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Professional Consultation: Comprehensive Management of Chronic Knee Pain

Originally published on Pain Medicine News

Dear Arizona Pain Specialists,

Many of my patients with chronic knee pain initially present complaining of persistent symptoms despite exhausting several conservative treatment options. The vast majority of them do not desire surgery or are not surgical candidates. How can I effectively manage patients with refractory chronic knee pain?


Dr. Genu Wine

Dear Dr. Genu Wine,

This is a very common question among both primary care and pain management providers. Knee pain is a very common complaint that can be debilitating when severe. A proper evaluation must begin with a thorough history and physical examination.

If the patient is not a surgical candidate, there are several conservative treatment options—such as physical therapy for retraining of proper mechanics, kinesiology taping to improve proprioception, acupuncture and chiropractic treatment—that may alleviate the patient’s symptoms. Depending on the nature of the pain, a variety of analgesic medications may be prescribed, including anti-inflammatory drugs, membrane-stabilizing agents and in severe cases, opioid analgesics. Unfortunately, these medications may not significantly reduce the pain and their long-term compliance may be limited by untoward side effects. Additionally, there are a number of patients who have intractable chronic pain following more invasive treatment options such as a total knee arthroplasty (TKA). Studies have reported that 20% of patients undergoing TKA have persistent postsurgical pain.1 These patients often present to the pain clinic frustrated by the failure of conservative and possible surgical interventions. Fortunately, depending on the pain generator, there is a wide array of interventional treatment options that can be implemented.

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Exceeding Patient Expectations

Originally published on Pain Medicine News

Dear Arizona Pain Specialists,

I am a physician-owner of a pain practice in Mississippi, and have begun to hear complaints from several patients about my practice. These complaints primarily center around the staff on the phones being in a hurry, rude and generally unhelpful. None of these complaints are directed at the medical care that we deliver, but I find myself struggling daily to address these needs. What is the missing piece that is preventing my practice from satisfying my patient’s needs?


Dr. Tele-path

Dear Dr. Tele-path,

A common misconception in medicine is that a patient’s experience, positive or negative, is defined by his or her experience with a medical provider. In reality, what happens before or after the patient visit is just as important as what occurs in the exam room. A great example of this is how your staff interacts with and treats patients on phone calls.

Providing excellent patient care involves making excellent clinical decisions and supporting patients’ needs in and outside of the office. Understanding C.A.R.E. and how it can be applied to your practice will improve the patients’ perception of your practice and of the medical community.

So what is C.A.R.E.?

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Is It Time To Change the Way We Report Pain?

Originally published on Pain Medicine News

By Paul Lynch, MD, Tory McJunkin, MD, Douglas Gentile, PhD, and Ryan Tapscott, PhD

“Although we all know that pain is multidimensional, we still often measure it on a 0 to 10 scale because that is quick and simple for both the patient and the doctor. This oversimplification doesn’t seem to match our understanding of pain and doesn’t seem to address a patient’s true quality of life. What other options exist for measuring pain, especially if we are documenting reductions for clinical studies and future reimbursement changes?”

- Measured in Manhattan

Dear Measured,

image You have voiced a concern that is shared by almost all pain physicians. All of us have seen patients who had dramatic improvements in their quality of life from an intervention, but fail to report a dramatic change in the numerical rating scale (NRS). I can think of an elderly patient with 9/10 pain who was bound to her home for much of the day…

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pain relief tips

Pain Tips & Tricks

Chronic pain is debilitating and life changing. It not only affects the ability to go through day-to-day activities, but severely limits any extra activities with family, friends and loved ones and takes away from enjoyment of life. One in five Americans suffers from a chronic pain condition – we feel no one should have to live in constant, life-altering pain. Concurrently with treatment from a pain physician, there are exercises, foods, groups and activities that can greatly reduce the burden chronic pain places on you and your loved ones. Learn about these simple and easy to implement methods to aid in your chronic pain relief.



Pain Management Research

Arizona Pain Specialists is on the cutting edge of medical research and advancements. As medicine evolves, treatments and diagnostic methods improve and change, and Arizona Pain Specialists stays at the forefront of these medical advancements. Arizona Pain Specialists is also involved in research programs and studies, and not only utilizes their research in the Arizona Pain Specialists locations, but contribute these findings to the medical community at-large, helping others benefit and find pain-free lifestyles. Learn how you can benefit from these programs.

Arizona Pain Specialists Updates

What’s new at Arizona Pain Specialists? here you will find updates about our practice, patients accomplishments, and events we participate in.