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Index of Articles by Volume/Issue

Vol. 10, No.6

Jul/Aug 2010

Testosterone Replacement in Chronic Pain Patients
Adequate testosterone serum levels are required in males and females not just for libido and sexual function but also for cellular growth, healing, maintenance of muscle mass and bone, and central nervous system maintenance of opioid receptors, blood- brain barrier, and dopamine-norepinephrine activity. by Forest Tennant, MD, DrPH and Lisa Lichota, DO
Why Some Patients Require High Dose Opioid Therapy
Chronic pain syndrome represents the end stage of maladaption of having pain as the stressor and, as a result, homeostasis is severely disturbed in all aspects with abnormal default settings for emotions, immunity, hormone balance, thought, and memory. by Edward Manougian, MD
Raising Pain Tolerance Using Guided Imagery
Patients can derive not only symptomatic relief but actual physiologic healing in response to treatments that primarily work through beliefs and attitudes about an imagined reality. by David E. Bresler, PhD, LAc, DiplAc (NCCAOM)
Long-Standing Groin Pain in a Male Athlete
Case report of chronic unilateral pain from a sports-related groin injury is discussed along with proposed pathophysiology, diagnosis, and treatment. by Melissa Blum, DO
Assessing Pain of the Pediatric Patient in the Emergency Setting
The reliability of subjective pain scales for the pediatric patient depends on the particular scale being used, the demographics of the child, the origin of the child's pain, as well as any social and environmental factors surrounding the child at the time of self-report. by Eric Steinberg, OMS IV and Leonard B. Goldstein, DDS, PhD
Guest Editorial: Anticipating the Future of Pain Management
by Joel S. Hochman, MD
Guest Editorial: FDA's Proposed Risk Evaluation and Mitigation Strategy (REMS) for Opioids
A brief overview and critique. by Kenneth L. Kirsh, PhD; John F. Peppin, DO, FACP; and John J. Coleman, PhD
Publisher's Message: He Never Really Left
by Marvin Rosenfeld
Prolotherapy: Platelet Rich Plasma Prolotherapy as First-Line Treatment for Meniscal Pathology
Animal research together with five patient case reports demonstrate that Platelet Rich Plasma Prolotherapy (PRPP) is effective in the treatment of MRI-documented meniscal tears. by Ross A. Hauser, MD; Hilary J. Phillips; and Havil Maddela
Headache: Cluster Headache
Summary of cluster headache characteristics and update on abortive treatments utilizing first-line and second-line medications. by Lawrence Robbins, MD
Laser Therapy: Effectiveness of Laser and Non-Coherent Light Therapies
Many laser therapy equipment manufacturers are designing and selling emitters or probes that contain both laser and non-coherent light diodes together in a hybrid emitter to harness the effects of both. by William J. Kneebone, RN, DC, CNC, DIHom, FIAMA, DIACT
Fibromyalgia: Opinion on Preliminary Guidelines for the Clinical Diagnostic Criteria for Fibromyalgia
Omitting "undue sensitivity to touch" from any diagnostic criteria for fibromyalgia will, in this author's opinion, disparage one seminal feature that is the essence of fibromyalgia and confound a definitive diagnosis. by Robert Bennett, MD
HIT Advisor: Doctors May Now Electronically Prescribe Schedule II Drugs
An in-depth look into the past, present and future of the electronic prescribing of controlled substances. by Peter Kaufman, MD

Vol. 10, No.6

June 2010

Platelet Rich Plasma for Hamstring Tears
A case report of a single percutaneous application of platelet rich plasma to a severe hamstring tear demonstrates sustained improvements with near-complete repair on MRI. by David C. Karli, MD and Brent R. Robinson, BS
Non-Responsive Pain Patients With CYP-2D6 Defect
Pain patients who do not respond to the analgesic properties of opioids have a chance of being genetically incapable of generating the clinically-active metabolite of these medications. by Alan Edwards, PAC, BS-PHARM
Urine Drug Testing as an Evaluation of Risk Management Strategies
Implementation of multiple risk assessment and monitoring strategies appears to lower the rate of inappropriate UDT results. by Ted Jones, PhD; James D. McCoy, FNP-BC; Todd Moore, PhD; Susan Daffron, FNP; and Joe
Co-Morbid Psychological Disorders in Interventional Pain Management
Depression, anxiety, interpersonal issues, personality disorders, and cognitive decline may decrease the effectiveness of interventions. by James Cloyd, PhD
The New Iontophoresis
High potency corticoid hormones that are iontophoretically delivered by modern electromagnetic instruments have therapeutic benefit. by Forest Tennant, MD, DrPH
Compliance Monitoring and Effective Risk Mitigation Strategy
Compliance monitoring using laboratory screening and confirmation, together with physician education, can support an effective risk mitigation strategy. by Michael Evans, PhD; Scott Kriger, PhD; Joshua Gunn, PhD; and Gene Schwilke, PhD
Cultural Differences and Pain Management
An osteopath's experience in Southwestern Alaska with Native Americans provides a perspective on how cultural differences may confound and complicate pain management. by Michelle J. Curtin, DO and Leonard B. Goldstein, DDS, PhD
Publisher's Message: There's a Lot to Pain Management
by Marvin Rosenfeld
Interventional Therapy: Thoracic Facet Injections
Thoracic facet-mediated pain may be more common than previously thought and, due to potentially confounding pain patterns of competing structures in and around the thoracic spine, the gold standard for diagnosing facet-mediated pain is intraarticular injection. by Jonathan Blau, MD, PA
Head and Neck: Kinetic Chain from the Toes Influences the Craniofacial Region
This study examines the relationship between plantar toe flexion and mouth opening and the resulting subjective pain relief of pain to the head, neck and mandibular regions. by David Rubenstein, PhD
FMS: An Osteopathic Approach to Fibromyalgia
A patient-centered, health-oriented approach that includes utilization of manual diagnosis and treatment as a complement to medication, counseling, and nutritional advice. by Michael A. Seffinger, DO, FAAFP
Headache: Vitamin D Levels in Pain and Headache Patients
On-going studies implicate low levels with many disease states, including pain and headache, and so it is prudent to normalize a patient’s Vitamin D serum level. by John Claude Krusz, PhD, MD; Jane Cagle, LVN; Jonette Albright, NP; and Virginia
HIT Advisor: Electronic Prescription of Controlled Substances
A major milestone in healthcare it history has been reached with DEA lifting restrictions on e-prescribing. by Peter Kaufman, MD
Laser Therapy: The Treatment of Achilles Tendonitis Utilizing Therapeutic Laser
Evidence supports considering therapeutic laser in the treatment and rehabilitation of Achilles tendonitis alone or in combination with more conventional therapies. by William J. Kneebone, RN, DC

Vol. 10, No.5

May 2010

Making Practical Sense of Cytochrome P450
Guidelines for the likely 20 to 30% of pain patients who have a genetic defect involving one of three major CYP450 enzymes and so cannot effectively metabolize certain opioids that must be converted to a metabolite to be effective. by Forest Tennant, MD, DrPH
Non-Pharmacologic Treatment of Shingles
Shingles pain and lesions resolved in 48 hours after treatment with frequency-specific microcurrent. by Carolyn McMakin, MA, DC
Treatment of Painful Cutaneous Wounds
Comprehensive management and pain control are critical for patients with chronic wounds in order to improve outcomes and speed healing. by Michael Maier, DPM
Guest Editorial: Treating Myofacial and Other Idiopathic Head and Neck Pain
Neuromuscular dentistry looks at the system as a whole, including teeth and bones, together with a comprehensive evaluation of the musculature involved. by Mark Duncan, DDS, FAGD, DICOI, LVIF
In Memoriam: David G. Simons, MD
by Carolyn McMakin, MA, DC
Publisher's Message: A Meaningful Exchange
by Marvin Rosenfeld
Ethics and Health Policy: Pain, Neurotechnology and the Treatment-Enhancement Debate
Protocols for the use of medical interventions should be frequently assessed, revised and followed by reflective evaluation and prudent governance to establish guidelines and policies. by James Giordano, PhD, Mphil; Justin Rossi, BSc; and Adriana Gini, MD
Clinical Report: Functional Capacity Evaluation (FCE)
While not yet precise enough as a predictive tool, FCE can be combined with other sources of information such as medical, rehabilitative and diagnostic data to help resolve issues of compensability, disability and employability. by Tiziano Marovino, DPT, DAAPM
Prolotherapy: The New Age of Prolotherapy
In addition to traditional prolotherapy, platelet-rich plasma and stem cells are also available to enhance healing of musculoskeletal injuries and mitigation of pain. by Donna Alderman, DO
Laser Therapy: Enhancement of Nerve Regeneration by Therapeutic Laser
Therapeutic laser shows promise as an accelerator of healing and neural regeneration in the central nervous system. by William J. Kneebone, RN, DC
Headache: Chaos (Nonlinear Dynamics) and Migraine
By affecting chaotic (nonlinear) controls, whereby a tiny change in initial conditions may lead to a profound difference later in the process, new therapies may be employed that use less drug in the migraine cascade than is currently required. by Lawrence Robbins, MD and Cameron Leith, PhD

Vol. 10, No.3

April 2010

Refractory Chronic Migraine
RCM is often a disabling, debilitating and challenging illness and patients who have medication overuse headache or psychological comorbidities require a combination of therapeutic approaches. by Lawrence Robbins, MD
Diagnostic and Therapeutic Issues of Neuropathic Pain
The use of laboratory studies and imaging studies in the diagnosis of neuropathic pain present clinical challenges and, although medications remain the mainstay of therapy, it is frequently necessary to try multiple different medications and modalities for adequate treatment. by Richard M. Donnini, DO
Taking Advantage of the Peripheral Opioid Receptor
Opioids applied in a topical cream that directly target the peripheral opioid receptors (which grow in inflammatory pain sites to attract natural endorphin compounds for pain relief and immune enhancement) may have advantages relative to oral opioids. by Forest Tennant, MD, DrPH
Post-Operative Inguinodynia From Hernia Surgery
Inguinodynia as a hernia post-operative chronic pain syndrome may occur due to an assortment of causes including mesh shrinkage, inflammation, scarification, as well as surgical technique. by Jeffrey B. Mazin, MD, FACS
Traumatic Brain Injury (TBI) Pain Phenomena
The primary focus when helping TBI pain patients should involve understanding the diagnoses, recognizing pain, assisting with pain relief and providing the opportunity to improve function. by Glenna Tolbert, MD
Publisher's Message
Opioid Prescribing and Genetic Metabolic Deficiencies to Be Featured in the May Issue by Marvin Rosenfeld, Publisher
Fibromyalgia: Physical Medicine and Rehabilitation for Fibromyalgia
Optimal rehabilitation outcomes in a fibromyalgia patient require that the treatment be tailored to the individual patient's symptoms, examination findings and subject to periodic testing to allow for adjustment. by Scott Stoney, MD
Interventional Therapy: Emergency Protocols for the Spinal Injectionist
This second of two articles addresses the fact that emergencies arise so infrequently that physicians don’t think about or practice emergency protocols in advance and offers suggestions for being prepared to handle complications during spinal interventional procedures. by Richard M. Rosenthal, MD
CRPS: Body Perception Disturbance (BPD) in CRPS
Current and emerging therapeutic approaches including desensitization techniques and mirror visual feedback, together with the introduction of a new clinical tool for the early identification of BPD. by Jenny Lewis, PhD, Dip COT and C. S. McCabe, PhD, RGN
Laser Therapy: Therapeutic Laser in the Management of Arthritis
Applying laser therapy to the arthritis patient by using a combination of application techniques can provide considerable relief in many cases. by William J. Kneebone, RN, DC
Ethics and Health Policy: Realizing the "Promise" of Pain Management and
Considerations for Practice, Ethics and Policy by James Giordano, PhD and Gerhard H�ver, PhD

Vol. 10, No.2

March 2010

Deconstructing Complex Regional Pain Syndrome
Progress in understanding the pathophysiology of CRPS is leading to new and more effective treatments. by Robert J. Schwartzman, MD
Introduction to a Referred Sympathetic Pain Map
The Fibromatome Map bridges the gap between recent pharmaceutical discoveries of widespread pain due to hyperactive nerves and interventional spine medicine by effectively identifying and treating specific nerve roots that cause widespread pain. by Mathew C. Wallack, MD
Feedback and Response Regarding ACOEM's Practice Guidelines
Guest Editorial: Psychologists as Primary Care Providers
Psychologists are trained in advanced skills that intrinsically lend themselves to the management of chronic pain and complex health care problems. by Ron Lechnyr, PhD, DSW, and Terri Lechnyr, PhD
Guest Editorial: FDA's Risk Evaluation and Mitigation Strategies Program
Proceed with Extreme Caution by Mark Collen
Publisher's Message: You Can Be An Author
by Marvin Rosenfeld
Interventional Therapy: Avoiding Complications From Interventional Spine Techniques
This first of two articles helps practitioners identify and avoid complications associated with spinal interventions and offers suggestions for resuscitation should a severe complication occur. by Richard M. Rosenthal, MD; Denice Starley, DO; and Chad Austin, MD
Laser Therapy: Laser Therapy in the Management of Fibromyalgia
Therapeutic low-level laser has good pain relieving and anti-inflammatory effects and has been shown to increase the quality of life in Fibromyalgia patients. by William J. Kneebone, RN, DC
Clincal Report: Expanding Ellipsoidal Decompression (EED�) of the Spine
A novel approach to the treatment of neck pain and postural dysfunction by a self-administered therapy provides an immediate treatment effect in the form of disc positional and conformational changes. by Tiziano Marovino, DPT, DAAPM
Ethics and Health Policy: Neurotechnology, Evidence, and Ethics
On Stewardship and the Good in Research and Practice by James Giordano, PhD
Head and Neck: Sphenopalatine Ganglion Neuralgia Diagnosis and Treatment
The sphenopalatine ganglion has been infrequently implicated in vague symptoms of the head, face, gums, teeth, neck and back since the early 1900s. by Edwin A. Ernest, III, DMD

Vol. 10, No. 1

Jan/Feb 2010

Genetic Influences on Pain Perception and Treatment
Genomic variations influence basal pain sensitivity and the likelihood of developing chronic pain so it is logical that the future of medicine is to provide more focused treatment based on a person's genetic code. by Alyson Fincke, DO
Biopsychosocial Approach to Management of Total Joint Arthroplasty Patients
Preoperative biopsychosocial screening can identify patients at risk for poor post-surgical outcomes and determine whether patients would benefit from additional pre- or post-surgical treatment aimed at increasing physical function or reducing psychosocial distress. by Krista J. Howard, MS; Mohammed A. Khaleel, MD; Henry B. Ellis, MD; and Robert J.
Use and Effectiveness of Spinal Cord Stimulation
Spinal cord stimulation has been one of the major advances in the efficacious and cost-effective treatment of chronic pain patients with multiple, different pain processes. by Richard M. Donnini, DO
Hormone Replacements and Treatments in Chronic Pain: Update 2010
When severe pain and stimulation of the pituitary-adrenal-gonadal axis goes unabated over time, exhaustion of some adrenal compounds may develop and, left untreated, may pose a combination of problems. by Forest Tennant, MD, DrPH
Opioid Treatment 10 Year Longevity Survey: Final Report
Patients in this study were found to be functioning quite well after 10 or more years on generally stable opioid dosages, with the vast majority able to care for themselves and even drive. by Forest Tennant, MD, DrPH
Publisher's Message: Our Tenth Year
by Marvin Rosenfeld, Publisher
CRPS: An Overview of CRPS
A brief overview of some of the principles and components of the evaluation and management of CRPS. by Peter A. Moskovitz, MD
Headache: Headache in Children and Adolescents
A multidisciplinary approach�a balance of medication with therapy and lifestyle changes�is the most helpful for children with severe headaches to help them return to normal functioning in home, school and social life. by Joseph Maides, DO and Lawrence Robbins, MD
Ethics and Health Policy: Balancing Evidence, Efficacy and Stakeholder Values in
The task ahead is to integrate a moral vision and ethical roadmap into the development of unifying guidelines and policies that acknowledge and preserve particular values of stakeholders, adapt and mobilize market structures in the service of medicine and, in so doing, strive to uphold the integrity of pain care as a patient-centered endeavor. by James Giordano, PhD
Prolotherapy: Dextrose Prolotherapy Injections for Chronic Ankle Pain
In this retrospective observational study of chronic unresolved ankle pain, Hackett-Hemwall dextrose prolotherapy helped promote a measurable decrease in the pain and stiffness of the treated joints and improvement in clinically-relevant parameters. by Ross A. Hauser, MD; Marion A. Hauser MS, RD; and Joe Cukla, BA, LPN
Interventional Therapy: Thoughts on Interventional Articles for 2010
by Richard Rosenthal, MD
Laser Therapy: Therapeutic Laser in the Treatment of Herpes Zoster
Laser therapy can be easily and economically utilized in the treatment of both acute phase herpes zoster and in chronic post-herpetic neuralgia. by William J. Kneebone, RN, DC

