Pain Talk: Recent Episodes
Dr. Maureen Allen
A podcast dedicated to bringing together experts who study and support individuals living with pain.
In this episode we talk to Dr. Tina Korownyk about the PEER Simplified Guidelines for pain management.
The post Episode 76 : Dr. Tina Korownyk – PEER Simplified Guidelines first appeared on Pain Talk.
Today we are delighted to be joined by Dr. Jen Potter to speak about a recent body of work done by her and her colleagues, primarily exploring the evidence of psychological interventions specifically looking at mindfulness based stress reduction and cognitive behavioral therapy in the management of lower back pain.
Jen is a practicing family physician and assistant professor in the Department of Family Medicine at the University of Manitoba, participating in clinical and academic teaching as well as research, quality improvement, and faculty development. She is also a member of the PEER (Patients, Experience, Evidence, Research) team.
The post Episode 75 : Dr. Jen Potter – Psychological Solutions for Lower Back Pain first appeared on Pain Talk.
We are pleased today to be joined by Dr. Joshua Rash, an assistant professor in the department of psychology in Memorial University of Newfoundland as well as a director of Memorial University of Newfoundland Behavioral Medicine Center. Dr. Rash will be sharing his expertise as a clinical health and rehab psychologist on a number of related subjects such as behavioral medicine, health behavior change, chronic disease management and cardiovascular psychophysiology.Additional LinksWellness Together – https://www.wellnesstogether.ca/en-CA
Pain Canada – https://www.paincanada.ca/
The post Episode 74 : Dr. Josh Rash – Part 2 first appeared on Pain Talk.
We are pleased today to be joined by Dr. Joshua Rash, an assistant professor in the department of psychology in Memorial University of Newfoundland as well as a director of Memorial University of Newfoundland Behavioral Medicine Center. Dr. Rash will be sharing his expertise as a clinical health and rehab psychologist on a number of related subjects such as behavioral medicine, health behavior change, chronic disease management and cardiovascular psychophysiology.Additonal LinksWellness Together – https://www.wellnesstogether.ca/en-CA
Pain Canada –https://www.paincanada.ca/
The post Episode 73 : Dr. Josh Rash – Part 1 first appeared on Pain Talk.
Join us for the conclusion of our 2 part series talking to Dr. Cecily Havert. She is a primary care practitioner based in North Virginia, and she brings her extensive background in both preventative health and mental health into the discussion about chronic pain, having a special interest in those who have had a lived experience with it.
The post Episode 72 : Dr. Cecily Havert – Part 2 first appeared on Pain Talk.
Join us for the first of a 2 part series talking to Dr. Cecily Havert. She is a primary care practitioner based in North Virginia, and she brings her extensive background in both preventative health and mental health into the discussion about chronic pain, having a special interest in those who have had a lived experience with it.
The post Episode 71 : Dr. Cecily Havert – Part 1 first appeared on Pain Talk.
Today we continue talking to Dr. Sam Hickcox – Medical Director and Shelley LeDrew – Program Lead of the Atlantic Mentorship Network for Pain and Addition as they talk about how the Network is improving the care of those living with pain or addiction in Atlantic Canada. https://www.atlanticmentorship.com/
The post Episode 70 : Atlantic Mentorship Network for Pain and Addiction – Part 2 first appeared on Pain Talk.
Today we’re talking to Dr. Sam Hickcox – Medical Director and Shelley LeDrew – Program Lead of the Atlantic Mentorship Network for Pain and Addition as they talk about how the Network is improving the care of those living with pain or addiction in Atlantic Canada. https://www.atlanticmentorship.com/
The post Episode 69 : Atlantic Mentorship Network for Pain and Addiction – Part 1 first appeared on Pain Talk.
After a long hiatus, Paintalk returns and wants to start off the new year strong with a look at new and interesting developments in how we understand and manage chronic pain. We first want to take what we’ll call is a chronic pain update, mainly focusing on some of the skills that are being advocated for in regards to Pain Reprocessing Therapy (PRT). In particular we’ll talk in relation to a new book released by Alan Gordon, an individual who has a lived experience with chronic pain. The book is called The Way Out, and was written together with Alan Gordons’ colleague.Gordon, Alan: Healing Chronic Pain: The Way Out. ISBN: 9780593086834
Hashmi, J. A., Baliki, M. N., Huang, L., Baria, A. T., Torbey, S., Hermann, K. M., … & Apkarian, A. V. (2013). Shape shifting pain: chronification of back pain shifts brain representation from nociceptive to emotional circuits. Brain, 136(9), 2751-2768.
