The PM&R Podcast

To advance the professional knowledge in physical medicine and rehabilitation, and related specialties, through the dissemination of informational interviews with published authorities and experts in the field.

Episode 31: Misinterpretations of the 2016 Opioid Guidelines 05/21/2019

Episode 31: Misinterpretations of the 2016 Opioid Guidelines 2016 was a watershed year in the United States in the attempt to reverse the epidemic of opioid overdose deaths and addiction. Perhaps no event crystallized this intention more than a set of guidelines released by the Centers for Disease Control and Prevention offering evidence-based prescriptions for responsible opioid prescription. This influential document did have the net effect of reducing opioid prescriptions for pain, but also had unintended effects in the process. Dr. Roger Chou is here to discuss the intended and unintended effects three years out. Dr. Chou is a unique authority in the pain medicine field because of his influential scientific publications and, more uniquely, his participation as a member of the CDC consensus panel that created the 2016 guidelines. He is a recent co-author of a New England Journal of Medicine that discusses his reservations about how the guidelines have been misunderstood and misapplied. /episode/index/show/pmandrpodcast/id/9869594

Episode 30: Urine Drug Screens in Pain Medicine 12/02/2018

Episode 30: Urine Drug Screens in Pain Medicine Dr. Joshua Schrecker is a member of the clinical team at Aegis Sciences Corporation. He received his Doctor of Pharmacy from the University of Tennessee College of Pharmacy. He has expertise in developing leadership skills within a corporate environment and has received certifications through completion of advanced cardiac life support courses. On this episode, Dr. Schrecker discusses the clinical utility and role of urine drug screens. /episode/index/show/pmandrpodcast/id/7766264

Episode 29: Dysautonomia 11/16/2018

Episode 29: Dysautonomia Dysautonomia is the most important nervous system problem you have probably never heard about. It is a vast grouping of diseases that affects the body's most basic functions that occurs below the level of direct conscious control--temperature control, digestion, and regulation of blood pressure are some of the critical functions of this unheralded system. When things go wrong with the system, it is obvious to patients. The problem is the cultural awareness and conventional medical system has been slow to recognize and effectively treat this dysautonomia. Enter: Kelly Freeman. A survivor turned patient advocate, Kelly is the founder of The Dysautonomia Project dedicated to educating patients and clinical providers alike to close this big gap. Having survived dysautonomia herself, she has founded The Dysautonomia Project to provide patient advocacy and education. She is the co-author of a book of the same name and her website can be found at thedysautonomiaproject.org. /episode/index/show/pmandrpodcast/id/7582544

Episode 28: Opioid Induced Hyperalgesia 02/20/2018

Episode 28: Opioid Induced Hyperalgesia Dr. Christina Hayhurst is an assistant professor of Anesthesiology and Critical Care medicine at Vanderbilt University Medical Center. She trained at the University of Virginia, where she first began to explore opioid-sparing anesthetics and the effects of high-dose opioids on post-operative outcomes. At Vanderbilt, in addition to critical care, she is a member of the Perioperative Anesthesia service, which designs and implements enhanced recovery protocols for a variety of surgical services, with an emphasis on opioid reduction. Her research interests include the clinical implications of opioid-induced hyperalgesia in the perioperative and critically ill patient populations. /episode/index/show/pmandrpodcast/id/6279978

Episode 27: Mast Cell Activation Syndrome 08/28/2017

Episode 27: Mast Cell Activation Syndrome Mast cell activation syndrome is a condition that most doctors have never heard about, yet it is an important cause of illness that is underrecognized and, as a result, misdiagnosed. It belongs in the category of chronic inflammatory illnesses with symptoms including fatigue, allergy-like symptoms and problems with virtually every organ system in the body. Dr. Lawrence Afrin is a leading scientist and clinician on mast cell activation syndrome. Dr. Afrin is based out of the University of Minnesota and the author of the book Never Bet Against Occam, a book detailing his clinical experiences and knowledge of this mysterious disease. /episode/index/show/pmandrpodcast/id/5683058

Episode 26: Legal Considerations of Opioid Prescription 08/28/2017

Episode 26: Legal Considerations of Opioid Prescription Dr. Jack Berger discusses his experiences as a medical consultant to the California Medical Board and a regular expert witness in cases in which doctors are accused of mis-prescribing opioids. Dr. Berger has served as the director of residency training in regional anesthesia and acute pain medicine since 2000 and holds the academic rank of Professor of Clinical Anesthesiology at the Keck School of Medicine of the University of Southern California. He has been practicing pain medicine since 1982. /episode/index/show/pmandrpodcast/id/5682986