Vol. 9, No. 9

Nov/Dec 2009

A Practical Guide for the Use of Opioids in Chronic Pain
With proper knowledge, safeguards, structure and record keeping in place, primary care physicians may find a personal comfort level in prescribing opioids to chronic pain patients who legitimately require them. by Jennifer P. Schneider, MD
Testosterone Replacement in Female Chronic Pain Patients
Testosterone assists opioids in crossing the blood brain barrier and helps activate a number of central receptors and neurochemicals systems. It is a judicious, ethical, and clinically necessary practice to replace testosterone in female chronic opioid patients�subject to informed consent. by Forest Tennant, MD, DrPH
Special Section: Nutritional Supplements in Pain Practice
Restoring the Natural Opioid System With D-Phenylalanine (DPA); and Milk Thistle to Enhance Liver Function and Drug Therapy by Julia Ross, MA, MFT; and By Donald Adema, DO
Co-Morbid States Are the Rule, Not the Exception, in Pain Practice
Depression, anxiety, coping, somatization, sleeplessness, and hypochondriasis are prevalent in the chronic pain population and, left untreated, are associated with greater risk for poor outcomes. by Murray H. Rosenthal, DO, FAPA
Publisher's Message: Thank You, Dr. Webster
by Marvin Rosenfeld, Publisher
Clinical Report: Computerized Dynamometry in Impairment Evaluations
Isokinetic computerized dynamometry provides objective, reproducible, and valid measurements in clinical decision making regarding return to sport, return to work, and impairment and disability assessments. by Tiziano Marovino, DPT, DAAPM
Head and Neck: Middle Ear, Eustachian Tube, and Otomandibular/Craniofacial Pain
This case report found that a unique monomodal treatment protocol�utilizing a passive intra-oral appliance�both verified the diagnosis and provided immediate relief to sympathetically-mediated pain suffered by the patient over the previous ten years. by Gale D. Kloeffler, DDS
HIT: Dictation Versus EMR-Based Reports
With dictation costs going up, government and third party payers mandating that doctors transition to EMR systems, and ARRA reimbursements for EMR "meaningful use" to start in 2011, the time for a decision on purchasing an EMR system is closer than you think. by Greg Winterkamp
Fibromyalgia: Adult Growth Hormone Deficiency in Fibromyalgia
Growth hormone deficiency was found in many fibromyalgia patients in a community rheumatology practice. by Thomas J. Romano, MD, PhD
Prolotherapy: Dextrose Prolotherapy for Unresolved Wrist Pain
This retrospective observational study of patients with unresolved wrist pain noted improvements in many quality of life parameters after Hackett-Hemwall dextrose prolotherapy. by Ross A. Hauser, MD; Marion A. Hauser, MS, RD; and Patricia Holian, RN
Electromedicine: Cumulative Response from Cranial Electrotherapy Stimulation for Chronic Pain
Results from five CES sessions�administered over the course of treatment to 525 consecutive chronic pain patients�confirmed that an initial decrease in pain after the first session was typically followed by further decreases in pain from the cumulative effects of this modality. by Jerry T. Holubec, DO
Ethics and Health Policy: Neuroethics at the Close of the Decade of Pain Control and Research
Changing Views from the Cave to the Crest by James Giordano, PhD

Vol. 9, No. 8

October 2009

Hackett-Hemwall Dextrose Prolotherapy for Unresolved Elbow Pain
In this retrospective pilot study at an Outpatient Charity Clinic in Rural Illinois, Hackett-Hemwall dextrose prolotherapy helped reduce pain and stiffness and clinically improved the quality of life in people with unresolved elbow pain. by Ross A. Hauser, MD; Marion A. Hauser, MS, RD; and Patricia Holian, RN
Simultaneous Use of Opioid and Electromagnetic Treatments
Concurrent therapeutic electromagnetic applications complement opioid treatment and promote enhanced pain control. by Forest Tennant, MD, DrPH
Intradermal BTX-A Reduces Frequency and Severity of Pain for MMD
Intradermal Botulinum Toxin in painful dysfunction of the muscles of mastication (MMD) suggest an excellent ability of BTX-A to reduce nocioceptive symptoms by mechanism(s) other than motor inhibition of muscle contraction. by William R, Knoderer MD, DDS and John Claude Krusz, PhD, MD
Pain and Self-Regulation
Humans have an adequate potential for learning self-control of a variety of bodily functions and the resulting ability is a function of adequate teaching, learning, and practice over a period of time. by Gabriel E. Sella, MD, MPH, MSc, PhD (HC)
Deep Cervical Muscle Dysfunction and Head/Neck/Face Pain, Part 2
Deep cervical flexor strength and endurance training may be useful in the management of symptoms related to mechanical impairment of the neck. by Howard W. Makofsky, PT, DHSc and Leonard B. Goldstein, DDS, PhD
Adjunctive Psychiatric Pain Management Treatment
The psychiatric /psychological modality is a crucial component of comprehensive treatment for chronic pain. by Sarah M. Whitman, MD
Publisher's Message: How About This?
by Marvin Rosenfeld
Guest Editorial: Keeping Prescribers on Board if Certification Becomes Part of REMS
Consequences need to be acknowledged and serious thought given to the full impact that the FDA's proposed Risk Evaluation and Mitigation Strategies (REMS) plan might have. by Steven D. Passik, PhD and Kenneth L. Kirsh, PhD
Laser Therapy: Magneto-Laser Therapy of Pulpitis and Vertebra Column Osteochondrosis
A review of a Russian stomatological hospital based study indicated magneto-laser therapy resulted in greater positive results than traditional pharmacological and physiotherapeutic treatment. by William J. Kneebone, RN, DC
Commentary: The Experience of Pain
Health, health care, evidence-based medicine and the metrics paradox by Peter Moskovitz, MD
Ethics and Health Policy: Pain Care of Severely Neurally-Compromised Patients
Practical and Ethical Considerations by Anita Gupta, PharmD, DO and James Giordano, PhD

Vol. 9, No. 7

September 2009

Patients Who Require Ultra-High Opioid Doses
The goal of ultra-high dosage therapy is to relieve pain and improve function in those chronic pain patients that are profoundly ill, impaired, and/or bed- or house-bound � without producing sedation. by Jennifer Schneider, MD; Alfred Anderson, MD; and Forest Tennant MD, Dr PH
Disordered Sacroiliac Joint Pain
The partial displacement or dislocation of the sacroiliac joint is a poorly understood and seldom diagnosed condition that may be responsible for a number of back pain or upper body painful conditions. by Laurence E. Badgley, MD
Pain Management in Nursing Homes and Hospice Care
Despite the availability of a wide variety of effective pharmacologic and non-pharmacologic treatments, understanding of pain remains a significant problem in nursing homes and hospices. by Leonard B. Goldstein, DDS, PhD and Davina I. Glaser, RN, MS, CHPN
Helping Patients Understand the World of Pain Medicine
Patients need to better understand their health care providers' concerns regarding alcohol, drugs and pain medications, as well as what is expected of them in their role as patients in order to maximize treatment outcomes. by Ron Lechnyr, PhD, DSW and Terri Lechnyr, PhD
Multidisciplinary Case Report : Share the Risk Pain Management in a Dedicated Facility
First in a series of case reports. by David Bergman, MD, DLFAPA; Joseph Shurman, MD; and Phyllis Meagher, MBA
Relief of Symptoms Associated with Peripheral Neuropathy
Low-level consumption of glutathione-enhancing micronutrients may be beneficial in relieving symptoms of neuropathy of unknown origin. by Mark Gostine, MD and Larry Pawl, MD
Guest Editorial: The Multi-Disciplinary Pain Medicine Fellowship
Will it change the practice of pain medicine? by John E. Tetzlaff, MD
Continuous Lumbar Epidural Infusion of Steroid
Administering a continuous lumbar epidural infusion of corticosteroid and normal saline via an indwelling epidural catheter/infusion pump over a 3-day period offers a minimally-invasive option for treatment of lumbar radiculopathy. by Michael Shapiro, MD
Anomalous Opiate Detection in Compliance Monitoring
There are multiple variables outside of laboratory testing to consider when interpreting a patient's test results and deciding whether or not they are compliant with their medication. by Michael Evans, PhD; Scott Kriger, PhD; Joshua Gunn, PhD; and Eugene Schwilke
Publisher's Message: Don't Choose Up Sides
by Marvin Rosenfeld
Publisher's Message: Don't Choose Up Sides
by Marvin Rosenfeld
Headache: Efficacy of Stimulants in Migraineurs with Comorbidities
Stimulants may be beneficial for chronic migraine patients presenting with various comorbidities such as attention deficit hyperactivity disorder (ADHD), depression and fatigue. by Lawrence Robbins, MD and Joseph Maides, DO
Head and Neck Pain: Hand Tremor with Dental Medicine Implications
While many hand tremor cases may be linked to genetic predisposition or other origin, some hand and body tremors may be trigeminal nerve-related. by Edwin A. Ernest, III, DMD
Clinical Report: Non-Surgical Spinal Decompression (NSSD)
In the presence of overt, symptomatic disc disease, preliminary results of NSSD suggest a stronger therapeutic effect than conventional traction and may offer a non-surgical alternative to some patients. by Tiziano Marovino, DPT, DAAPM
Ethics and Health Policy: Anticipating Biotechnological Trends in Pain Care
Precautionary Purpose and Process by James Giordano, PhD and Dennis K. McBride, PhD, MPA
Laser Therapy: Thermal Imaging Guided Laser Therapy - Part 2
An Innovative Method for Determining Optimal Treatment Location and Effectiveness by William J. Kneebone, RN, DC
HIT Advisor: EMR Adoption
It is not all about taking advantage of the economic stimulus incentive payments! by Greg Winterkamp

Vol. 9, No. 6

Jul/Aug 2009

Interventions for Radiating Upper Extremity and Cervical Facet Pain
Recent developments mean safer and better outcomes of therapy for radiating pain of the neck and shoulders. by Gabor B. Racz, MD, FIPP, ABIPP and James E. Heavner, DVM, PhD, FIPP (Hon)
Screening Blood Panel to Evaluate New Chronic Pain Patients
Fundamentally, the screening panel recommended here is intended to distinguish a severe, chronic pain patient from a mild or moderate chronic pain patient. by Forest Tennant, MD, DrPH
Need for More Accurate ER Diagnoses of ACL Injuries
Recognition of ACL injury by emergency room physicians is essential to optimize outcomes through early and appropriate treatment. by Melissa Ruth Blum, DO and Leonard B. Goldstein, DDS, PhD
Effective Monitoring of Opiates in Chronic Pain Patients
Laboratory testing for patients receiving prescription opioid pain relievers has been recommended by several organizations and governmental agencies to assure patient compliance, safe use to minimize risk, and assist in the identification of possible drug diversion or misuse of the drug. by Michael Evans, PhD; Scott Kriger, PhD; Joshua Gunn, PhD; and Gene Schwilke
Cytokine Testing in Clinical Pain Practice
While lacking specificity, this emerging test shows potential as a valuable clinical screening tool in helping to rule in or out whole categories when weighing initial evidence for a diagnosis. by R. Steven Singer, MD
Publisher's Message: We Are Honored
by Marvin Rosenfeld
Headache: Long-Acting Opioids for Refractory Chronic Migraine
Study results for a group of difficult-to-treat migraineurs provide a basis for determining efficacy and guidelines for the use of long-term opioids in this population. by Lawrence Robbins, MD
Prolotherapy: Neural Therapy and its Role in the Effective Treatment of Chronic Pain
Neural therapy is a powerful treatment that can be quite effective in resolving autonomic nervous system dysfunction and pain, especially in the complex pain patient. by Gerald R. Harris, DO
Ethics and Health Policy: Ethics, Pain Care, and Obama's Policy Intentions
A View Toward "the Hill" by Aaron Damiani and James Giordano, PhD
Clinical Report: Spinal Pain And Neuromuscular Deficiency
When inhibited deep core muscles of the spine are the cause of back pain, a neuromuscular re-activation approach can help normalize muscle firing patterns between the local and global musculature and thus alleviate back pain. by Tiziano Marovino, DPT, DAAPM
Laser Therapy: Thermal Imaging Guided Laser Therapy: Part 1
An innovative method for determining optimal treatment location and effectiveness of laser therapy. by William J. Kneebone, RN, DC

Vol. 9, No. 5

June 2009

Use of Pulsed Radiofrequency in Clinical Practice
A retrospective study showed that PRF is effective as a replacement for both epidural steroid injections and surgery in the treatment of radicular pain as well as cases of peripheral nerve damage. by Richard Rosenthal, MD
Post-Stroke Pain
A clinical history and physical examination with judicious use of appropriate diagnostic modalities are mandatory in identifying what is the likely pain in stroke survivors. by Stephen Yang, MD; Martin Grabois, MD; and Brian Bruel, MD
Musculoskeletal Ultrasound
A brief overview of diagnostic and therapeutic applications in musculoskeletal medicine. by Elmer G. Pinzon, MD, MPH and Randy E. Moore, DC, RDMS
Human Chorionic Gonadotropin In Pain Treatment
HCG has great potential as an adjunct in the treatment of severe, chronic pain patients—particularly in those who demonstrate hormonal deficiencies or who show progressive wasting and deterioration. by Forest Tennant, MD, DrPH
Diagnosis of Low Back Pain
Physical, hands-on examination can yield useful information for a differential diagnosis. by Rudolph J. Maier, MD
Neuropathic Pain
A discussion of the pathophysiology of neuropathic pain and an overview of the modalities used to alleviate it. by Konstantina Svokos, BS, OMS IV, and Leonard B. Goldstein, DDS, PhD
Publisher's Message: A New Service from Practical Pain Management
by Marvin Rosenfeld
Prolotherapy: Dextrose Prolotherapy for Recurring Headache and Migraine Pain
This retrospective case series study revealed that Hackett-Hemwall dextrose prolotherapy appears to provide an effective, long-lasting treatment for recurring tension and migraine headache pain and their associated symptoms. by Ross A. Hauser, MD and Heather McCullough, MA
Ethics and Policy: Ethics, Education, and Policy: Relationship and Mutual Reliance
by James Giordano, PhD
Head and Neck: Painful Herpetic Reactivation and Degenerative Musculoskeletal Injury
by Edwin A. Ernest, III, DMD
Headache: Preventive Medications for Chronic Daily Headache
A review of long-term continuation rates of daily preventive medications for chronic daily headache (CDH). by Lawrence Robbins, MD and Joseph Maides, DO

Vol. 9, No. 4

May 2009

Application of Spinal Segmental Physiology to Evaluating Chronic Pain
A simple dermatomal screening process is used to help isolate the location of an offending segment when spinal 'segmental facilitation' is the cause of a chronic pain disorder. by John L. Beck, MD
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. by Joseph Shurman, MD; David Bergman, MD, DLFAPA; George Koob, PhD; Michael Lardon, MD; and Phyllis Meagher, MBA
Pain Management in a Palliative Care Setting
by Leonard B. Goldstein, DDS, PhD and Scott Falkowitz, BS, OMS III
Precursor Amino Acid Therapy
A new entry into pain management. by Forest Tennant, MD, DrPH
Opioid Treatment Longevity Study: Interim Report
by Forest Tennant, MD, DrPH
Dental Consequences of Pain Management
Pain and its associated issues can contribute to oral bacterial growth and inflammatory processes which, in turn, affects systemic health conditions. by Robert Reed, DDS, QME; David Schames, BA; Y. Dov Prero, BA, MEd; and Deborah Kheradyar, BS
Publisher's Message: The PPM Calendar of Articles Is in Work
by Marvin Rosenfeld
Clinical Bioethics: Intellectual and Moral Tasks in Intersection: Part 2
Information, Consent, Autonomy, and Agency by Mark V. Boswell, MD, PhD; Jill Kaspar; and James Giordano, PhD
Prolotherapy: Prolotherapy for Sacroiliac Joint Laxity
Using the prone posterior iliac glide test, the practitioner can clinically detect instability of the sacroiliac joint and confirm restoration of stability following prolotherapy. by Dr. R. C. Sweeting, F.R.C.S.(C), F.R.A.C.S.(ORTH)
Laser Therapy: Neuroma Pain of the Foot Successfully Managed with Laser Therapy
Using exclusive laser treatment, a foot neuroma case�for a patient that was not effectively treated by conventional medicine�was resolved to a pain-free state over the course of six weeks. by John L. Stump, DC, PhD, EdD
Fibromyalgia: Milnacipran: A New Treatment Option for Fibromyalgia
by Philip J. Mease, MD

Vol. 9, No. 3

April 2009

Opioid Antagonists In Pain Management
Available evidence suggests that the opioid antagonists naloxone and naltrexone offer potential benefits for enhancing opioid analgesia as well as monotherapy for managing certain challenging pain conditions. by Stewart B. Leavitt, MA, PhD
Comorbidity of Musculoskeletal Injury Pain and PTSD
A biopsychosocial approach is best suited for assessment and treatment of traumatic musculoskeletal pain with concomitant post-traumatic stress disorder (PTSD). by Margaret M. Perish, MA; Rob A. Haggard, MS, LPC; Amanda Buelow; Jokae Ingram; and Robert J. Gatchel, PhD, ABPP
Amino Acids and Diet in Chronic Pain Management
This first installment of a multi-part series on amino acids and diet outlines their critical importance in pain practice. by Julia Ross, MA, MFT and Forest Tennant, MD, DPH
Restoration of Normal Cervical Lordosis
Unlike axial linear traction, expanding ellipsoidal decompression (EED�) successfully decompresses joints and enhances or restores the lordotic curve. by C. Norman Shealy, MD, PhD
Tension Headaches
While they are more prevalent in patients, there is often a presumptive migraine diagnosis due to the severity of pain, a migraine-centric focus, or the cross-over dental/medical nature of tension headaches themselves. by Keith A. Yount, DDS, MAGD
Publisher's Message: A Few Thoughts
Electronic Medical Records�An Urgent Message by Marv Rosenfeld
Clinical Bioethics: Intellectual and Moral Tasks in Intersection, Part 1
Assessing the experience of pain: making the subjective objectively appreciable. by Jill Kaspar; Mark V. Boswell MD, PhD; and James Giordano, PhD
Head and Neck: Craniofacial Pain of Cardiac Origin
Cardiac-induced referred pain to the craniofacial region may drive a referral to a dentist and potentially miss the diagnosis of a life-threatening cardiac condition. by Edwin A. Ernest, III, DMD
Laser Therapy: Clinical Case Study of Low Level Laser Therapy
LLLT accelerated healing and improved symptoms and outcome for second degree scalding burns on human skin for the subject patient. by Stephanie A. Leonard, DC, CCFC
Headache: Post-Traumatic Headaches, Migraines, and Sleep Disorders
Most, if not all, post-concussion symptoms are quite treatable and can often make a dramatic difference in the quality of life for a patient recovering from traumatic brain injury. by John Claude Krusz, PhD, MD
HIT Advisor: Take Advantage of the Economic Stimulus Incentive Payments
Having a fully implemented EMR by 2011 that demonstrates 'meaningful use' qualifies physicians for a phased incentive of $44,000; otherwise, starting in 2015, lack of an EMR will result in reduced reimbursements. by Greg Winterkamp

