REPOST: Are you getting pain meds you don’t need?

A new report reveals that patients hospitalized for reasons other than surgery were given opioid pain medications, some of which are more than what is typically prescribed, thus running the risk of overdose. Cindy Kuzma of Fox News looks into the overuse of potent painkillers in the article below.

Image source: Fox News

Oxycontin. Vicodin. Percocet. Opiates like these can make the agony of surgery or cancer more bearable. But potent painkillers come with serious risks—namely addiction and even death.

That’s why health experts have repeatedly warned against their overuse—especially for those with less-severe complaints. But a new report raises questions about whether people are listening.

The findings: Researchers at Beth Israel Deaconess Medical Center in Boston analyzed the records of more than 1 million patients hospitalized for reasons other than surgery, finding that more than half were given some opioid pain medications, such as codeine, morphine, or oxycodone. Of those, one-quarter received the equivalent of 100 milligrams of morphine at one time—enough to pose the risk of overdose, says study author Dr. Shoshana Herzig.

The study couldn’t assess exactly whether all these doses were needed. However, the high rate suggests at least some of them weren’t.

Why We’re So Drugged Up
Doctors have good reasons for doling out these doses. National medical organizations have instructed them to treat pain as a vital sign just like blood pressure or heart rate, Dr. Herzig says. And no physician wants a rep as someone who ignores suffering, says Dr. Kenneth Candido, an anesthesiologist at Advocate Illinois Masonic Medical Center in Chicago.

You play a role, too. No stethoscope or lab test can measure pain, so doctors typically ask you to report your discomfort levels on a scale of 1 to 10. Many people struggle to assign a number to agony—everyone experiences pain differently and some tolerate it better than others, Dr. Candido explains. More often than not, patients exaggerate their pain—sometimes on purpose, to get more of the numbing, mind-altering effects of these drugs, Dr. Candido says.

High doses may also stem from patients failing to tell their doctors about prescription or illegal drugs they’re taking at home, he says. And if you doc doesn’t know what you’re pumping into your bloodstream, he may be more likely to write a script. But you should tell your doc of habits at home: Drugs like Valium or even heavy drinking can interact dangerously with narcotics, or make you resistant to their pain-killing effects.

Know this: If your pain is so searing you can’t tolerate it—and milder drugs or techniques don’t help—opioids could be your best choice. But often, that’s not the case. Protect your own health with these suggestions:

• Ask whether your hospital employs pain physicians. These doctors have special training in both using narcotics properly and offering alternatives for pain relief, including nerve blocks and distraction techniques. “Not every doctor has these tools in their armamentarium,” Candido says.

• Some doctors assume once you’re in the hospital, your pain is severe, Herzig says. But in many cases, plain old ibuprofen might actually work better since it treats swelling and inflammation. Ask if there are other options—you’ll take your doc off autopilot.

• About one-fourth of all the patients in the study got a dose of opiates on the day they left the hospital, suggesting they may have walked out with a prescription, Herzig says. Before you fill a script, make sure your doctor has run it through the state-monitoring database. This will cut down on too-high doses.

And while you're at it, make sure you know the top 10 Questions Every Man Must Ask His Doctor.

 Pain physicians like Dr. Melanie Novak have special training in both using narcotics and offering alternatives for pain relief. Get tips on proper pain management from this Twitter account.

REPOST: How Your Knees Can Predict the Weather

Many people who suffer from arthritis and migraine believe that their condition worsens during weather changes. Well, they could be right. The Wall Street Journal reports that scientists have found a link between pain symptoms and weather patterns. 

Image Source: online.wsj.com

The Wolff family of Paramus, N.J., was eyeing the gathering clouds and debating whether to cancel a planned park trip when 6-year-old Leora piped up with an idea: "Let's call Grandma. Her knees always know when it's going to rain!"

Leora's grandmother, Esther Polatsek, says she started being sensitive to the weather in her 20s, when a fracture in her foot would ache whenever a snowstorm approached. Now 66 and plagued by rheumatoid arthritis, Mrs. Polatsek says she suffers flare-ups whenever the weather is about to change.

"It's just uncanny. Sometimes it'll be gorgeous out, but I'll have this awful pain. And sure enough, the next morning it rains," she says. "It may be just a few drops, but it makes my body crazy."
Do weather conditions really aggravate physical pain?

It is one of the longest running controversies in medicine.

