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Case Report: How We Grew Our Pain Practice Amidst Pandemic, Opioid Crisis
COVID-19 led to sudden and unforeseeable changes in every aspect of our lives. Hospitals and independent medical practices were forced to adapt to rapidly changing safety guidelines and left to make changes based on their individual circumstances. Many private practices faced severe financial difficulties and steadily declining revenues as patients were hesitant to seek medical care.
TeleRheumatology Before and During the COVID-19 Pandemic
The COVID-19 pandemic has upended nearly every aspect of daily life, including routine medical care. In early April 2020, in-person medical practice visits were down 69% from pre-pandemic levels and, at the same time, telemedicine visits were at their highest levels in recorded history.
How to Conduct a Pain Evaluation Using Telemedicine
What you can – and cannot – assess in a virtual visit, and how to compensate. Plus, what to document.  
COVID-19 Long Haulers: A Look at Cardiovascular Risk
COVID-19 infection may cause a number of clinically significant cardiovascular events in connection with what is being called Post-COVID Syndrome or Long COVID. An indirect effect is related to the delayed diagnosis of urgent non-COVID conditions, because of concern with going to a hospital.
How COVID Has Changed Pain Practice and Policies
It has been just about a year since the United States entered into a variety of voluntary and mandatory lockdown measures in response to COVID-19, forcing the face of healthcare to change almost overnight.
Advanced Practice Matters with Theresa & Jeremy: Mentorship
I, Theresa, was recently approached by a woman who was new in her career as a nurse practitioner in pain management – she sought me out as a mentor.
What Pain Providers Read This Year – and Why You Should Read Them Too
Presenting:  PPM's Recommended Reading from the Editorial Advisory Board  
Navigating New York's Medical Marijuana Program: A Patient Handout
Since the approval of medical cannabis in New York state in 2014, there has been an increasing amount of interest in its clinical use. The role of medical cannabis has been particularly expanding in the pain specialty, where physicians have been seeking more non-opioid based treatments for chronic pain. 
Resident’s Corner: What Pain Medicine Education is Missing in the COVID Era
With the COVID-19 pandemic continuing to rage around the world and additional waves of infection likely, education in pain medicine will have to change in different ways in the coming years to train future physicians.
Commentary: Pausing Drug Testing During the Pandemic Is Not the Answer
Mistakes are not a problem – not learning from them is. A commentary.  
Advanced Practice Matters with Theresa & Jeremy: COVID, Pain, and Power
Introductory Note from the Authors In 2018, PPM introduced a new column called “Ask the APP” to bring awareness of the issues APRNs, NPs, and PAs face when practicing in the specialty of pain management.
Special Report: Race, Pain Management, and the System
Chronic pain is one of the most common conditions, affecting an estimated 116 million Americans, but it is not treated equally in this country – inside the data and perspectives from Michael Schatman, PhD, Terri Lewis, PhD, Sherra M. Watkins, PhD.
A Pilot Study: Incidence and Prediction of Diversion among Opioid Therapy Patients
Editors Note: Although opioid-related overdoses appeared to plateau or even decline, recent data suggests that opioid overdoses may again be on the rise.
Are Clinicians Effectively Counseling Patients on Safe Opioid Storage and Disposal? Survey Results
Prescription opioids play a vital role in the treatment of pain; however, unused pills may be diverted for nonmedical use, contributing to the abuse and misuse of opioid medications. Misuse is defined as taking prescription drugs for a different purpose than directed by the prescriber, and/or taking drugs more often, for a longer duration, or in greater amounts than prescribed.1
After the Task Force: A Conversation with Vanila A. Singh, MD
The field of pain management is undergoing changes like never before. With an opioid crisis and a pandemic, people in chronic pain are suffering on multiple fronts. Practitioners are similarly challenged with trying to help a growing patient population, largely from a distance, while also trying to maintain their own health – and sanity – without burning out.
Editorial: Fudin and Gudin Tackle Pain Care History – Asking, Have We Done a 180?
A commentary from PPM's Co-Editors-at-Large  
Tips from the Field: How to Enhance Practice Efficiency
Medical practices are facing growing pressure to provide value-based care, which is defined by a high ratio of positive outcomes to total cost of care.1 Increasing this ratio requires that the right patient see the right provider at the right location for the optimum amount of time at optimum cost.
