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Ridgeview and the Ridgeview Continuing Medical Education Program are proud to present the Ridgeview Podcast: CME Series; a quality, portable and on-demand continuing medical education, that features a variety of exceptional physicians, providers and other staff from Ridgeview and it's affiliates. Hosts of the program are Fred DeMeuse, PA-C, Jason Hicks, PA-C, and Leah Radde, RN. Thanks for tuning-in, downloading and listening! 

 

DISCLOSURE ANNOUNCEMENT 

The information provided through this and all Ridgeview podcasts as well as any and all accompanying files, images, videos and documents is/are for CME/CE and other institutional learning and communication purposes only and is/are not meant to substitute for the independent medical judgment of a physician, healthcare provider or other healthcare personnel relative to diagnostic and treatment options of a specific patient's medical condition; and are property/rights of Ridgeview & Ridgeview Clinics.  Any re-reproduction of any of the materials presented would be infringement of copyright laws. 

It is Ridgeview's intent that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It is not assumed any potential conflicts will have an adverse impact on these presentations. It remains for the audience to determine whether the speaker’s outside interest may reflect a possible bias, either the exposition or the conclusions presented.

Ridgeview's CME planning committee members and presenter(s) have disclosed they have no significant financial relationship with a pharmaceutical company and have disclosed that no conflict of interest exists with the presentation/educational event.

Sep 22, 2022

In the second podcast of season 5, Dr. Nima Adimi, a pain and spine specialist at Ridgeview discusses many areas around pain management, including how we evaluate, manage and treat pain and spine patients, the multidisciplinary teamwork involved, current guidelines, new and contemporary management strategies, and what is in the pipeline for the future of pain medicine.

Enjoy the podcast.

Objectives:
Upon completion of this podcast, participants should be able to:

  • Describe the types of tools available for people suffering with chronic pain.
  • Identify ways to get patients access for pain management.
  • Differentiate the diverse and broad nature of treatments available to those suffering from chronic pain.

CME credit is only offered to Ridgeview Providers & Allied Health Staff for this podcast activity. Complete and submit the online evaluation form, after viewing the activity.  Upon successful completion of the evaluation, you will be e-mailed a certificate of completion within approximately 2 weeks. You may contact the accredited provider with questions regarding this program at  Education@ridgeviewmedical.org.

To receive continuing education credit for this activity - click the link below, to complete the activity's evaluation.

CME Evaluation

(**If you are listening to the podcasts through iTunes on your laptop or desktop, it is not possible to link directly with the CME Evaluation for unclear reasons. We are trying to remedy this. You can, however, link to the survey through the Podcasts app on your Apple and other smart devices, as well as through Spotify, Stitcher and other podcast directory apps and on your computer browser at these websites. We apologize for the inconvenience.) 

DISCLOSURE ANNOUNCEMENT 

The information provided through this and all Ridgeview podcasts as well as any and all accompanying files, images, videos and documents is/are for CME/CE and other institutional learning and communication purposes only and is/are not meant to substitute for the independent medical judgment of a physician, healthcare provider or other healthcare personnel relative to diagnostic and treatment options of a specific patient's medical condition; and are property/rights of Ridgeview Medical Center & Clinics.  Any re-reproduction of any of the materials presented would be infringement of copyright laws. 

It is Ridgeview's intent that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It is not assumed any potential conflicts will have an adverse impact on these presentations. It remains for the audience to determine whether the speaker’s outside interest may reflect a possible bias, either the exposition or the conclusions presented.

Ridgeview's CME planning committee members and presenter(s) have disclosed they have no significant financial relationship with a pharmaceutical company and have disclosed that no conflict of interest exists with the presentation/educational event.

Thank-you for listening to the podcast.

SHOW NOTES: 
*See the attachment for additional information.
  
In-take process:
About 80% of patients referred to Ridgeview's pain center are LBP patients. The first conversation is the usual Goals of Care which are highly important in setting the expectations for the patient, including what type of testing or imaging the patient has received, what treatment modalities have they tried.

Neuropathic pain is caused by damage or injury to the nerves that transfer information between the brain and spinal cord from the skin, muscules and other parts of the body. The pain is usually described as a burning sensation and affected areas often sensitive to the touch.  

Nociplastic pain (a type of pain caused by damage to body tissue. A pain that feels sharp, aching or throbbing) or a type of pain which is mechanically different from the normal nociceptive pain caused by inflammation and tissue damage or the neuropathic pain which results from nerve injury. It may occur in combination with the other types of pain or in isolation. Its location may be generalized or multifocal and it can be more intense than would be expected from associated physical causes. Its causes are not fully understood, but is thought to be a dysfunction of the central nervous system whose processing of pain signals may have become distorted or sensitised. This type of pain typically arises in some chronic pain conditions, with the archetypal condition being fibromyalgia.

Opiod Induced Hyperalgesia
Which is a common diagnosis for Dr. Adimi. During this podcast, listeners learn the limitations for further interventions due to hyperalgesia. These interventions will often require opioid titration prior to implementing therapy.

Multimodal Treatment Options:
Include non-addictive strategies, such as physical therapy, chropractic, fucntional/personal trainer, behavioral health. Discussions continue regarding medications such as gabapentinoids and their side effects, NSAIDs, muscle relaxers, medical cannabis, low dose naltrexone, etc.

Interventional Strategies
Least invasive strategies are discussed, including: trigger point injectsions, epidural, radiofrequency ablation medial branch blocks, facet joint injections, occipital and trigeminal nerve blocks, spinal cord stimulators, peripheral nerve stimulators.

During this section of the podcast, Dr. Adimi discusses how spinal cord stimulators are impacting pain with new and exciting modalities, intrathecal pain pumps and their limitations an dhow the use of narcotics, anesthetics and snal poison (ziconotide) are implemented. Dr. Adimi notes that SCS are not effective for mechanical back pain/arthritis patients.

Vertiuflex for spinal stenosis patients is discussed, along with the "mild" procedure and minimally invasive lumbar decompression.     

In wrapping up the podcast, Dr. Adimi discusses the future of pain and the new arena or space the pain specialist will be occupying. New research on SCS for Prakinson, movement disorders, dystonia as well as how it impacts select patient populations like Peripheral Diabetic Neuropathy Study.       

Thanks for listening.
Please check out the additonal show notes for additional resources.