Vol. 9, No. 2

March 2009

CME Accredited Monograph: Opioid Risk Management
Dispelling the Myths and Integrating Clinical Strategies to Protect Your Practice by Herbert D. Kleber, MD; Howard A. Heit, MD; and Bruce Nicholson, MD
Brain Atrophy With Chronic Pain
Recent studies clearly show that chronic pain unto itself causes brain atrophy and altered neurochemistry and sensory function of the central nervous system. by Forest Tennant, MD, DrPH
Reducing Pain and Anxiety During Reduction of a Fracture
A reduction of a fractured wrist�normally performed in an emergency department�was safely and successfully performed by an orthopedic surgeon at a soccer tournament medical facility with the benefit of psychological techniques and deep breathing. by Raymond J. Petras, BE, MA, PhD
Evaluating Function/Impairment of Low Back Pain Using SEMG
Recent advances in the use of surface electromyography (SEMG) have proved useful in the evaluation of movement, gait, postural, and functional disturbances in low back pain patients. by Robert J. Gatchel, PhD, ABPP; Mark D. Ricard, PhD; Emily Brede, RN; and Krista J. Howard, MS
Chronic Pain and Atypical Herpetic Viral Reactivation
Retrospective study suggests that herpetic reactivation may be a more common cause of unexplained chronic pain syndromes than previously thought and can be effectively treated with long-term antiviral therapy. by Sean Maloney, MD; Katherine Taber, PhD; Susan Jensen, MD; Virginia Gil-Rivas, PhD; Paula Goolkasian, PhD; Rickilynn Mancil, MA; Joan Buckler, DPT
Medication-Induced Xerostomia Secondary to Pain Management
Long-term pain management, with its usage of prescriptive medications, may have serious negative oral health side-effects including significant dental pathology, soft-tissue problems, and potential loss of dentition. by William M. Gabriel, DDS; Dovi Prero, BS; Deborah Kheradyar, BS; and David Schames, BA
Publisher's Message
Why Is Pain Management Different? by Marvin Rosenfeld
Clinical Bioethics: Neuroscience, Neurophilosophy, and Neuroethics of Pain, Pain Care, and Policy (N3P3)
Program, Purpose and Process by James Giordano, PhD
Fibromyalgia: Acupuncture for Fibromyalgia
Acupuncture may be a useful intervention to manage chronic pain of fibromyalgia. by Richard E. Harris, PhD
Laser Therapy: Treatment of Scapulohumeral Periarthritis and Post Traumatic Joint Pain
A Review of a Russian Hospital-Based Study using Magneto-Laser Therapy by William J. Kneebone, RN, CRNA, DC
HIT Advisor: Automate Your Clinic, Part II: Automate Around the Doctor
With the current economic problems, 2009 is the year to automate your clinic to be profitable or, at the very least, initial steps can be taken to computerize faxes and paper files without disrupting your own patient focus. by Greg Winterkamp
Guest Editorial: Treating Chronic Pain by Patient Empowerment
by Thomas J. Purtzer, MD
Guest Editorial: Successful Treatment of Intractable Pain
by Joel S. Hochman, MD

Vol. 9, No. 1

Jan/Feb 2009

Blending Prescription Pain Treatments With Alternative Medicine
Certain non-prescription, alternative/complementary measures can be easily, conveniently, and inexpensively incorporated�along with prescription medicine�into routine pain practice. by Donald Adema, DO
Pre-Implant Psychological Evaluations
A follow-up study of patients who have undergone implant of a pain management device. by Terri A. Lechnyr, PhD
Deep Cervical Muscle Dysfunction and Head/Neck/Face Pain
Myofascial stretching, self-mobilization, and muscle strengthening of the deep neck flexors may ameliorate forward head posture, cervicogenic headache, and tension-type headaches. by Leonard B. Goldstein, DDS, PhD and Howard W. Makofsky, PT, DHSc, OCS
Atypical Herpetic Reactivation and Chronic Pediatric Pain
A report of three unexplained, severely-disabling pediatric cases, in otherwise healthy children, successfully treated with long term anti-viral therapy. by Sean R. Maloney, MD; Susan Jensen, MD; and Katherine H. Taber, PhD
Guest Editorial: In My Opinion
Thoughts on tolerance, hyperalgesia, and short-acting opioids. by Jennifer P. Schneider, MD
Commentary: Dr. Forest Tennant Speaks Out
Are We Losing Our Way? by Forest Tennant, MD, DrPH
Publisher's Message
Heard Through the Grapevine by Marvin Rosenfeld
Clinical Bioethics: What a Decade of the Mind Affords the Decade of Pain Control and Research
by James Giordano, PhD
Headache: Personality Disorders in Migraineurs
With a higher than normal prevalence of moderate or severe personality disorder in this population, recognizing the disorder allows alteration of both goals and approach. by Lawrence Robbins, MD
Pharmacotherapy: Pain Management in the Elderly
Structured methods help identify and assess pain in older adults while appropriate analgesic selection and dosing can reduce adverse drug reactions. by David Elliott, PharmD
Clinical Report: Trigger Point Ablation and TMJ Syndrome
A self-management approach to eradicating trigger points contributing to TMJ disorder or facial pain. by Tiziano Marovino, DPT, DAAPM
Laser Therapy: Treating Shoulder Pain in Hemiplegic and Spinal Cord Injured Patients
by Gabi Zeilig, MD and RTmi Guibert, MD, MSc
Prolotherapy: Platelet Rich Plasma in Prolotherapy
Case reports on lateral elbow pain, low back pain, and medial knee pain indicate a remarkable improvement in outcomes after prolotherapy incorporating platelet rich plasma. by Donna Alderman, DO
Head and Neck: Cervical Disc Disease With Referred Pain to TMJ
A case report of cervical injury from a motor vehicle accident resulting in a cascade of physical changes over six months and referring pain to the TMJ and face. by Edwin A. Ernest, III, DMD
HIT Advisor: 2009 Is The Year to Automate Your Clinic - Part 1
With the current economic and political climate, it is clearly time to automate your clinic and increase profitability in the process. by Greg Winterkamp

Vol. 8, No. 9

Nov/Dec 2008

Appropriate Opioid Dosing for Activities of Daily Living
Excess opioid dosage and overprescribing in a chronic pain patient can only be diagnosed by a physical examination that documents the presence of the classic signs of opioid excess including hypotension, bradycardia, and miosis, among others � not on the basis of arbitrary upper limits on dosage or opioid combinations. by Forest Tennant, MD, DrPH and Jeffery Reinking, MD
Neurodevelopmental Basis for Chronic Regional Pain Syndrome
A primer on the first level of evaluation in the practical application of neuropostural evaluations (P.A.N.E. process). by John L. Beck, MD
Trigger Point Injections: Techniques, Pitfalls, and Alternatives
Tips on practicing good technique for inactivating trigger points while avoiding pitfalls and minimizing complications. by Bernard E. Filner, MD
Guest Editorial: Multidisciplinary Pain Clinics vs. Opioid Treatment For Chronic Pain
Collaborators or antagonists? by Jennifer Schneider, MD
Opioid-induced Sexual Dysfunction
Causes, diagnosis, and treatment of a common but an often undiagnosed problem in chronic opioid pain patients. by Stephen Colameco, MD, MEd
Publisher's Message: 5th World Congress of the World Institute of Pain
March 13-16, 2009; New York City by Marv Rosenfeld
Clinical Bioethics: An Open Letter to the President-Elect
Pain Care and the Promise of What Lies Ahead by James Giordano, PhD
Headache: Management of Chronic Headache
A review of assessment and treatment of outpatient chronic headache patients along with a commentary on aggravating and mitigating factors. by Lawrence Robbins, MD
Headache: IV Ketamine Effect on Post-Concussional Migraine
Outpatient intravenous ketamine treatment of CRPS-Type 1 simultaneously eradicated post-concussional migraine in patient. by Cris M Schade, MD, PhD and John Claude Krusz, PhD, MD
Fibromyalgia: Fibromyalgia Medical Education
The National Fibromyalgia Association offers two new healthcare professional programs. by Rae Marie Gleason, Executive Director of the NFA
Interventional Therapy: Long-term Opioid Therapy and Sleep-Disordered Breathing
by Lynn R. Webster, MD, FACPM, FASAM
Laser Therapy: Therapeutic Laser Evolution - Part 2
by Douglas Johnson, ATC, CLS, and William J. Kneebone, RN, DC
Clinical Report: Neuromuscular Training In Pain Management
Re-activation of the deep local stabilizing muscles of the spine has been demonstrated to be an essential part of rehabilitation for the musculoskeletal system and, in particular, mechanical spine pain. by Tiziano Marovino, DPT, DAAPM
Head and Neck: Sphenomandibularis Muscle and Retro-Orbital Headache
Patients experiencing retro-orbital headaches that are not adequately managed by drugs may be an indication of sphenomandibularis referred pain. by Edwin A. Ernest, III, DMD
HIT Advisor: Advances in Fax Technology
Your clinic's manual faxing is obsolete and is costing you many thousands of dollars per year. by Greg Winterkamp

Vol. 8, No. 8

October 2008

Muscle Physiology, Kinetics, Assessment, And Rehabilitation
A review of some basic science, homeostasis, functional specialization, resting and activity tonus, objective methodology in assessment, and rehabilitation considerations. by Gabriel E. Sella, MD, MPH, MSc, PhD
Botulinum Toxin Type-A In Pain Management
A review of of BTX-A including a discussion of its mode of action and case studies illustrating its use in treatment of a variety of pain presentations. by Gordon D. Ko, MD; Ian Finkelstein, MD; Brian Freund, MD, DDS; and Pankaj Dhawan, MD
The Pseudo-RSD Pain Patient
A case report of a patient successfully mimicking the signs and symptoms of reflex sympathetic dystrophy (RSD) together with a review of what is currently known about RSD presentation, epidemiology, pathophysiology, and a discussion on impairment determination for RSD sufferers. by Alex Ambroz, MD, MPH; Kelly Peters, MSN; Robert S. Zucker, MD, MPH; and Clara Ambroz, MD, MPH
Topical Use of Morphine
Used as an adjunct in severe chronic pain patients who take systemic opioids, topical morphine enhances pain relief, decreases pain flares, promotes stretching and walking, and reduces cost of treatment. by Forest Tennant, MD, DrPH
Publisher's Message: Join Us in Another Important Study
The Tennant Opioid Longevity Study by Marvin Rosenfeld
Diagnostic Technology: Non-surgical Decompression Treatment for Carpal Tunnel Syndrome
An orthosis worn at night�providing a slow and sustained stretch on the tight aponeurotic structures adding tension to the carpal tunnel�may avoid surgery and subsequent physical therapy. by Tiziano Marovino, DPT
Clinical Bioethics: Toward a Neuroethics of Pain Medicine
Pain medicine must continue to progress to meet the challenges posed by advances in scientific understanding and technology and ever-widening philosophical and ethical issues and imperatives arising from them. by James Giordano, PhD
Laser Therapy: Therapeutic Laser Evolution�Part 1
A review of the historical generations of laser technology that leads up to the present. by Douglas Johnson, ATC, CLS
Headache: Chronic Migraine: An Interactive Case History
A step by step guide through the diagnosis of a complex headache patient. by Lawrence Robbins, MD
HIT Advisor: Consistent Documentation Drives Compliance
The importance of having consistent documentation in proving compliant patient care. by Ted A. Arkfeld, DC, MS
Head and Neck: TMJ Pain and Temporal Tendonitis with Autonomic Features
A case review of a patient who presented with symptoms of trigeminal autonomic cephalalgia as well as TMJ and temporal tendon-related pain symptoms. by Edwin A. Ernest, III, DMD

Vol. 8, No. 7

September 2008

Functional Restoration and Complex Regional Pain Syndrome
The functional restoration model�utilizing a carefully selected combination of therapies including medications, interventions, rehabilitation therapies, and psychological treatment approaches�may provide the best hope for treating CRPS. by Steven D. Feinberg, MD and Rachel M. Feinberg, PT, DPT
Omega-3 Fatty Acids and Neuropathic Pain
Case studies demonstrate that oral intake of omega-3 polyunsaturated fatty acids from pharmaceutical-grade fish oils supplements results in pain and functional improvement in patients with neuropathic pain. by Gordon D. Ko, MD, FRCPC; Leigh Arseneau, BSc, ND; Nathaniel Nowacki, BA; Serge Mrkoboda, BSc
Osteopathic Manipulative Medicine for Lower Back Pain
OMM can be a useful tool in the diagnostic and therapeutic management of various mechanical low back disorders. by Wolfgang Gilliar, DO, FAAPMR; and Leonard B. Goldstein, DDS, PhD
Guest Editorial: A Decade of Pain Wasting Away
Have improvements in state policies translated into improved patient access to effective pain relief? by Kathryn L. Hahn, PharmD, DAAPM
Practical Application of Neuropostural Evaluations
The P.A.N.E. Process: Basic Principles and the First Three Tests by John L. Beck, MD
Longitudinal Study of Long-term Opioid Patients
A 10- and 20-year follow-up of severe, chronic pain patients treated with daily opioids indicates that some chronic pain patients greatly benefit from long-term opioid therapy. by Forest Tennant, MD, DrPH
Cervical Myofascial Trigger Points in Headache Disorders
Two case reports illustrate the utility of recognition and treatment of TrPs in headache patients. by Jeffrey Nelson, MD; CTsar Fern�ndez-de-las-Pe�as, PT, PhD; and David G. Simons, MD
Publisher's Message: Response to "Putting the Pain Patient in His Place"
In the July/August issue, I commented on the dilemma for pain management regarding the proper placement of pain patients. Among the responses was the following very thoughtful dissertation by Dr. Jennifer Schneider, an esteemed member of our Editorial Advisory Board. by Marvin Rosenfeld
Head and Neck: Hamular Process Bursitis
Often misdiagnosed as otitis media or Eagle's syndrome, this relatively unknown disorder presents as soft palate pain, throat pain, ipsilateral maxillary pain, ear pain and difficulty and pain with swallowing. by Wesley E. Shankland II, DDS, MS
Clinical Bioethics: Pain Care for a Global Community�Part 2
Ethics and Economics in Intersection by James Giordano, PhD; Michael E. Schatman, PhD; and Roland Benedikter, PhD, DPhil
Laser Therapy: Class IV Therapy Lasers Maximize Primary Biostimulative Effects
This new class of therapeutic lasers of laser therapy delivers higher-powered penetrating infra-red energy to deeper target sites, as well as shortening treatment times for wide area applications. by Phillip Harrington, DC and Julian Vickers, DC
HIT Advisor: Cell Phone Impact on Your Pain Practice
Taking advantage of fast-emerging cell phone technology to interface with your computer system will offer many efficiencies and benefits for your pain practice. by Greg Winterkamp

Vol. 8, No. 6

Jul/Aug 2008

Evaluating Pain Intervention Effectiveness and Compliance
Innovative ways to identify patients with severe, chronic pain and assess effective pain control by various standardized, objective measures to monitor clinical progress. by Forest Tennant, MD, DrPH
Vitamin D for Chronic Pain
According to a comprehensive review of the clinical research evidence, helping certain patients overcome chronic musculoskeletal pain and fatigue syndromes may be as simple, well tolerated, and inexpensive as a daily supplement of vitamin D. by Stewart B. Leavitt, MA, PhD
Neurobiological Basis for Chronic Pain
A new paradigm offers a unique perspective and postulates that the fundamental causation of most chronic pain is neurobiological. by John L. Beck, MD
Publisher's Message: Putting the Pain Patient in His Place
by Marv Rosenfeld
Imaging: Unravelling the Mysteries of Myofascial Pain Syndromes
The results of recent studies tend to suggest that Magnetic Resonance Elastrography (MRE) technology can detect and quantify deep taut bands of soft tissue and accurately distinguish a symptomatic or pathologic taut band versus a more normal region of tightness. by Tiziano Marovino, DPT, DAAPM and Jonathan Quinton, BSc, SPT
Laser Therapy: Low-Level Laser Therapy for Trigeminal Neuralgia
Case reports on two patients whose unrelenting facial pain and hypersensitivity from their diagnosed trigeminal neuralgia resolved with low-level laser therapy. by Leonard F. Vernon, DC and Rafael J. Hasbun, MD
Clinical Bioethics: Pain Care for a Global Community
The Importance of a Philosophy of Medicine by Francesca Marin, PhD and James Giordano, PhD
Head and Neck: Orbital-Inner Canthus Headache Due to Medial Temporal Tendonitis
Pain presenting as an intense headache apparently radiating from the inner canthus of the eye or orbit, but actually referred from medial temporal tendonitis, underlines the complexity of facial structures. by Edwin A. Ernest, III, DMD
Electromedicine: CES for Mild Traumatic Brain Injury
Based on the consistently robust results of cranial electrotherapy stimulation (CES) seen throughout this preliminary data, the use of this safe and effective electromedical modality as an adjunct to medical and psychological interventions for mild traumatic brain injury patients should be considered. by Daniel L. Kirsch, PhD, FAIS
Fibromyalgia: Duloxetine: A New Indication for the Treatment of Fibromyalgia
Duloxetine (Cymbalta�, Eli Lilly ) joins pregabalin (Lyrica�, Pfizer, Inc.) as the second drug to gain approval by the FDA for the treatment of fibromyalgia. by Melissa Olivadoti, PhD
Pharmacotherapy: Head to Toe Non-prescription Drug History
A practical approach to assess nonprescription drug history in pain patients in the context of formulating a treatment strategy. by Charles D. Ponte, PharmD

