Articles Posted in Chronic Pain

Helping a Patient in Pain who Fears Movement

Psychological Injuries Without Physical Injuries

Helping a Patient in Pain who Fears Movement

Things like energy level, function, mood, sleep quality, and many other quality of life measurements are changed in the presence of pain and the resulting lack of movement.  When a patient is suffering from pain and is afraid of movement, there is a great barrier to achieving quality health.  Among all therapeutic interventions, exercise is perhaps the least invasive and most effective way to manage a person in pain.

Electronic Medical Records in Patients with Chronic Pain

 Avoiding Pitfalls in Electronic Medical Records in Patients with Chronic Pain

I’m Ed Smith, a Sacramento Chronic Pain Lawyer. There is no longer a time where physicians and other healthcare providers need to dig through filing cabinets in order to find patients charts or running through the office looking everywhere for a lost chart as the patient waits to be treated.  The times have changes with the addition of the electronic medical record (EMR) in the office-based setting.  It is now as simple as clicking a mouse to check patients in for their visits or to tell the provider that the patient can be seen.  Test results are uploaded easily from the laboratory and healthcare providers have the patient’s chart available at any time of the day or night as long as they have computer access.  Electronic medical records have made the job of keeping records much more efficient.

Management of Substance Abuse after Trauma

Management of Substance Abuse after Trauma

I’m Ed Smith, a Sacramento Brain Injury Lawyer. Substance abuse, especially alcohol intoxication, is the underlying cause of almost half of all traumatic injuries in the US.  One survey showed that 75 percent of intoxicated patients have a prior history of clinically-significant alcohol related life events and 26 percent admit to significant pre-injury alcohol problems.  This means that alcohol abuse disorder is reported to be the most prevalent disease among trauma survivors.  Injured problem drinkers are subsequently more likely to be reinjured, re-hospitalized, and to die compared to normal people.  Despite the high incidence of substance abuse, it is rarely screened for in rehabilitation units.

Rates of alcohol problems are particularly high among those with traumatic injuries, including traumatic brain injury and spinal cord injury.

Links between alcohol problems and traumatic brain injury/spinal cord injury will be described in terms of the prevalence of these problems together and the effects on outcome.  There are persistent stereotypes and myths about substance abuse that may interfere with the implementation of effective screening and intervention programs. Continue reading

Trauma and Trigeminal Neuralgia

Trigeminal neuralgia involves extreme pain in the face caused by damage or inflammation to the trigeminal nerve or the fifth cranial nerve. There are three branches to the trigeminal nerve, any one of which can be affected. The trigeminal nerve breaks off into an ophthalmic nerve, which innervates sensation around the eye, the maxillary nerve, which innervates sensation around the cheek and maxillary area, and the mandibular nerve, which regulates sensation of the lower jaw area.

In cases of traumatic trigeminal nerve injury, any one of the branches can be affected but the pain is usually on one side of the face.

Many people are familiar with carpal tunnel syndrome (CTS) as a condition caused by repetitive stress injuries such as working with vibrating tools, heavy manual labor, and even less impactful but repeated movements such as typing. Within these categories, carpal tunnel syndrome is often a workplace injury. What is less well known, however, is traumatic carpal tunnel syndrome that can be triggered by a single injury to the hand or wrist from an event such as a motor vehicle collision, a sports injury, or a slip-and-fall injury.

traumatic carpal tunnel syndrome
Carpal tunnel syndrome in general results from compressing the median nerve where it passes through the wrist in the passage known as the “carpal tunnel.” This compression of the nerve can result in pain, tingling (paresthesias), and numbness in the fingers — thumb, index finger, middle finger, and part of the ring finger — and parts of the hand that are served by the median nerve, and in chronic or severe cases even much more serious symptoms such as muscle wasting. (There are also some non-trauma causes of CTS including arthritis, diabetes, certain drug reactions, or growths within the wrist — these can cause the same pressure on the median nerve that is associated with single traumatic and repetitive injury causes.)

Traumatic carpal tunnel syndrome — as well as the non-traumatic versions — is generally diagnosed based upon the reported symptoms and certain classic “signs” for the disease. Phalen’s Maneuver, for example, involves flexing the wrist and holding it in position — when pain or numbness appears within one minute in the fingers innervated by the median nerve, it is considered a positive sign, and the fast the symptoms appear the “more positive” the result is considered to be. Another test involves Tinel’s Sign in which the skin is gently tapped over the ligament band that forms part of the carpal tunnel. If this produces pain or tingling in the fingers of the median nerve distrution, the test is positive. Electrodiagnostic testing that examines the conductivity of the median nerve may often be used to confirm a suspected case of carpal tunnel syndrome.

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What does a multidisciplinary approach to chronic pain mean?  This is when health care professionals from multiple fields address the needs of the patient rather than only one medical provider treating a patient.

In the US, many people only treat pain by seeing their primary care physician and/or a visit to the emergency room.  This often does little to alleviate chronic pain. These visits may contribute to the chronic pain sufferer feeling marginalized or without hope for their symptoms.

A multidisciplinary approach can be viewed as a more holistic way to treat a person.

People who have sustained catastrophic injuries (and their families) are often in need of very specific, specialized information regarding the injury suffered, the latest care and support options, research into new treatment options, and the psychological and emotional support that can come from connecting with other people who have suffered similar losses.  For some of the categories of catastrophic injuries, the following resources may be helpful:

resources for catastrophic injuriesBurn Injury Resources

The Phoenix Society for Burn Survivors is an online collection of information and resources for the victims of serious burn injuries and their families.  In addition to being an information resources, the society organizes an annual meeting for burn survivors, medical professionals and fire fighters.

medical marijuana for relief of chronic painMany alternative remedies for chronic conditions have been explored in recent years, and one that is receiving an increasing amount of attention from traditional medical practitioners is the use of medical marijuana for relief of chronic pain.

A recent study conducted in Australia looked at more than 1500 people who were receiving opioid drugs for relief of chronic pain conditions (not related to cancer). Most were experiencing pain from neck and back injuries, from arthritis or other rheumatological problems, or from severe headaches. Among this group, about 1 in 6 reported also using medical marijuana for relief of chronic pain in addition to their prescribed narcotic medications. As a group, those who reported using cannabis tended to being having more severe pain and were on higher doses of opiods.

Of those who reported use of medical marijuana for relief of chronic pain, more than a third described it as “very effective” as a pain reliever, either on its own or in conjunction with their prescribed medications.

From time to time, I find web resources that may be especially helpful to my clients who suffer from chronic pain. Recently, I came across www.PainAction.com which fits the bill.

PainAction is a website specifically designed to helped people who suffer from all kinds of chronic pain. I like it because it emphasizes self action, instead of a medical model that encourages those who suffer pain to just “do what the doctor orders”.

The site includes a Medication Safety Library, a free downloadable Guide to Pain Management and a self check quiz that patients can take to guide them into managing their pain.

The number of trucking accidents has increased significantly over the last two decades. Federal laws and regulations govern the trucking industry. These laws establish standards that trucking companies, owners, and drivers must meet, and often determine who is responsible for a trucking accident. More info can be found here.

trucks.freeway
When it comes to trucking accidents there are a host of players who may be responsible for a victims injuries and damages including the following:

1. The driver of the truck – sometimes the driver is not an employee of the company who owns the truck or leases the truck but rather is an independent contractor. It is important to identify who the driver is working for as soon as possible.

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