Pain and the Injured Worker
Physicians who treat injured workers with painful conditions face complex challenges that require skills beyond those of a clinician. To address these challenges effectively, physicians need to understand the logic…
Chronic Daily Headache
Chronic daily headache (CDH) is a challenging condition to treat. CDH is often accompanied by significant comorbidities, such as chronic fatigue, depression, anxiety, and insomnia, which further complicate treatment. Unrealistic…
Interdisciplinary Rehabilitation
Interdisciplinary pain rehabilitation programs are infrequently used in the United States in the treatment of chronic pain. Comprehensively addressing the contributors to chronic pain, which include behavioral, psychological, and physical…
Nutrition and Pain
Research is providing compelling evidence for Hippocrates’ oft quoted “Let food be thy medicine.” Despite this, most graduating physicians receive only a few hours of instruction about nutrition and coaching…
Psychiatric and Psychological Perspectives on Chronic Pain
Chronic pain patients often have psychiatric disorders that negatively influence their responses to treatment. Also, many of them have dysfunctional beliefs and coping strategies, even if they do not meet…
Exercise Therapy for Chronic Pain
The benefit of exercise for pain control likely comes from the impact of exercise on the endogenous opioid system and on central pain modulatory systems. Patients with some chronic pain…
Injections for Chronic Pain
Although interventional procedures should be used cautiously in the setting of chronic pain, there is a role for a variety of injections to facilitate a patient’s overall rehabilitation program. There…
Opioid Therapy in Chronic Pain
Opioids remain the strongest and most effective analgesics available. The downside is that they are addictive and potentially dangerous. Throughout history, although recognizing the value of opioids in treating serious…
Chronic Pain Assessment
Key points • Although physiatrists are ideally suited to assess chronic pain, they need to perform a careful history and physical examination for accurate assessment. • Specific attention should be…