Practical Pain Management

Scenario: Patient with Sickle Cell Crisis Seeks Relief for Acute Pain in the ED Patient BM* is a 39-year-old man with sickle cell disease who presents to the ED with pain in both his arms and legs, which he describes as achy and throbbing. He shares that the pain started the prior night and felt like the usual pain crises that he typically experiences. The pain continued despite taking his home dose of oxycodone/paracetamol (Percocet 10/325mg). He endorsed 10/10 pain.

Thirty-five years ago, the term was coined.1 “I suggested the term ‘sarcopenia’ in a summation talk at a meeting on aging epidemiology in Albuquerque in 1988,” Irwin Rosenberg, MD, professor emeritus of pharmacology and experimental therapeutics at Tufts University School of Medicine, recalled.“ Those remarks were published in 1989.”1 Dr. Rosenberg utilized two Greek words: sarx for flesh and penia for reduced or deficient.

Visits to pain clinics specifically designed for older adults were associated with improvements in pain and pain interference, based on data from 67 pain service centers for older adults in Australia and New Zealand.¹ Multidisciplinary pain clinics have shown effectiveness in managing chronic pain, but data on specific outcomes for older adults are limited, wrote Nancy Chen, MBBS, of Austin Health, Heidelberg, Victoria, Australia, and colleagues.

Jennifer Crow, of Tennessee, spent her Independence Day weekend resting, she says, “in too much pain to do anything.” After the U.S. Supreme Court decision overturning Roe v. Wade, her pharmacy wouldn’t fill her prescription for methotrexate, a medication taken by Crow and millions of people with rheumatoid arthritis (and other forms of inflammatory arthritis), lupus, and cancer.

More than ever, healthcare providers are seeking opioid alternatives with low risk of addiction that are safe and effective for managing chronic pain. Some alternative therapies being researched are psychedelic drugs including MDMA (3,4-methylenedioxymethamphetamine) and psilocybin. Understanding how these drugs could work in a clinical setting may provide benefits when treating people with chronic pain. Herein, we look at MDMA and psilocybin.

The 64th annual American Headache Society (AHS) Scientific Meeting held in June 2022 in Denver, CO, had a rich menu of neuroscientific topics. The event is organized by the headache specialists who herald primarily from the specialty of neurology, but this community also includes clinicians of other medical specialties with an interest in migraine disease as well as postdoctoral and medical students.

Magnesium in the Body: A Brief Background Magnesium is a chemical element that is found throughout nature, including the earth’s crust, foods, and in the human body. An adequate magnesium supply is important for human bone structure and cellular reactions, including nerve impulses.¹ Humans obtain magnesium through various food sources, such as legumes, whole grains, seeds, dairy, chocolate, meat, and coffee.

More than 20 million people in the United States suffer from peripheral neuropathy. Neuropathic pain can be caused by any damage to the somatosensory nervous system, potentially affecting both the peripheral and central nervous systems.¹ There is no specific diagnostic test that can confirm neuropathic pain with 100% accuracy, making the best diagnostic approach the patient interview, identification of underlying causes, and exclusions.

Migraine with aura is a neurological phenomenon characterized by visual disturbances and less commonly sensory, speech, and/or motor symptoms that generally precede the headache onset.