Nov/Dec 2009
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A Practical Guide for the Use of Opioids in Chronic Pain
With proper knowledge, safeguards, structure and record keeping in place, primary care
physicians may find a personal comfort level in prescribing opioids to chronic pain
patients who legitimately require them.
by Jennifer P. Schneider, MD
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Testosterone Replacement in Female Chronic Pain Patients
Testosterone assists opioids in crossing the blood brain barrier and helps activate a
number of central receptors and neurochemicals systems. It is a judicious, ethical, and
clinically necessary practice to replace testosterone in female chronic opioid
patientsùsubject to informed consent.
by Forest Tennant, MD, DrPH
Special Section: Nutritional Supplements in Pain Practice
Restoring the Natural Opioid System With D-Phenylalanine (DPA); and Milk Thistle to Enhance Liver Function and Drug Therapy
by Julia Ross, MA, MFT; and By Donald Adema, DO
Co-Morbid States Are the Rule, Not the Exception, in Pain Practice
Depression, anxiety, coping, somatization, sleeplessness, and hypochondriasis are
prevalent in the chronic pain population and, left untreated, are associated with greater
risk for poor outcomes.
by Murray H. Rosenthal, DO, FAPA
Publisher's Message: Thank You, Dr. Webster
by Marvin Rosenfeld, Publisher
Clinical Report: Computerized Dynamometry in Impairment Evaluations
Isokinetic computerized dynamometry provides objective, reproducible, and valid
measurements in clinical decision making regarding return to sport, return to work, and
impairment and disability assessments.
by Tiziano Marovino, DPT, DAAPM
Head and Neck: Middle Ear, Eustachian Tube, and Otomandibular/Craniofacial Pain
This case report found that a unique monomodal treatment protocolùutilizing a passive intra-oral applianceùboth verified the diagnosis and provided immediate relief to sympathetically-mediated pain suffered by the patient over the previous ten years.
by Gale D. Kloeffler, DDS
HIT: Dictation Versus EMR-Based Reports
With dictation costs going up, government and third party payers mandating that doctors transition to EMR systems, and ARRA reimbursements for EMR "meaningful use" to
start in 2011, the time for a decision on purchasing an EMR system is closer than you think.
by Greg Winterkamp
Fibromyalgia: Adult Growth Hormone Deficiency in Fibromyalgia
Growth hormone deficiency was found in many fibromyalgia patients in a community rheumatology practice.
by Thomas J. Romano, MD, PhD
Prolotherapy: Dextrose Prolotherapy for Unresolved Wrist Pain
This retrospective observational study of patients with unresolved wrist pain noted
improvements in many quality of life parameters after Hackett-Hemwall dextrose
prolotherapy.
by Ross A. Hauser, MD; Marion A. Hauser, MS, RD; and Patricia Holian, RN
Electromedicine: Cumulative Response from Cranial Electrotherapy Stimulation for Chronic Pain
Results from five CES sessionsùadministered over the course of treatment to 525 consecutive chronic pain patientsùconfirmed that an initial decrease in pain after
the first session was typically followed by further decreases in pain from the cumulative effects of this modality.
by Jerry T. Holubec, DO
Ethics and Health Policy: Neuroethics at the Close of the Decade of Pain Control and Research
Changing Views from the Cave to the Crest
by James Giordano, PhD
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