Redefining the “Pain Specialist” of Today
What it takes to hold oneself out as a “pain specialist” is a question I began to ponder when I started working in pain management 20 years ago, with the larger question being, what exactly is a “pain specialist?” I thought the answer would be straightforward, but after two decades of clinical practice in the specialty, I still don’t have a clear answer.
Resident’s Corner: Climbing the Learning Curve in Pain Management
To those unfamiliar with the current landscape of medical training in pain management, there are no pain management or pain medicine residencies. To enter a pain medicine fellowship, an applicant must have completed a residency in anesthesia, physical medicine and rehabilitation, neurology, emergency medicine, psychiatry, or family medicine.
Pandemic Presents Unexpected Opportunity to Embrace Multimodal Analgesia and the Integrative Care Team
Background: Pandemic-Related Hospitalizations Pose Potential Pain-Med Shortages Demands on the healthcare system have increased and evolved due to the COVID-19 pandemic.
20/20 with Dr. Suzanne Amato Nesbit: Clinical Pharmacy Roles and Disparities
How the COVID-19 Pandemic Is Transforming Pain Care
During the 40-plus years of my medical practice, I have never observed disruption on the scale we are experiencing today. The changes we are observing could easily be compared to those faced by a community after a tsunami devastates their land and creates unimaginable chaos.
How the COVID Pandemic is Changing Medical Practice: A Q&A with Steven H. Richeimer, MD
The COVID pandemic has changed the practice of medicine in numerous ways, and its effects are experienced not only in the day-to-day critical care and emergency medicine settings but also in the area of pain management. In Steven H. Richeimer’s clinical practice, for example, which is a tertiary care center, patient care has been significantly altered.
How HCPs Can Use Telemedicine in the Time of Coronavirus
Telemedicine, also known as telecare or telehealth, has been used for many years to ease communication between providers and patients, and offers a convenient option for patients that require regular follow-up observation but are unable to ambulate easily due to medical comorbidities.
Treating Pain by Overcoming Communication Barriers
A Clinical Commentary
Will 2020 Be the Year of Patient Education?
A Clinical Commentary
When to Keep Your License: Older Physicians and Boundary Issues
A Guest Commentary
A Physician Primer: Drugs with Orphan Designations for the Treatment of Pain Conditions
Recommendations of the HHS Pain Management Task Force
A June 2019  Issue PPM Online Exclusive
How to Provide Effective Pain Management to LGBTQ Individuals
Providing effective pain care to special population groups, including members of the LGBTQ community
Perspective: Could NGF Antagonists Be the Safest, Most Efficacious Class of Drug We Have to Treat Pain?
The author shares his clinical experience with the use of nerve growth factor (NGF) antagonists in the management of chronic pain.
Correspondence: Continuing the “Pain Specialist” Dialogue
September/October 2019 Letters to the Editor, including a dialogue around pain practitioner credentials.
Guest Editorial: Sex Differences in Pain
It's become increasingly clear that males and females require unique assessments of their chronic pain conditions.
The Federal Controlled Substances Act: A Primer for Providers
What HCPs need to know regarding the prescribing of controlled substances, including refills and DEA registration.
Book Review: A Useful Guide for New Pain Practitioners
A new book by Peppin, et al, offers pain practitioners, policymakers, and regulators clarification around prescription opioids.
The Sex Question in Primary and Pain Care
The University of Florida's Meryl J. Alappattu, PT, DPT, PhD, on why HCPs need to be asking about sexual pain.
Blood Biomarkers Show Promise for Precision Pain Management
Individual biomarkers may change the way pain is reported and managed.
Chronic Wound Management in the Ambulatory Setting
Despite low supportive evidence, certain advanced wound therapies may benefit patients.
Brief Behavioral Interventions for Chronic Pain
How to implement behavioral pain medicine strategies across the continuum of chronic pain care.
Letters: Slipping Rib Syndrome; Burning Leg Pain; CGRP Complications
June 2019 PPM Letters to the Editor, featuring CGRP (Aimovig) complications, CRPS, and slipping rib syndrome.
For APPs: How to Contribute to Clinical Research
As an advanced practice provider (RN, PA, APP) working in pain management, can I contribute to clinical research?