Episode 26: Metabolic Medicine 11/12/2016

Episode 26: Metabolic Medicine Metabolic medicine is a fascinating paradigm to treat the individual patient. The individualization of care, everyone agrees, is the future of medicine, but the assessment and use of readily available patient parameters--things easily obtainable today--is still rare. Dr. Michael Rothman joins us today to discuss metabolic medicine and how he uses it in his clinical practice MD Wellness in New Jersey. Board-certified in internal medicine and emergency medicine, Dr. Rothman employs a unique approach that tracks dynamic clinical and laboratory measures, such as urinary pH, to determine the underlying imbalances in his patients. The identification and correction of dualities is one of the core principles of this approach. These dualities are familiar to most physicians, but not usually thought of as directly treatable entities. Distinctions like sympathetic and parasympathetic, anabolic and catabolic, acid and alkaline comprise some of the foundational categories. Dr. Rothman proposes specific life-style changes and the judicious use of lipid compounds to correct these measures with the goal of restoring health rather than masking symptoms. He also discusses one of his greatest influences, Dr. Emanuel Revici, a legendary physician in his time whose reputation and prescient work has largely been forgotten. Learn more about Dr. Rothman from his website at mdwellnessmd.com and his Amazon five-star rated book Edibolic Stress. /episode/index/show/pmandrpodcast/id/4825952

Episode 25: Chronic Inflammatory Response Syndrome Part 2 07/14/2016

Episode 25: Chronic Inflammatory Response Syndrome Part 2 Dr. Ritchie Shoemaker returns to discuss the diagnosis and management of a condition he discovered as a physician-researcher, chronic inflammatory inflammatory syndrome (CIRS). CIRS is important because it is a scientifically-validated condition that affects millions of Americans, most often in the form of chronic illness after mold exposure. (One out of every two buildings in the United States is water-damaged.) Genetically vulnerable patients develop a wide range of symptoms including fatigue, depression, muscle soreness and other symptoms and are often misdiagnosed by the medical establishment as having fibromyalgia, chronic fatigue syndrome or a psychiatric condition. In our first conversation, Dr. Shoemaker discussed how he came to discover this mysterious illness as a family medicine doctor in Maryland. In this second part, we turn our attention toward all things clinical including the case definition of CIRS, the main symptoms, biomarkers, genetic susceptibility, visual contrast sensitivity testing and the treatment protocol. To learn more, we highly recommend his books Mold Warriors and Surviving Mold and his website survivingmold.com. /episode/index/show/pmandrpodcast/id/4514389

Episode 24: Complex Inflammatory Response Syndrome 07/02/2016

Episode 24: Complex Inflammatory Response Syndrome Ritchie Shoemaker, M.D. is a recognized leader in the field of biotoxin-related illness. Dr. Shoemaker was a primary care physician in Pocomoke, Maryland who began treating a mysterious illness in 1996 related to a Pfiesteria outbreak in the Chesapeake Bay. His subsequent journey in patient care, advocacy and scientific research led him to identify a common underlying pathway called the Chronic Inflammatory Response Syndrome (CIRS). CIRS is the end-result illness that occurs after exposure to biotoxins in genetically susceptible individuals. Dr. Shoemaker identified the same clinical symptoms, vision problems and alterations in blood work reflecting underlying inflammatory and immune irregularity in patients who became chronically ill after exposure to a wide range of biotoxins from Pfiesteria, blue-green algal blooms in Florida, tick bites and, most prevalent, mold from water-damaged buildings. He is the author of Mold Warriors and Surviving Mold. Dr. Shoemaker is joining us for a two-part interview. In this first segment, he discusses the events that led to his discovery of CIRS. The second segment will focus on the clinical work-up of CIRS. Learn more at Dr. Shoemaker's website survivingmold.com /episode/index/show/pmandrpodcast/id/4487143

Episode 23: Low Back Biomechanics 04/02/2016

Episode 23: Low Back Biomechanics Our guest today is Stuart McGill, PhD. Professor McGill is a Professor of Spine Biomechanics at the University of Waterloo. He has over 400 scientific publications including three text books: Low Back Disorders, Back Mechanic and Ultimate Back Fitness and Performance. Professor McGill will be discussing low back pain evaluation and management with us today. You can learn more at his website backfitpro.com. /episode/index/show/pmandrpodcast/id/4266575

