Discover and read the best of Twitter Threads about #PAIN
Most recents (24)
2)which underscores the need for close supervision of these patients."
Let's take a look at their rationale for their conclusion.
Of 9940 patients who received 3 or more #opioid prescriptions over an 8 years, 51 experienced an #overdose, 6 of the 51 experienced a fatal event.
Let's take a look at their rationale for their conclusion.
Of 9940 patients who received 3 or more #opioid prescriptions over an 8 years, 51 experienced an #overdose, 6 of the 51 experienced a fatal event.
3)The researchers did not make the yearly data available, nor did they provide data on any known prior history of Substance Use Disorder #SUD within the #Patient population.
It's impossible to determine how they performed their calculations to obtain these results.
It's impossible to determine how they performed their calculations to obtain these results.
4)While they did provide percentage risk based on MME dosages, they also Risk based folks multipliers which obscures actual risk. The highest percentage of risk reported based on MME dosage was less than 2%,
Limitation: Low OD Rate 🙄🤦♂️
acpjournals.org/doi/10.7326/00…
Limitation: Low OD Rate 🙄🤦♂️
acpjournals.org/doi/10.7326/00…
Back to basics‼️
A tweetorial on a clinical approach to #joint #pain 🪡
1/n
The 🔠ABCDE approach
🅰️ Articular (or not!) 🦴
🅱️ Background (& burden) 🎒
C Chronology 🕰️
D Distribution 📍
E Extra-articular 🍂
Let’s dive deeper
#MedTwitter
#RheumTwitter
A tweetorial on a clinical approach to #joint #pain 🪡
1/n
The 🔠ABCDE approach
🅰️ Articular (or not!) 🦴
🅱️ Background (& burden) 🎒
C Chronology 🕰️
D Distribution 📍
E Extra-articular 🍂
Let’s dive deeper
#MedTwitter
#RheumTwitter
2/n
#Pain is #inflammatory if worst in the AM/ after rest
#Swelling which is not bony #Synovitis the sine qua non of #inflammatory #arthrits
#Stiffness esp in AM & > 1 hour
“How do you feel when you wake in the morning?”
is a great question to ask
#MedTwitter
#RheumTwitter
#Pain is #inflammatory if worst in the AM/ after rest
#Swelling which is not bony #Synovitis the sine qua non of #inflammatory #arthrits
#Stiffness esp in AM & > 1 hour
“How do you feel when you wake in the morning?”
is a great question to ask
#MedTwitter
#RheumTwitter
3/n
🅱️ = BACKGROUND
Age 🕰️
Gender ♈️♎️
Race 🧕🏻
#Comorbidities
Pregnancy🤱🏻
And 🅱️ = Burden👩🏻🦼
#impact of disease
#MedTwitter
#RheumTwitter
🅱️ = BACKGROUND
Age 🕰️
Gender ♈️♎️
Race 🧕🏻
#Comorbidities
Pregnancy🤱🏻
And 🅱️ = Burden👩🏻🦼
#impact of disease
#MedTwitter
#RheumTwitter
Just doing some digging. #Pain is extremely nuanced. And the approach should also. W my kids #health & #pain there has been continued lack of knowledge, assumptions, & unwillingness to understand.
➡️#Anatomy of those that had #TPAIT & lack of understanding
by many docs 1
➡️#Anatomy of those that had #TPAIT & lack of understanding
by many docs 1
how this can impact #pain
➡️ Not identify or understanding impact of #MalabsorptionSyndrome
➡️Assumption that removal of #pancreas should immediately ‘solve’ issue of #ChronicPain
➡️ #GastricEmptying issues
➡️ Age of my kids (too young to have #pain)
➡️ Lack of 2
➡️ Not identify or understanding impact of #MalabsorptionSyndrome
➡️Assumption that removal of #pancreas should immediately ‘solve’ issue of #ChronicPain
➡️ #GastricEmptying issues
➡️ Age of my kids (too young to have #pain)
➡️ Lack of 2
understanding & identification of #MedicalTrauma
➡️T3c #Diabetes
➡️ Impact of #NASH on #pain & options for #care
There are numerous factors that are critical in #Treating an #ChronicPain in #Individuals. They list of few listed above that are factors w my kids, have often 3
➡️T3c #Diabetes
➡️ Impact of #NASH on #pain & options for #care
There are numerous factors that are critical in #Treating an #ChronicPain in #Individuals. They list of few listed above that are factors w my kids, have often 3
#Pain is nuanced
The difficulty with articles such as below example, is nuances not recognized.