Hippocrates in 400 B.C. noticed that some illnesses were seasonal. The traditional Chinese medicine term for rheumatism (fengshi bing) translates to "wind-damp disease."

But modern scholars have gotten inconsistent results in studies that tried to match weather patterns to reported pain symptoms—leading some to dismiss the connection as highly subjective or all in sufferers' minds.

"People's beliefs about arthritis pain and the weather may tell more about the workings of the mind than of the body," concluded the late Stanford psychologist Amos Tversky in the mid-1990s, after comparing the pain reports of 18 rheumatoid-arthritis patients with local weather conditions for a year and finding no connection.

Still, other studies have linked changes in temperature, humidity or barometric pressure to worsening pain from rheumatoid arthritis and osteoarthritis, as well as headaches, tooth aches, jaw pain, scar pain, low-back pain, pelvic pain, fibromyalgia, trigeminal neuralgia (a searing pain in the face), gout and phantom-limb pain.

Scientists don't understand all the mechanisms involved in weather-related pain, but one leading theory holds that the falling barometric pressure that frequently precedes a storm alters the pressure inside joints. Those connections between bones, held together with tendons and ligaments, are surrounded and cushioned by sacs of fluid and trapped gasses.

"Think of a balloon that has as much air pressure on the outside pushing in as on the inside pushing out," says Robert Jamison, a professor of anesthesia and psychiatry at Harvard Medical School. As the outside pressure drops, the balloon—or joint—expands, pressing against surrounding nerves and other tissues. "That's probably the effect that people are feeling, particularly if those nerves are irritated in the first place," Dr. Jamison says.

Not everyone with arthritis has weather-related pain, says Patience White, a rheumatologist at George Washington University School of Medicine and a vice president of the Arthritis Foundation. "It's much more common in people with some sort of effusion," an abnormal buildup of fluid in or around a joint that frequently occurs with inflammation.

Many patients swear that certain weather conditions exacerbate their pain. Consequently, orthopedists, rheumatologists, neurologists, family physicians, chiropractors, physical therapists—even personal trainers—report an increase in grousing among their clients when the temperature drops or a storm approaches.

"I can tell you emphatically there are certain days where practically every patient complains of increased pain," says Aviva Wolff, an occupational therapist at the Hospital for Special Surgery in New York City, and Mrs. Polatsek's daughter. "The more dramatic the weather change, the more obvious it is."

Both the Weather Channel and AccuWeather have indexes on their websites that calculate the likelihood of aches and pains across the country, based on barometric pressure, temperature, humidity and wind. Changes in those conditions tend to affect joints even more than current conditions do, says AccuWeather meteorologist Michael Steinberg, which is why the Arthritis Index shows more risk the day before a storm or a sharp drop in temperature is forecast.

Image Source: online.wsj.com

 Some sufferers say their joints can be more accurate than meteorologists. Rheumatoid-arthritis sufferer Bill Balderaz, 38, president of a digital-marketing firm in Columbus, Ohio, recalls feeling "the worst arthritis pain I've ever had—I could barely move" one day last year, even though it was sunny and clear. By midafternoon, a land-based hurricane known as a derecho with 80 mile-per-hour winds unexpectedly buffeted Ohio and three other states, traveling 600 miles in 10 hours and knocking out power for 10 days. "The storm caught everyone off guard. It was clear one minute and then the skies opened up," Mr. Balderaz says.

Tests on animals seem to bear out the impact of weather. In one study, guinea pigs with induced back pain exhibited signs of increased pain by pulling in their hindpaws in low barometric pressure.

Cold weather seems to raise the risk of stroke, heart attacks and sudden cardiac death, some research shows. Heart-attack risk rose 7% for every 10 degrees Celsius (18 degrees Fahrenheit) drop in temperature, according to a study of nearly 16,000 patients in Belgium, presented at the European Society of Cardiology last month. British researchers studying years of data on implanted defibrillators found that the risk of ventricular arrhythmia—an abnormal heart rhythm that can lead to sudden death—rose 1.2% for every 1.8 degrees Fahrenheit drop, according to a study in the International Journal of Biometerology last month.

Once blamed on physically demanding tasks like shoveling snow, the increased heart risk due to cold may be due to thickening blood and constricting blood vessels, researchers think.