Vol. 8, No. 5

June 2008

Safe Analgesic Use in Patients with Renal Dysfunction
General guidelines for appropriate use of analgesics and co-analgesic adjuvants in pain patients with co-existing renal insufficiency. by Raphael J. Leo, MA, MD
Emerging Role of NPs and PAs in Pain Management
Nurse Practitioners and Physician Assistants offer the best hope for dealing with the resistance of Primary Care Physicians to provide appropriate pain management for chronic pain patients. by Jennifer Schneider, MD
Pain and the Brain
A synthesis and summary of the current understanding of brain response to pain learned from functional magnetic resonance imaging (fMRI). by Robert J. Gatchel, PhD, ABPP; Richard C. Robinson, PhD; Yuan B. Peng, MD, PhD; Oscar J. Benitez, PhD Candidate; and Carl E. Noe, MD
Realistic Pacing of Pain Patients'Activities
Recognizing and avoiding tendencies to rush, multi-task, or otherwise over-exert during relative lulls in pain helps reduce subsequent pain flare-ups and achieve a more comfortable and sustainable activity level. by Ron Lechnyr, PhD, DSW and Terri Lechnyr, PhD
Eye Screening and Intractable Pain Management
How to interpret and use eye signs to help prescribe opioids for intractable pain. by Forest Tennant, MD, DrPH
Publisher's Message
Did You Miss The Cover? by Marvin Rosenfeld
Clinical Bioethics: Chronic Pain and Substance Abuse
Spectrum Effects and Ethical Considerations by James Giordano, PhD and Rachel Wurzman, MS
Head and Neck: Superior Pharyngeal Constrictor Muscle Dysfunction
Sprain or tendinitis of this large quadrilateral constrictor muscle may present as soreness, tightness, or pain at the pterygoid plate and may involve palatal muscles and ear symptoms as well. by Edwin A. Ernest III, DMD
Prolotherapy for Golfing Injuries and Pain
An effective non-surgical treatment option for golf-related injuries, including low back pain, lateral and medial epicondylitis, wrist ligament injuries, shoulder injuries, and other musculoskeletal joint pain. by Donna Alderman, DO
Fibromyalgia: Proposed Models of Fibromyalgia Sub-Types
A proposed framework for sub-types within the greater 'fibromyalgia construct' addresses the heterogeneous fibromyalgia population and moves toward a rational, mechanistic approach to therapy. by Patrick B. Wood, MD
HIT Advisor: IT Consultants - Whom Should You Trust?
by Greg Winterkamp
Laser Therapy: Post-Herpetic Neuralgia Pain And Laser Acupuncture
Background, diagnosis, discussion, and case report of successful management of post-herpetic neuralgia pain in an elderly patient using laser acupuncture. by John L. Stump, Michael Allen, and Laura Oglesby

Vol. 8, No. 4

May 2008

Chronic Daily Headache
An overview of the four types of chronic headaches: chronic migraine, chronic tension-type headache, new daily persistent headache, and hemicrania continua. by Bryan Liou and Soma Sahai-Srivastava, MD
New Daily Persistent Headache
An under-diagnosed disorder, NDPH is characterized by an abrupt onset of a new headache disorder in someone not generally troubled by headache. by R. Steven Singer, MD
The Biopsychosocial Approach to Pain Management
The biopsychosocial model has led to the development of the most therapeutic- and cost-effective interdisciplinary pain management programs and makes it far more likely for the chronic pain patient to regain function and experience vast improvements in quality of life. by Robert J. Gatchel, PhD, ABPP; Krista J. Howard, PhD Candidate; and Nancy D. Kishino
Long-term Therapy Using Short Acting Opioids for Chronic Non-cancer Pain
A cohort study explores the role of conditioning factors, dosage stability, opioid agreement violations, patient satisfaction, and the patient's own estimated improve-ment in overall quality of life. by Daniel M. Doleys, PhD; Donald Cornelius, MD; Sharon Watters; and Marilyn P. Marino, RN
Pain Management and Terminal Illness
The prevalence of pain in terminally-ill patients requires that physicians acquire the skills necessary to provide palliative pain treatment at end of life. by Kathleen Broglio, MN, ANP-BC, ACHPN and B. Eliot Cole, MD, MPA
Publisher's Message
A Salute to Our Supporters by Marvin Rosenfeld, Publisher
Clinical Bioethics: Confidentiality, Choice, and The Question Of Autonomy
by James Giordano, PhD and Nisha Dogra, MD, PhD
Head and Neck: Temporal Arteritis and Temporal Tendonitis Co-morbidity
by Edwin A. Ernest III, DMD
Pharmacotherapy: Opioids in Patients With Renal Or Hepatic Dysfunction
The use of opioids in geriatric patients and those with hepatic or renal insufficiency can present significant challenges for clinicians. by Gina M. Carbonara, PharmD
Laser Therapy: Laser Acupuncture as a Pain Relief Modality
Lasers provide a simple, and effective, non-invasive alternative to needle acupuncture in treating musculoskeletal pain. by William J. Kneebone, RN, CRNA, DC

Vol. 8, No. 3

April 2008

CES in the Treatment of Pain Related Disorders
Cranial electrotherapy stimulation studies demonstrate that this modality is effective, safe, and easy to use as a stand-alone or complementary, cost effective, non-medication treatment for the management of pain�especially in chronic pain patients. by Daniel L. Kirsch, PhD, DAAPM, FAIS and Marshall F. Gilula, MD
Protecting Pain Physicians from Legal Challenges: Part 2
Practice recommendations to avoid malpractice resulting in deaths, complications, or undertreatment along with illustrative case examples. by Forest Tennant, MD, DrPH
Commonsense Opioid-Risk Management in Chronic Non-Cancer Pain
A Clinician's Perspective by James D. Toombs, MD
Personality Disorders and the Bipolar Spectrum
Recognition and management in a pain clinic setting. by Lawrence Robbins, MD and Patricia Goldfein
Maximizing Safety with Methadone and Other Opioids
Risks associated with opioids can be safely and effectively managed while providing life-saving analgesia to chronic pain patients. by Lynn R. Webster, MD, FACPM, FASAM
Publisher's Message
The Tennant Blood Study Revisited by Marvin Rosenfeld
Clinical Bioethics: Technology in Pain Medicine
Research, Practice, and the Influence of the Market by James Giordano, PhD
Head and Neck: Injection Needle Injury of Oral Sensory Nerves
A discussion of inferior alveolar nerve and lingual nerve needle injury from transdermal and trans-mucosal injections concomitant with ipsilateral temporal tendonitis. by Edwin A. Ernest III, DMD
HIT Advisor: The Differences Between Document Imaging, Document Management, Practice
by Greg Winterkamp

Vol. 8, No. 2

March 2008

Iontophoresis in Pain Management
Iontophoresis has been shown to effectively manage painful symptoms associated with superficial tissue structures in a wide variety of patients. by Tiziano Marovino, DPT, DAAPM and Claire Graves
Interpreting the Clinical Significance of Pain Questionnaires
A comparison of effect sizes of commonly used patient self-report pain instruments provides an objective ranking of such tools. by Whitney Worzer, MS, PhD Candidate; Brian R. Theodore, MS, PhD Candidate; Mark Rogerson, PhD Candidate; and Robert J. Gatchel, PhD, ABPP
Protecting Pain Physicians from Legal Challenges, Part 1
Sudden, unexpected deaths in opioid-treated chronic pain patients are an unfortunate occurrence. Nevertheless, pain physicians should be aware of potential causes, take preventive actions and, if the unforeseen happens, be prepared to defend against legal challenges. by Forest Tennant, MD, DrPH
Anticephalgic Photoprotective Premedicated Mask
Report of successful treatment for migraine and/or tension headaches utilizing an anticephalgic photoprotective mask with a topical medication containing bryonia and rhus toxicodendron. by Morton I. Hyson, MD
Platelet Rich Plasma (PRP): A Primer
A brief overview of PRP, its constituents, applications, and processing considerations. by Robert E. Marx, DDS, Sherwin V. Kevy, MD, and May S. Jacobson, PhD
Publisher's Message
A Precaution and a Meeting by Marvin Rosenfeld
Interventional Therapy: Intrathecal Therapy Trials With Ziconotide
A trialing protocol before initiation of long-term ziconotide intrathecal therapy is presented. by David Caraway, MD, PhD; Michael Saulino, MD, PhD; Robert Fisher, MD; Stuart
Clinical Bioethics: Culture and the Ethics of Patient-Centered Pain Care
by James Giordano, PhD and Joan C. Engebretson, DrPH
Head and Neck: Temporomandibular Dysfunction and Migraine
TMD often coexists with daily or near-daily headache syndromes but is overlooked by many physicians in the history and physical examination. by Jeffrey P. Nelson, MD
Complex Regional Pain Syndrome (CRPS): Right Unilateral Electroconvulsive Therapy
Results and implications of this increasingly utilized option for the treatment of refractory CRPS. by Franklin Michaels, Jr.
HIT Advisor: Compliant Documentation
by Ted A. Arkfeld, DC, MS, CICE, CPC
Laser Therapy: Maximizing Tertiary Effects of LLLT
The tertiary effects of phototherapy—namely, immune system stimulation, increases in endorphin production, and lymphatic stimulation—help to attain optimal clinical outcomes. by William J Kneebone, DC, CNC, DIHom, FIAMA, DIACT
News Profile: Daniel L. Kirsch, PhD
Daniel L. Kirsch, PhD, DAAPM, FAIS Selected as Recipient of the 2008 Richard S. Weiner Pain Education Award
Obituary: Harvey Rose, MD
Crusader for the Family Physician's Right to Treat Pain by Forest Tennant, MD, DrPH

Vol. 8, No. 1

Jan/Feb 2008

Platelet Rich Plasma (PRP) Matrix Grafts
PRP application techniques in musculoskeletal medicine utilize the concentrated healing components of a patient's own blood�reintroduced into a specific site�to regenerate tissue and speed the healing process. by David Crane, MD and Peter A.M. Everts, PhD
Spine-Related Pain In Sports Medicine
A brief review of evaluation and treatment strategies for sports-specific disorders. by Elmer G. Pinzon, MD, MPH
Outpatient Interventional Treatments for Migraines and Pain Flare-ups
An outpatient clinic can provide an effective variety of IV treatments�individually or in combination�for definitive control of pain. by John Claude Krusz, PhD, MD
Identifying Abusers Prior to Initiating Chronic Opioid Therapy
Strategies for prescribing physicians to identify chronic pain patients at high risk for inappropriate utilization of prescription opioid analgesics. by Michael E. Schatman, PhD
Urine Drug Tests in a Private Chronic Pain Practice
The likelihood of surprises leads to the recommendation that virtually all patients who receive chronic opioids should be tested initially, occasionally at random, as well as for cause. by Jennifer Schneider, MD and Ashley Miller
Role of SR Opioids in Treating Chronic Pain
A Practical Guide by Jennifer P. Schneider, MD
Publisher's Message
A New CRPS Department by Marvin Rosenfeld
Clinical Bioethics
Grappling With the Ethics of Practical Pain Management by James Giordano, PhD
Head and Neck
Adenoid Cystic Carcinoma of the Parotid Gland by Edwin A. Ernest, III, DMD
HIT Advisor
Evaluation and Management Codes Drive Medical Necessity by Ted A. Arkfeld, DC, MS, CICE, CPC

Vol. 7, No. 9

Nov/Dec 2007

Critical Transition From Short- to Long-Acting Opioid Therapy
While most pain patients are initially treated with short-acting opioids, severe unremitting pain involving biological manifestations requires transitioning to long-acting opioids�but not on the basis of equivalency tables. Instead, long-acting opioids should be carefully phased in at low dosages while keeping the short-acting opioid regimen in place until it can be safely curtailed. by Forest Tennant, MD, DrPH
Dysfunction and Rehabilitation of the Shoulder
Considerations of muscular relationships in pain management based on Surface Electromyographic (SEMG) Studies. by Gabriel E. Sella, MD
Placebos in Pain Management
A chronic pain patient’s personal perspective on the power of placebos in mitigating chronic pain. by Mark Collen
Publisher's Message
The Best Patient Is An Informed Patient by Marvin Rosenfeld
Interventional Therapy: Ziconotide Combination Intrathecal Therapy
Retrospective case studies in intrathecal drug therapy patients with severe chronic pain demonstrate the safety and efficacy of ziconotide in improving pain management while reducing—or halting—oral and intrathecal narcotic pain medications. by Michael J. Eastman, BA, PA-C and Steven P. Johnson, MD
Pharmacotherapy: Chronic Cancer Pain Management
Appropriate pain assessment�along with the proper use of opioid analgesics and the management of common opioid side effects�are vital components in an overall treatment and monitoring plan. by Charles D. Ponte, PharmD
Prolotherapy: Dextrose Prolotherapy and Pain of Chronic TMJ Dysfunction
Many of the subjective symptoms of pain, stiffness, and crunching sensation in patients with TMJ dysfunction were reduced greater than 50% in 92% of the prolotherapy patients in this study. by Ross A. Hauser, MD; Marion A. Hauser, MS, RD; and Krista A. Blakemore, BA
Clinical Bioethics: The Good Patient
Responsibilities and Obligations of the Patient-Physician Relationship by James Giordano, PhD
Head and Neck: TMJ Derangement and SUNCT Syndrome Co-Morbidity
Case report of signs and symptoms of internal derangement of the temporomandibular joint (TMJ) co-morbid with short-lasting unilateral neuralgiform headache attacks from conjunctival injection and tearing (SUNCT) syndrome. by Edwin A. Ernest, III, DMD
Electromedicine: CES in the Treatment of Addictions: A Review and Meta-Analysis
Addictions are serious and poorly understood problems that may involve prescribed or illicit drugs, alcohol, or compulsive behavioral patterns involving sex, gambling, eating or "surfing the net." Cranial electrotherapy stimulation (CES) has been shown in 15 studies to quickly, safely and effectively reduce the physical withdrawal, psychological cravings and co-morbid anxiety, insomnia and depression in people suffering from addictive disorders. by Daniel L. Kirsch, PhD, DAAPM, FAIS and Marshall F. Gilula, MD
Laser Therapy: Low Level Laser Therapy (LLLT) - Part 2
A review of seminal works on the theory of non-mechanistic, quantum physics effects of low level energy on biological systems. by Daniel J. Murphy, DC
HIT Advisor: Compliant Billing, Coding and Documentation for Interventional Pain
by Ted A. Arkfeld, DC, MS, CICE, CPC

Vol. 7, No. 8

October 2007

Central Role of Dopamine in Fibromyalgia
A review of the evidence that fibromyalgia is associated with a disruption of dopaminergic neurotransmission together with a discussion of its therapeutic implications. by Patrick B. Wood, MD
Combined Phrenic Nerve Palsy and Cervical Facet Joint Pain
Pain management challenge in diagnosing and treating a rare case of PNP in combination with cervical facet joint pain in a diabetic patient. by Connie Ecklund, RN, MSN, APNP, BC and Mazin Ellias, MD, FRCA
Mistakes Made by Chronic Pain Patients
A guide for chronic pain patients to help them avoid pitfalls and mistakes and become part of the team in helping to restore a better quality of life for themselves. by Ron Lechnyr, PhD, DSW and Terri Lechnyr, PhD, LCSW
Publisher's Message
Two New Board Members by Marvin Rosenfeld
Electromedicine: CES in the Treatment of Insomnia: A Review and Meta-analysis
Cranial Electrotherapy Stimulation (CES) is an effective, established treatment for insomnia that avoids polypharmacy interactions for pain patients taking medications while simultaneously reducing anxiety, depression, and pain. by Daniel L. Kirsch, PhD, DAAPM, FAIS and Marshall F. Gilula, MD
Interventional Therapy: A Clinical Guide To Weaning Off Intrathecal Opioids
This clinical guide was developed to help clinicians wean patients from intrathecal opioid therapy. by Stuart Rosenblum, MD, PhD; Robert Fisher, MD; David Caraway, MD, PhD; and Michael
Laser Therapy: Low Level Laser Therapy
Effects at the cellular level increase ATP energy and DNA synthesis and benefit acute and chronic musculoskeletal aches and pains, chronic inflammation, acute soft-tissue injuries, as well as other conditions. by Dan Murphy, DC, DABCO
Prolotherapy: Dextrose Prolotherapy for Unresolved Neck Pain
An observational study of patients with unresolved neck pain who were treated with dextrose prolotherapy at an outpatient charity clinic in rural Illinois. by Ross A. Hauser, MD and Marion A. Hauser, MS, RD
Imaging: Three Dimensional Imaging of the Foot
The use of force plate technology provides new insight into potential sources of foot and/or leg pain by providing pathoanatomical visualization of foot pressure patterns, foot velocity, and motion characteristics. by Tiziano Marovino, DPT, FAAPM
Clinical Bioethics: The "Promise" of Pain Medicine: Profession, Oaths, and the Probity of Practice
by James Giordano, PhD and Paul J. Hutchison, MA
Head and Neck: Patulous Eustachian Tube, Part 2
Often unrecognized, the symptoms of patulous eustachian tube may, and often do, mimic other ear conditions. by Edwin A. Ernest, III, DMD
Pharmacotherapy: Avoiding the Pitfalls of Opioid Reversal with Naloxone
With its wide margin of safety, low cost, and multiple routes of administration, naloxone is an ideal antidote for opioid toxicity but it should only be used to reverse respiratory depression while closely monitoring the patient. by Elizabeth J. Scharman, PharmD
HIT Advisor: HIT Advisor: Using EMRs to Make Your Patient "Triage" and Clinical Flow More
by Greg Winterkamp

Vol. 7, No. 8

Sep 2007

Structuring Opioid Therapy
Patient stratification for certain characteristics can minimize the risk of sleep apnea and respiratory depression. by Lynn R. Webster, MD, FACPM, FASAM
Education And Exercise Program For Chronic Pain Patients
Y-Pep, a Canadian community-based program for chronic pain patients, provides hope, improves physical function, pain tolerance, and coping skills. by C. King-VanVlack, BSc, MSc, PhD; et al
Chronic Persistent Pain Can Kill
Case report of a male patient whose death was hastened by chronic pain. by Thomas J. Romano, MD, PhD
Smoking and Aberrant Behavior in Chronic Pain Patients
A narrative review of smoking and aberrant drug-taking behavior in chronic pain patients together with emerging clinical implications. by Lara K. Dhingra, PhD, and Steven D. Passik, PhD
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. by Karel Schram, PA-C, and Wayne Kohn, DO
Burning Mouth Syndrome
The large array of potential pathologies for this condition requires investigative skill, tenacity, patience, and empathy to differentially diagnose and treat. by Keith A. Yount, DDS, MAGD
Managing Pain in Intensive Care Units
Aggressive pain management for the typically very ill and unstable patients in the ICU must be individualized based on the circumstances of each patient's pathology and condition. by Ronald Go, MD, Kathleen Broglio, ANP-CS, ACHPN, and B. Eliot Cole, MD
Oxycodone to Oxymorphone Metabolism
Interpreting urine drug tests in pain patients treated with oxycodone requires an understanding that oxymorphone, although considered a minor metabolite, can sometimes equal or exceed urine concentrations of oxycodone. by Jennifer Schneider, MD and Ashley Miller
Publisher's Message
Interview with Sheri Gavinski, ICPCD by Marvin Rosenfeld
APS Response to the Washington State Guidelines
by Judith A. Paice, PhD, RN
Clinical Bioethics
Rational, Emotive, Ethical Approaches To Bio-Psychosocial Pain Care by James Giordano, PhD and Joan Walter, JD, PA-C
Laser Therapy
Pain Relief Strategies When Using a Continuous Output GaAlAs Laser by William J. Kneebone, CRNA, DC, CNC, DIHom, FIAMA, DIACT
Head and Neck Pain
Patulous Eustachian Tube, Part 1 by Edwin A. Ernest III, DMD
HIT Advisor
Get Better Connected To Your Patients Over the Internet by Greg Winterkamp