For example, I could identify as someone with #chronicPain I have a few conditions that are accompanied by #pain.
My #pain is NOT unrelenting, it’s there ‘hovering’ in the 1
The difficulty with articles such as below example, is nuances not recognized.
For example, I could identify as someone with #chronicPain I have a few conditions that are accompanied by #pain.
My #pain is NOT unrelenting, it’s there ‘hovering’ in the 1
background. I do #yoga 🧘♂️ & #meditation & for ME, for the #pain I experience, it provides benefit.
However, take my kids; NASH, kidney disease, gastroperisis, T3, scar tissue neuropathy etc. #mindfullness #meditation is not going even touch it. Not in anyway
2 example of 2
However, take my kids; NASH, kidney disease, gastroperisis, T3, scar tissue neuropathy etc. #mindfullness #meditation is not going even touch it. Not in anyway
2 example of 2
#pain experiences.
It’s understandable that many in nation that are not in #medical profession struggle w the #nuances
What I struggle w & what I believe #harms those w #ChronicPain is the generalization of #pain by #medicalprofessionals & lack of individualizing care based 3
It’s understandable that many in nation that are not in #medical profession struggle w the #nuances
What I struggle w & what I believe #harms those w #ChronicPain is the generalization of #pain by #medicalprofessionals & lack of individualizing care based 3
1⃣/9⃣ #COVID19 lockdowns disrupted normal life, including access to healthcare. We conducted 3⃣studies📰 on chiropractic #patients in Spain 🇪🇸 who were isolated & couldn't receive their usual care 👩⚕️.
🌟Here's what we found…👇👀
🌟Here's what we found…👇👀
2⃣/9⃣ We gathered observational cross-sectional data from 648 #patients across Spain 🇪🇸 during the strictest phase of the #COVID19 lockdown (April 2020).
🔴Participants were experiencing acute or chronic #pain at the time of the survey.
nature.com/articles/s4159… @SciReports👇
🔴Participants were experiencing acute or chronic #pain at the time of the survey.
nature.com/articles/s4159… @SciReports👇
3⃣/9⃣ 🦠 #COVID19 wasn't just a #PhysicalHealth crisis. Influenced by multiple factors, including #anxiety & pandemic-related outcomes, pain worsened ⬆️ during lockdown 😰💭
🔴Time to consider the #biopsychosocial implications of the #pandemic & lockdowns!
#MentalHealth👇
🔴Time to consider the #biopsychosocial implications of the #pandemic & lockdowns!
#MentalHealth👇
So you want to be a dance physio? 🩰
🧵1/12
🧵1/12
Get to know the terminology, lifestyle & culture. Many dance physios have a background in performing, but not all. However, knowing the difference between ‘fosse walks’ & a grande jeté en tournant will help you understand/manage dance injuries & importantly gain performers’ trust
Read the literature 📚🩰 Dance Science is a fast-developing area and there’s a growing body of evidence to refer to. @JDMS_IADMS publish a quarterly journal with fantastic articles. Also follow @ACPSEMdance @NIDMS_ @onedanceuk @TL_DanceScience @ukbapam @AdamMattiussi
If you ask me, NYC should stop riding Buffalo’s coat tails by trying to claim Cellino & Barnes for the five boroughs (they’re Buffalo through and through) and lean into the absolute weirdness of NYC originals 800-PAIN-LAW.
How can you not be obsessed with 800-PAIN-LAW?? Their branding tries to look like the MTA’s! Their billboards are weird as fuck! The head guy looks like a Ken doll!
800-PAIN-LAW: Are they in on the joke? I think so, but who can say!