And rising humidity may cause joints to swell and stiffen. In fact, tendons, ligaments, muscles, bones and other tissues all have varying densities, so they may expand or contract in different ways in changing conditions, Dr. Jamison says.

In people with chronic inflammation from arthritis or past injuries, even slight irritations due to the weather can aggravate sensory nerve cells, known as nociceptors, that relay pain signals to the brain. That may explain why some people with neuropathic pain and phantom-limb pain also report weather-related flare-ups.

"Fibromyalgia patients seem to be the most sensitive," says Susan Goodman, a rheumatologist at the Hospital for Special Surgery. She also notes that while some people seem to be extremely sensitive to weather, others with similar conditions aren't, for reasons that aren't clear. That may explain why many studies find no clear association, she says.

Some weather conditions seem to relieve pain. In one study, the warm, high-pressure Chinook winds common to western Canada lessened patients' neuropathic pain, the kind brought on by disease or injury. For other patients, the same climate increased migraines and sinus headaches.

Some pain sufferers say they feel better in warm, dry climates where weather conditions seldom change. When she went to Israel in the 1990s, "I felt like I was 20 years younger when I stepped off the plane," says Mrs. Polatsek, the rheumatoid-arthritis patient.

But studies haven't consistently borne out the benefits of one climate over another. "There really is no place in the U.S. where people report more or less weather-related pain," says Dr. Jamison. He surveyed 557 arthritis sufferers in four cities in 1995 and found that more than 60% believed the weather affected their pain—regardless of whether they lived in San Diego, Boston, Nashville, Tenn., or Worcester, Mass.

Visiting a warm, dry climate may bring temporary relief, Dr. Jamison adds. "But if you live there full time, your body seems to acclimatize and you become sensitive to even subtle weather changes." 

Dr. Melanie Novak specializes in the diagnosis and treatment of various types of pain, including arthritis and migraine. This website provides more information on pain management.

REPOST: The shocking, stabbing pain disorder you've never heard of

About 12 out of 100,000 people are affected by trigeminal neuralgia, a facial pain disorder.  Seeking to promote awareness on the disease, patients organized the International Trigeminal Neuralgia Awareness Day, which took place on October 7.  Read this article from CNN for the story:

(CNN) -- Imagine shocks radiating across your cheek, a knife cutting into your skin or the feeling of hot coal burning your face, but not being able to find relief from the pain for months, or even years.

That's what some trigeminal neuralgia patients say they endure on a regular basis.

Trigeminal neuralgia is a facial pain disorder associated with the trigeminal nerve, which carries sensation from your brain to your face. Slight touches to the face, whether it's a breeze, hair falling onto your temple or simply brushing your teeth, may trigger flashes of pain. The pain is most commonly caused by a blood vessel pushing on the trigeminal nerve. There is no cure.

It affects approximately 12 out of every 100,000 people per year, according to the National Institute of Health, and is more common in women and people over 50.

 

iReporter Leslie Martella and her son Garrett Buckelew, then 12, before his first trigeminal neuralgia surgery. Image Source: www.cnn.com

"Trigeminal neuralgia is an uncommon disease and as a result, most physicians have very little experience with it. That is one of the reasons it's difficult to diagnose," said Ronald Brisman, a New York neurosurgeon who specializes in the disorder.

The unbearable pain and search for a cure, as well as the medical field's unfamiliarity with the disorder, has led a group of about 30 trigeminal neuralgia patients to fight for awareness. Several of them, in addition to others with the disorder, started by sharing their personal stories with CNN iReport.

'I want to imagine a world where nobody has ... this pain'

Nikki Samuel is one of those people. Her goal is to educate others about the disease, as well as let people know about the first International Trigeminal Neuralgia Awareness Day on October 7. Dozens of buildings and structures across the world are lighting up teal for the day.

 

Nikki Samuel on her 40th birthday last year. Image Source: www.cnn.com

"If we know that somebody, somewhere is looking for a cure and not just another medication or an even more invasive, risky procedure, it gives us hope," she wrote in her iReport. "I want to imagine a world where nobody has to survive with this pain."

Samuel started experiencing the facial pain in 2005 and was diagnosed with Atypical Facial Pain. A variety of medications were ineffective and in 2008, the registered nurse from Leicester, England, admitted defeat and resigned from her job.

"I had achieved my dream and there it was, being taken away from me by this relentless, debilitating pain," she said.