Accessed: Here (https://academic.oup.com/brain/article/136/9/2751/291636)
Lumley, M. A., & Schubiner, H. (2019). Psychological therapy for centralized pain: an integrative assessment and treatment model. Psychosomatic medicine, 81(2), 114.
Accessed at: Here (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6355353/pdf/nihms-1512285.pdf)
Chronic pain: Can our brain fix it? (Podcast)
Accessed: Here (https://gimletmedia.com/shows/science-vs/episodes#show-tab-picker)
The post Episode 68 : Pain Reprocessing Therapy (PRT) – Part 4 first appeared on Pain Talk.
After a long hiatus, Paintalk returns and wants to start off the new year strong with a look at new and interesting developments in how we understand and manage chronic pain. We first want to take what we’ll call is a chronic pain update, mainly focusing on some of the skills that are being advocated for in regards to Pain Reprocessing Therapy (PRT). In particular we’ll talk in relation to a new book released by Alan Gordon, an individual who has a lived experience with chronic pain. The book is called The Way Out, and was written together with Alan Gordons’ colleague.
Gordon, Alan: Healing Chronic Pain: The Way Out. ISBN: 9780593086834
Hashmi, J. A., Baliki, M. N., Huang, L., Baria, A. T., Torbey, S., Hermann, K. M., … & Apkarian, A. V. (2013). Shape shifting pain: chronification of back pain shifts brain representation from nociceptive to emotional circuits. Brain, 136(9), 2751-2768.
Accessed: Here (https://academic.oup.com/brain/article/136/9/2751/291636)
Lumley, M. A., & Schubiner, H. (2019). Psychological therapy for centralized pain: an integrative assessment and treatment model. Psychosomatic medicine, 81(2), 114.
Accessed at: Here (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6355353/pdf/nihms-1512285.pdf)
Chronic pain: Can our brain fix it? (Podcast)
Accessed: Here (https://gimletmedia.com/shows/science-vs/episodes#show-tab-picker)
The post Episode 67 : Pain Reprocessing Therapy (PRT) – Part 3 first appeared on Pain Talk.
After a long hiatus, Paintalk returns and wants to start off the new year strong with a look at new and interesting developments in how we understand and manage chronic pain. We first want to take what we’ll call is a chronic pain update, mainly focusing on some of the skills that are being advocated for in regards to Pain Reprocessing Therapy (PRT). In particular we’ll talk in relation to a new book released by Alan Gordon, an individual who has a lived experience with chronic pain. The book is called The Way Out, and was written together with Alan Gordons’ colleague.
Referenced In This Episode
Gordon, Alan: Healing Chronic Pain: The Way Out. ISBN: 9780593086834
Hashmi, J. A., Baliki, M. N., Huang, L., Baria, A. T., Torbey, S., Hermann, K. M., … & Apkarian, A. V. (2013). Shape shifting pain: chronification of back pain shifts brain representation from nociceptive to emotional circuits. Brain, 136(9), 2751-2768.
Accessed: Here (https://academic.oup.com/brain/article/136/9/2751/291636)
Lumley, M. A., & Schubiner, H. (2019). Psychological therapy for centralized pain: an integrative assessment and treatment model. Psychosomatic medicine, 81(2), 114.
Accessed at: Here (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6355353/pdf/nihms-1512285.pdf)
Chronic pain: Can our brain fix it? (Podcast)
Accessed: Here (https://gimletmedia.com/shows/science-vs/episodes#show-tab-picker)
The post Episode 66 : Pain Reprocessing Therapy (PRT) – Part 2 first appeared on Pain Talk.
After a long hiatus, Paintalk returns and wants to start off the new year strong with a look at new and interesting developments in how we understand and manage chronic pain. We first want to take what we’ll call is a chronic pain update, mainly focusing on some of the skills that are being advocated for in regards to Pain Reprocessing Therapy (PRT). In particular we’ll talk in relation to a new book released by Alan Gordon, an individual who has a lived experience with chronic pain. The book is called The Way Out, and was written together with Alan Gordons’ colleague.
