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Back and Neck Pain, Pain Clinics and Interventional Pain Management in Canada

Teaser: 

Arani Kulamurugan,1 Pranjan Gandhi,2 Markian Pahuta,3 Mohammad Zarrabian,4 Daipayan Guha,5

1Michael DeGroote School of Medicine, McMaster University, Hamilton, ON.
2Michael DeGroote School of Medicine, McMaster University, Hamilton, ON.
3Department of Surgery, Division of Orthopaedics, McMaster University, Hamilton, ON.
4Department of Surgery, Division of Orthopaedics, McMaster University, Hamilton, ON.
5Department of Surgery, Division of Neurosurgery, McMaster University, Hamilton, ON.

CLINICAL TOOLS

Abstract: This paper examines the role of pain clinics in Canada, focusing on non-surgical interventions to manage cervical and lumbar degenerative pathologies. These pathologies have a substantial impact on health care and the economy. Since non-interventional management strategies are often insufficient, pain clinics can be effective in providing image-guided injections to reduce symptoms and rates of surgery. Given the challenges of access and long wait times for treatment, the expansion of pain clinics may be an interim solution to improve outcomes and alleviate the burden on Canadian healthcare.
Key Words: radiculopathy, myelopathy, back pain, neck pain, pain clinic.

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

You can take quizzes without subscribing; however, your results will not be stored. Subscribers will have access to their quiz results for future reference.

Pre-test CME Quiz Post-test CME Quiz
1. Identifying the specific type of back pain guides the choice of treatment, enhancing patient outcomes.
2. Interventional strategies have demonstrated significant benefits when combined with traditional medical and physical therapies.
3. Axial pain, radiculopathy, neurogenic claudication and myelopathy have distinct symptoms and relief mechanisms, making accurate diagnosis critical.
4. Improving the distribution and accessibility of multidisciplinary pain management services will improve the outcomes for patients with chronic pain.
Differentiating Pain Syndromes: It is essential to distinguish among axial neck/back pain, radicular pain, neurogenic claudication and myelopathy to institute proper back pain management. Axial pain is worsened by physical activity, radicular pain is limb dominant, neurogenic claudication is exacerbated by prolonged standing and relieved by sitting, and myelopathy produces upper motor neuron findings in both upper and lower limbs.
Role of Pain Clinics: Offering a wide range of services, pain clinics are cost-effective and improve quality of life and functionality through interventional pain management, mental health support, and physical therapy.
Barriers to Accessing Care: Access to multidisciplinary pain treatment facilities in Canada is limited by long wait times and significant regional variability.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Back Health, radiculopathy, myelopathy, back pain, neck pain, pain clinic

#39: The Future of Medicine, Part 1

Welcome to 3P: Pills, Pearls, and Patients where we will discuss current events in medicine, stories from real patient-physician encounters, and gain insight into what it's like being a physician in today's society.

Please note that while the first episode is available to listen to without registration, accessing additional episodes will require you to subscribe and log in.

  Back to Pills, Pearls & Patients (3P)

Welcome back to another episode. The next series of episodes that we're going to begin together is entitled The Future of Medicine.

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Dr. Marina Malak is a family physician in Mississauga, Ontario and a lecturer and faculty member at the University of Toronto. She is actively involved in medical advocacy, and is a board member of the Mississauga Primary Care Network. She is also a member of the National Committee of Continuing Professional Development at the College of Family Physicians of Ontario, and a member of the Research Ethics Board at Trillium Health Partners.

She is passionate about patient care; medical education; and promoting mental, physical, and emotional wellness. She enjoys reading, writing, public speaking, puzzles, doodling in her bullet journal, and creating drawings on Procreate.

#9: Women's Health Imaging

Welcome to Inside Radiology: A Primary Care Perspective where we explore the world of radiology and its applications in primary care.

Please note that while the first episode is available to listen to without registration, accessing additional episodes will require you to subscribe and log in.

