NT2000iX™ generator is intended to be used for pain management. The NT2000iX™ generator is to be used only with separately cleared/approved lesion/temperature probes (NeuroTherm™ radiofrequency probes and SPINECATH™ and ACUTHERM™ catheters). The NT2000iX™ generator is indicated for use in the peripheral nervous system.Warnings/Precautions: Hazardous electrical output, Electric shock hazard, Explosion Hazard, Fire Hazard, Pooling Hazard, Ignition Hazard, Fuse Replacement, Risk of RF burns to patient, Interference with active implants, Interference with other equipment, Probes. User’s Guide must be reviewed for detailed disclosure. User’s Guide must be reviewed for detailed disclosure.DRGIndications for Use: US: Spinal column stimulation via epidural and intra-spinal lead access to the dorsal root ganglion as an aid in the management of moderate to severe chronic intractable* pain of the lower limbs in adult patients with Complex Regional Pain Syndrome (CRPS) types I and II.***Study subjects from the ACCURATE clinical study had failed to achieve adequate pain relief from at least 2 prior pharmacologic treatments from at least 2 different drug classes and continued their pharmacologic therapy during the clinical study.**Please note that in 1994, a consensus group of pain medicine experts gathered by the International Association for the Study of Pain (IASP) reviewed diagnostic criteria and agreed to rename reflex sympathetic dystrophy (RSD) and causalgia, as complex regional pain syndrome (CRPS) types I and II, respectively. CRPS II (causalgia) is defined as a painful condition arising from damage to a nerve. Nerve damage may result from traumatic or surgical nerve injury. Changes secondary to neuropathic pain seen in CRPS I (RSD) may be present, but are not a diagnostic requirement for CRPS II (causalgia).International: Management of chronic intractable pain.Contraindications: US: Patients who are unable to operate the system, who are poor surgical risks. Patients who have failed to receive effective pain relief during trial stimulation.International: Patients who are unable to operate the system, are poor surgical risks, are pregnant, or under the age of 18.Warnings/Precautions: Diathermy therapy, implanted cardiac systems or other active implantable devices, magnetic resonance imaging (MRI), computed tomography (CT), electrosurgery devices, ultrasonic scanning equipment, therapeutic radiation, explosive and flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery, equipment and vehicles, pediatric use, pregnancy, and case damage.Adverse Effects: Unpleasant sensations, changes in stimulation, stimulation in unwanted places, lead or implant migration, epidural hemorrhage, hematoma, infection, spinal cord compression, or paralysis from placement of a lead in the epidural space, cerebrospinal fluid leakage, tissue damage or nerve damage, paralysis, weakness, clumsiness, numbness, sensory loss, or pain below the level of the implant, pain where needle was inserted or at the electrode site or at IPG site, seroma at implant site, headache, allergic or rejection response, battery failure and/or leakage. Clinician’s Manual must be reviewed for detailed disclosure.SCSIndications for Use: Spinal cord stimulation as an aid in the management of chronic, intractable pain of the trunk and/or limbs, including unilateral or bilateral pain associated with the following: failed back surgery syndrome and intractable low back and leg pain.Contraindications: Patients who are unable to operate the system or who have failed to receive effective pain relief during trial stimulation.Warnings/Precautions: Diathermy therapy, implanted cardiac systems or other active implanted devices, magnetic resonance imaging (MRI), electrosurgery, explosive and flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery, equipment and vehicles, pediatric use, pregnancy, and case damage. Patients who are poor surgical risks, with multiple illnesses, or with active general infections should not be implanted.Adverse Effects: Unpleasant sensations, changes in stimulation, stimulation in unwanted places, lead or implant migration, epidural hemorrhage, hematoma, infection, spinal cord compression, or paralysis from placement of a lead in the epidural space, cerebrospinal fluid leakage, paralysis, weakness, clumsiness, numbness, sensory loss, or pain below the level of the implant, pain at the electrode or IPG site, seroma at IPG site, allergic or rejection response, battery failure. Clinician’s Manual must be reviewed for detailed disclosure.AbbottOne St. Jude Medical Dr., St. Paul, MN 55117 USA, Tel: 1 651 756 2000Neuromodulation.Abbott™ Indicates a trademark of the Abbott group of companies.‡ Indicates a third party trademark, which is property of its respective owner.© 2020 Abbott. All Rights Reserved.MAT-2008840 v1.0 | Item approved for global use.