#lymeDisease is being #imprisoned in a life of brutal symptoms for YEARS! It IS a sentence of #imprisonment. The corruption of #lyme medicine=innocent people convicted & unjustly punished for crimes committed by federal “health” agencies & #bigPharma representatives.For profit 2/
The CDC & #vaccine makers KNOWINGLY made #lymeDisease testing fail & reversed #lyme medicine science (began lying about all its impacts) in the 90s & then for the next 30 years told doctors not to test for Lyme & if they do, to use the test they made fail for their #vax trials.3/
For 30 YEARS, fed agency & #bigPharma representatives have continued to corrupt #lymeDisease medicine so their past remains hidden & can continue to make money off all the medicines sold to those suffering from illnesses CAUSED by the #lyme those reps caused to go undiagnosed 4/
😣Patient: "All my joints are painful & swollen!"😣
👩⚕️But when you examine the patient, you don't find any joint swelling
How to approach this scenario? 🤷
#MedTwitter #RheumTwitter #MedEd 🧵🧵🧵
(1/10)
👩⚕️But when you examine the patient, you don't find any joint swelling
How to approach this scenario? 🤷
#MedTwitter #RheumTwitter #MedEd 🧵🧵🧵
(1/10)
Now there are two possibilities
1️⃣ There was a joint swelling which is no longer there
OR
2️⃣ There was no joint swelling to begin with
(2/10)
1️⃣ There was a joint swelling which is no longer there
OR
2️⃣ There was no joint swelling to begin with
(2/10)
Let's start with the first one– there was indeed joint swelling which is no longer there
That means we are dealing with
☝️ An episodic inflammatory disease
✌️ Drug modified disease
(3/10)
That means we are dealing with
☝️ An episodic inflammatory disease
✌️ Drug modified disease
(3/10)
Are you on #pain medications or use #opioids? If so, and you do a ketogenic diet, you may find you are more sensitive to opioids. (1/6)
Now, this was a mouse study. And you are not a mouse. I am aware of that. But I am not surprised by the findings of this study. Why? (3/6)
Warning ⚠️ ⛔️ : Uncomfortable Thread 🪡
My tweets lately have focused on my daughter’s #healthcare at @SanfordHealth & our struggle to access appropriate & compassion care where her agency is not taken away. I know the threads my be uncomfortable for some particularly if you 1
My tweets lately have focused on my daughter’s #healthcare at @SanfordHealth & our struggle to access appropriate & compassion care where her agency is not taken away. I know the threads my be uncomfortable for some particularly if you 1
are a #medical professional. I am aware that many are thinking 💭‘what’s the back story’, ‘something they did caused this no #medical facility or #medical #professional would partake in this’. I get that. There IS a back story. A child at 2 wks having her 1st #hereditary 2
#pancreatitis flare. In 1st grade undergoing her 1st #transplant. In 6th grade undergoing 2nd #transplant. Complications, no real follow up. Complications being ignored. Physicians both on #transplant team as well as others questioning her symptoms, her #pain. Dismissing & 3
This thread is
Chapter 47, titled
“Forgetting:
“Our Edenal Experience in the Womb & the Loss of a “Golden Age”
“…an Account, in Fictional Form, of Being a Fetus”
of *Dance of the Seven Veils II*
by Michael Adzema
THREAD sillymickel.blogspot.com/2023/02/forget… #psyche #prenatal
D7V2 47/1
Chapter 47, titled
“Forgetting:
“Our Edenal Experience in the Womb & the Loss of a “Golden Age”
“…an Account, in Fictional Form, of Being a Fetus”
of *Dance of the Seven Veils II*
by Michael Adzema
THREAD sillymickel.blogspot.com/2023/02/forget… #psyche #prenatal
D7V2 47/1
*Dance of the Seven Veils II* by Michael Adzema is due out March, 2023.