Vol. 7, No. 6

Jul/Aug 2007

Howard Hughes and Pseudoaddiction
A retrospective case report of this remarkable individual's 30-year survival by self-medicating his intractable pain with codeine, anti-inflammatories, muscle relaxants, and stimulants�not as a drug-seeker, but as a "relief-seeker." by Forest Tennant, MD, DrPH
Diabetic Neuropathy Study
Under-consumption or lack of critical nutrients in the diets of diabetics may be implicated in diabetic complications including neuropathy. by Mark Gostine, MD; Larry Pawl, MD; Michael David, DPM; and William Decker, DPM
Publisher's Message
Washington State Guidelines Revisited by Marv Rosenfeld, Publisher
Viewpoint: The OxyContin� Controversy
The Unwarranted Attacks on Doctors, Pharmaceutical Companies, and Opioids Must Stop by Forest Tennant, MD, DrPH
Clinical Bioethics: Pain and Psychopathology in Military Wounded
How Etiology, Epidemiology Sustain an Ethics of Treatment by James Giordano, PhD and Joan Walter, JD, PA-C
Interventional Therapy: Occipital Nerve Stimulation for Treatment of Migraine
Minimally-invasive electrical nerve stimulation of the greater and/or lesser occipital nerves may be extremely effective in treating refractory migraine. by James E. Hagen, MSc and Daniel S. Bennett, MD, DABPM
Electromedicine: Use of TENS In Pain Management
Recent advances in transcutaneous electrical nerve stimulation (TENS) have shed new light on the efficacy as well as the mechanism of action and provide a solid foundation for clinical utilization and subsequent research. by James D. Pomonis, PhD, and Joseph R. Shurman, MD
Fibromyalgia: Pregabalin for the Treatment of Fibromyalgia
The approval of pregabalin (Lyrica�) for the treatment of fibromyalgia by the Food and Drug Administration marks a welcome advance. by Patrick B. Wood, MD
Laser Therapy: Infrared Photo Energy May Reduce Neuropathic Pain
Near infrared light therapy, together with physical therapy, may be able to reduce pain in neuropathy patients and possibly reduce medication dosage levels of those undergoing drug therapy. by Thomas J. Burke, PhD
Imaging: Osteoporosis Testing: DEXA Method
Patients at risk for painful fractures due to bone loss can benefit from dual energy x-ray absorptiometry (DEXA) testing that can numerically assess subtle changes in bone mineral density over time. by Tiziano Marovino, DPT, FAAPM
Pharmacotherapy: Pharmacologic Management of Opioid-Induced Adverse Effects
When lifestyle changes and non-pharmacological treatments fail, adjuvant drug therapies�along with regular patient assessment�may limit the adverse effects of opioid therapy. by Gina M. Carbonara, PharmD
Prolotherapy: Prolotherapy For Knee Pain
A reasonable and conservative approach to knee tendonitis/tendonosis, sprain-strains, instability, diagnosis of meniscal tear, patellofemoral pain syndrome including chrondromalacia patellae, degenerative joint disease, and osteoarthritis pain. by Donna Alderman, DO
HIT Advisor
Are You Ready For Pain Management EMR Evidence-Based Guidance Systems? by Greg Winterkamp

Vol. 7, No. 5

June 2007

Chronic Pain and Co-Morbid Brain Injury From IED Trauma
Case presentation of a US veteran of Operation Iraqi Freedom following injuries from two consecutive Improvised Explosive Devices (IEDs). by Mordecai N. Potash, MD
Urine And Blood Tests
Why and when to use each test in pain treatment. by Forest Tennant, MD, DrPH
Publisher's Commentary: What's Happening in Washington State?
Adoption of a suggested daily limit on opioid dosing sparks controversy. by Marv Rosenfeld, Publisher
Commentary from the Editor in Chief Emeritus
The Washington Opioid Dosage Restriction � Assault on Care or Necessity? by Forest Tennant, MD
Viewpoint:
The OxyContin Controversy by Joseph Shurman, MD
Clinical Bioethics: Pain Research
The Relationship of Knowing and Doing by James Giordano, PhD and Julia Pedroni, PhD
Electromedicine: CES in the Treatment of Depression, Part 2
This second article, of a two-part series on the efficacy of Cranial Electrotherapy Stimulation (CES) in treating depression, reviews the results of meta-analysis conducted on CES studies. by Daniel L. Kirsch, PhD, DAAPM, FAIS , and Marshall F. Gilula, MD
Interventional Therapy
SCS Treatment Of Painful Diabetic Peripheral Neuropathy by Ani C. Khodavirdi, PhD and Francis McDonnell, MD
Interventional Therapy: Trialing for Intrathecal Therapy
Comments and Considerations by Daniel M. Doleys, PhD and Thomas J. Krauss, DO
Fibromyalgia
Guidelines for Beneficial Group Exercise for Fibromyalgia by Janice H. Hoffman, BA, CES
Imaging
Cardiac CT � A Work In Progress by Tiziano Marovino, DPT, FAAPM
Laser Therapy
Treatment of Chronic Neck Pain Utilizing Low Level Laser Therapy by William J. Kneebone, DC, CNC, DIHom, FIAMA, DIACT
Pharmacotherapy
Walking the Tightrope of Appropriate Pain Management by Raylene M. Rospond, PharmD, FCCP, BCPS
HIT Advisor
Are You Really Utilizing Your EMR by Ted Arkfeld, MS, DC, DABFE, CICE, CPC

Vol. 7, No. 4

May 2007

Paradigm Shift in Cancer Pain Management
Application of an interdisciplinary, psychosocial model�along with early intervention�can change the focus from palliation of advanced pain complications to that of preempting chronicity and improving quality of life for cancer patients. by John P. Garofalo, PhD; Robert J. Gatchel, PhD, ABPP; Andrew Baum, PhD
Self-Protection Against "Off-Label" Lawsuits
The current medico-legal climate is hampering the long-standing medical prerogative to prescribe a particular drug for a therapeutic effect deemed beneficial to the patient. by Forest Tennant MD, DrPH
Publisher's Message
A Pain Management Forum by Marvin Rosenfeld
Viewpoint
Methadone Perspectives by Forest Tennant, MD, DrPH and Joseph Shurman, MD
Clinical Bioethics
Invoking the Placebo Effect by James Giordano, PhD
Electromedicine
CES in the Treatment of Depression by Daniel L. Kirsch, PhD, DAAPM, FAIS , and Marshall F. Gilula, MD
Fibromyalgia
Fibromyalgia Patient Insights by Lynne Matallana, MA
Head and Neck Pain
Cervical-Medullary Meningioma by Edwin A. Ernest III, DMD
Imaging
Multidimensional Ultrasonography by Tiziano Marovino, DPT, FAAPM
Interventional Therapy
Sedation Levels for Intraspinal Injections by Lynn R. Webster, MD, FACPM, FASAM
Laser Therapy
Deep Penetration Therapeutic Laser by William J. Kneebone, RN, CRNA, DC, CNC, DIHom, FIAMA, DIACT
Prolotherapy
Prolotherapy For Low Back Pain by Donna Alderman, DO
HIT Advisor
Pen Tablets by Greg Winterkamp

Vol. 7, No. 3

April 2007

Viewpoint
Methadone Deaths and Warnings by Forest Tennant, MD, DrPH
National Campaign Seeks Zero Prescription Overdose Deaths
Public Service Announcement by www.zerodeaths.org
Cervical Decompression Treatment
Study results confirm positive results from the use of an inflatable device to decompress cervical vertebrae and relieve cervical pain due to postural abnormalities. by C. Norman Shealy, MD, PhD
Urine Drug Screening in Everyday Practice
Routine urine testing is more readily accepted by patients when it is implemented as an integral part of a drug therapy program. by Anthony J. Kozma, DO
Publisher's Message
Reader Response Sparks Changes by Marvin Rosenfeld
Head and Neck Pain
TMJ Quick Screening Exam by Edwin A. Ernest III, DMD
Imaging
Dual Modality Imaging by Tiziano Marovino, DPT, FAAPM
Interventional Therapy
Practical Issues of Reimbursement for IT Drug Delivery: The Ziconotide Model by William Stuart, RPh, and Keri L. Fakata, PharmD
Laser Therapy
Phototherapy Applications, Part 2: Occupational Injuries by Douglas Johnson, ATC, CLS
HIT Advisor
The Difference Between EMR Hype and Reality by Greg Winterkamp
Clinical Bioethics
Chronic Pain and Spirituality by James Giordano, PhD
Electromedicine
CES in the Treatment of Anxiety Disorders, Part 2 by Daniel L. Kirsch, PhD, DAAPM, FAIS , and Marshall F. Gilula, MD

Vol. 7, No. 2

March 2007

Complex Interplay of Participants in Opioid Therapy
An historical and contemporary view of societal, medical, manufacturer, payer, and legal interactions affecting the prescription and use of opioids for pain management. by Dana Bernstein, PhD, MS; Anna W. Stowell, PhD; Rob Haggard, BS, MS Degree Candidate; Whitney Worzer, BA, MS Degree Candi
Viewpoint
Moderated by Forest Tennant, MD, DrPH and Joseph Shurman, MD by Joseph Shurman, MD
Clinical Bioethics
A Big Picture: Neurogenesis, Pain, and the Reality and Ethics of Pain Medicine by James Giordano, PhDJames Giordano, PhD
Electromedicine
CES in the Treatment of Anxiety Disorders by Daniel L. Kirsch, PhD, DAAPM, FAIS and Marshall F. Gilula, MD
Fibromyalgia
Sleep Disturbances in Fibromyalgia by Carol A. Landis, DNSc, RN, FAAN
Head and Neck Pain
Migraine-like Headache of Temporal Tendonitis by Edwin A. Ernest III, DMD; Mario E. Martinez, DMD, MS; David B. Rydzewski, MD; and E. George Salter, PhD
Interventional Therapy
Are Intrathecal Therapy Trials Necessary? by Lynn R. Webster, MD, FACPM, FASAM
Laser Therapy
Phototherapy Applications In Sports Medicine by Douglas Johnson, ATC, CLS
Pharmacotherapy
Using Methadone Effectively and Safely as Analgesic by Thomas C. Mercurio, BS, PharmD Candidate and Mary Lynn McPherson, PharmD, BCPS
HIT Advisor: Interoperability, Part 3
Understanding where you are in the Evolution of Computerization by Greg Winterkamp

Vol. 7, No. 1

Jan/Feb 2007

Prolotherapy for Musculoskeletal Pain
A primer for pain management physicians on the mechanism of action and indications for use. by Donna Alderman, DO
Electromyography (EMG) and Musculoskeletal Pain
A synopsis of the clinical applications and complementarities between two predominant motor testing modalities for musculoskeletal dysfunction: needle and surface EMG. by Gabriel E. Sella, MD, MPH, MSc, PhD (HC)
Gastrointestinal Adverse Effects of Opioids
A review of the pathophysiology of opioid-related gastrointestinal effects together with treatment options. by Mamie H. Dong, MD, Joseph R. Pisegna, MD, Jonathan D. Kaunitz, MD
Therapeutic Laser For Chronic Low Back Pain
Laser therapy offers a safe and effective treatment modality as either primary or adjunctive therapy. by William J. Kneebone, CRNA, DC, CNC, DIHom, FIAMA, DIACT
Minimally-Invasive, Interventional Spine Treatment Part II
Diagnostic and therapeutic intradiscal interventions for pain generated from internal disc disruption. by Elmer G. Pinzon, MD, MPH
Surviving a Loved One's Chronic Pain
A guide for family and friends of pain patients. by David Kannerstein, PhD and Sarah M. Whitman, MD
Publisher's Message
Restructuring Practical Pain Management by Marvin Rosenfeld
Guest Editorial
The Continuing Need for Pain Education by B. Eliot Cole, MD, MPA
Head and Neck Pain
Neuralgic Pain of the Temporomandibular Joint by Edwin A. Ernest III, DMD, and E. George Salter, PhD
Electromedicine
Electromedical Treatment of Headaches by Daniel L. Kirsch, PhD, DAAPM, FAIS
Clinical Bioethics
Resolutions: Examining the Past, Present and Future of Pain Management by James Giordano, PhD
Fibromyalgia
Fibromyalgia in Older Adults by Kim Dupree Jones, PhD; Casey R. Shillam, RN; Rebecca Lee Ross, RN;Dianne G. Adams, MPH
HIT Advisor
Interoperability�Part 2 by Greg Winterkamp

Vol. 6, No. 8

Nov/Dec 2006

Interventional Therapy Department: Minimally-Invasive Interventional Spine Treatment, Part 1
Flouroscopically-directed spinal injection techniques may improve the efficacy of physical therapy and functional restoration protocols. by Elmer G. Pinzon, MD, MPH
Pediatric Headaches
Initial treatment of pediatric headaches may benefit by using conservative, reversible modalities for tension headache before resorting to medications for migraine. by Keith A. Yount, DDS, MAGD
Practical Applications of Low Level Laser Therapy
A brief review of some of the basic concepts of low level laser therapy, clinical indications for its use, and treatment options when applying therapeutic lasers to patients in pain. by William J. Kneebone, CRNA, DC, CNC, DIHom, FIAMA, DIACT
Strength Testing in Pain Assessment
Quantitative, objective measurement of muscle strength in the extremities is suggested as a means of improving the validity and reliability of strength measurements in pain assessment. by Alex Ambroz, MD, MPH; Robert Zucker, MD, MPH; Clara Ambroz, MD, MPH
Editor's Memo
Neurogenesis: A Goal of Chronic Pain Treatment by Forest A. Tennant, MD, DrPH
Publisher's Message
Fibromyalgia Department by Marvin Rosenfeld
Head and Neck Pain
Hyoid Bone Syndrome by Edwin A. Ernest III, DMD, and E. George Salter, PhD
Pharmacotherapy
Practical Use of Analgesics for Pain Management by Charles D. Ponte, PharmD
Electromedicine
Electromedical Treatment of Headaches by Daniel L. Kirsch, PhD, DAAPM, FAIS
Clinical Bioethics
On the Role of Primary Care Within a System of Integrative Multi-Disciplinary Pain Management by James Giordano, PhD; Pierre LeRoy, MD; and Uday Uthaman, MD
Imaging
Mobile MRI: Imaging on Wheels by Tiziano Marovino, DPT, FAAPM
HIT Advisor
Interoperability, Part 1 by Greg Winterkamp

Vol. 6, No. 7

October 2006

Share the Risk Model
Originating in San Diego, this practice model is an example of successful collaboration among doctors to mitigate professional risks while improving care for pain patients. by Joseph Shurman, MD; John Sack, MD; Gloria Shurman, PhD; Bradley Schnierow, MD; and Ceasar Gabriel, BSP
Observational Study of Dural Punctures
A retrospective review of the rate of dural punctures as a complication of lumbar epidural steroid injection—with and without guiding fluoroscopy. by Anthony H. Guarino, MD
Using Topiramate in the Treatment of Migraine
The number one drug used by neurologists for migraine and daily headache, topirimate is only reluctantly used by primary care physicians. This article is an attempt to demystify a very effective drug in the physician's migraine armentarium. by R. Steven Singer, MD
Guest Editorial
Low Level Laser Therapy: A Clinician's View by Bernard E. Filner, MD
Practice Patterns of Clinicians Treating Vulvar Pain
Expert opinion is an important source of information for clinicians hoping to treat this condition efficiently and effectively. by Glenn Updike, MD
Editor's Memo
Share The Care—Not Just The Risk by Forest A. Tennant, MD, DrPH
Publisher's Message
Writing for Departments and Announcing Our New Imaging Department by Marvin Rosenfeld
Pharmacotherapy
An Overview of Sleep Medications by Chris Terpening, PhD, PharmD
Head and Neck Pain
Ernest Syndrome and Insertion of the SML at the Mandible by Edwin A. Ernest, III, DMD
Interventional Therapy
Treating Sports Related Injury and Pain with Light Therapy by Joseph Hsin, MD and Jon Weston, MBA
Electromedicine
Microcurrent Electrical Therapy (MET): A Tutorial by Daniel L. Kirsch, PhD, DAAPM, FAIS
Clinical Bioethics
Pain as Disease and Illness: Part Two by James Giordano, PhD
HIT Advisor
So Many Electronic Medical Record Systems, So Costly! by Greg Winterkamp

Vol. 6, No. 6

September 2006

Identification and Management of Cardiac-Adrenal-Pain Syndrome
Severe, chronic, under-treated pain may produce cardiac and adrenal complications that, in some pain patients, can lead to premature death. by Forest Tennant, MD, DrPH
Fibromyalgia: New Hope And New Pharmaceuticals
While few therapies have proven effective in the past, recent pharmacologic advances provide new hope for this difficult-to-treat disorder. by Andrew J. Holman, MD
Treating Neuropathic Pain In Multiple Sclerosis (MS) Patients
MS patients with neuropathic pain demonstrated improvement using the oral synthetic cannabinoid nabilone. by Gordon D. Ko, MD, ; William A. Wine, MA, PhD; and Ethan J. Tumarkin, BSc
Profile In Access To Pain Treatment
Going It Alone: Thomas Purtzer, MD runs a frugal pain practice by referring patients to independent multi-disciplinary specialties only as needed. by David Rosenfeld
Editor's Memo
The First Order Of Business: Pulse Rate And Blood Pressure by Forest A. Tennant, MD, DrPH
Publisher's Message
The Results Are In by Marvin Rosenfeld
Pharmacotherapy
Contemporary Pharmacology by Charles D. Ponte, PharmD, CDE, BCPS, BC-ADM
Head and Neck Pain
Superior Pharyngeal Constrictor Muscle Pain by Edwin A. Ernest, III, DMD, FAANaOS; Mark W. Ernest, BA; E. George Salter, PhD
Interventional Therapy
When Should Spinal Cord Stimulation (SCS) be Considered? by Lynn Webster, MD
Electromedicine: Cranial Electrotherapy Stimulation in the Treatment of Fibromyalgia
by Daniel L. Kirsch, PhD, DAAPM, FAIS
Laser Therapy: Choosing and Using a Low Level Laser in Pain Management
by Larry Lytle, DDS, PhD
Clinical Bioethics
Understanding Pain as Disease and Illness - Part 1 by James Giordano, PhD
HIT Advisor
How Regional Health Information Organizations Will Impact Practices by Greg Winterkamp