Referenced In This Episode
Gordon, Alan: Healing Chronic Pain: The Way Out. ISBN: 9780593086834
Hashmi, J. A., Baliki, M. N., Huang, L., Baria, A. T., Torbey, S., Hermann, K. M., … & Apkarian, A. V. (2013). Shape shifting pain: chronification of back pain shifts brain representation from nociceptive to emotional circuits. Brain, 136(9), 2751-2768.
Accessed: Here (https://academic.oup.com/brain/article/136/9/2751/291636)
Lumley, M. A., & Schubiner, H. (2019). Psychological therapy for centralized pain: an integrative assessment and treatment model. Psychosomatic medicine, 81(2), 114.
Accessed at: Here (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6355353/pdf/nihms-1512285.pdf)
Chronic pain: Can our brain fix it? (Podcast)
Accessed: Here (https://gimletmedia.com/shows/science-vs/episodes#show-tab-picker)
The post Episode 65 : Pain Reprocessing Therapy (PRT) – Part 1 first appeared on Pain Talk.
Today we’ll be talking about how the PEER approach can be used to tackle osteoarthritis or degenerative disease. We’ll be talking about where you can find some more great references to excellent and compelling research, and differing osteoarthritis and what is a degenerative disease.
The post Episode 64 : A PEER Approach to Osteoarthritis or Degenerative Disease first appeared on Pain Talk.
Today we’ll discuss the review of common interventions for chronic low back pain by Dr’s Kirkwood, Allan and Korownyk from the PEER simplified decision rule. Listeners can access this review at Canadian Family Physician January 2021, pages31-2. Link Here
The post Episode 63 : PEER Approach to Lower Back Pain first appeared on Pain Talk.
Today we continue our discussion on the intricacies of pain in the human body, everything from how we interpret pain and use that knowledge to help us emphasize with our patients and others dealing with pain.
The post Episode 62 : The Science Behind Pain – Part 2 first appeared on Pain Talk.
Today we will be discussing an incredibly interesting topic in the Science of Pain. We won’t be diving into the minute details of how our bodies and brains interpret pain, instead we want to look at the basic overview of how we interpret pain and use that knowledge to help us emphasize with our patients and others dealing with pain.
The post Episode 61 : The Science Behind Pain – Part 1 first appeared on Pain Talk.
We continue our conversation with Natasha. We will be talking about pharmacotherapy in the management of acute pain with a deep dive into the efficacy of opioid analgesics.
The post Episode 60: Acute Pain w/ Natasha Rodney-Cail – Part 2 first appeared on Pain Talk.
We now shift to a different expert in Acute Pain Natasha Rodney-Cail. We will be talking about pharmacotherapy in the management of acute pain with a deep dive into the efficacy of opioid analgesics.
The post Episode 59: Acute Pain w/ Natasha Rodney-Cail first appeared on Pain Talk.
We continue our conversation with Pam exploring the evidence regarding common pharmacotherapy in the management of acute pain.
The post Episode 58: Acute Pain w/ Pam McLean-Veysey – Part 2 first appeared on Pain Talk.
Today we dig into the literature that exams the evidence for pharmacotherapy in the management of acute musculoskeletal pain with Pam McLean-Veysey.
The post Episode 57: Acute Pain w/ Pam McLean-Veysey – Part 1 first appeared on Pain Talk.
Acute pain is the normal physiological response to a chemical, thermal or mechanical stress. The goal of pain management is to make pain more tolerable and reduce the risk of chronic pain developing. We will discuss many commonly used tactics including using medication such as ibuprofen.
The post Episode 56: The Management of Acute Pain first appeared on Pain Talk.
Today we continue our discussion of CHS and it’s management. Stopping cannabis is the only known treatment as of the posting of this episode, however many harm reduction strategies to minimize symptomatology such as lowering the THC content can be considered. Therapies that manage acute episodes such as topical capsaicin and atypical antiemetics will be discussed.
The post Episode 55: Cannabinoid Hyperemesis Syndrome – Part 2 first appeared on Pain Talk.
CHS is a paradoxical response to chronic cannabis use. Individuals describe severe, intense, colicky belly pain with vomiting. Relief frequently comes from hot showers and baths which is indicative of the syndrome. Although the cause is unknown, recent studies have identified the TRPV 1 receptor as the culprit and the ever-rising THC content in the cannabis bud.
