Stanford Pain Medicine

12/05/2025

Common Concerns About Antidepressants for Pain

Q: “Does this mean my pain is just in my head?”
A: No. Your pain is real. These medicines work because chronic pain involves the nervous system. Treating the nervous system directly can lower pain, even if the original injury has healed.

Q: “Will I get addicted?”
A: No. Antidepressants are not addictive. You don’t get cravings or need more and more to feel the same effect.

Q: “What if I don’t have depression?”
A: That’s completely fine. Many people take antidepressants only for pain relief. The doses and goals may be different than when treating depression.

Read more:

Learn how antidepressants like duloxetine and amitriptyline can help with nerve pain, fibromyalgia, and migraines—safe, effective, options

12/04/2025

Pain Throughout a Woman’s Lifespan

-Adolescence
Menstrual pain often begins around age 12 and, while common, can sometimes signal conditions like endometriosis, making early evaluation important to prevent long-term sensitization of the nervous system.

-Reproductive
Pain during fertility treatments, pregnancy, childbirth, and postpartum recovery is frequently under-treated, leaving many women to manage significant discomfort without adequate support.

-Midlife and Menopause
Hormonal changes in perimenopause and menopause can trigger hot flashes, sleep issues, joint pain, and painful in*******se, all of which deserve timely attention to maintain quality of life and independence.

Explore treatment strategies that can be tailored throughout each phase:

Understanding women’s pain from adolescence through menopause — and why it deserves attention

12/03/2025

Effective chronic pain care often requires a multidisciplinary approach. The “4 Ps” framework offers a simple way to remember the core components:

•Physical therapy
•Pharmacology
•Procedures
•Psychological support

Integrating all four can lead to more comprehensive and sustainable outcomes.

12/02/2025

Pain isn’t always visible. Belief still matters.

12/01/2025

“I hoped to be doing a mix of clinical work, research, and teaching at an academic medical center,” says Dr. Valerie Jackson of her past career ambitions. “This is what I’m doing now!”

Lacking an extensive background in pain management, Jackson pursued Stanford Pain’s Psychology Fellowship to advance her goals.

“Learning a lot about rare diseases as well as medical/pharmacological interventions was a steep learning curve,” she shares. “However, repeated exposure to complex cases taught me a breadth and depth of pain management knowledge that few pain psychology programs offer.”

Jackson says the interdisciplinary nature of the program at Stanford Pain Management Center is unique. Psychology is not an afterthought, nor just checking the box to say "psychosocial factors were considered."

“The pain psychology team is top-notch,” the UCSF associate clinical professor says. “My clinical and research supervisors were not only exceptional and available during my fellowship, but nearly a decade out, I am still in touch and collaborate and consult freely.”

11/26/2025

In this episode of Not Your Mother's Pelvic Floor podcast, Dr. Kristen MacKenzie dives into pelvic pain, the nervous system, and how our brain and body communicate with each other.

She and host Aliya Dhalla cover topics like:

• Why tests + scans can be normal, yet pain and dysfunction can still be present
• Dr. MacKenzie’s top tips to create safety within the nervous system and body to help manage persistent pelvic pain
• Why pelvic floor muscles can become "tight" and how this can contribute to chronic pelvic pain
• How Dr. MacKenzie talks about "body stuff" with her small kids

Listen: https://bit.ly/48jdTlb

The Not Your Mother's Pelvic Floor Podcast · Episode

11/25/2025

What’s ketamine’s potential in pain medicine, really? Join our 12/1 lecture, “Ketamine in Chronic Pain Management: Current Evidence and Future Directions,” with current fellow Dr. Sheri Wang to hear the science, safety info, and how this treatment works. https://bit.ly/40xpb2c

11/25/2025

New research using AI and MRI on the lower leg points to a simple takeaway: bigger calf muscles can push down harder at the ankle—think a stronger push when pointing your toes or pushing off when you walk. Extra fat inside the muscle doesn’t.

The study scanned both calves with a fat–water MRI and used a computer-vision model to measure muscle size and fat inside the muscle (intramuscular fat, or IMF). Then the team looked at age, BMI, s*x, and how hard people could press down with their foot.

Why it matters:
-Muscle health is key for mobility and independence.
-A fast, noninvasive way to track muscle size and quality could help clinics tailor rehab, study aging, and guide training—without hours of manual image analysis.