Vol. 6, No. 5

Jul/Aug 2006

Urine Drug Testing and Monitoring in Pain Management
Scientifically sound urine drug testing can be an effective means to augment pharmacotherapy and assist with medical/legal aspects of the healthcare environment. by Frank A Fornari, PhD, David M. Siwicki, MD, Gwen B. Bauer, PhD
Vitamin D Deficiencies in Pain Patients
This condition, associated with muscle weakness, myopathy, and consequently musculoskeletal pain, was found to be prevalent in the patient population studied. by Mark L. Gostine, MD and Fred N. Davis, MD
Potential Hazards of Vertebroplasty
Improperly executed intrathecal injection of methyl methacrylate during vertebroplasty causes neurologic deficit and arachnoiditis. by J. Antonio Aldrete, MD, MS; Maria del Socorro Romero Figueroa, MD; and Rhamsis F. Ghaly, MD
Splenius Capitis Muscle Syndrome
This syndrome typically mimics the respective pain patterns of temporal tendonitis and migraine headache. by Edwin A. Ernest III, DMD, FAANaOS and Mark W. Ernest, BA.
Clinical Pearls for Treating Headache Patients
Years of observations in evaluating and treating migraineurs provides insights into the complexities of this patient population. by Dr. Lawrence Robbins, MD
Lessons Learned from a Headache TMD Study
A retrospective study of two groups of patients yields some insight into the relationship of TMD and headaches. by John S DuPont Jr., DDS and Chris Brown,DDS
Editor's Memo
Tailor-Made Medications Are Critical For Chronic Pain Treatment by Forest A. Tennant, MD, DrPH
Publisher's Message
Improvement With Your Help by Marvin L. Rosenfeld
Guest Editorial
Guidelines for Opioid Management of Pain by J. S. Hochman, MD
Interventional Therapy
Interventional Therapies in the Continuum of Care by Lynn Webster, MD
Electromedicine
Why Electromedicine? by Daniel L. Kirsch, PhD, DAAPM, FAIS
Laser Therapy
Determining Which Low Level Laser to Use by Larry Lytle, DDS, PhD
Clinical Bioethics
by James Giordano, PhD
HIT Advisor
by Greg Winterkamp

Vol. 6, No. 4

May/Jun 2006

Managing Diabetic Peripheral Neuropathic Pain (DPNP)
A review of the diagnosis, evaluation, and treatment of diabetic peripheral neuropathic pain. by Ronaldo Go, MD and B. Eliot Cole, MD, MPA
Assessing Secondary Gain In Chronic Pain Patients
Ongoing assessment and management of secondary gain issues in chronic pain patients is an important part of the therapeutic process. by Jeff Dersh, PhD; Robert J. Gatchel, PhD, ABPP; and Tom Mayer, MD
Chronic Overuse Sports Injuries
Practical evaluation and treatment modalities. by Elmer “Al” Pinzon, MD, MPH; FABPMR, FABPM and Mick Larrabee, PT, MS, SCS, EMT, CSCS
Smoking and Low Back Pain
A review of research findings regarding the relationship of smoking and low back pain. by Bilal F. Shanti, MD, Gabriel Tan, PhD, and Ihsan F. Shanti, MD, PhD
Temporal Tendinitis: Migraine Mimic
Diagnosis and treatment of temporal tendonitis, a very common disorder that is often mistaken for migraine. by Edwin A. Ernest, III, DMD
Non-Pharmacologic Therapy for Chronic Opioid-Dependent Sickle Cell Pain
Study results confirm the efficacy of Benson’s Relaxation Response in reducing pain and medication in this patient population. by Adam Poster
Osteoarthritis of The Knee
Pain Management options for alleviating pain and increasing mobility for patients with this disease. by Edward H. Miller, MD
Editor's Memo
The Underutilization of Intrathecal Treatment by Forest A. Tennant, MD, DrPH
Publisher's Message
Departmentalizing the Wisdom of Our Authors by Marvin L. Rosenfeld
Guest Editorial
Tumblin’ Dice — Why Does Random Matter? by James Patrick Murphy, MD
Laser Therapy
Introducing Low Level Laser Therapy to Pain Management by Larry Lytle, DDS, PhD
Clinical Bioethics
Moral Virtue and the Pain Physician by James Giordano, PhD
HIT Advisor: Workflow & Clinical Decision Making, Part II
Automated protocols for a structured and systematic approach to patient care (“evidenced based medicine”) is inherent in a big push towards integrating updated, real-time information into EMR systems. by Greg Winterkamp

Vol. 6, No. 3

April 2006

Breakthrough Pain in Non-Cancer Patients
An observational study of breakthrough pain in non-cancer patients with chronic low back pain. by Anthony H. Guarino, MD and Martha E. Cornell, RN, BSN
Adjuvant Analgesia for Management of Chronic Pain
An updated review of traditional adjuvant analgesics, psychotropic agents, other newer medications, and non-pharmacological adjuvant modalities for pain. by Bilal F. Shanti, MD, Gabriel Tan, PhD, Ihsan F. Shanti, MD, PhD
A Muscular Approach to Headache
Muscular dysfunction of head muscles may result in headache due to muscle over-exertion and fatigue. by G.E. Sella, MD, MSc, MPH, PhD (HC) DAAPM
The Role of MMPI-2 In Assessment Of Chronic Pain
MMPI-2 data is best viewed as one of multiple sources of patient information, including history, social support networks, coping ability, and more. by Robert J. Gatchel, PhD, ABPP
Electroanalgesic Nerve Block
Theory and case reports on an advanced generation electroanalgesic medical device (EAD) in reducing or mitigating acute and/or chronic intractable pain conditions. by Robert H. Odell, Jr., MD, PhD, Richard Sorgnard, PhD, and Hans Ulrich May, MD
Case Presentation of Munchausen Syndrome
Following epidural analgesia in a chronic pain patient, an occurrence of thoracic epidural abscess led to a finding of Munchausen Syndrome. by Mazin Ellias, MD,FRCA and Yakub Ellias, MD, FRCS0
The American Board Of Independent Medical Examiners (ABIME)
Dedicated to the improvement in quality of independent medical examinations. by Mohammad I. Ranavaya, MD, MS, FRCPI, FFOM, CIME, and Thomas A. Beller, MD, CIME
Editor's Memo
Opioid Malabsorption—Can You Stomach This? by Forest A. Tennant, MD, DrPH
Publisher's Message
And the Winner Is... by Marvin L. Rosenfeld
Guest Editorial
Sedation Safety and Comfort by Robert J. Rogers, MD, FACP, Diplomat ABA and ABIM
Clinical Bioethics
On Knowing by James Giordano, PhD
HIT Advisor
Workflow & Clinical Decision Making, Part I by Greg Winterkamp

Vol. 6, No. 2

March 2006

Assessment and Treatment of Chronic Pain
A physician’s guide to a biopsychosocial approach. by John Mark Disorbio, Ed.D., Daniel Bruns, Psy.D, and Giancarlo Barolat, MD
Tennant Blood Study—Summary Report
Opioid blood levels in high dose, chronic pain patients. by Forest Tennant
Oxycodone to Morphine Rotation
The author describes one opioid rotational procedure found to be effective. by Mazin Ellias MD, FRCA
Epidural Indomethacin Alternative in Adult Onset Diabetics
Study confirms hyperglycemia resulting from epidural corticosteroid injections in diabetic patients with recurrent post-laminectomy radiculopathy and assesses indomethacin as a suitable alternative to corticosteroids. by J. Antonio Aldrete, MD, MS, and Uriah Guevara, MD
Office-based Treatment of Opioid Dependence
New hope for patients with concomitant pain and addiction issues. by John Allen, MS, CRNA
The Psychiatric Model of Treating Chronic Pain
Psychiatric illnesses do not need to be present in order for the psychiatric model to be successfully used in achieving the multidisciplinary goal of biopsychosocial balance. by Abbey Strauss, MSW, MD
Editor's Memo
Pain Treatment—The Great Stabilizer by Forest A. Tennant, MD, DrPH
Publisher's Message
How About You? by Marvin L. Rosenfeld
Guest Editorial
Focus on Urine Drug Monitoring by Joseph Shurman, MD and Ronald C. Backer, PhD
Clinical Bioethics
Pain Care at the End of Life by James Giordano, PhD
Guest Editorial
Clinical Drug Testing for Pain Medicine by Frank A. Fornari, PhD
Health Information Technology Advisor
Inter Office Communication by Greg Winterkamp

Vol 6, No. 1

Jan/Feb 2006

Infusion Catheter Epidural
Continuous infusion of lumbar epidural corticosteroid effectively reduces inflammation and pain by “bathing” the suspect spinal structure over a three day period. by Michael Shapiro, MD
Role of Psychology in Pain Management
An overview of the various roles that psychology and psychologists play in pain management. by Leanne R. Cianfrini, PhD and Daniel M. Doleys, PhD
The Demise of Multidisciplinary Pain Management Clinics?
A potential strategy for addressing the conflicting ethos of business-oriented insurance and corporate healthcare versus the ends and means of right and morally sound patient care. by Michael E. Schatman, PhD, DAAPM
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. by Barry Eliot Cole, MD, MPA
Tennant Blood Study — First Update
Collaborative blood level survey of effective opioid administration in opioid-tolerant chronic pain patients. by Forest Tennant, MD, DrPH
Do Topical Herbal Agents Provide Pain Relief?
A pilot study of chronic pain patients with fibromyalgia demonstrated a positive response to topical herbal agents. by Gordon D. Ko, MD, CCFP(EM), FRCPC, Annie Hum, MD, CAFCI, and George Traitses, DC
Suspecting and Diagnosing Arachnoiditis
A review of the symptoms noted in a group of patients with arachnoiditis presents an analysis of clinical observations of this disease. by J. A. Aldrete MD, MS
Editor's Memo
Practical Science Meets the Art of Pain Medicine by Forest A. Tennant, MD, DrPH
Publisher's Message
Our Positions by Marvin L. Rosenfeld
New Report of a High-Dose Morphine Metabolite
A previously unreported metabolite of high-dose morphine treatment, hydromorphone, has recently been discovered by a select few laboratories. by Michael Evans, PhD, Andrea Terrell, PhD, DABCC, Robert Foery, PhD, DABCC/TC, Breain Ma’Ayteh, MA, and John Constantine, BS
Health Information Technology Advisor
HIT Advisor: Tips Towards an Effective Paperless System: Can You Afford It? by Greg Winterkamp
Bioethics
Pain Medicine, Morality, and the Marketplace: Time for a Change by James Giordano, PhD
Guest Editorial
The Dimensions of Pain by William M. Lamers, Jr., MD

Vol. 5, No. 7

Nov/Dec 2005

Tennant Blood Study: Preliminary Report
Collaborative blood level survey of effective opioid administration in opioid-tolerant chronic pain patients. by Forest Tennant, MD, DrPH
Head Region Neuropathies
As part of a differential diagnosis of pain associated with tooth, gum, tongue, palate, or face, the potential presence of neuropathies should also be considered before performing irreversible procedures. by Keith A. Yount, DDS, MAGD
Childhood Costochondritis and Biofeedback
A clinical case examination of behavioral treatment using a relaxation model of biofeedback in treating this rare painful disorder. by Roslyn E. Feierstein, PhD
Treating Muscular Dysfunction of Lower Limbs
An SEMG view of investigation of muscular dysfunction and rehabilitation of the lower limb muscles. by G.E. Sella, MD
Chronic Pain and Biopsychosocial Disorders
The BHI™ 2 Approach to Classification and Assessment. by Daniel Bruns, PsyD and John Mark Disorbio, EdD
Physical Therapy in Pain Management
Physical therapy has evolved as a supportive specialty of medicine and contributes expertise in multi-modal treatment techniques and therapies that specifically target painful conditions. by Tiziano Marovino, DPT, FAAPM
Bioethics and Intractable Pain
Pragmatic and ethical issues in the clinical use of the term “Intractable Pain.” by James Giordano, PhD
Editor's Memo
Control or Cure: Tell It Like It Is by Forest A. Tennant, MD, DrPH
Publisher's Message
This Year and Next by Marvin L. Rosenfeld
Health Information Technology Advisor
EMR Goals and Commitment by Greg Winterkamp

Vol. 5, No. 6

Sep/Oct 2005

The Role of Tertiary Gain in Pain Disability
Tertiary gain—gains sought or attained from a patient’s illness by someone other than the patient—can be a perpetuating factor in illness and disability. by Jeff Dersh, PhD; Robert J. Gatchel, PhD, ABPP; and Nancy Kishino, OTR, CVE
Neurostimulation in Chronic Pain Patients
As a cost-effective intervention, neurostimulation can play an important role in chronic pain patients failing more conservative treatment approaches. by Leonard B. Goldstein, DDS, PhD and Shelley Gilbert, BS
How Expert Testimony Distorts the Standard of Care
During regulatory assaults, a disturbing pattern of conflict exists between expert testimony offered against pain-treating physicians employing opioid analgesics and the scientific evidence and medical principles upon which a rational standard of care for pain management is based. by Frank B. Fisher, MD
DEA Enforcement Versus Pain Practice
Aggressive DEA action against drug abuse and diversion ensnares some legitimate prescribers. by Kathryn Foxhall
Botox Treatment of Chronic Refractory Low Back Pain
Studies indicate that a specific treatment protocol using Botulinum Neurotoxin A can provide a sustained reduction in chronic, refractory low back pain for about 50% of such patients. by Bahman Jabbari, MD
Treating Muscular Dysfunction of Upper Limbs
A Surface Electromyography (SEMG) approach to the investigation of muscular dysfunction and rehabilitation of upper limb muscles. by G.E. Sella, MD, MPH, MSc, PhD (HC)
Physiological Consequences of Guided Imagery
What every pain therapist should know about guided imagery. by David E. Bresler, PhD, LAc
Publisher's Message
An Alert to Prescribing Physicians by Marvin L. Rosenfeld
Editor's Memo
Have a Heart: The cardiovascular consequences of uncontrolled pain by Forest A. Tennant, MD, DrPH
Health Information Technology Advisor
Audit Your Infrastructure by Greg Winterkamp
Guest Editorial
Group Psychotherapy for Chronic Pain Patients by Sarah M. Whitman, MD

Vol. 5, No. 5

Jul/Aug 2005

Targeted Peripheral Analgesics in Chronic Pain Syndromes
New compounding formulations and certain ‘off-label’ uses of available analgesics—in topical and transdermal distribution—offer increased potency with fewer side-effects to other body systems. by Edwin Dunteman, MD, MS
Tiredness and Chronic Pain Management
Understanding and treating the causes and symptoms of tiredness among chronic pain sufferers helps clinicians to optimize pain management. by Lawrence M. Probes, MD
First Line Treatment of Musculoskeletal and Neuropathic Pain
Initial treatment of musculoskeletal and neuropathic pain can be more effective by incorporating combination pharmacologic alternatives as adjuncts to oral or parenteral analgesic medication. by Mark F. Rottenberg, MD, MS
TMD/Facial Pain and Forward Head Posture
Forward head posture—with its attendant craniocervical, neurophysiologic and arthrokinematic interactions—may be either a causative or aggravating factor in TMD. by Leonard B. Goldstein, DDS, PhD and Howard W. Makofsky, PT, DHSc, OCS
Pain Drug Use Policy
State boards of medical examiners are responsible for adopting and enforcing a policy for the use of controlled substances for the treatment of pain within the limits of federal controlled substance laws and regulations. by Nick Paolo, Managing Editor
Effective Non-Drug Treatment Of Depression
A review of the evolution in electrical and photo stimulation for effectively treating depression in chronic pain patients. by C. Norman Shealy, MD, PhD
Editor's Memo
Are Generic Opioids Cutting the Mustard? by Forest A. Tennant, MD, DrPH
Publisher's Message
Force Multiplier by Marvin L. Rosenfeld
Health Information Technology Advisor
Government Mandates for Electronic Medical Records (EMR) by Greg Winterkamp, owner/CEO and founder of Addison Health Systems, Inc.
Guest Editorial
Therapeutic Drug Monitoring by Dr. Michael Evans, PhD, Breain Ma'Ayteh, MA, and John Constantine, BS

Vol. 5, No. 4

May/Jun 2005

Pain Treatment in Ambulatory Medical Practice
A primer on the current state of pain treatment and how walk-in medical practices can cope with the various aspects of a patient’s pain. by Uday S. Uthaman, MD, FACFP and Pierre L. LeRoy, MD, FACS
Chronic Pain and Cannabinoids
A survey of current fibromyalgia treatment approaches together with an overview and case studies of a new “old” treatment approach. by Gordon Ko, MD, CCFP(EM), FRCPC and William Wine, PhD, DSc(toxicology)
Pain from Muscular Dysfunction
An introductory view of SEMG methodology in the investigation and rehabilitation of dysfunctional and painful axial skeleton muscles. by G. E. Sella, MD
Ziconotide for Chronic Severe Pain
The emerging use of Ziconotide shows potential of becoming a powerful non-opioid analgesic in the pain physician’s armamentarium. by Lynn R. Webster, MD and Keri L. Fakata, PharmD
Lumbar Back Belts in the Workplace
A review of the efficacy of lumbar back belts in the workplace in reducing back injuries and pain. by Tiziano Marovino, DPT, FAAPM
Spinal Cord Stimulation
An overview and case study of spinal cord (dorsal column) stimulation in a spine-centered/orthopaedic clinical practice setting. by Elmer G. Pinzon, MD, MPH
Editor's Memo
One Way Doesn’t Fit All by Forest A. Tennant, MD, DrPH
Publisher's Message
Is Intractable a Dirty Word? by Marvin L. Rosenfeld