The post Episode 54: Cannabinoid Hyperemesis Syndrome – Part 1 first appeared on Pain Talk.
We continue our discussion on an approach to taper opioids. When to do it, how to do it and why tapering may be necessary.
The post Episode 53: Tapering Opiods – Part 2 first appeared on Pain Talk.
Today we discuss the tapering of opioid analgesics. The ultimate goal of opioid tapering, that is to say gradually reducing dosage, is to make the patient feel better. Tapering an opioid has the ability to reduce pain intensity and to improve mood and function. However, there is no single tapering strategy to fit all patients. The longer the patient has been on opioids, the longer the tapering process should be. The 2017 Canadian Opioid Guidelines recommend 5-10% every 2-4 weeks as a reasonable rate for chronic pain patients.
The post Episode 52: Tapering Opiods – Part 1 first appeared on Pain Talk.
Today we continue to talk about Jen and the experience of total body pain and how to help patients move forward in their life with purpose and connection.
The post Episode 51: When Pain Becomes Widespread first appeared on Pain Talk.
Today we continue with our discussion on chronic pain and multiple unexplained symptoms. We delve into how to talk with patients about this complex clinical presentation and the role of central sensitization. Individuals who have experienced trauma in their life often function in a survival mindset. Their ability to process information may be hindered by their daily heightened state of alarm. We need to foster a safe environment using language that tells them, “you’re safe with me”.
The post Episode 50: Trauma Informed Care – Part 2 first appeared on Pain Talk.
All humans experience life differently. Our journeys are as unique as the habits and behaviors we use to navigate the challenges we will inevitably meet along the way. For some, that journey can be influenced by events that cause intense physical and psychological stress reactions. These events are often referred to as traumatic. Traumatic events change a person and can create turmoil especially if these events occur in childhood. What science tells us is that the consequences of trauma are far-reaching and can be directly or indirectly linked to mental illness, chronic disease, suicide, and overall failure to thrive. A trauma-informed approach to healthcare acknowledges the existence of significant trauma (past and present) and the role it plays in the health and recovery of the individual. Today we will explore the role of trauma in chronic pain and how important a SAFE approach to care is paramount. The language we use, the movement we suggest, and the pharmacotherapy we dispense need to be based on minimizing fear and potential harm in order to allow these individuals to thrive.
The post Episode 49: Trauma Informed Care – Part 1 first appeared on Pain Talk.
Hey everyone, we’re continuing our approach to the angry patient and how we can promote calm and connection. Anger comes from a place of fear and uncertainty, so bringing calm and predictability can help us connect with compassion.
The post Episode 48: The Angry Patient – Part 2 first appeared on Pain Talk.
Working with patients who are angry or hostile can be challenging. Often anger comes from a place of fear and uncertainty. When a patient, however, is reaching the boiling point, it is important that you recognize the signs early and attempt to defuse the situation. In our 2-part series will discuss some tools and strategies.
The post Episode 47: The Angry Patient – Part 1 first appeared on Pain Talk.
Unlike localized pain conditions, total body pain is felt throughout the body and can cause additional symptoms such as fatigue, stress and depression. It is often described as mild, moderate or severe, and can be acute, intermittent or long-term (chronic). Today we explore chronic total body pain what drives it and how we can support patients to a functional quality of life.
The post Episode 46: Total Body Pain – “Doc, I have pain everywhere. Can you help me?” first appeared on Pain Talk.
Insomnia is a common sleep problem for adults. The National Institutes of Health estimates that roughly 30 percent of the general population complains of sleep disruption, and approximately 10 percent have associated symptoms of daytime functional impairment consistent with the diagnosis of insomnia. Although many factors contribute to sleep disruption, opioid analgesics, in particular short-acting, are some of the biggest culprits. This week we look at how opioids contribute to sleep disruption and how to avoid the trap of adding sedative-hypnotics to an already high-risk pharmacological soup.
The post Episode 45: Sleep and Opioids – “Doc, can you give me something to sleep” first appeared on Pain Talk.
Dr. Flusk is a pain physician and anesthesiologist practicing in St. John’s Newfoundland. He is actively involved in medical education at the undergraduate and postgraduate levels. Today he shares with us his experience as a lead reviewer on the Associations of Faculties of Medicine curriculum development.
The post Episode 44: Developing a Curriculum – Dr. David Flusk first appeared on Pain Talk.
