Stories about: pain management

Hip pain in young athletes: Q&A with a sports medicine specialist

hip pain athletes

When a young athlete visits their pediatrician or primary care provider (PCP) with hip pain, the proper course of treatment isn’t always clear. The damage caused by acute and traumatic hip injuries can often be determined in imaging, while overuse injuries may be more difficult to diagnose.

For significant injuries requiring surgical intervention, it’s always in the best interest of a young athlete to be immediately referred to a pediatric orthopedic surgeon. But for nagging hip pain that doesn’t have a discernible cause, the best course of action may not be evident.

Notes talked to Mininder Kocher, MD, MPH, orthopedic surgeon and associate director of the Sports Medicine Division at Boston Children’s Hospital, about how to best handle hip pain in young athletes. …Read More

Racial disparities in analgesia: Who gets pain relief?

teddy bear hospital bed pain management
(upixa/Shutterstock)

These are challenging times for clinicians who care for children and adults in pain. The general philosophy regarding the level of attention that should be paid to pain as well as its treatment has changed dramatically during the past 30 years, swinging wildly between extremes, and remains a moving target.

The first published recognition of pain undertreatment in adults occurred in the 1970s, with identification of similar and more dramatic concerns for children emerging a few years later. Research documenting the short- and long-term negative consequences of poorly-treated pain—coupled with the development and marketing of new opioid compounds—led to a dramatic increase in analgesia prescribing for essentially all painful conditions.

Unfortunately, although most patients who were prescribed opioids benefited, it became clear that these agents were not as benign as had been assumed, and that addiction, diversion, opioid hyperalgesia and other adverse effects were legitimate concerns. Although one would assume that these concerns would only limit the indiscriminate use of these drugs for inappropriate situations, in fact, the pendulum swung to the other extreme, with a wave of negative publicity leading to the scrutiny of essentially any use of narcotic analgesics.

As a result, at this time, we run the genuine risk of returning to a state of opiophobia and denying individuals in severe pain the mercy of access to these incredibly valuable drugs.

It is with these societal currents in mind that we read a recent article in JAMA Pediatrics that identified significant undertreatment of children with severe pain associated with appendicitis while in the emergency department (ED). …Read More

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