Caveats:
-These are links, not cause-and-effect.
-The group was adults 18–60 from one setting. More diverse, longer-term studies are needed.

Full paper: https://bit.ly/4i7uIUJ

11/21/2025

On the Pain Matters Podcast, Dr. Amber Borucki joins hosts Sudheer Potru and Zafeer Baber to discuss acetaminophen use during pregnancy and childhood. They highlight a major Swedish study that refutes links between acetaminophen and autism, and explore safe, effective strategies for managing pain in expectant mothers and children, emphasizing guidance from healthcare providers for proper dosing.

Podcast Episode · Pain Matters Podcast Network · 10/31/2025 · 35m

11/20/2025

Ketamine is a dissociative anesthetic with growing evidence for treating depression and chronic pain. In our upcoming lecture, “Ketamine in Chronic Pain Management: Current Evidence and Future Directions,” we’ll break down what the science shows and what it means for patients. Topics include:

-How ketamine was developed and discovered

-The different ways it can be given

-How it can help manage chronic pain

-Safety, side effects, and monitoring

Join us on December 1: https://bit.ly/40xpb2c

11/19/2025

All About the Sciatic Nerve
Did you know that the sciatic nerve is the largest nerve in your body? It begins in your lower back, travels through your buttocks, and runs down the back of each leg. It then branches into smaller nerves that reach your lower legs and feet. This nerve plays a big role in how you move and feel.

What Does the Sciatic Nerve Do?
The sciatic nerve helps control many of the muscles that let you bend your knee, move your lower leg, and move your foot and toes. These muscles are important for everyday activities like standing, walking, and running.

The sciatic nerve also carries sensation from much of the lower leg and foot. This includes feeling things like touch, pressure, or temperature. Other nerves, like the femoral nerve, help with sensation in the front and inner parts of the leg—so the sciatic nerve doesn’t do it all, but it does a lot.

What Happens When the Sciatic Nerve Gets Hurt?
Sometimes the sciatic nerve can get irritated or squeezed. This is called sciatica. It most often happens because of a herniated disc or narrowing of the spine, but injuries can cause it too.

When the sciatic nerve is affected, you might feel pain that starts in your lower back and travels down your leg. People often describe the pain as sharp, burning, or like an electric shock. You may also feel tingling, numbness, or weakness in your leg or foot, which can make walking or sitting uncomfortable.

Recognizing Symptoms of Sciatica
•Pain in the lower back that travels down the back of the leg

•Numbness or weakness in one leg

•Tingling in the leg or foot

•Trouble moving the leg or foot

•If these symptoms show up, it’s important to get medical advice. Early care can help manage symptoms and prevent longer-term issues.

Here are some ways to support your back and the nerves that run through it:
•Stay active: Gentle movement like walking, swimming, or cycling helps keep muscles strong and flexible.

•Stretch often: Stretching your lower back and hamstrings can reduce tension.

•Lift safely: Bend your knees, not your back, when picking up heavy objects.

•Use good posture: Sitting and standing with a straight, supported spine can prevent strain.

When to See a Doctor
•If you have ongoing pain, discomfort, or weakness in your legs, talk to a doctor. They can help find the cause and suggest treatments such as physical therapy or other options.
•Understanding and caring for your sciatic nerve can support your overall mobility and comfort.

Graphic shared by Dr. Abdullah Terkawi. Watch his full lecture here:
https://bit.ly/3JIYZfR

11/18/2025

How Sleep Changes as We Age—and What You Can Do About It

As we get older, it’s normal for sleep to change. You might notice that your sleep feels lighter, more broken up, or that you wake up earlier than you used to. It might even take longer to fall asleep. Older adults also spend less time in deep and REM sleep, which can make sleep feel less refreshing.

“These changes are a normal part of aging,” says Dr. Samsuk Kim. But sleep problems are also more common as we get older. Two of the most frequent issues are insomnia and sleep apnea.

Insomnia means having trouble falling asleep or staying asleep. It affects more than half of older adults and can contribute to physical health problems, emotional distress, and even more pain.

The good news is that insomnia is treatable. The most recommended approach is cognitive behavioral therapy for insomnia (CBT-I). Research in people with both chronic pain and insomnia has shown that CBT-I not only improves sleep but can also help reduce pain, says Dr. Samsuk Kim.

If sleep is a struggle for you, talking to your healthcare provider about CBT-I or other treatment options can make a big difference.