Childkind certification recognizes the commitment of an institution to evidence guided pediatric pain management. Dr. Allen Finley and Erin Aubrey talk with us this week about what Childkind certification is, how health care institutions can put steps in motion to achieve this recognition, and how health care providers within the institution can come together with a common goal; compassionate pediatric pain management.
The post Episode 43: Childkind Certification – Pain Management in Children first appeared on Pain Talk.
Dr. Trudy Taylor is a respected Rheumatologist practicing in Halifax NS. Today we conclude our discussion with Dr. Taylor and our conversation on the management and diagnosis of inflammatory arthritis and what to do when it co-exists with central sensitization or chronic pain.
The post Episode 42: Dr. Trudy Taylor – Part 3 first appeared on Pain Talk.
In this week’s podcast, Dr. Taylor helps us break down the challenges of interpreting and using biomarkers to monitor and identify inflammatory arthritis. A biomarker is a measurable indicator of the severity or presence of some disease state.
The post Episode 41: Dr. Trudy Taylor – Part 2 first appeared on Pain Talk.
Living with inflammatory arthritis and chronic pain can be challenging. Dr. Trudy Taylor, a rheumatologist practicing in Halifax will help us breakdown how these two painful conditions can co-exist and how to improve the quality of life for individuals using pharmacological and non-pharmacological therapies.
The post Episode 40: Dr. Trudy Taylor – Part 1 first appeared on Pain Talk.
Today, we welcome back Virginia McIntyre who is someone who knows chronic pain all too well. This week we want to see how COVID-19 has impacted her life as she navigates a new normal and the challenges of living with chronic pain during a pandemic. She shares with us some strategies that can help build resiliency during this time of uncertainty and unpredictability.
The post Episode 39: Virginia McIntyre – Chronic Pain and COVID-19 first appeared on Pain Talk.
We cannot change how COVID-19 has impacted our lives, but we can change how we respond to the uncertainty that it creates. We have a choice to focus on how vulnerable we are as a people or to begin the task of building resiliency to the virus and the uncertainty we feel. Resiliency is our ability to THRIVE in times of change and uncertainty. It is not a natural skill, rather it is something we learn. Today we continue our discussion on how to build resiliency. Remember, you are not alone. We are in this together. Stay strong, stay safe.
The post Episode 38: Chronic Pain and COVID-19 – Part 2 first appeared on Pain Talk.
One of the aspects not often considered when talking about COVID-19 is the impact on people suffering from chronic pain. Today we’re talking about how COVID-19 has impacted the lives of individuals living with Chronic pain, and how to manage the uncertainty to find ways to calm pain.
The post Episode 37: Chronic Pain and COVID-19 – Part 1 first appeared on Pain Talk.
Today we finish our conversation with Dr. Vincent Adams, a chiropractor with an interest in providing care to patients living with chronic pain.
The post Episode 36: Dr. Vincent Adams – Part 2 first appeared on Pain Talk.
Today we are talking with Dr. Vincent Adams who is a chiropractor practicing in Prince Edward Island. Vince shares some of the challenges that come with providing care to individuals living with complex pain, but also some of the benefits that present themselves.
The post Episode 35: Dr. Vincent Adams – Part 1 first appeared on Pain Talk.
Today we’ve reached out to Don Daniel Ocay who is a Ph.D. candidate with an interest in pediatric pain. Daniel will share with us the good work his team is undertaking in Montreal at McGill University, and his work with the Quebec Network of Junior Pain Investigators a Quebec-wide forum of student researchers in the field of pain.
The post Episode 34: Don Daniel Ocay and the QNJPI first appeared on Pain Talk.
We conclude our discussion with Dr’s Allan and Korownyk, exploring the challenges of urine drug monitoring in clinical practice.
The post Episode 33: Guidelines for Cannabis and Opioid Use Disorders – Part 3 first appeared on Pain Talk.
Today we continue our discussion with Dr’s Allan and Korownyk on the simplified guidelines for cannabis and opioid use disorders in primary care.
The post Episode 32: Guidelines for Cannabis and Opioid Use Disorders – Part 2 first appeared on Pain Talk.
Dr.’s Mike Allan and Tina Korownyk are trailblazers in their field of primary care research. Both have contributed to practice-changing guidelines on the use of cannabis in clinical practice and the management of opioid use disorders in primary care.