Complications within Neuromodulation

Play Episode Listen Later Sep 24, 2020 22:13

ReferencesProclaim™ DRG Neurostimulation System Clinician’s Manual. Plano, TX. 2018.Cameron, Tracy. "Safety and efficacy of spinal cord stimulation for the treatment of chronic pain: a 20-year literature review." Journal of Neurosurgery: Spine 100.3 (2004): 254-267.Deer, Timothy R., et al. "The Neurostimulation Appropriateness Consensus Committee (NACC) recommendations for infection prevention and management." Neuromodulation: Technology at the Neural Interface1 (2017): 31-50.B. North, D. Kidd, J. Shipley and R. S. Taylor, "Spinal cord stimulation versus reoperation for failed back surgery syndrome: a cost effectiveness and cost utility analysis based on a randomized, controlled trial.," Neurosurgery, vol. 61, no. 2, pp. 361-369, 2007.Deer TR, Levy RM, Kramer J, et al. Dorsal root ganglion stimulation yielded higher treatment success rate for complex regional pain syndrome and causalgia at 3 and 12 months: a randomized comparative trial. Pain. 2017;158(4):669-681."Safety and efficacy of spinal cord stimulation for the treatment of chronic pain: a 20-year literature review." Journal of Neurosurgery: Spine 100.3 (2004): 254-267“The Appropriate Use of Neurostimulation: Avoidance and Treatment of Complications of Neurostimulation Therapies for the Treatment of Chronic Pain.” Deer et al. 2014“Neurostimulation Appropriateness Consensus Committee (NACC): Recommendations on Bleeding and Coagulation Management in Neurostimulation Devices.” Deer et al. 2017https://www.asra.com/asra-news/article/153/prevention-and-treatment-of-infections-dPeter Staats MD, Richard, North MD, Konstantin Slavin MD, Timothy Deer MD, Kristina Davis PhD, and Chananit Hutson PhD presented this preliminary data at the 21st Annual Meeting of the North American Neuromodulation Society in Las Vegas, NV,USA on January 11–14, 2018.Diwan, Sudhir, and Timothy R. Deer. Advanced Procedures for Pain Management. Springer International Publishing:, 2018. https://www.springer.com/gp/book/9783319688398Eldabe, Sam, Eric Buchser, and Rui V. Duarte. "Complications of spinal cord stimulation and peripheral nerve stimulation techniques: a review of the literature." Pain Medicine 17.2 (2016): 325-336.Deer, Timothy R., et al. "The neuromodulation appropriateness consensus committee on best practices for dorsal root ganglion stimulation." Neuromodulation: Technology at the Neural Interface 22.1 (2019): 1-35.Bedder, Marshall D., and Helen F. Bedder. "Spinal cord stimulation surgical technique for the nonsurgically trained." Neuromodulation: Technology at the Neural Interface 12 (2009): 1-19.Horan, Mattias, et al. "Complications and Effects of Dorsal Root Ganglion Stimulation in the Treatment of Chronic Neuropathic Pain: A Nationwide Cohort Study in Denmark." Neuromodulation: Technology at the Neural Interface (2020). *12:06 includes content from the physician speakers experience**21:55 includes content from the physician speakers experience Rx OnlyBrief Summary: Prior to using these devices, please review the User’s Guide for a complete listing of indications, contraindications, warnings, precautions, potential adverse events, and directions for use. The system is intended to be used with leads and associated extensions that are compatible with the system.DRGIndications for Use: US: Spinal column stimulation via epidural and intra-spinal lead access to the dorsal root ganglion as an aid in the management of moderate to severe chronic intractable* pain of the lower limbs in adult patients with Complex Regional Pain Syndrome (CRPS) types I and II.***Study subjects from the ACCURATE clinical study had failed to achieve adequate pain relief from at least 2 prior pharmacologic treatments from at least 2 different drug classes and continued their pharmacologic therapy during the clinical study.**Please note that in 1994, a consensus group of pain medicine experts gathered by the International Association for the Study of Pain (IASP) reviewed diagnostic criteria and agreed to rename reflex sympathetic dystrophy (RSD) and causalgia, as complex regional pain syndrome (CRPS) types I and II, respectively. CRPS II (causalgia) is defined as a painful condition arising from damage to a nerve. Nerve damage may result from traumatic or surgical nerve injury. Changes secondary to neuropathic pain seen in CRPS I (RSD) may be present, but are not a diagnostic requirement for CRPS II (causalgia).International: Management of chronic intractable pain.Contraindications: US: Patients who are unable to operate the system, who are poor surgical risks. Patients who have failed to receive effective pain relief during trial stimulation.International: Patients who are unable to operate the system, are poor surgical risks, are pregnant, or under the age of 18.Warnings/Precautions: Diathermy therapy, implanted cardiac systems or other active implantable devices, magnetic resonance imaging (MRI), computed tomography (CT), electrosurgery devices, ultrasonic scanning equipment, therapeutic radiation, explosive and flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery, equipment and vehicles, pediatric use, pregnancy, and case damage.Adverse Effects: Unpleasant sensations, changes in stimulation, stimulation in unwanted places, lead or implant migration, epidural hemorrhage, hematoma, infection, spinal cord compression, or paralysis from placement of a lead in the epidural space, cerebrospinal fluid leakage, tissue damage or nerve damage, paralysis, weakness, clumsiness, numbness, sensory loss, or pain below the level of the implant, pain where needle was inserted or at the electrode site or at IPG site, seroma at implant site, headache, allergic or rejection response, battery failure and/or leakage. Clinician’s Manual must be reviewed for detailed disclosure.SCSIndications for Use: Spinal cord stimulation as an aid in the management of chronic, intractable pain of the trunk and/or limbs, including unilateral or bilateral pain associated with the following: failed back surgery syndrome and intractable low back and leg pain.Contraindications: Patients who are unable to operate the system or who have failed to receive effective pain relief during trial stimulation.Warnings/Precautions: Diathermy therapy, implanted cardiac systems or other active implanted devices, magnetic resonance imaging (MRI), electrosurgery, explosive and flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery, equipment and vehicles, pediatric use, pregnancy, and case damage. Patients who are poor surgical risks, with multiple illnesses, or with active general infections should not be implanted.Adverse Effects: Unpleasant sensations, changes in stimulation, stimulation in unwanted places, lead or implant migration, epidural hemorrhage, hematoma, infection, spinal cord compression, or paralysis from placement of a lead in the epidural space, cerebrospinal fluid leakage, paralysis, weakness, clumsiness, numbness, sensory loss, or pain below the level of the implant, pain at the electrode or IPG site, seroma at IPG site, allergic or rejection response, battery failure. Clinician’s Manual must be reviewed for detailed disclosure.AbbottOne St. Jude Medical Dr., St. Paul, MN 55117 USA, Tel: 1 651 756 2000Neuromodulation.Abbott™ Indicates a trademark of the Abbott group of companies.‡ Indicates a third party trademark, which is property of its respective owner.© 2020 Abbott. All Rights Reserved.MAT-2008365 v1.0 | Item approved for global use.

