Non-steroidal anti-inflammatory drugs (NSAIDs) are the most used drugs for acute and chronic pain. More than 30 billion doses of NSAIDs are consumed annually from more than 70 million prescriptions.1 Despite their common use, NSAIDs are not free of serious toxicities. In the pre-Vioxx (rofecoxib) era, gastrointestinal toxicity was the primary concern for many NSAIDs….
A recent position statement by the Society of Behavioral Medicine (SBM) concludes that patients with persistent pain need better access to psychosocial care in all healthcare settings.1 The SBM offers 10 health policy recommendations for improving such access, including removing system-related barriers, providing referral tools, reimbursing for evidence-based psychosocial approaches, prioritizing generalist-level and specialist pain…
A systemic review supports the ideas that exercise benefits the physical and mental health of patients experiencing pain related to hip and/or knee osteoarthritis (OA). Overall, research indicates that patients who exercised had slightly lower rates of pain and greater physical function, as well as slightly improved self-efficacy and social function…
Bad things happen to good rheumatologists—and to their patients—and can have profound personal and professional consequences for the doctor. Sometimes recommended treatments can have predictable, but devastating, side effects. Even if the rheumatologist does everything right according to evidence-based best practice, patients can still have bad outcomes, even die—with resulting feelings of sadness, anger, guilt…
In July 2017, Todd A. Graham, MD, a practicing orthopedic surgeon in South Bend, Ind., was fatally shot after getting into a heated dispute with a patient and her husband over a requested opioid prescription.1 The murder of Dr. Graham is a tragic example of the potential dangers of physician-patient disagreements. Rheumatology patients often endure…
(Reuters Health)—Patients with rheumatoid arthritis (RA) may be more likely to become disabled if they’re obese, a U.S. study suggests. Researchers examined data on more than 25,000 patients with RA. Most were overweight or obese when they joined the study. Those who were severely obese were more likely to report some disability at baseline. Over…
You see a patient for the first time to establish care for Sjögren’s disease. She complains of dry eyes, dry mouth and diffuse arthralgias. You do not appreciate any synovitis on physical exam. Of note, you are the fourth rheumatologist she has seen during the past year. Toward the end of the clinic visit, she…
NEW YORK (Reuters Health)—Tai chi improves fibromyalgia symptoms at least as effectively as aerobic exercise, according to a new trial. Aerobic exercise is the most commonly recommended non-drug treatment for fibromyalgia, Dr. Chenchen Wang of Tufts University School of Medicine in Boston and her colleagues note in The BMJ, online March 12.1 However, Dr. Wang…
As medical and recreational marijuana becomes more accessible, researchers seek creative ways to study the cannabis plant and explore the complexities of the endocannabinoid system in pain relief. Rheumatologists currently face an influx of patients asking if marijuana can help them. Here’s a look at the evolving research on cannabinoids for rheumatologic pain management and how doctors are discussing it with their patients…
SAN DIEGO—Increasingly, technological advances are placing new tools into the hands of office-based rheumatologists. And they don’t have to cost a lot in capital equipment outlays by the medical group, because some of the best advances can be accessed via the device that is already in most doctors’ pockets, their smartphone. Smartphone technology gets more…