Did I Miss a Better Peripheral Neuropathy Treatment?

In March, I shared a case of a woman with diabetes-related peripheral neuropathy to highlight issues of pain management in primary care. To recap: Maria, age 68, had been experiencing burning pain sensations in her feet and ankles for the past 3 years. I decided to prescribe duloxetine, and I asked for and received feedback … Read more

Primary Care Tips for Common Ortho Problems

Knee and shoulder pain are common complaints for patients in the primary care office. But identifying the source of the pain can be complicated, and an accurate diagnosis of the underlying cause of discomfort is key to appropriate management — whether that involves simple home care options of ice and rest or a recommendation for … Read more

What’s the Most Likely Cause of This Man’s Severe Headaches?

A 35-year-old man comes to clinic for evaluation of new, severe headaches. He reports that these started 3 days ago. His headache is worse when he stands, and resolves when he lies down. Valsalva maneuver makes the headache much worse. The headaches are present in the occipital region. He has also noticed the onset of … Read more