The patient A 43-year-old woman presented to the Norton Neuroscience Institute Face Pain Clinic with severe trigeminal neuralgia pain affecting the left side of her face. She described the pain as sharp, electrical, and shock-like — triggered by everyday activities such as eating, speaking, applying makeup and exposure to cold air. The condition progressively had…
A standardized primary care approach to knee and shoulder conditions — X-rays, a couple months of physical therapy followed by possible MRI and maybe referral to orthopedics — can prevent chronic disability as well as unnecessary imaging and referrals, according to Nyagon G. Duany, M.D., an orthopedic surgeon and sports medicine specialist with Norton Orthopedic…
Back pain among adolescents has become increasingly common in pediatrics, particularly in primary care. Once relatively rare, it now affects an estimated 28% to 48% of school-age children, with higher rates among adolescents and athletes. “Adolescent back pain is now common and often multifactorial, with posture-related pain now representing a significant proportion of cases,” said Kent…
The initial evaluation for trigeminal neuralgia is typically in primary care, but patients frequently also present to dental and ear, nose and throat settings, according to Brian M. Plato, D.O., a neurologist and headache specialist with Norton Neuroscience Institute. The uncommon condition is characterized by facial pain within the distribution of the trigeminal nerve. The…
The goal of Norton Leatherman Spine Back and Neck Pain Clinics is to see patients referred by primary care physicians, emergency departments or other clinicians in an expedited fashion. We strive to offer appointments within 72 hours of referral and often can see patients the next day. Even patients whose symptoms do not appear urgent…
Enhanced Recovery After Surgery, or ERAS, is being used for heart, colorectal, abdominal, and hip and knee replacement surgeries at Norton Healthcare. It was piloted at Norton Audubon Hospital four years ago and has since been implemented at Norton Healthcare’s other adult-service hospitals. With ERAS, patients receive non-narcotic analgesics before surgery, decreasing the need for…
Norton Specialty Rehabilitation Center Norton Specialty Rehabilitation Center offers physical therapy for chronic pain, including strength training, flexibility exercises and posture awareness. These active treatments can aid in reducing or eliminating the use of pain medication. “Research shows exercise and active treatment is one of the most effective therapies for chronic pain and addressing disability,”…
The morphine equivalent daily dose (MEDD) translates the dose and route of each opioid a patient has received over the previous 24 hours to a morphine equivalent using a standard conversion table. The MEDD should be used anytime an opiate is prescribed. “This formula helps in the vigilant monitoring, reduction and tapering; prescription of naloxone;…
Research shows there are some short-term benefits of opioid therapy in certain situations, but there are no studies showing the long-term effectiveness of opioids for chronic pain. As a result, a paradigm shift is underway from opioids to nonopioid analgesics, according to James T. Jennings, M.D., medical director of adult primary care for Norton Medical…
Episode two of the new “MedChat” podcast is now available; the podcast provides an option for convenient continuing medical education for physicians. This episode of the “MedChat” podcast addresses chronic pain management through complementary and integrative medicine, and is geared toward specialists in internal medicine, family medicine and other specialties that treat patients with chronic…
Treating the pain associated with endometriosis usually requires a combination of surgical and medical interventions. There are now several medications on the market that can be used. The newest is Orilissa (elagolix), which is indicated for the management of moderate to severe pain associated with endometriosis, and was approved by the Food and Drug Administration…