The post Episode 31: Guidelines for Cannabis and Opioid Use Disorders – Part 1 first appeared on Pain Talk.
Today’s podcast will look at the forces that drive persistent pain. In Session 6 we started the conversation about Neuro Inflammation and Central Sensitization. Today we will discuss pain protective behaviours as well as the messengers that contribute to ongoing pain.
The post Episode 30: Forces that Drive Chronic Pain first appeared on Pain Talk.
Today we finish our discussion about Methadone, a strong, unique synthetic opioid analgesic used to manage pain and opioid use disorders. We’ll break down common myths and misconceptions as we discuss the role of Methadone in clinical practice.
The post Episode 29 : Methadone : Part 2 first appeared on Pain Talk.
Methadone is a synthetic opioid developed by the Germans in the second world war as an alternative to morphine. It is widely used in the management of complex pain often seen in palliative care patients and as well it is recognized as an effective treatment for the management of opioid use disorders.
The post Episode 28 : Methadone : Part 1 first appeared on Pain Talk.
The World Health Organization is a specialized agency of the United Nations that is concerned with international public health. It was established on 7 April 1948, and is headquartered in Geneva, Switzerland. The WHO is a member of the United Nations Development Group. In May 2019 the WHO designated Chronic pain as a disease in its own right which helps to legitimize and validate chronic pain as a legitimate disease.
The post Episode 27 : World Health Organization first appeared on Pain Talk.
In part two of the Canadian Pain Task Force, we continue the conversation regarding the work of the Canadian Pain task Force and dig into how Canadians can get involved and participate in the data gathering.
The post Episode 26 : Canadian Pain Task Force : Part 2 first appeared on Pain Talk.
Today we welcome the two co-chairs of the Canadian Pain Task Force, Maria Hudspith and Dr. Fiona Campbell. The CPTF’s goal is to provide advice to Health Canada regarding evidence and best practices for the prevention and management of chronic pain. The release of Phase 1 of 3 marks a formal commitment by the Government of Canada to better understand and address the needs of people living with chronic pain.
The post Episode 25 : Canadian Pain Task Force : Part 1 first appeared on Pain Talk.
Ritalin is not an amphetamine. It will not show up in a urine immunoassay unless it’s designed to pick up methylphenidate. Today is the third in a series of podcasts on urine drug screening. We’re going to continue the conversation regarding some of the most common challenges we run into and discuss some of the challenges.
The post Episode 24 : Urine Drug Screening : Part 3 first appeared on Pain Talk.
Today is the second of three podcasts on urine drug screening. We’ll explore specific drug immunoassays, specifically about some of the many challenges present with the interpretation of immunoassays as well as the role of gas chromotography.
The post Episode 23 : Urine Drug Screening : Part 2 first appeared on Pain Talk.
Urine drug monitoring (UDS) is an important tool used in clinical practice to screen and identify possible misuse and abuse of various substances used in clinical practice. It should always be done for patients and never to them.
The post Episode 22 : Urine Drug Screening : Part 1 first appeared on Pain Talk.
Today we finish our interview with Dr. Juurlink and discuss challenges regarding the dual active opioid analgesic, Tramadol.
The post Episode 21: Tramadol – Not just any opioid: Part 2 with Dr. David Juurlink first appeared on Pain Talk.
Today we are joined by Dr. David Juurlink head of the Clinical Pharmacology and Toxicology division at Sunnybrook Health Sciences Centre in Toronto, Ontario and we’re talking all things Tramadol. Tramadol is a dual active opioid analgesic that has unique properties that make it complex. Historically it has not received the same oversight and monitoring as most conventional opioids despite its mechanism. Its use as a “safer alternative” to higher potency opioids has seen a steady rise in its use in Canada.
The post Episode 20: Tramadol – Not just any opioid: Part 1 with Dr. David Juurlink first appeared on Pain Talk.
Today we’re concluding our three-part series on how to reduce the risk of chronic pain by using a SAFE-ED approach.
The post Episode 19: SAFE Approach to Pain: Part 3 first appeared on Pain Talk.
Today we’re going to talk about the factors that increase one’s risk for chronic pain and how we might help reduce that risk. Chronic pain is similar to other chronic diseases like heart disease where certain forces can come together to increase someone’s risk factor for that disease.