Episode 22: Meditation and Pain 11/25/2015

Episode 22: Meditation and Pain Our guest today is Dr. Fadel Zeidan. Dr. Zeidan is an assistant professor of neurobiology and anatomy at Wake Forest School of Medicine and associate director of neuroscience at the Center for Integrative Medicine. His programmatic line of research is focused on determining the neural mechanisms that mediate the relationship between self-regulatory practices and health. He is especially interested in determining if and how mindfulness-based mental training regimens affect pain and health. Dr. Zeidan will be discussing the effects of mindfulness meditation on a spectrum of pain outcomes. /episode/index/show/pmandrpodcast/id/3977813

Episode 21: Osteoporosis 10/24/2015

Episode 21: Osteoporosis We welcome Dr. Lani Simpon. Dr. Lani is a certified clinical densitometrist and has a doctorate in chiropractic care. She is the author of the highly-regarded book Dr. Lani’s No-Nonsense Bone Health Guide and will be discussing osteoporosis with us today. You can learn more about Dr. Lani and find more educational resources at her website lanisimpson.com. /episode/index/show/pmandrpodcast/id/3884850

Episode 20: Opioid Induced Hypogonadism 10/23/2015

Episode 20: Opioid Induced Hypogonadism Our guest today is Anna Maria Aloisi, MD, PhD. Professor Aloisi studied at and now teaches at the University of Siena. Her research activity focuses on pain and hormonal-induced effects in pain mechanisms. She will be discussing opioid-induced hypogonadism with us today. /episode/index/show/pmandrpodcast/id/3884805

Episode 19: Efficacy of Epidural Steroid Injections 09/21/2015

Episode 19: Efficacy of Epidural Steroid Injections We welcome return guest Roger Chou, MD. Among his many titles and distinctions, Dr. Chou is a Professor in the Departments of Medicine and Medical Informatics & Clinical Epidemiology at Oregon Health & Science University (OHSU) School of Medicine. He will discuss his recent article Epidural Corticosteroid Injections for Radiculopathy and Spinal Stenosis A Systematic Review and Meta-analysis published in the Annals of Internal Medicine. /episode/index/show/pmandrpodcast/id/3813572

Episode 18: Complex Regional Pain Syndrome 09/04/2015

Episode 18: Complex Regional Pain Syndrome /episode/index/show/pmandrpodcast/id/3778833

Episode 17: Managing Chronic Pain in Patients with Opioid Dependence 07/08/2015

Episode 17: Managing Chronic Pain in Patients with Opioid Dependence /episode/index/show/pmandrpodcast/id/3662423

Episode 16: Considerations of Long-term Opioid Therapy for Chronic Pain 06/17/2015

Episode 16: Considerations of Long-term Opioid Therapy for Chronic Pain /episode/index/show/pmandrpodcast/id/3619932

Episode 15: Rehabilitation in Amyotrophic Lateral Sclerosis 03/31/2015

Episode 15: Rehabilitation in Amyotrophic Lateral Sclerosis /episode/index/show/pmandrpodcast/id/3463324

Episode 14: Self-Hypnosis 02/10/2015

Episode 14: Self-Hypnosis We welcome guest Tenley Fukui, MA, LPC. Ms. Fukui will be discussing her recent study entitled A Randomized Control Trial of Hypnosis Compared with Biofeedback for Adults with Chronic Low Back Pain published in the European Journal of Pain. /episode/index/show/pmandrpodcast/id/3355304

Episode 13: Platelet-Rich Plasma 02/10/2015

Episode 13: Platelet-Rich Plasma We welcome guest Jamil Bashir, MD, a regenerative medicine and interventional orthopedics fellow at the Centeno Schulz clinic. He will be discussing his article The Emerging Use of Platelet-Rich Plasma in Musculoskeletal Medicine published in the January 2015 issue of The Journal of the American Osteopathic Association. /episode/index/show/pmandrpodcast/id/3355274

Episode 12: Concussions 02/08/2015

Episode 12: Concussions We welcome Erin Reynolds, PsyD on today’s discussion of concussion evaluation and management. Dr. Reynolds is a clinical neuropsychologist and instructor at the University of Pittsburgh Medical Center Sports Medicine Concussion Program in the Department of Orthopaedic Surgery. She specializes in neurocognitive psychology, with a particular focus on sports concussion and its many related conditions. Dr. Reynolds offers expertise in the assessment of sports-related concussion, recovery within a pediatric and adolescent population, and biopsychosocial aspects of recovery from sports-related concussion. /episode/index/show/pmandrpodcast/id/3351803