  Inside Radiology: A Primary Care Perspective

Good morning. I am Dr. D'Arcy Little. Your host of Inside Radiology: A Primary Care Podcast. Today we're going to talk about a new topic. That's the topic of women's health imaging.

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Welcome to Inside Radiology: A Primary Care Perspective podcast! I'm Dr. D'Arcy Little, your host. As a community radiologist and former family physician, I'm passionate about empowering primary care doctors with the knowledge and insights they need. With my unique perspective, I aim to bridge the gap between primary care and radiology, presenting the complexities of radiology in a way that resonates with you. My goal is to equip you with tools to enhance patient care and decision-making. Join me on this educational journey as we explore the world of radiology, tailored for primary care physicians like you. Together, let's elevate primary care radiology.

Pediatric Scabies

Teaser: 

Ou Jia (Emilie) Wang,1 Joseph M. Lam, MD, FRCPC,2

1 Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
2Department of Pediatrics, Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada.

CLINICAL TOOLS

Abstract: Scabies, caused by the Sarcoptes scabiei var. hominis mite, is a common and highly contagious skin infestation that manifests with symptoms of intense itching and a generalized pruritic papular eruption. Crusted scabies, a severe form of the infestation, is more commonly seen in immunocompromised individuals. Scabies can affect individuals of all ages and is typically transmitted through close and prolonged skin-to-skin contact. Diagnosis relies heavily on clinical examination, with scabies preparation at multiple sites guided by dermoscopy. Management involves both treating the condition and preventing its spread to others, with the primary treatment being the application of topical scabicide medications to the entire body. Environmental decontamination measures are crucial in controlling the spread of scabies. Prompt diagnosis and treatment are essential to prevent complications and transmission to others.
Key Words: scabies, classic scabies, crusted scabies, infestations, pruritus, hypersensitivity reactions.

You may also listen to the latest podcast on Pediatric Scabies with Dr. Joseph Lam and Emilie Wang.

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

You can take quizzes without subscribing; however, your results will not be stored. Subscribers will have access to their quiz results for future reference.

Pre-test CME Quiz Post-test CME Quiz
A large range of prevalence exists with scabies and scabies is not reportable in Canada. It disproportionately affects individuals living in poverty and crowded conditions.
A definitive diagnosis of scabies can be made through visualization through microscopy of skin scrapings and tape samples or through dermoscopy.
Treatment of patients and close contacts and environmental measures must be taken to prevent further spread and infestation.
In scabies infestation, the female mite burrows under the skin and triggers a hypersensitivity reaction with symptoms of pruritus and inflammation.
Classic scabies is more common, while crusted scabies is rarer and more severe.
First-line treatment is topical 5% permethrin cream head to toe including the scalp in infants and young children and from the neck down in adults with retreatment in one week.
Environmental decontamination is important to preventing reinfestation.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Dermatology, scabies, classic scabies, crusted scabies, infestations, pruritus, hypersensitivity reactions
Disclaimer: 
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#38: A Rapid Overview of Polycystic Ovarian Syndrome (PCOS)

Welcome to 3P: Pills, Pearls, and Patients where we will discuss current events in medicine, stories from real patient-physician encounters, and gain insight into what it's like being a physician in today's society.

Please note that while the first episode is available to listen to without registration, accessing additional episodes will require you to subscribe and log in.

  Back to Pills, Pearls & Patients (3P)

Hello and welcome to the next episode of 3P, Pills, Pearls and Patients. I'm your host, Dr. Marina Malak. And today we're going to be talking about polycystic ovarian syndrome.

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1 applause

Dr. Marina Malak is a family physician in Mississauga, Ontario and a lecturer and faculty member at the University of Toronto. She is actively involved in medical advocacy, and is a board member of the Mississauga Primary Care Network. She is also a member of the National Committee of Continuing Professional Development at the College of Family Physicians of Ontario, and a member of the Research Ethics Board at Trillium Health Partners.

She is passionate about patient care; medical education; and promoting mental, physical, and emotional wellness. She enjoys reading, writing, public speaking, puzzles, doodling in her bullet journal, and creating drawings on Procreate.