Background: Despite medical advancements for organic and structural diseases, effectively managing acute and chronic functional pain syndromes remains a daunting challenge for hospitalists. Standard inpatient treatments frequently fail to adequately control symptoms, often compelling hospitalists to shift from diagnostics to the contentious task of tapering opioids in patients with legitimate pain. This pivot can lead [...]

Background: Despite medical advancements for organic and structural diseases, effectively managing acute and chronic functional pain syndromes remains a daunting challenge for hospitalists. Standard inpatient treatments frequently fail to adequately control symptoms, often compelling hospitalists to shift from diagnostics to the contentious task of tapering opioids in patients with legitimate pain. This pivot can lead [...]

Case Presentation: A 31-year-old man with past medical history of secondary syphilis and HIV/AIDS (CD4 47) intermittently on ART presented with worsening rectal pain and recurrent rectal abscesses. He endorsed rectal pruritis, nausea, weight loss, and lower extremity pain. He denied fevers, night sweats, abdominal pain, or diarrhea. Last year, he had a prior rectal [...]

Case Presentation: An 89-year-old man with coronary artery disease, hypertension, and osteoarthritis presented with acute-onset severe posterior neck pain, with no viral prodrome. The patient reported experiencing generalized weakness and associated headache, but denied any fevers, chills, cough, myalgia, joint pain, ulcers or rashes. Additionally, he did not report any photophobia, phonophobia, changes in vision, [...]

Case Presentation: A 23-year-old man with cystic fibrosis presented to the Emergency Department with a two-day history of gradual, persistent, right sided abdominal pain associated with dark, tarry stools. He was afebrile with unremarkable vital signs. Exam was notable for generalized abdominal tenderness most noticeable in the right lower quadrant and a normal rectal exam. [...]

Case Presentation: A 12-year-old Caucasian male with no significant medical history presented with a 6-day history of bilateral leg pain following a soccer game. As an avid soccer player, he had experienced similar episodes over the past three years, managed previously as “growing pains” with NSAIDs and acetaminophen. However, this presentation raised concern for an [...]

Background: Pain is a frequent symptom in patients who require inpatient rehabilitation. For example, 40-50% of patients hospitalized for stroke rehabilitation report pain. Further, 82% of those hospitalized for postsurgical orthopedic rehabilitation complain of at least moderate pain, and among those hospitalized for rehabilitation after acute traumatic spinal cord injury, 97% report pain at least once [...]

Background: Pain remains a major concern for medically hospitalized adults, and pain treatment is a focus of hospital quality reporting and improvement efforts. Pharmacologic treatment during hospitalization for acute pain and cancer pain rest on some evidence, but as many as 1 in 3 adult medical inpatients suffer from chronic pain. Little is known about [...]

Background: Chest pain and related symptoms are the number two reason patients visit emergency departments in the United States, often leading to routine hospitalization or observation. Improving utilization management of patients presenting to the emergency department with chest pain is an important goal for hospitals. Use of 5th generation troponins and risk stratifying tools can [...]

Background: Prior studies have found Black and Hispanic patients are more likely to experience disparities in pain management. Fewer studies have evaluated pain control based on age, sex, body mass index (BMI), or presence of a substance use disorder (SUD). While factors influencing management of acute pain are complex, striving for adequate pain control remains [...]