The Surgeon and Pain Physician Relationship

Play Episode Listen Later Sep 3, 2020 25:27

In the Lupe, Episode 5Join Dr. Lubenow and Dr. Pope and Special Guest, Dr. Petersen for the Abbott Virtual Scientific Forum Podcast, "In the Lupe: The Surgeon and Pain Physician Relationship" where they discuss strategies to create and develop a supportive relationship between pain physicians and neurosurgeons. ReferencesProclaim™ DRG Neurostimulation System Clinician’s Manual. Plano, TX. 2018.Deer, Timothy R., et al. "The Neurostimulation Appropriateness Consensus Committee (NACC) recommendations for infection prevention and management." Neuromodulation: Technology at the Neural Interface1 (2017): 31-50.Deer, Timothy R., et al. "The neurostimulation appropriateness consensus committee (NACC) safety guidelines for the reduction of severe neurological injury." Neuromodulation: Technology at the Neural Interface1 (2017): 15-30.B. North, D. Kidd, J. Shipley and R. S. Taylor, "Spinal cord stimulation versus reoperation for failed back surgery syndrome: a cost effectiveness and cost utility analysis based on a randomized, controlled trial.," Neurosurgery, vol. 61, no. 2, pp. 361-369, 2007. Rx OnlyBrief Summary: Prior to using these devices, please review the User’s Guide for a complete listing of indications, contraindications, warnings, precautions, potential adverse events, and directions for use. The system is intended to be used with leads and associated extensions that are compatible with the system.DRGIndications for Use: US: Spinal column stimulation via epidural and intra-spinal lead access to the dorsal root ganglion as an aid in the management of moderate to severe chronic intractable* pain of the lower limbs in adult patients with Complex Regional Pain Syndrome (CRPS) types I and II.***Study subjects from the ACCURATE clinical study had failed to achieve adequate pain relief from at least 2 prior pharmacologic treatments from at least 2 different drug classes and continued their pharmacologic therapy during the clinical study.**Please note that in 1994, a consensus group of pain medicine experts gathered by the International Association for the Study of Pain (IASP) reviewed diagnostic criteria and agreed to rename reflex sympathetic dystrophy (RSD) and causalgia, as complex regional pain syndrome (CRPS) types I and II, respectively. CRPS II (causalgia) is defined as a painful condition arising from damage to a nerve. Nerve damage may result from traumatic or surgical nerve injury. Changes secondary to neuropathic pain seen in CRPS I (RSD) may be present, but are not a diagnostic requirement for CRPS II (causalgia).International: Management of chronic intractable pain.Contraindications: US: Patients who are unable to operate the system, who are poor surgical risks. Patients who have failed to receive effective pain relief during trial stimulation.International: Patients who are unable to operate the system, are poor surgical risks, are pregnant, or under the age of 18.Warnings/Precautions: Diathermy therapy, implanted cardiac systems or other active implantable devices, magnetic resonance imaging (MRI), computed tomography (CT), electrosurgery devices, ultrasonic scanning equipment, therapeutic radiation, explosive and flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery, equipment and vehicles, pediatric use, pregnancy, and case damage.Adverse Effects: Unpleasant sensations, changes in stimulation, stimulation in unwanted places, lead or implant migration, epidural hemorrhage, hematoma, infection, spinal cord compression, or paralysis from placement of a lead in the epidural space, cerebrospinal fluid leakage, tissue damage or nerve damage, paralysis, weakness, clumsiness, numbness, sensory loss, or pain below the level of the implant, pain where needle was inserted or at the electrode site or at IPG site, seroma at implant site, headache, allergic or rejection response, battery failure and/or leakage. Clinician’s Manual must be reviewed for detailed disclosure.SCSIndications for Use: Spinal cord stimulation as an aid in the management of chronic, intractable pain of the trunk and/or limbs, including unilateral or bilateral pain associated with the following: failed back surgery syndrome and intractable low back and leg pain.Contraindications: Patients who are unable to operate the system or who have failed to receive effective pain relief during trial stimulation.Warnings/Precautions: Diathermy therapy, implanted cardiac systems or other active implanted devices, magnetic resonance imaging (MRI), electrosurgery, explosive and flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery, equipment and vehicles, pediatric use, pregnancy, and case damage. Patients who are poor surgical risks, with multiple illnesses, or with active general infections should not be implanted.Adverse Effects: Unpleasant sensations, changes in stimulation, stimulation in unwanted places, lead or implant migration, epidural hemorrhage, hematoma, infection, spinal cord compression, or paralysis from placement of a lead in the epidural space, cerebrospinal fluid leakage, paralysis, weakness, clumsiness, numbness, sensory loss, or pain below the level of the implant, pain at the electrode or IPG site, seroma at IPG site, allergic or rejection response, battery failure. Clinician’s Manual must be reviewed for detailed disclosure.AbbottOne St. Jude Medical Dr., St. Paul, MN 55117 USA, Tel: 1 651 756 2000Neuromodulation.Abbott™ Indicates a trademark of the Abbott group of companies.‡ Indicates a third party trademark, which is property of its respective owner.© 2020 Abbott. All Rights Reserved.MAT-2007291| Item approved for global use.

124. Diabetic Neuropathy

Play Episode Listen Later Sep 1, 2020 29:59

Managing neuropathic pain related to diabetes, and how to adapt diet to treat the disease This edition of Airing Pain has been supported by a grant from The Champ Trust and Foundation Scotland According to the most recent Scottish Diabetes Survey in 2018, there are an estimated 304,000 people living with a diagnosis of diabetes in Scotland, around 5% of the population. A long-term effect of diabetes can be the development of diabetic neuropathy. This edition of Airing Pain focuses on neuropathic pain in people with diabetes, and how the X-PERT diabetes courses helps people to deal with the complications that arise when living with diabetes. First up, Paul Evans speaks to David Bennett, Professor of Neurology at the University of Oxford, who outlines the differences between type 1 and type 2 diabetes and how the initial treatment plan differs between the types. Professor Bennett then goes on to describe how neuropathy develops in people living with diabetes and how neuropathic pain manifests. Paul then talks with Steve Sims, who lives with diabetic neuropathy as a result of type 2 diabetes. Paul and Steve discuss how they have adjusted their diets to deal with type 2 diabetes and how the X-PERT diabetes course has helped them to adjust to living with diabetes. Contributors: Professor Dave Bennett, Professor of Neurology, Nuffield Department of Clinical Neurosciences, University of Oxford Steve Sims, Secretary, Cardiff Diabetes Group. More information: The X-PERT diabetes courses – https://www.diabetes.co.uk/education/x-pert.html British Pain Society – britishpainsociety.org (http://www.britishpainsociety.org/) Pain Concern leaflet on Neuropathic Pain – http://www.painconcern.org.uk/neuropathic-pain Pain Concern leaflet on Diet and Pain – http://painconcern.org.uk/diet-and-pain/ IASP Global Year for the Prevention of Pain 2020 – http://www.iasp-pain.org/GlobalYear. With thanks to: The British Pain Society (BPS), who facilitated the interviews at their Annual Scientific Meeting in 2019 - britishpainsociety.org (https://www.britishpainsociety.org/) The International Association for the Study of Pain (IASP) iasp-pain.org (https://www.iasp-pain.org/) Diabetes UK, a leading UK charity that involves sharing knowledge on diabetes - https://www.diabetes.org.uk/.

Fellows Education: The first steps.