Letters: Opioid Conversions; Scrambler Therapy for CRPS
The April/May 2019 Letters to the Editor focus on opioid conversions (morphine to methadone) and scrambler therapy for CRPS.
Q&A with Howard L. Fields: How Patients’ Expectations May Control Pain
A Q&A with UCSF Neurologist Howard L. Fields, MD, PhD, on pain signals, pathways, decision-making, and optimism.
When Patient Education Fails to Improve Outcomes: A Low Back Pain Case
Further investigation into instructional interventions and their impact on pain chronification are necessary.
Letters: The Word "Catastrophizing;" AIPM Ceases Operations; Patient Questions
March 2019 Letters to the Editor: AIPM ceases operations, pain catastrophizing with Beth Darnall, and more.
APPs as Leaders in Pain Management
Is there value in having an Acute Pain Service, and can APPs take the lead? Our resident APP responds.
How to Compel Patients to Complete Home Exercises
Tips for encouraging patients with chronic pain to complete an exercise regimen.
Antidote to CDC Guideline; Plantar Fasciitis; Patient Input
Practitioners and peers discuss the CDC guidelines, plantar fasciitis, cannabis for migraine and rheumatoid arthritis, and light therapy.
The Future of Pain Management: An Experts' Roundtable
Industry experts Jianguo Cheng, Stefan Evers, W. Clay Jackson, Lynn Kohan, William Maixner, Paula Marchetta, and more share their visions.
A 2018 Update: The Federal Pain Research Strategy
The US Department of Health and Human Services established the Interagency Pain Research Coordinating Committee as part of the Patient Protection and Affordable Healthcare Act (Public Law 111-148) to coordinate all pain research efforts within HHS and across other federal agencies.
How to Fit into a New Practice
Fitting into a new practice may be tough, but there are several measures you can take to ensure a smooth transition.
How to Talk to Your Chronic Pain Patients
Early interactions with chronic pain patients are key to treatment acceptance trust, and ongoing communication.
Naloxone in Schools; Buprenorphine Conversions; OUD Management
Practitioners and peers discuss naloxone access in schools, converting products to buprenorphine, and OUD / MAT management.
Letters to the Editor: Recovery Centers Reject MAT, Cannabis for Chronic Headaches, Central Pain
Practitioners and peers discuss how recovery centers may rejection medication-assisted treatment for OUD, the prospect of cannabis for chronic headaches, and more.
Pharmacists as Essential Team Members in Pain Management
The Society of Palliative Care Pharmacists shares a vision for enhancing the pharmacist’s crucial role in chronic pain, palliative care, and hospice care.
New 3-Credit CME Online Course on Pain Management and Addiction
Resource for Your Practice
Challenges Facing Abuse-Deterrent Formulations
Inside the roadblocks affecting the pain care industry’s use ofabuse-deterrent opioids, including insurance coverage and prescribing tactics.
Editorial: Our Clinical Pain Neighborhood
New PPM Co-Editors-at-Large Jeff Gudin, MD, and Jeffrey Fudin, PharmD, reflect on the collaborative nature of the pain management community.
Letters to the Editor: ACT Therapy; Compounded Topicals
Clinicians answer reader questions and comments regarding ACT Therapy and topical analgesics.
Quality Training: One Center’s Experience with Pain Assessment
JPS Health Network and the American Society of Clinical Oncology share their experience in improving pain documentation and plans of care.
Behind the AHRQ Report
Many non-pharmacological therapies have limitations that stunt their progression into therapies for chronic pain.
The Importance of Developing Professional Relationships in Pain Practice
Clinicians treating patients with a variety of chronic pain conditions may improve overall outcomes by reaching out to other practices and specialists.
Independent Pain Practice: A Case Example
Clearway Pain Solutions Institute sought an outside partner to grow its advanced pain solutions both nationally and regionally.
Are Abuse-Deterrent Opioids Appropriate for Your Pain Patient?
Individual factors related to the patient make abuse- deterrent opioids a worthwhile consideration.
Managing a New High-Dose Opioid Patient
When taking over the management of a high-dose opioid patient, follow these steps to update their treatment plan.
Mobile Trackers and Digital Therapeutics
mHealth apps and other digital technology could make practitioner-patient communication smoother.
