Clinics in podiatric medicine and surgery
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Unfortunately, many physicians and patients only seek pharmacologic treatments to aid in pain relief; however, many nonpharmacologic interventions exist with excellent potential for pain treatment. This article reviews several of these strategies with an emphasis on clinical indications and expected outcomes. The topics of chronic pain psychology and prescription writing also are reviewed. As a medical provider, it is important to remain open minded to alternative approaches to pain control.
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Multidisciplinary pain management clinics provide the standard of care for the diagnosis, evaluation, and treatment of patients who have chronic pain. Primary care physicians are encouraged to maintain an active role in the care of patients after referral to these pain centers, often for long-term opiate therapy or complex regional pain syndrome. Insights into the role of pain management clinics after referral are discussed in this article.
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The podiatric physician often encounters complex painful neuropathies in daily practice. Diabetic neuropathy is one form of chronic neuropathic pain dealt with on a regular basis. The goal of this article is to review the pathophysiology, diagnosis, and treatment options of this complaint. Medical and surgical interventions are discussed, with a clinical emphasis on patient selection and prevention.