Play Episode Listen Later Aug 19, 2020 24:35

ReferencesProclaim™ DRG Neurostimulation System Clinician’s Manual. Plano, TX. 2018.Deer TR, Levy RM, Kramer J, et al. Dorsal root ganglion stimulation yielded higher treatment success rate for complex regional pain syndrome and causalgia at 3 and 12 months: a randomized comparative trial. Pain. 2017;158(4):669-681.Henderson, Jaimie M., et al. "NANS training requirements for spinal cord stimulation devices: selection, implantation, and follow‐up." Neuromodulation: Technology at the Neural Interface 12.3 (2009): 171-174.Deer, Timothy R., et al. "The Neurostimulation Appropriateness Consensus Committee (NACC) recommendations for infection prevention and management." Neuromodulation: Technology at the Neural Interface1 (2017): 31-50.Deer, Timothy R., et al. "The neurostimulation appropriateness consensus committee (NACC) safety guidelines for the reduction of severe neurological injury." Neuromodulation: Technology at the Neural Interface1 (2017): 15-30.Deer, Timothy R., et al. "The neuromodulation appropriateness consensus committee on best practices for dorsal root ganglion stimulation." Neuromodulation: Technology at the Neural Interface1 (2019): 1-35.Deer, Timothy R., et al. "Novel Intermittent Dosing Burst Paradigm in Spinal Cord Stimulation." Neuromodulation: Technology at the Neural Interface (2020).Tavel, Edward, et al. “Programming Optimization Strategies for Burst may Improve Outcomes.” NANS, Las Vegas, USA, 2017.*Smarter stimulation” described in the podcast at 15:53 is referring to neurostimulation with novel waveforms or parameters, and should not be described as “smart stimulation". Rx OnlyBrief Summary: Prior to using these devices, please review the User’s Guide for a complete listing of indications, contraindications, warnings, precautions, potential adverse events, and directions for use. The system is intended to be used with leads and associated extensions that are compatible with the system.DRGIndications for Use: US: Spinal column stimulation via epidural and intra-spinal lead access to the dorsal root ganglion as an aid in the management of moderate to severe chronic intractable* pain of the lower limbs in adult patients with Complex Regional Pain Syndrome (CRPS) types I and II.***Study subjects from the ACCURATE clinical study had failed to achieve adequate pain relief from at least 2 prior pharmacologic treatments from at least 2 different drug classes and continued their pharmacologic therapy during the clinical study.**Please note that in 1994, a consensus group of pain medicine experts gathered by the International Association for the Study of Pain (IASP) reviewed diagnostic criteria and agreed to rename reflex sympathetic dystrophy (RSD) and causalgia, as complex regional pain syndrome (CRPS) types I and II, respectively. CRPS II (causalgia) is defined as a painful condition arising from damage to a nerve. Nerve damage may result from traumatic or surgical nerve injury. Changes secondary to neuropathic pain seen in CRPS I (RSD) may be present, but are not a diagnostic requirement for CRPS II (causalgia).International: Management of chronic intractable pain.Contraindications: US: Patients who are unable to operate the system, who are poor surgical risks. Patients who have failed to receive effective pain relief during trial stimulation.International: Patients who are unable to operate the system, are poor surgical risks, are pregnant, or under the age of 18.Warnings/Precautions: Diathermy therapy, implanted cardiac systems or other active implantable devices, magnetic resonance imaging (MRI), computed tomography (CT), electrosurgery devices, ultrasonic scanning equipment, therapeutic radiation, explosive and flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery, equipment and vehicles, pediatric use, pregnancy, and case damage.Adverse Effects: Unpleasant sensations, changes in stimulation, stimulation in unwanted places, lead or implant migration, epidural hemorrhage, hematoma, infection, spinal cord compression, or paralysis from placement of a lead in the epidural space, cerebrospinal fluid leakage, tissue damage or nerve damage, paralysis, weakness, clumsiness, numbness, sensory loss, or pain below the level of the implant, pain where needle was inserted or at the electrode site or at IPG site, seroma at implant site, headache, allergic or rejection response, battery failure and/or leakage. Clinician’s Manual must be reviewed for detailed disclosure.SCSIndications for Use: Spinal cord stimulation as an aid in the management of chronic, intractable pain of the trunk and/or limbs, including unilateral or bilateral pain associated with the following: failed back surgery syndrome and intractable low back and leg pain.Contraindications: Patients who are unable to operate the system or who have failed to receive effective pain relief during trial stimulation.Warnings/Precautions: Diathermy therapy, implanted cardiac systems or other active implanted devices, magnetic resonance imaging (MRI), electrosurgery, explosive and flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery, equipment and vehicles, pediatric use, pregnancy, and case damage. Patients who are poor surgical risks, with multiple illnesses, or with active general infections should not be implanted.Adverse Effects: Unpleasant sensations, changes in stimulation, stimulation in unwanted places, lead or implant migration, epidural hemorrhage, hematoma, infection, spinal cord compression, or paralysis from placement of a lead in the epidural space, cerebrospinal fluid leakage, paralysis, weakness, clumsiness, numbness, sensory loss, or pain below the level of the implant, pain at the electrode or IPG site, seroma at IPG site, allergic or rejection response, battery failure. Clinician’s Manual must be reviewed for detailed disclosure.AbbottOne St. Jude Medical Dr., St. Paul, MN 55117 USA, Tel: 1 651 756 2000Neuromodulation.Abbott™ Indicates a trademark of the Abbott group of companies.‡ Indicates a third party trademark, which is property of its respective owner.© 2020 Abbott. All Rights Reserved.MAT-2006256 v1.0 | Item approved for global use.