Gaps in the Pharmacist’s Pain Management Role
A Virginia-based study provides insight into pharmacists' perceptions of pain practice, knowledge gaps, and the realities of dispensing scheduled pain medications.
Commentary: Limiting Opioid Prescriptions Alone Won’t Cut It
Pending legislation from the House of Representatives promises to offer more treatment alternatives for patients in chronic pain.
It Hurts: A New Practical Guide on Pain Management
An excerpt* from the preface of It Hurts: A Practical Guide for Pain Management (WellBridge Books, 2018).  Read more about Kern A. Olson, PhD, the author.
Parenteral Opioids Shortage: What Options Exist for US Health Centers and Hospitals?
There have been unintended consequences to the regulatory measures of reducing the quantity of opioids prescribed.
The Emergence of Trackable Pill Technology: Hype or Hope?
Technological advances in wearable medical technology have optimized delivery and efficiency of healthcare, including within the field of pain management.
Inside ASRA with David Provenzano, MD
The ASRA World Congress meeting will cover multiple therapies, as well as advocacy in pain practice.
Management of Intrathecal Therapies by Interprofessional Teams
While the physician may conduct the IT trial and implant, PAs, NPs, and RNs often provide follow-up, patient education, and technical care of the pump.
Nurse Burnout in Pediatric Pain Management: A Model and Pilot Intervention
Dousing the Physician Burnout Epidemic: An AMA Perspective
It is clear that physicians spend too much time on administrative tasks.
The Impact of Pain Practice
Physician burnout is a reality, and it comes at the expense of many pain patients.
Physician Burnout: An Oldtimer’s View
Recognizing, preventing, and treating physician burnout should be a priority to all pain practitioners.
Sharing the Risk: An Update to DEA & Doctors Working Together
The Share the Risk model focuses on providing chronic pain patients with a more comprehensive look, including legal and ethical considerations as well as cognitive and psychological profiles, at why and when they may require opioids.
Two Mobile Apps Aim to Target Patient Compliance & Safety
Two new pain management technologies make it easier to take prescriptions and respond to opioid overdose, including through administration of naloxone and direct observational therapy.
Why Prescribers Need to Adopt Abuse-Deterrent Opioids
ADC Chair Dan Cohen calls on the use of abuse-deterrent technologies to help deter patients and users from opioid misuse, abuse, and addiction.
Reporting Quality of Care in Cancer Pain Management
The American Society of Clinical Oncology aims to improve pain practice guidelines and management with new initiatives.
The Intensifying Conflict Between Opioid Control and Pain Control
CDC opioid prescribing guidelines continue to make it difficult for pain management practices. This report provides an inside look at what chronic pain patients and their practitioners are facing.
Pain Care in a Natural Disaster
Clinic guest-dosing and advance planning may help pain and addiction treatment centers to continue providing services when a natural disaster strikes.
The Internet of Medical Things
Big data and new devices may allow for practitioners to track patient adherence to medication, change payment models, and improve health outcomes.
Letters to the Editor: An opportunity to learn what is on the minds of your colleagues and patients.
Dr. Forest Tennant addresses public and practitioner concerns over morphine equivalent dosing, opioid tapering, and depressed testosterone levels.
How Well Do You Know Your Patient?
Physicians who listen to and heed patient functioning and feedback will assure quicker, more effective pain management.
Specialized Pharmacies Step Into Risk-Management Role
REMS, TIRF, CDC Guidelines—there is a lot that pain specialist must manage outside of their daily practice. To help, Jeff Gudin, MD, and other pain specialists rely on the expertise of specialized pain pharmacies.
AAPM Annual Meeting: Focus on Primary Care
A preview of American Academy of Pain Medicine's goals and expectations for their annual meeting, being held in Palm Springs, CA, February 18-21, 2016
Incorporating Concierge Medicine into Pain Management
Some physicians have turned to a Concierge Medicine model (fee-for-care) to better serve their chronic pain patients. Learn more about this type of health care model/
Pain Studies Program Emphasizes Pain Education as a Public Health Imperative
The Pain Research, Education, and Policy (PREP) program at Tufts University School of Medicine, Boston, Massachuesetts takes a unique approach to pain education. Practical Pain Management spoke with founding director of the PREP program Daniel B. Carr, MD, about the goals and vision of the program. Dr.