The post Episode 18: SAFE Approach to Pain: Part 2 first appeared on Pain Talk.
The next few weeks we’re going to dig deeper into reducing the risk of chronic pain. Promoting a SAFE-ED approach to acute pain can help reduce the risk of chronic pain.
The post Episode 17: SAFE Approach to Pain: Part 1 first appeared on Pain Talk.
Today we’ll discuss some of the concerning trends that we’re seeing related to the use of cannabis. One of the best environments to view this trend is in community based emergency departments.
The post Episode 16: Medical Marijuana: Part 3 first appeared on Pain Talk.
We continue our discussion of medical marijuana focusing on the where cannabinoids are found. In this podcast we’ll dig into the endocannabinoid system, phytocannabinoids and the final group we’ll discuss are the synthetic cannabinoids including the designer cannabinoid drugs found in the illicit marketplace that are contributing to significant morbidity and mortality.
Tournebize,J., et al,. Acute effects Of Synthetic Cannabinoids: Update 2015.
Substance Abuse 38(3):344, July-September
The post Episode 15: Medical Marijuana: Part 2 first appeared on Pain Talk.
Canada has the second largest consumption of cannabis world wide. While many people are using medical marijuana to manage various ailments, it’s use has only been approved for 3 conditions, those conditions being chemotherapy induced nausea/vomiting (CINV), neuropathic pain and pain at the end-of life, and spasticity associated with spinal cord injury and multiple sclerosis (MS). The next 3 episodes will explore the rules and responsibilities of clinicians regarding medical marijuana, different forms of cannabinoids and recommendations on a harm reduction approach.
The post Episode 14: Medical Marijuana: Part 1 first appeared on Pain Talk.
Solutions for Kids in Pain (SKIP) is a newly formed knowledge mobilization network, based at Dalhousie University and co-led by Children’s Healthcare Canada. It seeks to bridge the gap between current treatment practices and available evidence-based solutions for children’s pain in Canadian health institutions.
The post Episode 13: SKIP Interview first appeared on Pain Talk.
Pain Self-Management Programs (PSMP) are evidence driven, cost effective programs that provide information and teach practical skills on how to live and manage chronic pain.
The post Episode 12: Pain Self Management first appeared on Pain Talk.
Lauren McNeil is a Registered Dietitian with a Masters of Public Health in Nutrition and Dietetics currently residing in Toronto, Ontario. She graduated with honours from the University of Guelph (one of Canada’s leading nutrition programs) and completed a rigorous year-long dietetic internship with Nova Scotia Health Authority. During her dietetic internship she gained experience in acute-care, nutrition education, public health, diabetes, renal care, and much more. Find out more at her website www.tastingtothrive.com, check out her YouTube channel at Tasting to Thrive and find her on Instagram @tastingtothrive_rd!
The post Episode 11: Lauren McNeill RD, MPH first appeared on Pain Talk.
Dr. Michael Sangster is a pediatric physiotherapist who works with adolescents living with chronic pain. He works alongside other team members in the IWK hospital located in Halifax, Nova Scotia.
The post Episode 10: Dr. Michael Sangster first appeared on Pain Talk.
Inflammation is a natural reaction to the bodies attempt at self-protection to remove harmful stimuli. It is an essential component of the immune system, however inflammation can also cause damage to human tissue and cause organ dysfunction. As Nathan and Ding stated, the fundamental problem with inflammation is not how often it starts, but how often it fails to subside.
The post Episode 09: Neuro Inflammation first appeared on Pain Talk.
Central sensitization is a condition that occurs within the nervous system that contributes to a wind-up effect within the pain system, causing the nervous system to stay in a persistent state of reactivity. This persistent state lowers the threshold for what causes pain and contributes to a persistent state of pain even after the initial injury might have healed.
Central sensitization has two main characteristics, both of which involve a heightened sensitivity to pain and the sensation of touch. They are called allodynia and hyperalgesia.
The post Episode 08: Central Sensitization first appeared on Pain Talk.
Opioid analgesics, also known as painkillers, are an important type of medicines used in the management of pain. Despite their established benefit in acute pain, their usefulness in chronic pain has been questioned. While they bring relief to those with moderate to severe pain they also carry inherent risks that, when used in vulnerable populations or when combined with sedative-hypnotics, increase the possibility of serious complications such as opioid induced pain, addiction and death.