Vol. 5, No. 3

Apr 2005

Opioid Blood Levels in Chronic Pain Management
Determination of opioid levels in the blood is emerging as an important tool for ensuring the safety, effectiveness and integrity of opioid analgesic therapy in the treatment of chronic pain. by Lawrence M. Probes, MD
Hospice Care Practice, Part 2
Hospice and its implications for the physician and patients in dealing with end of life issues. by Wiliam M. Lamers, Jr., MD
Urinary Drug Testing In Pain Management
Urinary drug testing (UDT) as a means to assure compliance and monitoring of proper medication use is becoming commonplace in the clinical practice of pain management. by Orlando G. Florete Jr., MD
Iatraddiction: A Diagnostic Term In Lieu of Pseudoaddiction
Iatraddiction more precisely describes the etiology of behaviors currently referred to as “pseudoaddiction.” by Abbey Strauss, MSW, MD
Pelvic Floor Dysfunction: A Treatment Update
New treatment modalities take advantage of the maturing relationship between pelvic floor dysfunction and chronic pelvic pain. by Matthew E. Karlovsky, MD and Robert M. Moldwin, MD
Hormone Treatments in Chronic and Intractable Pain
An emerging practice. by Forest Tennant MD, DrPH
Editor's Memo
Power in the Blood by Forest A. Tennant, MD, DrPH
Publisher';s Message
Primary Care Physicians: Pain Management Gatekeepers, Providers or Both? by Marvin L. Rosenfeld
Technology Review
Intervertebral Differential Dynamics Therapy by C. Norman Shealy, MD, PhD

Vol. 5, No. 2

March 2005

Hospice Care Evolution, Part 1
This personal account of the early days of hospice care provides a perspective on progress to date and lessons learned. by William M. Lamers, Jr., MD
Radiofrequency Neuroablation in Chronic Low Back Pain
This retrospective study of pain outcomes for radiofrequency neuroablation patients confirms the viability of this modality where conservative, traditional treatments for chronic low back pain have failed. by Ripu Arora, MD, QME
Myofascial Elements of Low Back Pain
When treating myofascial trigger points (TrPs), contributing musculoskeletal, posture, and motion factors must be addressed in order to optimize outcomes. by Edwin D. Dunteman, MD, MS
Considerations in Treating Intractable Pain
Intractable Pain (IP) patients not only present unique factors that differentiate them from other patient groups, but also each individual’s background, personality, coping skills, etc. requires additional adaptation. by J. S. Hochman, MD
The ABC’s of PAIN
Mnemonics in the field of Pain Medicine provide practical and useful devices for mental checklists. by James Patrick Murphy, MD
Temporomandibular Joint Referred Pain
This retrospective study examined charts of 455 TMD patients to identify and categorize sites of referred pain. by John S. DuPont Jr., DDS
State Pain Laws: A Case for Intractable Pain Centers, Part III
State intractable pain laws provide provisions for aggressive pain treatment while protecting doctors from unwarranted prosecution—provided that strict guidelines are followed. by Marvin Rosenfeld
Therapies for Chronic Pain & Fibromyalgia
New therapies, combining complementary/alternative medicine (CAM) approaches and pharmacotherapy, provide options in treating chronic musculoskeletal pain. by Gordon Ko, MD, CCFP(EM), FRCPC, PhD
Editor's Memo
Over-prescribing and Over-medicating by Forest A. Tennant, MD, DrPH
Guest Editorial
National Council of Pain Organizations by Pierre L. LeRoy, MD, FACS

Vol. 5, No. 1

Jan/Feb 2005

‘High Dosage’ Opioid Management
The criteria for optimal opioid dosing for a specific patient must be clinically-adequate pain control and functional improvement while avoiding cognitive impairment and respiratory depression. by J.S. Hochman MD
‘Opiophobia’ Past and Present
The one drug class that has the optimum profile to manage severe, unremitting, intractable pain — opioids — is often shunned. by Bruce R. Moldovan, JD
Pain Management Pitfalls
Psychological research on intense provider-client interactions yields insight into the doctor-chronic pain patient relationship. by Ron Lechnyr, PhD, DSW, and Terri A. Lechnyr, MSW, LCSW
Musculo-Skeletal Diagnostic Ultrasound Imaging
This evolving, first-line imaging test for soft tissue lesions can provide superior diagnostic accuracy by visualizing internal soft tissue architecture and associated pathologies. by Tiziano Marovino, DPT, FAAPM
Diagnosing and Managing Interstitial Cystitis
New research suggests interstitial cystitis (IC), a painful bladder disorder, is quite prevalent in the general population. by Matt T. Rosenberg, MD; Matthew A. Hazzard, BA; and Charles W. Butrick, MD
Selection Criteria for Intrathecal Opioid Therapy
A survey of the “science” behind exclusionary psychological assessment finds that supporting empirical data is virtually non-existent. by Michael E. Schatman, PhD
Intractable Pain Centers’ Treatment Approach
Correctly identifying and certifying intractable pain patients legitimizes palliative treatments that may be required to alleviate the debilitating pain and suffering of these individuals. by Thomas J. Purtzer, MD
Editor's Memo
Primary Care Physicians and Schedule II, Long-Acting Opioids by Forest A. Tennant, MD, DrPH
Viewpoint
Ignoring Risk-Benefit Analyses: The Cox II Tragedy by Forest A. Tennant, MD, DrPH

Vol. 4, No. 6

Nov/Dec 2004

Chronic Pain, Osteoporosis, and Bone Density Testing
Bone density testing in chronic pain patients can diagnose osteoporosis and identify those at high risk for fracture, so that appropriate therapy can be initiated to reduce future fracture risk. by E. Michael Lewiecki, MD, FACP
Atypical Earache Otomandibular Symptoms
With a basic understanding of ear pain-related pathologies and referral patterns, a physician can provide a quick screening examination for atypical earache. by Keith A. Yount, DDS, FAGD
The IP Network: A Case for Intractable Pain Centers, Part II
Pain treatment is a multi-disciplinary undertaking that spans multiple specialties and must form a close-knit network to provide all facets of care for an IP patient. by Forest Tennant, MD DrPH and Marvin Rosenfeld
Pelvic Floor Tension Myalgia (PFTM)
PFTM is a myofascial diagnosis of exclusion after organic disease has been ruled out and requires multidisciplinary treatment for optimum outcomes. by Steve J. Wisniewski, MD and Mark H. Winemiller, MD
Medicare Pushes For Doctor Computerization
Medicare announces mandate to make all doctors electronic in ten years and change the way doctors get reimbursed in the next few years. by Greg Winterkamp
Atypical Facial Neuralgias
Persistent burning or lancinating facial pain with no clear etiology may point
to a diagnosis of neuropathic pain. by Soma Sahai-Srivastava, MD and Samir Macwan, MBBS
Trigger Point (TP) Low Level Laser Therapy
Case study documents a trapezius TP eradication after three sessions of far infra-red laser irradiation and confirmed with anatomic ‘before-and-after’ diagnostic ultra-sonographs. by Tiziano Marovino, DPT, FAAPM
Editor's Memo
Inadvertent Harm by Forest A. Tennant, MD, DrPH
Promising Therapies
Botulinum toxin as a pain treatment by Richard L. Barbano, MD PhD

Vol. 4, No. 5

Sep/Oct 2004

A Case For Intractable Pain Centers - Part 1
A crisis due to the scarcity of intractable pain (IP) centers is leaving suffering patients with no place to turn. by Marvin Rosenfeld
Diagnosing Diffuse Aches and Pains
A clinical approach to differentially diagnosing the patient who reports that “it hurts all over.” by Mazin Ellias, MD, FRCA
Co-existing Psychological Factors
The patient's personality and emotional state may adversely affect the use of medication such as opioids and treatment outcomes. by Moti Peleg, DSW, and Charles Carluccio, MD
Cold Lasers in Pain Management
Low energy laser therapy has been shown — at appropriate dosimetry, wavelength, duration, and site-specific application — to reduce tissue pain/tenderness, normalize circulation patterns in tissue trauma, and increase collagen formation in wounds. by Tiziano Marovino, PT, DPT, MSc, BA, BHSc, BRLS, Dip.PT, FAAPM
Opioid Therapy In Chronic Non-Cancer Pain Management
Despite fears fueled by negative press, opioid therapy — with proper evaluation and safeguards — is a legitimate, viable, and essential tool in managing severe, intractable, non-cancer pain. by Michael S. Leong, MD, and Mike Royal, MD
Occipital Nerve Block For Cervicogenic Headaches
Cervicogenic headaches — often misdiagnosed as sinus headache or ocular disturbances — may be effectively managed by the use of anesthesia to block the occipital nerve branches. by Steven D. Bender, DDS
Editor's Memo
Opioids Are Not Just “The Gold Standard” by Forest A. Tennant, MD, DrPH
Guest Editorial
Reflex Sympathetic Dystrophy (RSD) by Elena Juris

Vol. 4, No. 4

Jul/Aug 2004

Treatment of Acute Pain in the Orthopedic Patient
A review of the mechanisms of acute pain and treatment strategies in orthopedic patients with special emphasis on pre-emptive analgesia. by John E. Tetzlaff, MD
Fibromyalgia and Myofascial Pain Syndromes
A practical approach to the differential diagnosis and treatment of fibromyalgia and myofascial pain syndromes. by Edwin D. Dunteman, MD MS
Blockades for Sympathetically Maintained Pain (SMP)
A state-of-the-art survey of sympathetic blockades for SMP syndromes presenting in various parts of the body. by M.Ellias MD,FRCA
AAPM Exhibitors
AAPM Annual Meeting- San Antonio, TX, September 9-12, 2004
Fifteen Minute Headache Evaluation
With reasonable planning and preparation—by both the physician and the patient—an adequate headache evaluation is possible in a short visit. by R. Steven Singer, MD
Thermography in Pain Management
A technique for assessing and tracking changes in vascular-related pain syndromes. by Richard A. Sherman, PhD, Gabriel Tan, PhD, Bilal F. Shanti, MD
Women and Chronic Pain
Insights into the physiologic adaptations that predispose women to more frequent, sustained pain events and increased likelihood of chronic pain. by Keith A. Yount, DDS, FAGD
Editor's Memo
Self-Administered Opioid Injections: The Good, the Bad and the Ugly by Forest A. Tennant, MD, DrPH
From Research To Practical Application
Long Term Testosterone Treatment
Message from the Publisher
Call for papers — 2005 editorial features

Vol. 4, No. 3

May/Jun 2004

Trends in Pain Syndrome Diagnostic Technology
Current diagnostic technological devices can help identify numerous disorders of the peripheral and central nervous system in patients with chronic pain. by Joel Brill, MD, FACG
Failed Back Surgery Syndrome
Back surgery is an important treatment option yet a significant percentage have a poor outcome and may require either additional surgery, interdisciplinary treatment, or implantable devices to manage ensuing pain. by Robert J. Gatchel, PhD, ABPP; Brandy Miller, PhD Candidate; and Leland Lou, MD
Objective Documentation of Spine Pain
Surface Electromyography (SEMG) can provide an inexpensive, noninvasive method of evaluating and documenting spine pain. by Alex Ambroz, MD and George Gedevanishvili, MD
Diagnosis and Management of Generalized Vulvodynia
The prevalence of generalized vulvodynia may have been historically under-recognized by the medical profession. by Elizabeth Gunther Stewart, MD
At-Home Teaching Materials For Chronic Pain
Developing and using at-home teaching materials can leverage in-office visits and harness the patient’s own recuperative powers. by David Schechter, MD and Arthur Preston Smith, PhD
Pain, Sports, and Anabolic Steroids
by Forest A. Tennant, MD, DrPH

Vol. 4, No. 2

Mar/Apr 2004

Cardiovascular Consequences of Severe Acute Pain
Insufficiently-treated severe acute pain has been observed to have multifactorial, deleterious effects — direct and indirect — on the cardiovascular system. by John E. Tetzlaff, MD
Spine-Centered Chronic Pain Scenarios and Treatment Options
Clinical scenarios involving the complex issues surrounding adequate pain relief for spine-related chronic pain. by Elmer G. Pinzon, MD, MPH
Dramatically Disturbed Patients in Interdisciplinary Pain Programs
The dramatic personality disorders of the ‘Cluster B’ type — which can wreak havoc in an interdisciplinary pain treatment program — present clinics with a dilemma in handling these troublesome patients. by Michael Schatman, PhD
Provider-Patient Interactions
Understanding unconscious interpersonal defensive responses in a chronic pain practice to improve interactions. by Ron Lechnyr, PhD, DSW and Terri Lechnyr, MSW, LCSW
Adhesive Arachnoiditis: A Continuing Challenge
Poorly understood and often misdiagnosed, adhesive arachnoiditis continues to be a cause of severe, unremitting pain. by Sarah Alexandra Andreae-Jones (Smith), MB, BS
Editor's Memo
Who Will Treat the Tough Case?
Wanted: A physician in every community who will
treat the case that no one else will take! by Forest A. Tennant, MD, DrPH

Vol. 4, No. 1

Jan/Feb 2004

Complications of Uncontrolled, Persistent Pain
Persistent, unremitting pain may adversely affect the body's endocrine, cardiovascular, immune, neurologic and musculo-skeletal systems and require aggressive treatment of the pain as well as the resulting complications. by Forest Tennant MD, DrPH
Treatment-Resistant Migraines
Alternate strategies may be required for overcoming the treatment resistance of certain types of migraines. Strategies include rotating triptans, raising the triptan dosage, and using non-triptan medication. by Randall L. Oliver, MD and April Taylor, RN, BSN
Improving Postoperative Pain Outcomes
Multimodal pain management approaches — implemented perioperatively — may improve post-operative outcomes and improve overall patient satisfaction. by John A Adesioye, MBChB, MSc and Kwesi A. Edusei, MD
Peripheral Nerve Catheters for Acute Pain Control
A viable modality to control post-surgical acute pain by silencing the nociceptive signalling between the surgical insult and pain receptors. by John E. Tetzlaff, MD
The ABCs of Pain Clinic Referrals
Some basic, common-sense criteria for referring a patient to a pain treatment clinic. by Jeffrey C. Reinking, MD
Pain Treatment Does Not Interfere with Diagnosis or Treatment
by Forest A. Tennant, MD, DrPH

Vol. 3, No. 6

Nov/Dec 2003

Referred Pain vs. Origin of Pain Pathology
Understanding the organic and physiological patterns of referred pain helps identify the true origin of pathology and inform proper treatment. by James Woessner, MD, PhD
Laser-Accelerated Inflammation/ Pain Reduction and Healing
Low Level Laser Therapy (LLLT) precipitates a complex set of physiological interactions at the cellular level that reduces acute inflammation, reduces pain, and accelerates tissue healing. by Richard Martin, BS, CLT
TENS in the Treatment of Primary Dysmenorrhea
Transcutaneous electrical nerve stimulation (TENS) — as a treatment modality for primary dysmenorrhea — can act as a pain relief mechanism for women with painful menstrual cramps. by Howard Smith, MD and Vian Younan, MD
Coexistent Headache and Chronic Pain
The combination of headache and chronic pain in a patient presents challenges to both headache and pain management clinicians due to the lack of overlap between the two specialties. by R. Steven Singer, MD
Pain Complications and Treatment
by Forest A. Tennant, MD, DrPH

Vol. 3, No. 5

Sep/Oct 2003

Objective Musculo-Skeletal Measurement Protocols
Utilizing surface electromyography (SEMG) and systematic, standardized protocols, clinicians can objectively diagnose and document outcomes in the treatment of musculo-skeletal pain and disorders. by Gabriel E. Sella, MD, MPH, MSc, PhD
Chronic Pain and Male Sexual Dysfunction
Chronic pain — and some medications required to control it — may lead to sexual dysfunction, depression, and generate a self-reinforcing cycle. by Randall Lee Oliver, MD and April Taylor, RN, BSN, CDE
Osteopathic Medicine in Pain Management
Osteopathic manipulation is useful as an adjunct to other medical therapies for acute and chronic pain and plays an important role in algorithms for back pain and other musculo-skeletal conditions. by Marina G. Protopapas, DO and Tyler C. Cymet, DO
Lumbar Spine Rehabilitation
An update on the use of core muscle strengthening and lumbar spinal stabilization for patients with low back pain or other indications of spinal musculo-skeletal dysfunction. by Elmer G. Pinzon, MD, MPH
Editor's Memo
Is There a Hormone in Your Future? by Forest A. Tennant, MD, DrPH
Facility Profile
SpineKnoxville Adopts a Unique Approach

Vol. 3, No. 4

Jul/Aug 2003

Psychological Dimension of Pain Management
A comprehensive approach to pain management must address the psychological dimension with special emphasis on the patient’s own unique psychological response to chronic pain. by Ron Lechnyr, PhD, DSW and Terri Lechnyr, MSW, LCSW
Osteoarthritis of the Temporomandibular Joint
Presenting as toothache, earache, headache, difficulty opening the jaw, or simply jaw pain, osteoarthritis of the temporomandibular joint presents challenges in diagnosis and management. by Keith Yount, DDS
Post-Dural Puncture Headache Treatment
A case report on the use of a combination sumatriptan and Fioricet protocol in successful first line treatment of post-dural puncture headache. Complete references are listed following article abstract. by Ashok K. Saha, M.D., Vidya Vakhariya, M.D., Richard K. Baumgarten, M.D., Usree Kirtania, MS.
Preventing Post-Dural Puncture Headache
Puncturing the dura membrane in such a way as to leave a self-sealing flap may entirely eliminate post-procedure spinal fluid leakage that triggers puncture headaches. by Bela I. Hatfalvi, MD
Editor's Memo
Chronic Pain: A Disease Requiring Prevention by Forest A. Tennant, MD, DrPH
Lidoderm Studied for New Applications
While Lidoderm is currently FDA-approved only for the pain associated with postherpetic neuralgia (PHN), Phase IV studies suggest that Lidoderm has potential utility in a variety of chronic pain syndromes.
Letter to the Editor

