Chronic pain symptoms can be quite different from acute pain symptoms.1 One possible reason is sensitization, a process whereby neurons become more responsive to pain signals and/or translate non-painful stimuli into pain. Part 1 of this series described general neuro-adaptive processes leading to sensitization and clinical diagnostic criteria. Here in Part 2, management strategies for persons with sensitization are described.
Practitioners use symptoms to guide clinical evaluation and treatment. For example, chest pain on exertion suggests possible need for cardiac evaluation. Pain is a symptom we are trained to explore by asking questions such as, “How severe is your pain?” and “Where is the pain located?” We ask these questions because the answers help point us in the direction of a diagnosis. However, pain symptoms are sometimes unreliable. For people experiencing chronic pain, symptom characteristics may not match patterns found in acute cases. The physiological basis for this alternate pain experience can be the result of peripheral or central sensitization.
The American Medical Association (AMA) announced in September the release of the 2020 Current Procedural Terminology (CPT) code set featuring 248 new codes, including two that focus on dry needling. The newly developed codes for dry needling will be available for use by any qualified healthcare professional beginning Jan. 1, 2020.
The president is expected to sign the massive legislation.
As the second session of the 115th Congress nears the election, members of the House of Representatives and the Senate recently agreed on a comprehensive legislative package to help end the scourge of opioid addiction. The opioid issue, which federal and local legislatures across the country have been grappling with for several years, will soon see more federal dollars being focused on ways to help alleviate the destructive force associated with the addiction.