The post Episode 07: Opiod Analgesics first appeared on Pain Talk.
Chronic pain is a unique condition that requires a unique approach. It is a complex illness that co-exists with many medical conditions. The process of acute pain transitioning to chronic pain is called pain chronification. When pain becomes chronic the peripheral neuroanatomy becomes less important and central mechanisms such as central sensitization, neuroinflammation and psychological factors (fear, anxiety, pain avoidance) gradually take over necessitating a shift in management directed more at the central nervous system.
The post Episode 06: Chronic Pain first appeared on Pain Talk.
Virginia McIntyre shares her journey through the health care system and the many barriers she experienced.
The post Episode 05: Virginia McIntyre – Living with chronic pain first appeared on Pain Talk.
The International Association for the Study of Pain (IASP) defines acute pain as the normal, predicted physiological response to an adverse chemical, thermal, or mechanical stimulus whereas chronic pain is “pain without biological value that has persisted beyond the normal tissue healing time greater than 3 months”.
The post Episode 04: Acute Pain first appeared on Pain Talk.
The intensity of pain regardless of its duration or mechanism, is influenced by many factors that can have a positive or negative impact on how pain is experienced. Factors such as physical, emotional, social, and spiritual components all contribute to the multidimensional features of pain.
The post Episode 03: Total Pain first appeared on Pain Talk.
Pain has a purpose! The biological processes within our pain system act like an alarm to warn us of potential harm. These processes are linked to our fight, flight or freeze response which is a physiological reaction located in the Amygdala, or primitive brain in response to a real or perceived threat. Our ability to pay attention to pain and respond with purpose is essential for human survival.
When activated, these complex biological processes have the ability to alter pain signalling within the central and peripheral nervous system based on information rapidly gathered from higher-level sites within the brain.
Helpful Videos
Structured Approach to Pain
STEP 1
Use pain specific “Talking Points” that minimize fear and promote a safe caring environment.
Expose and debunk “worse case scenario” thinking of the patient
(Be open, curious, compassion, culturally sensitive, and non-judgemental)
1. Overall Message: “I believe you”
2. Acute pain: “When we experience pain, our brain is telling us that our tissue needs protection and attention. Can you tell me about the pain you’re having today?”
3. Chronic pain: “I can’t imagine how difficult living with chronic pain is for you. Can you tell me about the pain you’re having today?”
STEP 2
Are there any Interventions you can try?
Clinical actions that can modify the pain experience for the patient.
For example: Splinting, casting, nerve blocks, canes, crutches
STEP 3
Are there any Alternative Therapies you can try?
Therapeutic practices that have the healing effects of medicine but are not based on a scientific medical model.
For example: Acupuncture, homeopathy
STEP 4
What Pharmacotherapy could you try?
Pharmaceuticals that can modify our pain chemistry.
For example: Acetaminophen, anti-inflammatories
STEP 5
Risk Stratify for harm if Opioids or cannabinoids are used to manage pain.
Opioid Risk Tool
6 Step Approach to Chronic Pain1. LISTEN to the patient’s pain story
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ACKNOWLEDGE suffering
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EXAM carefully for any new pathology or progression of a pre-existing disease
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MAXIMIZE non-opioid and non-cannabinoid therapies
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RISK STRATIFY for harm if opioids and cannabinoids are used to manage pain
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MANAGE the risk by MAPing out an approach to opioids and cannabinoids
MAPINGMONITOR opioid and cannabinoid use for aberrancy
ADJUST immediately if aberrancy present
PRESCRIBE using principles of harm reduction
The post Episode 02: What we know about Pain first appeared on Pain Talk.
Meet Dr. Maureen Allen and learn about her journey in medicine and why she’s created the PainTalk podcasts.
The science of pain and our understanding of the nervous system has grown exponentially in the past decade.
No longer is pain viewed as a collection of cables passively transmitting nociceptive information; rather, it is seen as a dynamic structure that has the ability to change and adapt through sophisticated mechanism and complex biological messengers.
As our pain knowledge has grown, so has the development of both pharmacological and non-pharmacological interventions that can alter the pain experience for the patient.
The appropriate use of the different treatment modalities, however, requires a recognition that not all pain is the same nor are the goals of care, pain reduction targets, and pathophysiology similar.
The post Episode 01: Intro to PainTalk first appeared on Pain Talk.