It was seven years from her first pangs of pain before she was diagnosed with trigeminal neuralgia. As a way to cope, the 41-year-old has turned to online support groups.

"My online friends have been my lifeline," she said. "Trigeminal neuralgia has taken away many things, but it has given me the chance to 'meet' some amazing people and to make lifelong friendships."

'I have forgotten what a pain-free day feels like'

One of the people Samuel met online was Fred Gerwig, a former high school history teacher from rural West Virginia. Samuel's bravery inspired him to write about his experience, Gerwig said.

 

Fred Gerwig on a good day in March, relatively free of pain. Image Source: www.cnn.com

Leaving his classroom on September 7, 2011, the sunlight seared his eyes, bringing on what he thought was his first migraine. The searing pain never left.

After getting lidocaine injections to treat the migraine a month later, he said he started experiencing strange facial pains.

"There were shocks and pangs in my right cheek," he wrote on CNN iReport. "It felt as if a hot coal was lying on my right eye socket."

Since then, wind, noise and even a random touch have all intensified his never-ending pain.

Gerwig was later diagnosed with two disorders: "atypical" trigeminal neuralgia and a persistent unilateral headache on the same side. The "atypical" form of the disorder is marked by constant aching, burning and pain, according to the National Institute of Neurological Disorders and Stroke.

Numerous migraine and anti-seizure drugs haven't worked for him, and he's not a prime candidate for surgery to relieve pressure on his nerve. There aren't any blood vessels pushing on the trigeminal nerve, so the cause of his case is unknown.

"I have now forgotten what a pain free day feels like, and that changes you," said the stay-at-home dad. "You lose parts of yourself. You lose friends and family that can't deal with the fact that they cannot give you a hug, say a prayer and make you better."

'Watching him suffer has broken me'

Leslie Martella has crossed the country trying to find relief for her 16-year-old son, Garrett Buckelew. He was diagnosed with trigeminal neuralgia when he was 11, she said.

"Watching him suffer has broken me," the mother said. "Garrett used to be an all-star baseball player, gifted student with high academic scores and awards, with tons of friends, and now he barely leaves our home."

Buckelew has had four surgeries to alleviate his pain, and four more surgeries after a complication occurred during one of the procedures.

"Trigeminal neuralgia has taken over our lives and is relentless," she said. "It has robbed my child of his life."

The Huntsville, Alabama, mom wishes people knew about the real pain that patients with this invisible illness experience.

"If Garrett walked around with a hatchet sticking out of his face, then people would get it, but trigeminal neuralgia is invisible, and I hate it."

'I am a trigeminal neuralgia warrior'

When a flash of pain shot from her eye to her jaw one day in 1998, Patti SanFilippo hurried to the mirror looking for a mark on her face. There was nothing there.

The Bloomsburg, Pennsylvania, resident tried to describe the pain to her doctor, but she felt like a lunatic. She spent five years struggling to find answers before she was diagnosed.

Even after multiple medications and surgeries to treat the disorder, none have helped ease her facial pain.

"A typical day in my life knows no real time and follows no structure. Pain wins over all else and many days are spent in bed," she said. "I have missed many family functions, important birthdays and reunions with friends because the pain won on those days."

To stay positive, SanFilippo calls herself a "trigeminal neuralgia warrior." Surviving the "horrendous pain, the harsh medications and lack of awareness" has inspired her to fight for help and understanding of this outwardly invisible disorder.

"If my story has been read and shared then I know I did my part to start people learning, talking about and becoming more aware that such an evil condition exists and needs attention so desperately," she said. "It's hopefully just the beginning, there is still so much that needs to be done."

Melanie Novak, MD, specializes in the diagnosis and treatment of various types of pain, including complex regional pain syndrome (CRPS), sciatica, joint discomfort, and bursitis, among others.  Visit this Facebook page for more updates on her practice.

REPOST: September is Pain Awareness Month

The healthcare industry has attempted to raise awareness about different diseases and conditions by assigning a day or month each year to learning more about the illness.  The month of September is Pain Awareness Month.  The American Chronic Pain Association posts this article as a reminder on their website.

The month of September has been declared Pain Awareness Month.  Pain Awareness Month is a time when various organizations work to raise public awareness of issues in the area of pain and pain management. 

The first Pain Awareness Month was in 2001, when the ACPA led a coalition of groups to establish September as Pain Awareness Month.  ACPA established Partners for Understanding Pain and 80 organizations, both health care professionals and consumer groups, including the NAACP supported the effort. 

