Steven A. King, MD, MS

February 02, 2012

There is no doubt that because the number of cases of diabetes is rapidly growing in this country, so is the number of patients with diabetic neuropathic pain. Thus any new recommendations for improving treatment of DNP are welcome. However. . .

January 11, 2012

As technological advances in medicine have progressed from the measurement of temperature to the ability to test for genetic factors that can predispose to disease, physicians have sought objective measures for their patient’s problems. When it comes to pain, however-the most common complaint that drives patients to see doctors-we still rely on the subjective report of the individual patient as the primary measure.

November 04, 2011

Antidepressants are often referred to as “adjuvant analgesics.” Although the name suggests that these agents don’t provide direct pain relief in the same way as opioids or NSAIDs, it is well established that antidepressants provide excellent analgesia for many pain conditions.

September 24, 2011

We have long known that many adolescents have chronic pain. A new study highlights just how widespread it is-and the significant impact it can have.

August 25, 2011

For years, GI toxicity and risk of bleeding were the issues of most concern when deciding to prescribe an NSAID. The cardiac effects associated with these drugs were considered a positive in that least some have been shown to provide prophylaxis against myocardial infarction.

July 23, 2011

Pain is a subjective complaint. We can’t measure it as we can, for example, hematocrit, blood pressure, or blood glucose. If a patient doesn’t complain of pain, we generally assume that he or she isn’t experiencing it. But what about patients who have pain but who are physically or mentally unable to tell anyone about it?

May 03, 2011

Twenty years ago, the American College of Rheumatology (ACR) introduced the following clinical criteria for the diagnosis of fibromyalgia (FM) . . .

April 06, 2011

A variety of effective treatments are available for diabetic peripheral neuropathic pain (DPNP), including topical agents, oral medications, and nondrug approaches. The lidocaine patch 5% is recommended for relatively localized pain.

November 01, 2003

ABSTRACT: The results of diagnostic tests do not correlate well with the presence and severity of pain. To avoid missing a serious underlying condition, look for "red flags," such as unexplained weight loss or acute bladder or bowel function changes in a patient with low back pain. Nonopioid medications can be more effective than opioids for certain types of pain (for example, antidepressants or anticonvulsants for neuropathic pain). When NSAIDs are indicated, cyclooxygenase-2 inhibitors are better choices for patients who are at risk for GI problems or who are receiving anticoagulants. However, if nonspecific NSAIDs are not contraindicated, consider using these far less expensive agents. The tricyclic antidepressants are more effective as analgesics than selective serotonin reuptake inhibitors. When opioids are indicated, start with less potent agents (tramadol, codeine, oxycodone, hydrocodone) and then progress to stronger ones (hydromorphone, fentanyl, methadone, morphine) if needed.