it is subtitled,
*Prenatal/Perinatal Psychology, Mythology, and Your Divine Self*
*Infant to Prenate, Veils Four-Six*
& is Volume 3 in The Path of Ecstasy Series
THREAD wp.me/pwMlb-3jX
D7V2 47/2
it is subtitled,
*Prenatal/Perinatal Psychology, Mythology, and Your Divine Self*
*Infant to Prenate, Veils Four-Six*
& is Volume 3 in The Path of Ecstasy Series
THREAD wp.me/pwMlb-3jX
D7V2 47/2
“[*Quotes/highlights:*] “The bond between them is a love having no source in either. It is there, ever present, flowing back & forth like waves lapping on a beach...effortlessly, lazily.” []
READ/DWL CH… 1drv.ms/b/s!AvgkzaPrRv… #psychology #prenatal #consciousness
D7V2 47/3
READ/DWL CH… 1drv.ms/b/s!AvgkzaPrRv… #psychology #prenatal #consciousness
D7V2 47/3
Would @churchofengland @JustinWelby treat #NicolaBulley as he has treated my son #AmbroseGGBall and as he has treated @ProductsSystem aka #LovellTwins👭🏾 @GREATBritain @BestForBritain who both blocked me as if I have less #RightSideOfHistory @VictimSupport than #RefugeesWelcome .
What makes @BrianWillmot have the God given rights to show #NicolaBulley his #compassion #IntegrityInitiative but has never ever shown my sin #AmbroseGGBall the same #empathy towards #UnderstandingGoodSuccess @churchofengland @JustinWelby
What makes @Phil_VCSA @IICSAVSCP #IICSA @voicing_csa all feel their #Pain and suffering in #silencercentral @MindCharity @CharitySANE @heads_together @GiveUsAShout @mentalhealth @CoE_Antidiscri @MaggieOliverUK @wedger_jon @pienmashfilms @BreesAnna
🔥1/6 From my PhD:
"My #Back is Fit for Movement": A Qualitative Study Alongside a Randomized Controlled Trial for Chronic Low Back Pain
@Pain_NeuRa @HayleyLeake @AidanCashin @adrian_traeger @SylviaGustin2 @link_physio @EdelOH @UNSWMedicine @neuraustralia
pubmed.ncbi.nlm.nih.gov/36577460/
"My #Back is Fit for Movement": A Qualitative Study Alongside a Randomized Controlled Trial for Chronic Low Back Pain
@Pain_NeuRa @HayleyLeake @AidanCashin @adrian_traeger @SylviaGustin2 @link_physio @EdelOH @UNSWMedicine @neuraustralia
pubmed.ncbi.nlm.nih.gov/36577460/
2a/6 Why?
- The effects of non-pharmacological interventions for CLBP are sustained for only a few months at best.
- A multimodal intervention grounded in evidence of pain-related alterations in neural processing reduced #disability across 12 months: jamanetwork.com/journals/jama/…
- The effects of non-pharmacological interventions for CLBP are sustained for only a few months at best.
- A multimodal intervention grounded in evidence of pain-related alterations in neural processing reduced #disability across 12 months: jamanetwork.com/journals/jama/…
2b/6 The program #RESOLVE employed a “fit for purpose” framework: understand, feel and experience that the back is fit for purpose (movement), highlighting the #biopsychosocial nature of
pain and addressing biopsychosocial contributors to
pain experience⤵️
academic.oup.com/ptj/advance-ar…
pain and addressing biopsychosocial contributors to
pain experience⤵️
academic.oup.com/ptj/advance-ar…
1/14 #Men and #women experience disease differently. This is reminiscent of #SyndromeX and other chronic disease like #MECFS, #slow #virus manifestations, and even #LongCovid and post-acute sequelae of #SARSCoV2.
A thread summary article 🧵
anu.edu.au/news/all-news/….
A thread summary article 🧵
anu.edu.au/news/all-news/….
2/14 "#Women are up to 75 per cent more likely to experience #adverse #reactions to #prescription #drugs than #men because of a range of differences in #traits between the #sexes, according to a new study from The #Australian #National #University (#ANU)."
3/14 "The researchers believe more should be done to take this into account when treating #diseases."
How a valuable possession slowly damaged a young man's nerve
1. 30-year-old Sidh consulted me with severe sharp shooting #pain from right buttock to the leg & foot for 3 months. Pain was more while sitting and lesser while standing or walking. Pain increased on lying down.
1. 30-year-old Sidh consulted me with severe sharp shooting #pain from right buttock to the leg & foot for 3 months. Pain was more while sitting and lesser while standing or walking. Pain increased on lying down.
2. He was evaluated elsewhere.
MRI spine ruled out slipped disc and nerve compression in lower back region.
