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Interdisciplinary Pain Medicine Rotation (redirected from Interdisciplinary Pain Rotation)

Page history last edited by Dan Waldman 6 months, 2 weeks ago
UNM FAMILY MEDICINE RESIDENCY 
INTERDISCIPLINARY PAIN MEDICINE ROTATION INFORMATION

Location:  UNM Interdisciplinary Pain Clinic

Contact:  Brian Shelley, MD,  bshelley@salud.unm.edu

 

Schedule:

 

SUN

MON

TUE

WED

THU

FRI

SAT

AM

 

Continuity Clinic

Interdisciplinary Pain Medicine Clinic

(first Tuesday AM of the rotation is a self-study morning, please review articles/readings below) 

Interdisciplinary Pain Medicine Clinic

 

Interdisciplinary Pain Medicine Clinic

Interdisciplinary Pain Medicine Clinic

 

 

PM

 

Continuity Clinic

Continuity Clinic

Resident School

Continuity Clinic

Interdisciplinary Pain Medicine Clinic(1st/3rd Friday of the block) and Continuity Clinic (2nd/4th Friday of the block)

 

 

 

 

A word from  Dr. Shelley

Welcome to the chronic pain rotation! We are delighted that you will spend time with us learning about chronic pain. The Pain Consultation and Treatment Center is a multidisciplinary pain clinic utilizing an interdisciplinary approach to the treatment of chronic pain.  While there has been an interventional pain clinic at UNM for some time, we have never truly had an interdisciplinary pain clinic; a clinic that truly incorporates individuals from multiple disciplines to evaluate and treat patients with chronic pain. The pain team consists of an interventional pain physician, an addiction psychiatrist, pain psychologists, myofascial pain specialiss, a neurologist, chiropractors, a clinical pharmacist, a physical therapist, an internist, a physician assistant, and family medicine doctors. We are a consultative practice seeing predominantly patients with spine pain and headache disorders, but also very challenging neuropathic and muscular pain disorders.

 

Requirements:

 

You will have the opportunity to work with all of us during the rotation. Please see the schedule above.  We will expect you to attend all clinic sessions, didactic sessions, and conferences.  Other expectations are as follows:

 

  • Attend the Interdisciplinary Case Conference from 7:30-9:00 on the first, third and fifth Thursdays of every month.
  • Attend the “Spine Conference” @ 7:30-9:00 on the second and fourth Thursdays in the Clinical Neurosciences Conference Room (at the Pain Clinic).
  • Attend the ECHO Pain and Opioid Management  conference held weekly from 12:00-2:00 on Thursdays:
    • You may leave early in order to arrive at your PM clinic on time
    • You will be expected to present at least two cases of your choice at the conference during the month
  • Present a case at Quality Improvement Forum  (FM requirement)

 

The principle learning objectives for your experience are listed below. We will provide you with some basic, important pain articles at the beginning of the rotation. It is our hope that these will supplement your experience with us. 

 

Major Learning Objectives: 

At the end of the rotation, the resident will be expected to:

  1. Perform a detailed pain interview.
  2. Perform a focused pain examination with special attention to musculoskeletal and central and peripheral neurologic pathology.
  3. Describe basic pain physiology, nociception, and central/peripheral pain pathways.
  4. Interpret the SOAPP-R opiate risk assessment tool, the Brief Pain Inventory, GAD 7 and PHQ9.
  5. Perform a detailed evaluation of a patient with back pain.
  6. Perform a detailed evaluation of a patient with a headache disorder.
  7. Perform a mental status examination.
  8. Identify aberrant coping mechanisms exhibited by patients with pain.
  9. Describe the relationship of chronic pain to anxiety and depression.
  10. Describe non-pharmacologic, non-interventional approaches to patients with chronic pain:

               --acupuncture,

               --chiropractic

               --physical therapy

               --myofascial therapy

               --behavioral health modalities

  1. Define the basic pharmacology and role of non-opioid and opioid medications in the treatment of chronic pain:

          --True analgesics (NSAIDS, etc.)

               --Anti-depressants (TCAs and SNRIs)

               --Membrane Stabilizers (lidocaine, anti-epileptics, etc.)

               --Muscle relaxers

               --Topical Agents

               --Opioids

  1. Describe the indication for epidural steroid injections, facet injections, nerve blocks and spinal cord stimulators in the treatment of chronic pain.
  2. Describe the basic myofascial pain syndromes and perform trigger point injections.
  3. Perform a basic interpretation of plain films of the spine.
  4. Describe anatomic structures when viewing an MRI and differentiate between T1, T2 sequences.
  5. Describe the indications for an MRI of the spine.
  6. Identify opioid use disorder when encountering a patient with possible opioid misuse or abuse.
  7. Discuss the basic epidemiology of prescription opiate related death in the United States.
  8. Describe risk factors for opiate abuse and aberrant behaviors that may be associated with abuse of prescription opiates.
  9. Describe the New Mexico Board of Medicine guidelines for the treatment of chronic pain.
  10. Describe the schedules of Controlled Substances and understand the prescribing rules for each schedule of drugs.
  11. Describe the evaluation and treatment of: fibromyalgia, osteoarthritis, chronic low back pain, common chronic headache disorders, common neuropathic pain disorders and complex regional pain syndrome.
  12. Describe common potential drug-drug interactions with medications used to treat chronic pain.
  13. Describe the basic pharmacology, indications, potential drug-drug interactions of Suboxone (prescribed for chronic pain). 

 

Required Reading

periph neurop mayo.pdf

migraine.bmj.pdf

fibromyalgia.pdf

CRPS.bmj.pdf

Annal. LBP.guidelines.pdf

 

Other Resources

LUMBAR MRI INTERPRETATION PEARLS.pdf

 

We look forward to working with you in the Pain Consultation and Treatment Center and hope that your experience if both fruitful and enjoyable.

 

Brian M. Shelley MD

 

As always, please see Competency Based Rotation Goals

 

 

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