The History of Neuromodulation

Play Episode Listen Later Aug 5, 2020 27:29

ReferencesProclaim™ DRG Neurostimulation System Clinician’s Manual. Plano, TX. 2018.Deer TR, Levy RM, Kramer J, et al. Dorsal root ganglion stimulation yielded higher treatment success rate for complex regional pain syndrome and causalgia at 3 and 12 months: a randomized comparative trial. Pain. 2017;158(4):669-681.Deer T, et al. The Neuromodulation Appropriateness Consensus Committee on best practices for dorsal root ganglion stimulation. Neuromodulation. 2018;22(1):1-35.Kemler, M., Barendse, G., Kleef, M., Vet, H., Rijks, C., Furnée, C., Wildenberg, F. (2000). Spinal Cord Stimulation in Patients with Chronic Reflex Sympathetic Dystrophy The New England Journal of Medicine 343(9), 618-624. https://dx.doi.org/10.1056/nejm200008313430904Harden RN, Bruehl S, Perez RS, et al. Validation of proposed diagnostic criteria (the "Budapest Criteria") for Complex Regional Pain Syndrome. Pain. 2010;150(2):268-274. doi:10.1016/j.pain.2010.04.030North, R., Kidd, D., Farrokhi, F., Piantadosi, S. (2005). Spinal Cord Stimulation versus Repeated Lumbosacral Spine Surgery for Chronic Pain: A Randomized, Controlled Trial Neurosurgery 56(1), 98-107. https://dx.doi.org/10.1227/01.neu.0000144839.65524.e0Deer T, et al. The Neuromodulation Appropriateness Consensus Committee on best practices for dorsal root ganglion stimulation. Neuromodulation. 2018;22(1):1-35.Jude Medical™ Proclaim™ Neurostimulation System Clinician’s Manual. Plano, TX 2018Deer T, Slavin KV, Amirdelfan K, et al. Success Using Neuromodulation With BURST (SUNBURST) Study: Results From a Prospective, Randomized Controlled Trial Using a Novel Burst Waveform. Neuromodulation. 2017;20(6):543-552.Stauss T, et al. A multicenter real-world review of 10 kHz SCS outcomes for treatment of chronic trunk and/or limb pain. Annals of Clinical and Translational Neurology. 2019. doi:10.1002/acn3.720. * Up to 10 years of battery longevity at the lowest dose setting: 0.6mA, 500 Ohms, duty cycle 30s on/360s off. NOTE: In neurostimulation therapy, “dose” refers to the delivery of a quantity of energy to tissue. Safety comparisons and specific dose-response curves for each dosage have not been clinically established. Refer to the IFU for additional information.Hassle-free means recharge-free.** When compared to traditional tonic stimulation.***at 22:25 Speakers are referring to causalgia, not peripheral causalgia, this is defined in the ISI, see belowRx OnlyBrief Summary: Prior to using these devices, please review the User’s Guide for a complete listing of indications, contraindications, warnings, precautions, potential adverse events, and directions for use. The system is intended to be used with leads and associated extensions that are compatible with the system.DRGIndications for Use: US: Spinal column stimulation via epidural and intra-spinal lead access to the dorsal root ganglion as an aid in the management of moderate to severe chronic intractable* pain of the lower limbs in adult patients with Complex Regional Pain Syndrome (CRPS) types I and II.***Study subjects from the ACCURATE clinical study had failed to achieve adequate pain relief from at least 2 prior pharmacologic treatments from at least 2 different drug classes and continued their pharmacologic therapy during the clinical study.**Please note that in 1994, a consensus group of pain medicine experts gathered by the International Association for the Study of Pain (IASP) reviewed diagnostic criteria and agreed to rename reflex sympathetic dystrophy (RSD) and causalgia, as complex regional pain syndrome (CRPS) types I and II, respectively. CRPS II (causalgia) is defined as a painful condition arising from damage to a nerve. Nerve damage may result from traumatic or surgical nerve injury. Changes secondary to neuropathic pain seen in CRPS I (RSD) may be present, but are not a diagnostic requirement for CRPS II (causalgia).International: Management of chronic intractable pain.Contraindications: US: Patients who are unable to operate the system, who are poor surgical risks. Patients who have failed to receive effective pain relief during trial stimulation.International: Patients who are unable to operate the system, are poor surgical risks, are pregnant, or under the age of 18.Warnings/Precautions: Diathermy therapy, implanted cardiac systems or other active implantable devices, magnetic resonance imaging (MRI), computed tomography (CT), electrosurgery devices, ultrasonic scanning equipment, therapeutic radiation, explosive and flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery, equipment and vehicles, pediatric use, pregnancy, and case damage.Adverse Effects: Unpleasant sensations, changes in stimulation, stimulation in unwanted places, lead or implant migration, epidural hemorrhage, hematoma, infection, spinal cord compression, or paralysis from placement of a lead in the epidural space, cerebrospinal fluid leakage, tissue damage or nerve damage, paralysis, weakness, clumsiness, numbness, sensory loss, or pain below the level of the implant, pain where needle was inserted or at the electrode site or at IPG site, seroma at implant site, headache, allergic or rejection response, battery failure and/or leakage. Clinician’s Manual must be reviewed for detailed disclosure.SCSIndications for Use: Spinal cord stimulation as an aid in the management of chronic, intractable pain of the trunk and/or limbs, including unilateral or bilateral pain associated with the following: failed back surgery syndrome and intractable low back and leg pain.Contraindications: Patients who are unable to operate the system or who have failed to receive effective pain relief during trial stimulation.Warnings/Precautions: Diathermy therapy, implanted cardiac systems or other active implanted devices, magnetic resonance imaging (MRI), electrosurgery, explosive and flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery, equipment and vehicles, pediatric use, pregnancy, and case damage. Patients who are poor surgical risks, with multiple illnesses, or with active general infections should not be implanted.Adverse Effects: Unpleasant sensations, changes in stimulation, stimulation in unwanted places, lead or implant migration, epidural hemorrhage, hematoma, infection, spinal cord compression, or paralysis from placement of a lead in the epidural space, cerebrospinal fluid leakage, paralysis, weakness, clumsiness, numbness, sensory loss, or pain below the level of the implant, pain at the electrode or IPG site, seroma at IPG site, allergic or rejection response, battery failure. Clinician’s Manual must be reviewed for detailed disclosure.AbbottOne St. Jude Medical Dr., St. Paul, MN 55117 USA, Tel: 1 651 756 2000Neuromodulation.Abbott™ Indicates a trademark of the Abbott group of companies.‡ Indicates a third party trademark, which is property of its respective owner.© 2020 Abbott. All Rights Reserved.MAT-2006182 v1.0 | Item approved for global use.

The evolution of DRG

Play Episode Listen Later Jul 22, 2020 30:30

Learn the history of neurostimulation, the reason Abbott’s portfolio was designed in partnership with physicians, and why Drs. Timothy Lubenow and Jason Pope had an Abbott epiphany. This new podcast series was designed to help you transition from a fellowship to practiceReferencesDeer TR, Levy RM, Kramer J, et al. Dorsal root ganglion stimulation yielded higher treatment success rate for complex regional pain syndrome and causalgia at 3 and 12 months: a randomized comparative trial. Pain. 2017;158(4):669-681. Rx OnlyBrief Summary: Prior to using these devices, please review the User’s Guide for a complete listing of indications, contraindications, warnings, precautions, potential adverse events, and directions for use. The system is intended to be used with leads and associated extensions that are compatible with the system.Indications for Use: US: Spinal column stimulation via epidural and intra-spinal lead access to the dorsal root ganglion as an aid in the management of moderate to severe chronic intractable* pain of the lower limbs in adult patients with Complex Regional Pain Syndrome (CRPS) types I and II.***Study subjects from the ACCURATE clinical study had failed to achieve adequate pain relief from at least 2 prior pharmacologic treatments from at least 2 different drug classes and continued their pharmacologic therapy during the clinical study.**Please note that in 1994, a consensus group of pain medicine experts gathered by the International Association for the Study of Pain (IASP) reviewed diagnostic criteria and agreed to rename reflex sympathetic dystrophy (RSD) and causalgia, as complex regional pain syndrome (CRPS) types I and II, respectively. CRPS II (causalgia) is defined as a painful condition arising from damage to a nerve. Nerve damage may result from traumatic or surgical nerve injury. Changes secondary to neuropathic pain seen in CRPS I (RSD) may be present, but are not a diagnostic requirement for CRPS II (causalgia).Contraindications: US: Patients who are unable to operate the system, who are poor surgical risks, or who have failed to receive effective pain relief during trial stimulation.Warnings/Precautions: Diathermy therapy, implanted cardiac systems or other active implantable devices, magnetic resonance imaging (MRI), computed tomography (CT), electrosurgery devices, ultrasonic scanning equipment, therapeutic radiation, explosive or flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery and equipment, pediatric use, pregnancy, and case damage.Adverse Effects: Painful stimulation, loss of pain relief, surgical risks (e.g., paralysis). User’s Guide must be reviewed for detailed disclosure. AbbottOne St. Jude Medical Dr., St. Paul, MN 55117 USA, Tel: 1 651 756 2000Neuromodulation.Abbott™ Indicates a trademark of the Abbott group of companies.‡ Indicates a third party trademark, which is property of its respective owner.© 2020 Abbott. All Rights Reserved.MAT-2005387 v1.0 | Item approved for Global use.

