A 67-year-old man with a recent onset of diffuse muscular pain and stiffness and an erythrocyte sedimentation rate of 55 is referred to you by his family practitioner. He has a history of non-insulin-dependent diabetes mellitus, but no history of headaches or swollen joints. He has chronic back pain, has had two surgeries and was…
NEW YORK (Reuters Health)—Solid evidence suggests that anticonvulsants provide no benefit for low back or lumbar radicular pain and a high risk of harm, researchers say. “We started the study because these drugs were increasingly being used for low back pain and radiating leg pain, without the support of strong evidence of effectiveness,” principal investigator…
A 54-year-old woman is establishing care in your clinic after retirement of her previous rheumatologist. Your review of her records suggests that she was diagnosed with systemic lupus erythematosus seven years ago on the basis of symptoms of body pain and fatigue, and serologic evidence of positive ANA 1:40 (speckled) and borderline anti-SSB antibody. She…
In your daily contact with rheumatology patients, you likely come across several who have type 1 or 2 diabetes. Are you doing all you can to maximize their treatment? Most physicians know about the damaging health effects of uncontrolled diabetes. From vision loss to kidney failure to nerve damage, those with diabetes require regular vigilance…
For many uninsured and underinsured patients in Yuba City, Calif., seeing a rheumatologist used to mean taking a day off from work and driving 108 miles, roundtrip, to the University of California Davis Medical Center. That changed this year when patients were offered the option of having a telemedicine consultation with a rheumatologist as part…
No matter where you practice, rheumatology clinics are extremely busy. And in that hustle and bustle we find an uncomfortable jostling of priorities between delivering optimal care for as many patients as possible and upholding education for teachers and learners at all levels. Because salary usually comes from seeing more and more patients, teaching is…
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…
Patients can experience many different types of pain, and some patients with chronic pain may believe that only opioids will help them. According to Kelly Weselman, MD, the best way to begin managing pain is to determine its root cause and communicate with the patient about the best approach(es) for decreasing their specific pain…
With the aid of increasingly sophisticated neuroimaging technology, research into how the brain activates and changes in patients with chronic pain is delivering fascinating information that will hopefully pave the way to tailored, individual treatment of chronic pain. Over the past several years, data from neuroimaging studies have provided a new understanding of what occurs…
SAN DIEGO—What does cannabis offer to the treatment and management of rheumatology patients and the range of pain states they experience? What do we really know about its long-term effects? These are hard questions to answer with currently available data and a reality nuanced by complications cannabis advocates don’t always recognize, according to two experts…