The key to raising awareness is to get involved.   There are many things that you can do to help promote Pain Awareness Month.

• Talk with Friends & Family:  Let them know that September is Pain Awareness Month.  “Like” the ACPA on Facebook.  Encourage your friends to do the same
•  Talk with your Healthcare Provider: Let them know that September is Pain Awareness Month.  You also can share the tools to better communicate with your healthcare team found at the links below:
  • What We Have Learned
  • Going to the ER
  • Communication Tools
  • Pain Management Programs
  • Videos
  • Resources
  • FAQs
  • Glossary
  • Surveys
• Call your local government and community leaders to let them know about Pain Awareness Month and issues of pain and pain management.  Tools to communicate with governmental and community leaders are available Click Here
• Call your local media and ask them if they are doing a story on Pain Awareness Month. Tools to communicate with media can be found here 
• Donate to the ACPA: Your contributions allow us to help fulfill our mission  and work year-round to raise awareness and support for those with chronic pain. Click here to donate
• Take care of yourself!  Take time out for yourself this month.  Tools to help take care of yourself are below:
  • Relaxation Video
  • ACPA Communication tools to increase your interaction with your health care professional.
  • Medication Safety Video

Dr. Melanie Novak treats patients who suffer from chronic pain using a range of medication, injection treatments and therapy. Read more about managing pain on this blog.

The power of touch: Massage as a pain reliever

There’s more than just a touch of truth in the pain relieving effects of massages. According to health experts, massages that are performed properly can alleviate aches and help the body cope with pain.

Image Source: fibromyalgiabodypain.com

For several millennia, massage therapy has been used to relieve pain. Thought to have originated from the natural human tendency to rub aching parts of the body, different forms of massage therapy have been used by people from ancient China, Japan, India, Egypt, Greece, Rome, and a number of Arabic nations. Despite advances in medical technologies in modern times, massages remain popular therapies for pain, especially among athletes who experience muscle aches at an almost regular basis.

Image Source: bodywisewellbeing.com.au

The power of massage works in different ways. For one, it increases and enhances the flow of blood to affected muscles and joints, helping warm them and facilitating faster administration of the body’s natural pain killers. It also triggers the release of oxytocin, a hormone that promotes the feeling of contentment and muscle relaxation, among other things.

Image Source: menshealth.com

Massage also raises the levels of endorphins and serotonin—powerful pain relievers and mood regulators naturally produced by humans. Additionally, it reduces the amount of stress hormones present in the body. As such, people going through massage therapy experience reductions in pain and anxiety.

Massage is considered ideal for people suffering from back pain, tension, headaches, fibromyalgia, neck pain, and post-surgery discomfort. However, for safety purposes, prior consultations with doctors are best to determine which type of massage applies to one’s condition and how it must be administered.

Dr. Melanie Novak, MD, specializes in pain management. Follow this Twitter page for information about body pains and how they could be relieved naturally.

REPOST: Aspirin every other day may prevent colon cancer

So far, the American Cancer Society has ruled against taking aspirin daily to lower the risk of cancer. But such stance might soon change as researchers from Brigham and Women's Hospital discovered that taking aspirin every other day may help prevent colorectal cancer. So is aspirin the new go-to pill for cancer prevention? Read the full article below.





Image source: cnn.com

Many studies have touted the benefits of aspirin, and the latest one has good news for women.

This new research shows that low-dose aspirin may serve as a protection against colorectal cancer. The study was based on a long-term trial in a large group of women, who have been underrepresented in studies on this topic, said lead author Nancy R. Cook, associate biostatistician at Brigham and Women's Hospital and professor at Harvard Medical School. The study is being published this week in the journal Annals of Internal Medicine.

This builds on a significant body of research showing the potential preventative properties of aspirin in many cancers such as melanoma. This study did not find a strong link between aspirin and preventing any other kinds of cancer during the 18-year period, however.

None of this means that aspirin is right for everyone. Always consult a doctor before starting a new medical routine.

The study:

The study included nearly 40,000 women 45 and older who were part of the Women's Health Study. About 34,000 participated in follow-up. Researchers followed the women for up to 18 years from the start of the study.

The study participants were randomly assigned to either take 100 milligrams of aspirin or a placebo every other day. The alternate-day strategy was intended to reduce the side effects of aspirin, Cook said.