Nerve conduction studies had shown severe damage of right sciatic nerve (see the image below to see the location and course of sciatic nerve).
MRI spine ruled out slipped disc and nerve compression in lower back region.
Nerve conduction studies had shown severe damage of right sciatic nerve (see the image below to see the location and course of sciatic nerve).
3. No cause for sciatic nerve damage was obvious. On detailed enquiry, he informed that he always carried a "fat wallet" in his right back pocket, which remained in his pocket while he sat in office during work (10 hours a day).
Now, I could guess the cause.
(Pic from internet)
Now, I could guess the cause.
(Pic from internet)
Consider lead toxicity due to Ayurvedic medications in patients with unexplained abdominal pain
1. In the past 6 months, we saw 5 patients with unexplained abdominal pain associated with weakness of hands and feet. All were taking Ayurvedic medicines for various reasons.
1. In the past 6 months, we saw 5 patients with unexplained abdominal pain associated with weakness of hands and feet. All were taking Ayurvedic medicines for various reasons.
2. Blood lead levels were high in all of them (>25 mcg/dl). There was no history of occupational lead exposure in any of them.
They were treated with d-penicillamine (chelation therapy). Ayurvedic medicines were stopped.
#MedTwitter #NeuroTwitter #ayurvedicmedicine
They were treated with d-penicillamine (chelation therapy). Ayurvedic medicines were stopped.
#MedTwitter #NeuroTwitter #ayurvedicmedicine
3. Abdominal pain resolved. Weakness of hands and legs partially improved. Four patients had anemia and one had kidney damage (these showed only partial improvement).
Today's #blog covers why the #pain #trade is likely higher over the next few weeks as #sentiment improves and too much money is offside.
realinvestmentadvice.com/the-pain-trade…
realinvestmentadvice.com/the-pain-trade…
#Bullish optimism is building around:
- #Fed cutting rates
- #Economy will avoid #recession
- #Employment remains strong.
- #Earnings have corrected enough
Risk to that view remains a recession.
realinvestmentadvice.com/the-pain-trade…
- #Fed cutting rates
- #Economy will avoid #recession
- #Employment remains strong.
- #Earnings have corrected enough
Risk to that view remains a recession.
realinvestmentadvice.com/the-pain-trade…
It is called the “#paintrade” because it is the opposite of how #investors are currently positioned. Investor sentiment remains historically #bearish despite improvement since the October lows.
realinvestmentadvice.com/the-pain-trade…
realinvestmentadvice.com/the-pain-trade…
There's no friendly way to put this:
The new CDC Opioids Guidelines are a farce when it comes to saving patients' lives.
usatoday.com/story/opinion/… #chronicpain #opioids #opioidcrisis #fentanyl #lawenforcement #drugs #politics #health #disability #disabled #cancer #addiction #pain
The new CDC Opioids Guidelines are a farce when it comes to saving patients' lives.
usatoday.com/story/opinion/… #chronicpain #opioids #opioidcrisis #fentanyl #lawenforcement #drugs #politics #health #disability #disabled #cancer #addiction #pain
The CDC 2022 update is not meant to reform the guidelines
It's meant to absolve the CDC of guilt & wash its hands of an opioid prohibition & crisis it helped create
usatoday.com/story/opinion/… @elizableu @yashar @chadfelixg @conor64 @lhfang @stillgray @joerogan @TaylorLorenz
It's meant to absolve the CDC of guilt & wash its hands of an opioid prohibition & crisis it helped create
usatoday.com/story/opinion/… @elizableu @yashar @chadfelixg @conor64 @lhfang @stillgray @joerogan @TaylorLorenz
Christopher Jones, acting director of CDC’s National Center for Injury Prevention & Control
Said the guideline is about "improving the lives of patients living with pain.”
Then why did the CDC push further & deeper restrictions against patients?
Said the guideline is about "improving the lives of patients living with pain.”
Then why did the CDC push further & deeper restrictions against patients?
