The degree and extent of bone loss is most closely related to cumulative corticosteroid dose. The most rapid rate of bone loss is during the first 3 to 6 months of therapy. All patients starting gluocorticoids at any dose with an anticipated duration of at least 3 months or longer should start calcium 1200-1500mg/day and vitamin D 800-1000 international units/day supplementation. These patients should also be counseled on smoking cessation and weight-bearing activities. Additionally, they should be assessed for fall risk, baseline height, and history of fragility fractures.
CHRONIC PAIN MANAGMENT
Chronic pain is "pain that extends beyond the expected period of healing. Chronic pain may be divided into "nociceptive" (caused by activation of nociceptors), and "neuropathic" (caused by damage to or malfunction of the nervous system). Nociceptive pain may be divided into "superficial somatic" and "deep", and deep pain into "deep somatic" and "visceral". Neuropathic pain is divided into "peripheral" (originating in the peripheral nervous system) and "central" (originiting in the brain or spinal cord). Pain management (also called pain medicine) is that branch of medicine employing an interdisciplinary approach to the relief of pain and improvement in the quality of life of those living with pain. The typical pain management team includes medical practitioners, clinical psychologists, physiotherapists, occupational therapists, and nurse practitioners. Acute pain usually resolves with the efforts of one practitioner; however, the management of chronic pain frequently requires the coordinated efforts of the treatment team. Conditions related to pain: Arthritis, Back pain, Cancer, Complex pain syndrome, Headache, Irritable Bowel Syndrome, Myofascial Pain Syndrome, Sciatica, Lumbar spinal stenosis and cervical spinal stenosis. Drugs may include non-opoids such as : Gabapentin, Pregabalin, Levetiracetam, Topiramate, Antidepressants, Local anesthetics, Acetaminophen (Paracetamol), NSAIDs and opoids. Surgery can be corrective to treat the cause such as spinal discectomy for spinal herniation of disc, laminectomy for spinal stenosis, lumbar fusion for unstable spine, microvacular decompression for trigeminal neuralgia or palliative such as Spinal cord stimulation and. Intrathecal delivery system.
Disclaimer: The entire contents of this website are based upon the opinions of Dr. Mercola, unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Mercola and his community. Dr. Mercola encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. If you are pregnant, nursing, taking medication, or have a medical condition, consult your health care professional before using products based on this content.