Reader Comments

Nerve Renew

by Alisa Princy (2019-10-19)


An important feature of diagnosis is Nerve Renew Review tender trigger points. Besides, usually the patient is a female. It can occur at any age but is increasingly recognized in teenagers. For the diagnosis to be made, 11 of the 18 points must be tender on digital palpation. When is it appropriate for a patient to receive chronic pain medication? The answer is not an easy one. Pain doctors often run into situations where they are asked to see patients who are receiving chronic pain medication and want to switch over their care to receive these chronic pain medications. The decision is not always an easy one as there are certain medical, legal, and additional implications for treating a patient with chronic pain medications. One of the basic tenets of the workup regarding chronic pain medication is to figure out whether or not there is a legitimate reason for the patient necessitating treatment with the medications. 35% of patients receiving pain medications divert those medications. They may be selling them, or bartering them for other illicit substances. Therefore the first step in evaluating a patient who is seeking narcotic medication management is to do a complete workup to try and determine if there is an anatomic legitimate reason for those medications. Unfortunately in the evaluation of back pain pain doctors often run into the problem that over 40% of the time a specific pain generator cannot be identified. Then a doctor is put into a quandary of whether or not the patient has a legitimate reason for needing continual pain medications. Sometimes the answer is easy. For instance if the patient has chronic back pain from a degenerative scoliosis along with spinal stenosis and is not a candidate for spinal surgery secondary to other medical conditions that preclude this such as a liver problem where he or she cannot clot properly then the chronic pain medication may be the best method for that patient to receive pain relief but avoid the inevitable complications of spinal surgery. So what it comes down to is to determine if the patient has a legitimate reason for needing those medications and if anything can be done to reduce the need for those medications such as potentially providing interventional pain management injections, physical therapy, maybe spinal decompression therapy, or other avenues of pain management such as acupuncture, or naturopathic modalities.

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