Vol. 3, No. 3

May/Jun 2003

Biofeedback Pain Interventions
New biofeedback therapies—together with modern technology—provide viable alternatives in pain management. by Gabriel Tan, PhD, Richard Sherman, PhD, Bilal F. Shanti, MD
Family Dynamics and Chronic Pain
Accompanying depression and anxiety impacts a chronic pain patient’s family dynamics and requires a multidisciplinary, holistic approach to address associated issues. by Randall Lee Oliver, MD; April Taylor RN, BSN; and James P. Schroeder, LCSW, LMFT
Distinguishing Intractable Pain Patients from Drug Addicts
A comparison of intractable pain patients’ characteristics to those found in drug addicts shows how to discern the difference-both to give the IP patient due care and minimize drug abuse and diversion. by Joel S. Hochman, MD
Pain and the Elderly
Special considerations in the elderly population present practitioners with challenges in properly assessing and treating these patients for pain. by Patricia M. Dunn, CRNA
Editor's Memo
Time To Be More Aggressive by Forest A. Tennant, MD, DrPH
Letter to the Editor
News

Vol. 3, No. 2

Mar/Apr 2003

Legal Landscape of Pain Treatment
On overview of the legal, regulatory, and ethical issues relating to pain treatment. by Patricia M. Dunn, CNP
Distraction Techniques for Lumbar Pain
Inter-vertebral decompression — utilizing distraction techniques — widens disk spaces, lowers intradiscal pressure and promotes disk recovery. by Alan E. Ottenstein, MD
Balancing Pain Management and Professional Risk
A discussion on how to provide adequate pain relief while avoiding potential legal complications in prescribing controlled substances. by B. Eliot Cole, MD, MPA
Chronic Opioid Rules
Prescribing opioids for chronic pain requires set rules, a written plan, periodic re-evaluation, and vigilance to prevent illegal diversion of controlled substances. by Randall Lee Oliver, MD, and April Taylor, RN, BSN
Editor's Memo
Pain Treatment Challenges by Forest A. Tennant MD DrPH
Guest Editorial
National Pain Data Bank Minimizes Professional Risk by Alexandra Campbell, PhD, and Scott Raven, PhD

Vol. 3, No. 1

Jan/Feb 2003

Antidepressants in Pain Treatment
General guidelines in the selection of an antidepressant as an adjunct to analgesia and physical therapy in treating pain. by Joel Hochman, MD; A. V. Anderson, MD; and Forest Tennant MD, DrPH
Choosing the Right Triptan
Discussion of current triptan options in the treatment of migraine. by Randall Lee Oliver, MD; and April Taylor, RN, BSN
Minimally-Invasive Spine Interventions
A technology update of current minimally-invasive treatment options of lumbar discogenic pathology & internal disc disruption. by Elmer G. Pinzon, MD, MPH
A Conceptual Model of Pain: Treatment Modalities—Part 3
Part three of this series discusses treatment modalities available to the practitioner upon correctly characterizing the source(s) of pain. by James Woessner, MD, PhD
Thank You, Dr. Young... Welcome, Dr. Tennant
by Marvin Rosenfeld
Massage Therapy and Pain Management
by Brenda L. Griffith

Vol. 2, No. 6

Nov/Dec 2002

Carpal Tunnel Syndrome
Characterized by hand and wrist pain, CTS is a symptomatic distal median nerve neuropathy at the wrist and is the most commonly encountered entrapment neuropathy. by Howard J. Hoffberg, MD
Chronic Insomnia and Pain
Under-reported and under-treated, chronic insomnia coexists with-and perpetuates-chronic pain. by Randall Lee Oliver, MD; April Taylor, RN, BSN; and Rebecca Oliver
Identifying Pain-Drug Abusers and Addicts
Characterization and profiling of patients with deviant addictive behaviors helps weed out abusers from pain practices. by Forest Tennant, MD, DrPH; Laura Herman, RN, NP; Leah Silliman, BS, RN; and Jeffrey Reinking, MD
Conceptual Model of Pain: Measurement & Diagnosis - Part 2
Part two of this series discusses the measurement and evaluation of patient data as an integral part of pain diagnosis. by James Woessner, MD, PhD
Publisher's Memo
The Results Are In by Marvin Rosenfeld

Vol. 2, No. 5

Sep/Oct 2002

A Conceptual Model of Pain
The practicing physician’s guide to the causative mechanisms of pain and how to translate these basic principles into diagnoses and treatments. by James Woessner, MD, PhD
Taxonomy of Pain Patient Behavior
Perspectives on understanding motivations of patients exhibiting functional overlay and effectively dealing with the confounding behavioral aspects. by Ron Lechnyr, PhD, DSW and Henry H. Holmes, MD
Whiplash Injuries in Motor Vehicle Accidents
A comprehensive survey of whiplash-related musculoskeletal injuries, diagnoses, and treatment modalities. by Howard J. Hoffberg, MD
Fingerprints and HIPAA Compliance
Computerized documentation and fingerprint biometrics can help you become HIPAA compliant, while freeing up your time to be more productive. by Greg Winterkamp
Publisher's Memo
Online Reader Survey: Tell Us What You Think and Win a Prize by Marvin Rosenfeld
Product Reviews: Sensory Nerve Testing Instruments

Vol. 2, No. 4

Jul/Aug 2002

10th World Congress on Pain
The International Society for the Study of Pain (IASP) holds its 10th World Congress in San Diego. by Marvin Rosenfeld
Percutaneous Disc Decompression/ Discectomy - A Case Report
Successful outpatient treatment of symptomatic spinal claudication utilizing a new minimally-invasive percutaneous decompression/discectomy device. by Bradley D. Vilims, MD; Scott A. Brandt, MD and Robert E. Wright, MD
TMJ Disorder Mimic: Ernest Syndrome Diagnosis and Treatment
Often accompanied by other orofacial disorders and capable of mimicking other pain conditions, Ernest Syndrome is often missed or misdiagnosed. by John S. DuPont, Jr., DDS
A Global View of Evolving Pain Treatment Modalities: An Historical Perspective
The former head of the largest pain clinic in Central Europe offers observations on multi-disciplinary treatment modalities evolving over the past 25 years. by Fritz L. Jenkner, MD, FICS, FNYCS
Practical Headache Pearls
Extensive experience in evaluating and treating migraineurs yields observations that can help the practitioner grapple with the complexities of migraine patients. by Lawrence Robbins, MD
In Memoriam
Remembering a Leader in Pain Management by Marvin Rosenfeld

Vol. 2, No. 3

May/Jun 2002

Intractable Pain
Protocols for a lifetime of pain management for patients suffering constant, incurable, excrutiating, unrelenting pain. by Forest Tennant, MD, DrPH; John Liu, MD; and Laura Hermann, RN, FNP
Spinal Chord Stimulation
Implantable devices in the epidural space provides selected patients with control in managing a wide variety of painful disorders. by Tracy Cameron, PhD and Sue Elliott, RN, CNOR
Menstrually-Related Migraine Treatments
An overview of the efficacy of several triptan agents in menstrually-related migraine (MM), as well as of other treatment modalities that are commonly used in the treatment of MM. by Stephen D. Silberstein, MD, FACP
Acupuncture for Pain Relief
Indications and contra-indications for the use of acupuncture in the treatment of cranio-cervical and temporomandibular dysfunctions. by Leonard B. Goldstein, DDS, PhD, LAc, DABPM, DABFM, FICD
Post-Trauma Pain Management: A 'Back to Basics' Approach
Part two of “Terrorism's Effect on Chronic Pain Perception” discusses the importance of a natural, simple and integrative approach to chronic pain treatment. by Mark Allen Young, MD, MBA, FACP; Bryan O'Young, MD; H. Hoffberg, MD; Kornhauser, PhD; and Sokal, MD
Publisher's Memo
Covering the Field by Marvin Rosenfeld

Vol. 2, No. 2

Mar/Apr 2002

Terrorism's Effect on Chronic Pain Perception
by Mark Allen Young, MD, MBA, FACP; Bryan J. O'Young, MD; Steve A. Stiens, MD, MS; H. Hoffberg, MD; D. Cassius, MD; C. Narrow, MD; and S. Kornhauser, PhD
Chronic Opioid Treatments
Selected chronic pain patients, treated with opioids in a structured program, can improve function and maintain employment. by Stephen J. Roman, MD; Gerard A. Malanga, MD; Scott F. Nadler, DO; James P. Mclean; and Scott R. Millis, PhD
Blocking Out the Pain:
Electric nerve block treatments for sciatic neuritis. by James Woessner, MD, PhD
Effective Approaches: Study Questionnaires
Questionnaires employed in the study “Effective Approaches: Multidisciplinary Pain Management” from the Jan/Feb 2002 issue. by Scott L. Worsham, MEd and Ron R. Ziegler, PhD
Announcement from the Publisher
by Marvin Rosenfeld

Vol. 2, No. 1

Jan/Feb 2002

Pediatric Pain Management
Pharmacological techniques are quite useful for treating pain in children. by Mabel Link, MD and Corrie T. M. Anderson, MD
Effective Approaches
In this study, patients with sever chronic pain undergo treatment at an atypical multidisciplinary clinic. by Scott L. Worsham, MEd, MBA and Ron R. Ziegler, PhD
Head Pains
Modern management modalities are vital to treating headaches effectively. by Keith A. Yount, DDS, FAGD
Mastering Medications
This article discusses adjuvants and their application in managing pain. by B. Eliot Cole, MD, MPA
Publishers' Memo
Continuing your education in 2002 by Marvin Rosenfeld, Publisher

Vol. 1, No. 6

Nov/Dec 2001

Opioid Rotation - Mechanisms, Concepts, and Benefits
For patients experiencing side effects from opioids, switching the delivery and type of pharmaceutical can often provide relief. by Bilal F. Shanti, MD; Gabriel Tan, PhD; and Salwa A. Shenaq, MD, MBA
The Pain and Sleep Relationship (Complete Article)
CPAP and oral appliances offer hope for many pain patients suffering from sleep disorders. by John D. Zoidis, MD
Getting to the Point
Myofascial soft-tissue techniques can release trigger points and help patients better manage their pain. by Ron Lechnyr, PhD, DSW
Getting Off the Pain Roller Coaster
Identifying the psychological aspects of pain can lead patients on the right track to recovery. by Barry W. Weiss, PhD and Lillie Weiss, PhD
The Neural Plasticity Model of Fibromyalgia
The final installment of this series discusses treatment options and outcomes measurements for fibromyalgia. by C.C. Stuart Donaldson, PhD; Gabriel E. Sella, MD, MPH, MSc; and Horst H. Mueller, CPsych
Accurate Diagnosis
Sonograms are useful tools in the detection of stenosing tenosynovitis and other conditions. by Robert L. Bard, MD
Publisher's Memo
From the Comfort of Your Home (or Office) by Marvin Rosenfeld

Vol. 1, No. 5

Sep/Oct 2001

Cancer Pain - The Greatest Fear
Appropriate assessment is essential to treatment planning and successful management of the patient's pain. by Robert C. Young, MD and Terri B. Ades, MS, CS, RN, AOCN
Emergency Department Protocols (complete article)
Improving pain management in the ED provides better treatment options for patients. by Kenny Stein, MD
Accidentally Speaking
Car accident survivors are a driving force behind the increase in soft tissue injuries seen by pain clinicians. by Christopher Brown, DDS, MPS
Breaking Down the Barriers of Pain
The final installment of this series reviews prescribing schedule II-III drugs: practical definitions and strategies. by David Hubbard, MD
Thinking About Pain
Involving patients in treatment with psychologically based pain management can assist in their relief. by Roderick A. Borrie, PhD
The Neural Plasticity Model of Fibromyalgia - Theory, Assessment, and Treatment
The third installment of this series discusses sEMG and other treatment options for fibromyalgia. by C.C. Stuart Donaldson, PhD; Gabriel E. Sella, MD, MPH, MSc; and Horst H. Mueller, Cpsych
Magnets & Medicine (complete article)
A non-invasive approach to treating pain conditions, magnetic therapy offers alternative to traditional medicine. by Larry Kopelman, PhD, PT, ND, BCFE, IMD
Publisher's Memo
Your News Service by Marvin Rosenfeld

Vol. 1, No. 4

Jul/Aug 2001

The Mind-Body Connection
Frequently pain physicians must treat the depression that often accompanies chronic pain. by Donna Werner
Neurological Perspectives: Guidelines for the 21st Century - Part Four: Breaking Down the Barriers of Pain
Part four of this series reviews fibromyalgia and somatoform pain disorder tests and treatment options. by David R. Hubbard, MD
The Neural Plasticity Model of Fibromyalgia - Theory, Assessment, and Treatment
Part two of this series discusses sEMG and EEG as assessment techniques for fibromyalgia. by C.C. Stuart Donaldson, PhD; Gabriel E. Sella, MD, MPH, MSc; and Horst H. Mueller, CPsych
Getting Back on Track
Acupuncture is a complementary treatment strategy that can be employed alone or in conjunction with other modalities to treat lumbar pain. by John P. Kohler, MD; Elizabeth Mandel; and Ding Lian Jin, MD
Facing Reimbursement Challenges (complete article)
Delivering solid, validated evidence of treatment can be achieved by utilizing an outcomes measurement system. by Scott Raven
Publisher's Memo
Pain and the Law by Marvin Rosenfeld
Guest Editorial
Taking the Hurt Out of Pain
Pharmacists play an important role in helping to manage pain. by Charles D. Ponte, PharmD, CDE, BCPS, FASHP, FCCP, FAPhA

Vol. 1, No. 3

May/Jun 2001

The Neural Plasticity Model of Fibromyalgia: Theory, Assessment, and Treatment
Part one of this series presents the basis for understanding fibromyalgia theories. by C.C. Stuart Donaldson, PhD; Gabriel E. Sella, MD, MPH, MSc; and Horst H. Mueller, CPsych
Pharmaceutical Therapies
Effective pain relief can be achieved through the newest drugs on the market. by Donna Werner
Headache Relief
Long-acting opioids can help alleviate the pain associated with severe, refractory chronic daily headaches. by Lawrence Robbins, MD, and Halleh Akbarnia, MD
Breaking Down the Barriers of Pain: Neurological Perspectives for the 21st Century -
Part three of this series discusses clinical presentation, exam, and treatment options for a variety of conditions. by David R. Hubbard, MD
CES - A Practical Protocol for the Treatment of Pain
The final installment of this series covers cranial electrotherapy stimulation as a means of treating pain patients. by Daniel L. Kirsch, PhD, DAAPM
Publisher's Memo
Getting the Most Out of Practical Pain Management by Marvin Rosenfeld
Guest Editorial
New Directions by Martin Fields, MD

Vol. 1, No. 2

Mar/Apr 2001

Lumbar Discography & Therapeutic Intradiscal Procedures
Injection techniques play a major role in the management of disorders of the musculoskeletal system. by Elmer G. Pinzon, MD, MPH
MPS Treatment Methods
Multidisciplinary approaches are best utilized when caring for myofascial pain syndrome patients. by Myron Nicholas Senchyshak, DO
Providing Valuable Input
Psychological assessments play a major role in the treatment of chronic pain. by Jill Ahrold
Playing Dual Roles
Gabriel E. Sella, MD, discusses sEMG as the perfect tool for neuromuscular investigation and re-education. by Gabriel E. Sella, MD
MET Treatment Protocols
Part two of this series covers basic methodologies of Microcurrent Electrical Therapy. by Daniel L. Kirsch, PhD, DAAPM
A Good Night's Rest
Sleeping can sometimes be a nightmare for patients experiencing pain. by Donna Werner
Breaking Down the Barriers of Pain — Neurological Perspectives: Guidelines for the
Source-of-Pain physical examinations, diagnoses, and treatment options are reviewed in part two of this series. by David R. Hubbard, MD
Publisher's Memo
The Decade of Pain Control and Research by Marvin Rosenfeld
Guest Editorial
Physician's Gun Barrel Vision by Richard S. Materson, MD

Vol. 1, No. 1

Jan/Feb 2001

Breaking Down the Barriers of Pain - Neurological Perspectives: Guidelines for the 21st
New clinical approaches for diagnosing musculoskeletal and chronic pain conditions are discussed in part one of this series. by David R. Hubbard, MD
TMJ Repositioning
Using a hydrostatic oral appliance can help treat head, face and neck pain. by Leonard B. Goldstein, DDS, PhD
Bringing Pain to the Forefront of Treatment
Newly developed guidelines for managing pain add validity to patients' complaints. by Donna Werner
The Expert Series: The Perfect Treatment and Evaluation Tool
Renowned sEMG expert, Jeffrey R. Cram, PhD, shares his thoughts on biofeedback. by Jeffrey R. Cram, PhD
Microcurrent Electrical Therapy: Mechanisms and Results - Part One
In part one of this series, the efficacy of MET to control pain is reviewed. by Daniel L. Kirsch, PhD, DAAPM
Raising the Bar
Demonstrating the quality of service and improving the practice of pain management is the goal of the National Pain Data Bank/Pain Program Accreditation. by B. Eliot Cole, MD, MPA
Pharmaceuticals in the Pipeline
Relieving Pain with Pharmaceuticals by Donna Werner
Publisher's Memo
The Right Track by Marvin Rosenfeld
Guest Editorial
The Pain Relationship by David E. Bresler, PhD, LAc, Dipl Ac, QME

Vol. 0, No. 1

Sep/Oct 2000

Pharmaceuticals in the Pipeline - Anti-rheumatic Drugs
A review of the newest anti-rheumatic drugs available on the market. by Donna Werner
Corticosteroid Use in Pain Management
The basic properties, reactions and applications of corticosteroid use should be reviewed prior to treating patients. by Ted A. Lennard, MD
Fibromyalgia Syndrome & Surface Electromyography
Dynamic functional capacity and movement assessment via sEMG is a viable tool in treating patients with FMS. by Darice M. Putterman, PT, CAAAPM, CTIACA
Chronic Tension Headache
The use of sEMG biofeedback is effective for the treatment of headaches. by John G. Arena, PhD; Glenda M. Bruno, RN, MS; and Andrew G. Brucks, MS
Intraarticular Mechanisms for Pain Control
Postoperative pain control after surgery of the joint can be obtained through the use of intraarticular injections. by John E. Tetzlaff, MD
Publisher's Memo
The Future Will Be Brighter by Marvin Rosenfeld
Guest Editorial
It's Your Future: Time to Take Charge by Richard S. Weiner, PhD