„#longcovid. I have had it twice now. Never recovered from first infection. I am no longer able to stand for very long or make meals for my family. I can no longer work as I continuously have #fatigue, #migraines, #nausea, nerve #pain and #brainfog. …“
1/4
1/4
„I use to work full time and just started a new job with the IRS after a pause from working as a mail carrier for 12 years. I can no longer do my daily of walks of 3 to 5 miles. Or spend time hiking or kayaking. …“
2/4
2/4
„I enjoyed baking breads and pies and helping my older sister and aging parents out. I can no longer do that. I am a shell of myself. I have spent thousands of dollars and countless appts trying to figure out what was wrong with me in the beginning. …“
3/4
3/4
#women with #endometriosis have a higher risk of #stroke
1. Endometriosis is a common cause of #pelvic #pain and is known to increase the risk of #coronary artery disease (CAD). A recent study looked at the association of endometriosis and stroke.
#MedTwitter #gynecologist
1. Endometriosis is a common cause of #pelvic #pain and is known to increase the risk of #coronary artery disease (CAD). A recent study looked at the association of endometriosis and stroke.
#MedTwitter #gynecologist
2. Women with laparoscopically confirmed endometriosis had a 34% greater risk of stroke as compared to those without a history of endometriosis.
3. Of the total association of endometriosis
with risk of stroke, the largest proportion was attributed to hysterectomy/oophorectomy (39% mediated) and hormone therapy (16% mediated).
with risk of stroke, the largest proportion was attributed to hysterectomy/oophorectomy (39% mediated) and hormone therapy (16% mediated).
Longer daily #sedentary time increases the risk of #Knee, #Hip and #back #pain
1. 20-25% of people aged 50 or more suffer from orthopedic problems such as knee joint pain, hip joint pain, back pain and knee stiffness. Sedentary lifestyle is a major risk factor for them.
1. 20-25% of people aged 50 or more suffer from orthopedic problems such as knee joint pain, hip joint pain, back pain and knee stiffness. Sedentary lifestyle is a major risk factor for them.
2. In a recent study, men with sedentary time of 7.5 hours or more/day had 45% higher risk of orthopedic problems as compared to those with daily sedentary time of <7.5 hours.
#MedTwitter #ortho
#MedTwitter #ortho
3. A pink-collar job, physical inactivity during leisure time, and passive (e.g. riding in a car or train) versus active (e.g. walking or riding a bicycle) transportation- were more commonly associated with orthopedic problems in people with daily sedentary time >7.5 hours.
Case of a man who almost stopped eating and drinking, as the act of swallowing caused severe throat pain
1. 45-year old man presented with intense episodes of pain in throat, back of tongue and tonsils on the right side for three months. The pain radiated to ear.
#MedTwitter
1. 45-year old man presented with intense episodes of pain in throat, back of tongue and tonsils on the right side for three months. The pain radiated to ear.
#MedTwitter
2. #pain was excruciating and was triggered by eating, chewing or swallowing food, drinking water, sneezing or even yawning. Pain lasted for 30-45 seconds and occurred 10-15 times every hour. He was so scared to eat or drink that he lost 15 kg weight in those 3 months.
3. He consulted ENT and dental doctors, and detailed examination by them was normal.
He became depressed and also had suicidal thoughts. He consulted psychiatrist and was started on anti-depressant medications.
On his sister's (a medico) advice, he decided to take my opinion.
He became depressed and also had suicidal thoughts. He consulted psychiatrist and was started on anti-depressant medications.
On his sister's (a medico) advice, he decided to take my opinion.
Long-standing unwanted & unpleasant genital sensations in a woman of neurological origin
1. 41-year old woman presented with 3-year history of persistent abnormal sensations involving vagina, #clitoris and labia, without #sexual interest or #desire.
#MedTwitter #neurotwitter
1. 41-year old woman presented with 3-year history of persistent abnormal sensations involving vagina, #clitoris and labia, without #sexual interest or #desire.
#MedTwitter #neurotwitter
2. She found it hard to describe the sensations but used terms like vibrating, tingling, painful, throbbing, pulsating and numbness in vagina & surrounding regions. There was a sense of imminent #orgasm. Sexual activity & orgasm, however, did not relieve her symptoms.
3. Symptoms got worse on sitting and on lying down, but were lesser on standing or walking. Tight clothing or underwear aggravated her symptoms. She also had #pain in both legs, and felt the urge to constantly move her legs to reduce pain & discomfort (in legs & feet).