Episode 11: Clinical Considerations of Cannabis 01/10/2015

Episode 11: Clinical Considerations of Cannabis Our guest today is Gregory Carter, MD, MS. /episode/index/show/pmandrpodcast/id/3288963

Episode 10: Traumatic Brain Injury 12/15/2014

Episode 10: Traumatic Brain Injury /episode/index/show/pmandrpodcast/id/3241870

Episode 9: Plantar Fasciopathy 12/03/2014

Episode 9: Plantar Fasciopathy Our guest today is Dr. David Berbrayer, a specialist in physiatry, Physical Medicine and Rehabiliation, certified by the Royal College of Physicians and Surgeons of Canada and the American Board of Medical Specialties. /episode/index/show/pmandrpodcast/id/3216008

Episode 8: Hypnoanalgesia 11/06/2014

Episode 8: Hypnoanalgesia Our guest today is Renzo Lanfranco, LPsy, MSc. Dr. Lanfrano is trained in clinical psychology and obtained a Masters of Science in neuroscience from the University of Chile, where he is currently adjunct professor. He is an associate investigator in the Laboratory of Cognitive and Social Neuroscience at the Center of Investigation UDP- Foundation INECO for the Neurosciences. Dr. Lanfranco will discuss hypnoanalgesia with us today and his recently published article, Hypnoanalgesia and the study of pain experience: from Cajal to modern neuroscience. /episode/index/show/pmandrpodcast/id/3164145

Episode 7: Cancer Rehabilitation 10/22/2014

Episode 7: Cancer Rehabilitation Our guest today is Michael D. Stubblefield, MD, a cancer rehabilitation physiatrist at Memorial Sloan Kettering Cancer Center in New York. Dr. Stubblefield has numerous publications, including original research on the neuromuscular, musculoskeletal, and functional complications that patients sometimes develop as a result of cancer and cancer treatments. He is the author of the most authoritative textbook on the field entitled Cancer Rehabilitation: Principles and Practice and will speak with us today about the medical and clinical aspects of cancer rehabilitation. /episode/index/show/pmandrpodcast/id/3133572

Episode 6: Mesenchymal Stem Cell Therapies for the Treatment of Musculoskeletal Diseases 08/31/2014

Episode 6: Mesenchymal Stem Cell Therapies for the Treatment of Musculoskeletal Diseases Our guest is Joshua Hare, MD who is Chief Sciences Officer, Senior Associate Dean for Experimental and Cellular Therapeutics, Director of the Interdisciplinary Stem Cell Institute, and Louis Lemberg Professor of Medicine at the University of Miami Miller School of Medicine. Dr. Hare has published original research on regenerative medicine and the therapeutic potential of mesenchymal stem cells. /episode/index/show/pmandrpodcast/id/3039400

Episode 5: Nutritional Treatment after Traumatic Brain Injury 07/01/2014

Episode 5: Nutritional Treatment after Traumatic Brain Injury We discuss nutrition after traumatic brain injury with Angus Scrimgeour, PhD. Dr. Scrimgeour is currently serving as a nutritional biochemist at the United States Research Institute of Environmental Medicine where he investigates evidenced-based applications of nutrition for traumatic brain injury. His review, cited below, serves as the focal point of our interview and describes four nutrients demonstrating potential benefit: omega-3, zinc, vitamin-D, and glutamine. /episode/index/show/pmandrpodcast/id/2919974

Episode 4: Carpal Tunnel Syndrome 06/20/2014

Episode 4: Carpal Tunnel Syndrome We discuss carpal tunnel syndrome with Dr. Nigel Ashworth, a physiatrist on the faculty of the University of Alberta in Canada. Dr. Ashworth has over thirty publications, among them original peer-reviewed research on carpal tunnel syndrome. Our conversation covers diagnostic (and electrodiagnostic) considerations and management strategies, including the evidence for bracing, corticosteroid injection and carpal tunnel release. /episode/index/show/pmandrpodcast/id/2900561

Episode 3: Congenital Lower Limb Deficiencies 06/16/2014

Episode 3: Congenital Lower Limb Deficiencies In our third episode, we interview Dr. Scott-Wyard on congenital lower limb deficiencies. Dr. Scott-Wyard, who completed her combined PM&R/pediatric residency at Cincinnati Children's Hospital Medical Center, is a pediatric physiatrist at Shriners Hospitals for Children in Los Angeles where she heads the Children's Amputee Prosthetics Project. /episode/index/show/pmandrpodcast/id/2893457

The PM&R Podcast

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