Pain Specialty & Wellness

The world of pain and rehab specialization has been helping patients across a wide demographic for quite some time now. While this field is creating a positive movement towards better patient care across age, gender, ethnicity, and social conditions, it also means encountering a myriad of complaints, symptoms, complications, and concerns. For us physicians, this translates into medical complications, diagnostic uncertainty and difficulty in treatment, patient care, and patient satisfaction.

Answering the Challenge

To answer this challenge, an emerging perspective of advanced integrative medicine has bridged the gap to appropriately diagnose and improve patient care across the board. Testing and treating for potentially clinically relevant markers is a must when dealing with conditions involving healing time, severity of pain, efficacy of medications, inflammation associated with pain, complicating factors, etc.,

The numerous contributing factors are as follows:

1. Pituitary hyper stimulation or down-regulation.
   1. Hypothalamo-pituitary-adrenal axis dysfunction with pain and depression
   1. Opioid endocrinopathy within sex hormone production and pathways
2. Neurophysiological and neuromuscular findings for those with hypothyroidism
3. Increased estrogen or progesterone and neurogenic inflammation and prostaglandin secretions
4. Chondrogenic progenitor cell release in arthritic conditions mediated through estrogen and test
5. Testosterone mediated opioid receptor site sensitivity
6. Diabetes complications and pain management
7. Association between musculoskeletal pain and cardiovascular disease
8. Pain sensitivity and C-Reactive Protein
9. Inflammatory markers, varied anemias, and pain
10. Heart Failure, atherosclerosis, and connections with skeletal muscle and inflammation.

The Future of Healthcare

As we progress into the future of health care, we see that the literature propels us to do our patients the honor of treating them for all potential contributing factors to what they are struggling with. The tunnel vision approach that has been the focus for years is being forced out not only by research and development, but also by commercial and governmental payers themselves. With payers all beginning to pay attention to patient care, progression of condition, re-admittance, and medication usage, the term “proactive care” will be a staple in our not-so-distant future.

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Support Team, The NaviWell Group

9456 State Hwy 121, Frisco, Tx 75035
info@naviwellgroup.com

• An investigation of association between chronic musculoskeletal pain and cardiovascular disease in the Health Survey for England (2008). European Journal of Pain https://ncbi.nlm.nih.gov/pubmed/24167109
• Patients with chronic pain and abnormal pituitary function require https://www.ncbi.nlm.nih.gov/ pubmed/12842375
• Medical and psychological risks and consequences of long-term opioid therapy in women. https:// ncbi.nlm.nih.gov/pubmed/22905834
• A case of hypogonadotropic hypogonadism caused by opioid treatment for nonmalignant chronic pain. https:// ncbi.nlm.nih.gov/pubmed/23326276
• Hypothalamo-Pituitary-Adrenal Axis Dysfunction As a Contributory Factor to Chronic Pain and Depression https:// researchgate.net/profile/Gordon_Munro2/publication/5912979_Hypothalamo-pituitary- adrenal_axis_dysfunction_as_a_contributory_factor_to_chronic_pain_and_depression/links/ 0deec517e843a14c21000000.pdf
• Hypothalamic-pituitary-adrenal stress axis function and the relationship with chronic widespread pain and its antecedents http://arthritis-research.biomedcentral.com/articles/10.1186/ar1772
• The pituitary gland mediates acute and chronic pain responsiveness in stressed and non-stressed rats http:// sciencedirect.com/science/article/pii/0024320579902169
• Opioid endocrinopathy: a clinical problem in patients with chronic pain and long-term oral opioid treatment. https:// ncbi.nlm.nih.gov/pubmed/20473043
• Sex hormone suppression by intrathecal opioids: a prospective study https://ncbi.nlm.nih.gov/pubmed/12048415
• Polyneuropathy in hypothyroidism: clinical, electrophysiological and morphological findings in four cases http:// jnnp.bmj.com/content/50/11/1454.abstract? ijkey=2aa08760733ab38a93a3c07b2ed6dd482f94deb9&keytype2=tf_ipsecsha
• Neuromuscular status in hypothyroidism. https://ncbi.nlm.nih.gov/pubmed/7395461?dopt=Abstract
• Neurophysiological changes in neurologically asymptomatic hypothyroid patients https://ncbi.nlm.nih.gov/ pubmed/17143145
• Neuromuscular findings in thyroid dysfunction: a prospective clinical and electrodiagnostic https:// www.ncbi.nlm.nih.gov/pubmed/10811699
• Low Back Pain in Diabetes Mellitus and Importance of Preventive Approach https://ncbi.nlm.nih.gov/pmc/ articles/PMC3963658/
• The association between diabetes mellitus, glucose, and chronic musculoskeletal complaints. http:// biomedcentral.com/articles/10.1186/1471-2474-9-160
• C-Reactive Protein and Pain Sensitivity https://ncbi.nlm.nih.gov/pmc/articles/PMC3184380/
• Inflammation and atherosclerosis. Circulation https://ncbi.nlm.nih.gov/pubmed/11877368
• Decreased pain perception and risk for hypertension: https://ncbi.nlm.nih.gov/pubmed/10554582
• Association of Catastrophizing with Interleukin-6 Responses to Acute Pain https://ncbi.nlm.nih.gov/pmc/articles/ PMC2659503/
• Pain and high sensitivity C reactive protein in patients with chronic low back pain and acute sciatic pain https:// ncbi.nlm.nih.gov/pmc/articles/PMC1755532/
• High-sensitivity C-reactive protein in chronic low back pain with vertebral end-plate Modic signal changes. https:// ncbi.nlm.nih.gov/pubmed/17907216
• Tumor necrosis factor-immunoreactive cells and PGP 9.5-immunoreactive nerve fibers in vertebral endplates of patients with discogenic low back Pain and Modic Type 1 or Type 2 changes on MRI. https://ncbi.nlm.nih.gov/ pubmed/16641780
• Anti-nociceptive and anti-inflammatory effects of cyanocobalamin (vitamin B12) against acute and chronic pain and inflammation in mice. https://ncbi.nlm.nih.gov/pubmed/22588629
• Folate status and folate related anemia: a comparative cross-sectional study of long-term care and post-acute care psychogeriatric patients. https://ncbi.nlm.nih.gov/pubmed/15249150
• Prostaglandin E2 and pain–an update https://ncbi.nlm.nih.gov/pubmed/21804201
• Prostaglandins and Inflammation https://ncbi.nlm.nih.gov/pmc/articles/PMC3081099/
• Anemia of Inflammation http://asheducationbook.hematologylibrary.org/content/2010/1/276.long
• Burden of anemia in patients with osteoarthritis and rheumatoid arthritis in French secondary care http://biomedcentral.com/articles/10.1186/1471-2318-10-59
• Effects of Statins on Skeletal Muscle: A Perspective for Physical Therapists https://ncbi.nlm.nih.gov/pmc/ articles/PMC2949584/
• Analysis of Skeletal Muscle Torque Capacity and Circulating Ceramides in Patients with Advanced Heart Failure https:// ncbi.nlm.nih.gov/pmc/articles/PMC4967538/