123. Opioids and Chronic Pain

Play Episode Listen Later Jul 7, 2020 29:39

Rethinking long-term pain management This edition of Airing Pain has been supported by a grant from Kyowa Kirin. The opioid crisis reached its peak in the United States in 2017, where addiction and overprescription have led to 218,000 deaths from prescription overdoses between the years of 1999 and 2017. The side effects of opioids can affect the day-to-day activities of people managing long-term or chronic pain, yet society as a whole has yet to fully evaluate the relationship between opioids and addiction. In this edition of Airing Pain, producer Paul Evans talks to two leading pain specialists. First off, Paul Evans meets with Dr Srinivasa Raja, who discusses opioids effects on the body’s opioid receptors and how the human body processes pain. Dr Cathy Stannard then talks about the increase of opioid prescriptions in the UK and how the opioid crisis in the United Kingdom developed. In the second half of the programme, Paul speaks with Louise Trewern, a chronic pain patient and patient advocate, about opioids’ detrimental effect on her quality of life and how she was able to transition towards more effective methods of chronic pain management. Finally, Paul sits down with Dr Jim Huddy, a GP in Cornwall, who explains how the medical community is re-evaluating the relationship between opioids and chronic pain. Contributors: Dr Srinivasa Raja, Professor of Anaesthesiology and Critical Care Medicine and Neurology at the Johns Hopkins University School of Medicine, Maryland, USA Dr Cathy Stannard, Consultant in Pain Medicine and Pain Transformation Programme Clinical Lead for NHS Gloucestershire Clinical Commissioning Group Louise Trewern, Vice Chair of the Patient Voice Committee at the British Pain Society Dr Jim Huddy, Cornwall GP and Clinical Lead for Chronic Pain at NHS Kernow Clinical Commissioning Group. More information: British Pain Society – http://www.britishpainsociety.org Opioid prescribing for chronic pain guidance – http://www.england.nhs.uk/south/info-professional/safe-use-of-controlled-drugs/opioids Faculty of Pain Medicine’s opioids resources – http://www.fpm.ac.uk/opioids-aware. With thanks to: The British Pain Society (BPS), who facilitated the interviews at their Annual Scientific Meeting in 2019 - britishpainsociety.org (https://www.britishpainsociety.org/) The International Association for the Study of Pain (IASP) iasp-pain.org (https://www.iasp-pain.org/) .

Why a Pain Fellows' podcast?

Play Episode Listen Later Jul 6, 2020 27:07

A podcast for pain fellows covering topics that help you transition from fellowship to practice and give you the insight you need for real-world medicine. This episode introduces our hosts and shares insights on their pain medicine fellowship experiences. Please see our important safety information here https://www.neuromodulation.abbott/us/en/important-safety-info.htmlReferencesProclaim™ DRG Neurostimulation System Clinician’s Manual. Plano, TX. 2018.Deer TR, Levy RM, Kramer J, et al. Dorsal root ganglion stimulation yielded higher treatment success rate for complex regional pain syndrome and causalgia at 3 and 12 months: a randomized comparative trial. Pain. 2017;158(4):669-681.Deer T, et al. The Neuromodulation Appropriateness Consensus Committee on best practices for dorsal root ganglion stimulation. Neuromodulation. 2018;22(1):1-35.Kemler, M., Barendse, G., Kleef, M., Vet, H., Rijks, C., Furnée, C., Wildenberg, F. (2000). Spinal Cord Stimulation in Patients with Chronic Reflex Sympathetic Dystrophy The New England Journal of Medicine 343(9), 618-624. https://dx.doi.org/10.1056/nejm200008313430904Harden RN, Bruehl S, Perez RS, et al. Validation of proposed diagnostic criteria (the "Budapest Criteria") for Complex Regional Pain Syndrome. Pain. 2010;150(2):268-274. doi:10.1016/j.pain.2010.04.030 North, R., Kidd, D., Farrokhi, F., Piantadosi, S. (2005). Spinal Cord Stimulation versus Repeated Lumbosacral Spine Surgery for Chronic Pain: A Randomized, Controlled Trial Neurosurgery 56(1), 98-107. https://dx.doi.org/10.1227/01.neu.0000144839.65524.e0 Rx OnlyBrief Summary: Prior to using these devices, please review the User’s Guide for a complete listing of indications, contraindications, warnings, precautions, potential adverse events, and directions for use. The system is intended to be used with leads and associated extensions that are compatible with the system.Indications for Use: US: Spinal column stimulation via epidural and intra-spinal lead access to the dorsal root ganglion as an aid in the management of moderate to severe chronic intractable* pain of the lower limbs in adult patients with Complex Regional Pain Syndrome (CRPS) types I and II.***Study subjects from the ACCURATE clinical study had failed to achieve adequate pain relief from at least 2 prior pharmacologic treatments from at least 2 different drug classes and continued their pharmacologic therapy during the clinical study.**Please note that in 1994, a consensus group of pain medicine experts gathered by the International Association for the Study of Pain (IASP) reviewed diagnostic criteria and agreed to rename reflex sympathetic dystrophy (RSD) and causalgia, as complex regional pain syndrome (CRPS) types I and II, respectively. CRPS II (causalgia) is defined as a painful condition arising from damage to a nerve. Nerve damage may result from traumatic or surgical nerve injury. Changes secondary to neuropathic pain seen in CRPS I (RSD) may be present, but are not a diagnostic requirement for CRPS II (causalgia).Contraindications: US: Patients who are unable to operate the system, who are poor surgical risks, or who have failed to receive effective pain relief during trial stimulation.Warnings/Precautions: Diathermy therapy, implanted cardiac systems or other active implantable devices, magnetic resonance imaging (MRI), computed tomography (CT), electrosurgery devices, ultrasonic scanning equipment, therapeutic radiation, explosive or flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery and equipment, pediatric use, pregnancy, and case damage.Adverse Effects: Painful stimulation, loss of pain relief, surgical risks (e.g., paralysis). User’s Guide must be reviewed for detailed disclosure. Abbott One St. Jude Medical Dr., St. Paul, MN 55117 USA, Tel: 1 651 756 2000 Neuromodulation.Abbott™ Indicates a trademark of the Abbott group of companies. ‡ Indicates a third party trademark, which is property of its respective owner. © 2020 Abbott. All Rights Reserved.MAT-2004708 v1.0 | Item approved for Global use.