Some participants also took vitamin E on the nonaspirin days; the others took a placebo.

Colon cancer spotted by blood test

The results:

In the first 10 years, the researchers did not find an association between aspirin use and colorectal cancer; there seemed to be no benefit over taking a placebo.

But in women who were followed for longer than 10 years, the benefits of taking aspirin became clear: Between 10 to 18 years after the start of the study, researchers observed a 42% reduction in colorectal cancer in the group that was taking aspirin, relative to the women who were not. That averages out to about a 20% reduction over the length of the study.

Researchers did not find that age or other factors were significantly associated with the study results. Socioeconomic status was balanced between the group taking aspirin and those who received placebos.

Other studies have also found a delayed effect in aspirin's preventative properties, Cook said. Cancer usually takes about 10 years to develop from its early stages. It's possible that aspirin delays the formation of polyps, she said. Some studies have suggested that higher doses of aspirin have a shorter latent period - in other words, less time passes before the preventative benefits are seen.

On the downside, women taking aspirin were more likely to develop gastrointestinal bleeding and peptic ulcers, based on the information that women reported about themselves.

The researchers did not find any cardiovascular benefit to taking aspirin every other day, contrary to the preventative properties of aspirin against heart attack and stroke that have been found in many other studies, especially in men.

"We're not quite sure if it was because it was the low dose or because it's different in women than men," Cook said.

Similarly, although other studies have found that aspirin may prevent other kinds of cancers, this study did not find associations with any other kind of cancer. This could also be because of the low dose, but more research would need to be done to confirm.

No benefit to the vitamin E, taken every other day, was observed.

Conclusions:

This study adds to a large body of research that already established the potential of aspirin to prevent colon cancer, which had mostly been shown in men, Cook said. This study highlights the drug's protective potential in women.

Those with an elevated risk of the disease - for instance, a family history of colorectal cancer, or frequent polyps - should consider aspirin, Cook said.

Cook doesn't advocate taking aspirin every other day; daily is easier to remember. But consider the possible downsides as well. Aspirin increases the risk of bleeds; in rare cases, it can promote hemorrhagic stroke or gastrointestinal hemorrhage, Cook said. More commonly, peptic ulcer or gastric upset may occur.

In an accompanying editorial, Dr. Peter Rothwell of Oxford University noted the findings reinforce the idea that risks and benefits of aspirin should be considered separately in men and women.

"People really need to balance risks and benefits, and discuss with doctor whether they should be taking it," Cook said.


Dr. Melanie Novak believes that there’s no substitute to a multidisciplinary approach to health care. The inclusion of physical and behavioral therapy to an individualized treatment plan can be a key to help patients conquer their illness and increase their quality of life. Visit this blog to learn more about different types of therapies and holistic pain care.

Understanding what it takes to fight an invisible disease

Image source: agoramedia.com

Pain management experts, like Dr. Melanie Novak, and the people behind the American Society of Regional Anesthesia and Pain Medicine understand how chronic pain works. The problem is many people don’t.

An anesthesiologist at Vancouver General Hospital, Dr. Michael Negraeff shared his concerns about labeling chronic pain as a mental disorder in an interview for The Huffington Post. He believed that people dealing with persistent pain are already juggling heavy emotions, and judgmental looks from others will certainly not be of help.

“Worldwide, pain is one of the most significant causes of suffering, disability, and impairment,” Dr. Negraeff explains. “People living with persistent pain are four times as likely to attempt suicide as the general public.”


Image source: northeastpainmanagementclinic.com

The idea of mislabeling chronic pain as a psychological problem rather than a physical one stems from the absence of external signs and obvious symptoms. This is why this kind of pain is considered as an “invisible disease.” Unless they start to complain or talk about the pain, patients will continue to look normal to the people around them.

Dr. Negraeff reiterates the importance of providing support to people dealing with chronic pain, especially from the physicians. Doctors should never mindlessly dismiss complains on discomfort and distress because they do not have an idea of the extent of anxiety that the patients are dealing with.

For this reason, Dr. Negraeff asks a meaningful question to his colleagues: “Shouldn't our efforts be put towards pain management rather than on providing clinicians with excuses for not taking their patients' suffering seriously?”


Image source: smartpainmgmt.com

More information on the field of pain management can be found on this website.