12 Classes Offered at VA Pain School
The VA Pain Education School consists of 12-weeks of 1-hour classes with an additional 1-hour introduction class during the first week (total of 13 hours).
Pain Education Across VA Clinics
An evaluation of the VA's Pain Education School for healthcare providers who treat patients with chronic pain.
Commentary: Risk Assessment in the Digital Age
I congratulate the authors of this article on a new screening tool for their research and lucid writing.1 It is clear today that risk assessment and stratification are essential to mitigating risk with opioid use, and improvements in this area are
Opioid Prescribing Part 1: A Practical Guide to Appropriate Documentation
Pain is one of the most common reasons patients visit a health care professional. Professionals spend a great deal of time learning how to diagnose and treat pain-related medical problems but much less time learning how to document the process.
Practical Pain Management: The Nation’s Premier Teaching Journal for Pain Practitioners
Over a dozen years ago, the United States Congress proclaimed the “Decade of Pain,” and the infamous 1 to 10 visual analog pain score became the 5th vital sign. At just about the same time, Marvin Rosenfeld—not a physician but a publisher—believed that practicing physicians who treated pain patients needed a tutorial magazine that contained practical tips on case management.
When Referring Patients, Not All Pain Specialists Are the Same
Pain Management Coding Changes Can Sting, But Knowledge Can Help Ease the Pain
5 Things You Need to Do to Remain Compliant With AMA CPT Coding Change
  • Have you reviewed the coding changes for 2012?
  • Have you updated your super bills and templates?
New Tools for Improving Patient-to-Physician Communication in Clinical Practice
Article describes the benefits of using computerized patient-reported outcomes data in the clinical pain practice.
On the Role of Primary Care Within a System of Integrative Multi-disciplinary Pain Management
Article discusses the role of primary care within a system of integrative multi-disciplinary pain management.
Pain Education and Pain Educators
With limited opportunities of pain management residencies, and fellowships, alternate means must be employed for practicing physicians to train in the basics of pain management.
The Demise of Multidisciplinary Pain Management Clinics?
A potential strategy for addressing the conflicting ethos of business-oriented insurance and corporate healthcare vs the ends and means of right and morally sound patient care.
Share the Risk Model
Originating in San Diego, CA, the Share the Risk Model is an example of successful collaboration among doctors to mitigate professional risks while improving care for pain patients.
The ABC's of Pain Clinic Referrals
This article explains the some of the basic, common-sense criteria for referring a patient to a pain treatment clinic.
Provider-patient Interactions
Article explains how to understand unconscious interpersonal defensive responses in a chronic pain practice to improve interactions.
An Historical Perspective: A Global View of Evolving Pain Treatment Modalities
The former head of the largest pain clinic in Central Europe offers observations on multi-disciplinary treatment modalities evolving over the past 25 years.
Facility Profile: Casa Palmera
Casa Palmera has become a model center for the treatment of comorbid chronic pain, substance dependence, eating disorders, and emotional trauma by bringing together the best of Eastern and Western medicine with neuroscience.
The Multi-disciplinary Pain Medicine Fellowship
Article addresses the multidisciplinary pain medicine fellowship: Will it change the practice of pain medicine?
Share the Risk Pain Management in a Dedicated Facility
Article explains how the Share the Risk Model is used in pain management in a dedicated facility. this article is a first in a series of case reports.
Evaluation and Management Codes Drive Medical Necessity
In the last article, I discussed medical necessity since the OIG 2008 Work plan will focus on pain management clinics. Medical necessity definitions vary from one payer to the next. Fortunately, Medicare—and most Blue Cross and Blue Shield plans—publish their definitions.
Consistent Documentation Drives Compliance
As the healthcare world transitions to EMRs, it's more important than ever to have consistent documentation in proving compliant patient care.
Chronic Pain Program in a Primary Care Setting
With a designated pain professional and appropriate safeguards, a pain management program can be successfully integrated into a multi-physician primary care clinic.
Compliant Billing, Coding and Documentation for Interventional Pain Management
A pain management specialist reviews billing and coding requirements for the interventional pain management field.
HIT Advisor
Are You Really Utilizing Your EMR
Editor's Memo
Share The Care—Not Just The Risk
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