122. The Many Faces of Research

Play Episode Listen Later May 5, 2020 29:58

Visiting the forefront of research into pain conditions This edition of Airing Pain has been supported with a grant from The Mirianog Trust donated for this purpose. It was recorded at the end of April 2020, the second month of the UK’s Covid-19 lockdown. All interviews were recorded prior to the crisis. As research for a Covid-19 vaccine is a priority for the scientific community, this edition of Airing Pain focuses on the roles of researchers, and in particular the many disciplines that come together to increase the understanding, and therefore the management of chronic pain. First up, Paul Evans speaks to neurologist Claudia Sommer, whose research into fibromyalgia opens debate as to whether the condition should be treated as neuropathic pain. Physiotherapist David Easton then talks about the research-led ESCAPE PAIN rehabilitation exercise programme for people with osteoarthritis in their hips or knees. And finally, Paul visits the University of Bristol, where neuroscientist Bridget Lumb talks of the need for further research into the link between familiar contact and social interaction with chronic pain – particularly relevant at a time of social distancing – and social anthropologist Rachael Gooberman-Hill explains the role of the anthropologist in health and pain research. Contributors: Dr Claudia Sommer, Professor of Neurology at the University of Würzburg in Germany and President-Elect of the International Association for the Study of Pain David Easton, Physiotherapist at the Hywel Dda University Health Board in West Wales Dr Bridget Lumb, Professor of Neuroscience at the University of Bristol Dr Rachael Gooberman-Hill, Professor of Health and Anthropology and Director of the Elizabeth Blackwell Institute for Health Research at the University of Bristol. More information: Fibromyalgia Action UK - fmauk.org (https://www.fmauk.org/) With thanks to: The British Pain Society (BPS), who facilitated the interviews at their Annual Scientific Meeting in 2019 - britishpainsociety.org (https://www.britishpainsociety.org/) The International Association for the Study of Pain (IASP) iasp-pain.org (https://www.iasp-pain.org/) .

director university health germany professor research united kingdom study neuroscience visiting anthropology elect international association neurology physiotherapists many faces health research paul evans annual scientific meeting pain iasp

Ep58 - "Hydrotherapy and "Chronification" of Pain" With Mariana Vera, Ph.D.

Play Episode Listen Later Nov 10, 2019 22:16

Did you now that pain isn't centralized? We don't have a center of pain. We have a process called Central Sensitization. Mariana Vera joins us today to talk about all the parts of the brain becoming more sensitive to stimuli, how acute pain transitions over time to chronic pain (Chronification), and what Hydrotherapy can do for you. ABOUT TODAY'S GUEST - Mariana Arias Avila Vera Mariana Arias Avila Vera received her Ph.D. in Physical Therapy from Federal University of São Carlos (Brazil) in 2014. She is currently Assistant Professor in the Physical Therapy Undergraduate and Graduate Program at Federal University of São Carlos, member of the International Association for the Study of Pain (IASP) and Aquatic Physical Therapy International (APTI). Her research interests are electromyography, aquatic physical therapy, chronic pain, pain management, and electrophysical agents. Note: PT - Hydrotherapy and Pain Neuroscience Research Education Studies results not out - Dec 2018

pain study assistant professor physical therapy international association graduate programs federal university hydrotherapy central sensitization pain iasp

“Hydrotherapy and “Chronification” of Pain” With Mariana Vera, Ph.D.

Play Episode Listen Later Oct 17, 2019 22:18

Did you now that pain isn’t centralized? We don’t have a center of pain. We have a process called Central Sensitization. Mariana Vera joins us today to talk about all the parts of the brain becoming more sensitive to stimuli, how acute pain transitions over time to chronic pain (Chronification), and what Hydrotherapy can do for you. Mariana Arias Avila Vera received her Ph.D. in Physical Therapy from Federal University of São Carlos (Brazil) in 2014. She is currently Assistant Professor in the Physical Therapy Undergraduate and Graduate Program at Federal University of São Carlos, member of the International Association for the Study of Pain (IASP) and Aquatic Physical Therapy International (APTI). Her research interests are electromyography, aquatic physical therapy, chronic pain, pain management, and electrophysical agents. Note: PT – Hydrotherapy and Pain Neuroscience Research Education Studies results not out – Dec 2018

pain study assistant professor physical therapy international association graduate programs federal university hydrotherapy central sensitization pain iasp

Episode 04: Acute Pain

Pain Talk

Play Episode Listen Later Aug 28, 2019 24:37

The International Association for the Study of Pain (IASP) defines acute pain as the normal, predicted physiological response to an adverse chemical, thermal, or mechanical stimulus whereas chronic pain is “pain without biological value that has persisted beyond the normal tissue healing time greater than 3 months”.

study international association acute pain pain iasp

Ep23 - "Hydrotherapy and 'Chronification' of Pain" with Mariana Vera, Ph.D.

Play Episode Listen Later Apr 27, 2019 23:58

Did you now that pain isn't centralized? We don't have a center of pain. We have a process called Central Sensitization. Mariana Vera joins us today to talk about all the parts of the brain becoming more sensitive to stimuli, how acute pain transitions over time to chronic pain (Chronification), and what Hydrotherapy can do for you. Mariana Arias Avila Vera received her Ph.D. in Physical Therapy from Federal University of São Carlos (Brazil) in 2014. She is currently Assistant Professor in the Physical Therapy Undergraduate and Graduate Program at Federal University of São Carlos, member of the International Association for the Study of Pain (IASP) and Aquatic Physical Therapy International (APTI). Her research interests are electromyography, aquatic physical therapy, chronic pain, pain management, and electrophysical agents. Note: PT - Hydrotherapy and Pain Neuroscience Research Education Studies results not out - Dec 2018 Wayne

pain study assistant professor physical therapy international association graduate programs federal university hydrotherapy central sensitization pain iasp

“Hydrotherapy and ‘Chronification’ of Pain” with Mariana Vera, Ph.D.

The Healthcare Education Transformation Podcast

Play Episode Listen Later Jan 24, 2019 24:01

EPISODE 23 ft. Mariana Vera, Ph.D. – Did you now that pain isn’t centralized? We don’t have a center of pain. We have a process called Central Sensitization. Mariana Vera joins us today to talk about all the parts of the brain becoming more sensitive to stimuli, how acute pain transitions over time to chronic pain (Chronification), and what Hydrotherapy can do for you. Mariana Arias Avila Vera received her Ph.D. in Physical Therapy from Federal University of São Carlos (Brazil) in 2014. She is currently Assistant Professor in the Physical Therapy Undergraduate and Graduate Program at Federal University of São Carlos, member of the International Association for the Study of Pain (IASP) and Aquatic Physical Therapy International (APTI). Her research interests are electromyography, aquatic physical therapy, chronic pain, pain management, and electrophysical agents. Note: PT – Hydrotherapy and Pain Neuroscience Research Education Studies results not out – Dec 2018 Wayne

pain study assistant professor physical therapy international association graduate programs federal university hydrotherapy central sensitization pain iasp

Bronnie Thompson- A Unique International Inter-professional Education Program

Play Episode Listen Later Dec 26, 2018 52:24

Dr. Bronnie Thompson comes onto HET Podcast to chat about how she teaches the International Association for the Study of Pain (IASP) curriculum into a unique international interdisciplinary program along with discussing how she teaches pain to groups of patients in New Zealand. Bronnie's Email Address: bronnietnz@gmail.com Bronnie's Website & Blog: https://healthskills.wordpress.com/ Bronnie's University Profile: https://www.otago.ac.nz/healthsciences/expertise/profile/index.html?id=1773 Bronnie's Twitter Page: https://twitter.com/adiemusfree Master of Health Sciences endorsed in Pain and Pain Management from the University of Otago: https://www.otago.ac.nz/christchurch/study/postgraduate/otago011631.html International Association for the Study of Pain Website: https://www.iasp-pain.org/ San Diego Pain Summit Website: https://www.sandiegopainsummit.com/ Motivational Interviewing Website: https://motivationalinterviewing.org/ Kevin Polk's Website: http://www.drkevinpolk.com/ Kevin Polk Videos on YouTube: https://www.youtube.com/user/DrKevinPolk Russ Harris's Website: https://www.actmindfully.com.au/ Russ Harris's YouTube Page: https://www.youtube.com/channel/UC-sMFszAaa7C9poytIAmBvA Clip from Bronnie's Presentation on "Getting From "Perhaps" To "Yes": Motivation, Confidence And Communication" at the 2016 San Diego Pain Summit: https://www.youtube.com/watch?v=YyVr1AQ-y3k Bronnie's Interview on the Modern Pain Podcast: https://itunes.apple.com/us/podcast/modern-pain-podcast-episode-4-interview-bronnie-thompson/id1435013970?i=1000418987399&mt=2 Bronnie's Interview on The Physio Matters Podcast: https://itunes.apple.com/us/podcast/session-21-fathoming-fibromyalgia-dr-bronnie-thompson/id785762010?i=1000351510267&mt=2 Bronnie's Interview on The Pelvic Health Podcast: https://itunes.apple.com/us/podcast/graded-exposure-drs-sandy-hilton-bronnie-lennox-thompson/id1022705760?i=1000416545258&mt=2 Bronnie's Interview on The Healing Pain Podcast: https://itunes.apple.com/us/podcast/episode-77-dr-bronnie-lennox-thompson-how-to-live-life/id1112764695?i=1000405608266&mt=2 Bronnie's 1st Interview on the Healthy, Wealthy & Smart Podcast:https://itunes.apple.com/us/podcast/176-living-well-w-chronic-pain-w-dr-bronnie-thompson/id532717264?i=1000354627788&mt=2 Bronnie's 2nd Interview on the Healthy, Wealthy & Smart Podcast:https://itunes.apple.com/us/podcast/177-living-well-w-chronic-pain-part-2-w-dr-bronnie-thompson/id532717264?i=1000354839842&mt=2 Bronnie's 3rd Interview on the Healthy, Wealthy & Smart Podcast:https://itunes.apple.com/us/podcast/234-dr-bronnie-thompson-living-well-w-chronic-pain/id532717264?i=1000376757639&mt=2 The PT Hustle Website: https://www.thepthustle.com/ Schedule an Appointment with Kyle Rice: www.passtheptboards.com HET LITE Tool: www.pteducator.com/het Anywhere Healthcare: https://anywhere.healthcare/ (code: HET) Biography: Bronwyn Lennox Thompson initially trained as an occupational therapist, graduating 1984. She later completed her MSc with first class honours in Psychology in 1999 at Canterbury University, and in 2015 was awarded her PhD from the Department of Health Sciences at the University of Canterbury, Christchurch, New Zealand. She has worked in pain management for most of her clinical career, with her primary focus on pain management at work. She has practiced in interdisciplinary pain management programs, private practice, case management both for private organizations, and ACC, primary prevention and secondary prevention, and since 2002, teaching postgraduate papers in pain and pain management at Otago University. Her main interest areas include pain and anxiety, motivation for self-management, resilience and daily coping choices. The effect of her occupational therapy training has never fully left Bronwyn's aims in pain management. Occupational therapy has always targeted function, or the ability to fulfill life roles despite limitations. In the same way, Bronwyn's goals for pain management are to help people reduce the functional impact of pain and improve their engagement in living life to the full.

university master interview stress pain phd international psychology healthy study new zealand resilience unique coping presentation appointments acc msc physical therapy chronic pain christchurch international association health sciences clip physical therapists canterbury pain management noi physiotherapy physiotherapists occupational bronwyn otago education programs russ harris professional education otago university website blog bronnie canterbury university iasp pain iasp healing pain podcast san diego pain summit choosept bronnie thompson

IGCT Episode #260: Dr. Nikos Apostolopoulos "Less is More - microStretching"

Iron Game Chalk Talk with Ron McKeefery

Play Episode Listen Later May 17, 2018 41:42

For Show Notes and Coach McKeefery's Website - http://www.RonMcKeefery.com Now Available on iTunes http://bit.ly/1bPlMei Pick up your copy of Coach McKeefery's #1 Amazon International Bestseller "CEO Strength Coach" - http://www.CEOStrengthCoach.com Please “Thank” our sponsors who bring this show to you for free:PLAE - http://plae.us/Samson - https://www.samsonequipment.comIron Grip - http://www.irongrip.com/Intek - https://intekstrength.com/Train Heroic - http://trainheroic.com/Gym Aware - https://kinetic.com.au/gymaware.htmlWoodway - http://www.woodway.com/Versa Pulley - http://versaclimber.com/vp-versapulley/ Dr. Nikos Apostolopoulos is the Founder and Developer of microStretching® and Stretch Therapy®. He is the Director of the microStretching Clinic, the first in the world to pioneer the development of therapeutic and performance enhancement microStretching®. This recovery regeneration technique, based on functional-clinical anatomy, has been used to treat many professional, elite, and amateur athletes, as well as individuals suffering from various musculoskeletal disorders. Dr. Apostolopoulos graduated from the University of Wolverhampton (PhD - Muscle Physiology and Inflammation) and the University of Toronto (BPHE - Sports Medicine). He is a member of the International Association for the Study of Pain (IASP) and the International Society of Exercise and Immunology (ISEI). He has lectured and worked internationally as a consultant and therapist to various sports organizations and federations. Specialties: Recovery-Regeneration Specialist In This Episode We Discuss: What experience in his journey impacted him the most, and Why.Biggest mistake he has made and how he learned from it.Best practices for recovery and regeneration. The principles behind microStretching. Mental side of prepping between training sessions. Best piece of coaching advice he has ever received.His favorite quote, Book/App/Website recommendation.

director university founders study exercise developers inflammation international association international society nikos plae train heroic stretch therapy pain iasp coach mckeefery's website

IGCT Episode #260: Dr. Nikos Apostolopoulos "Less is More - microStretching"

Iron Game Chalk Talk 2.0

Play Episode Listen Later May 17, 2018 41:42

director university founders study exercise developers inflammation international association international society nikos plae train heroic stretch therapy pain iasp

98. IASP Global Year for Excellence in Pain Education and the Benefit of Pain Management Programmes