I’m boarded in Preventive Medicine with my specialty in Occupational Medicine. I’m also a staff physician at our campus Wound Care Clinic. I’d say 90% of my practice involves muscle skeletal injuries. The Wound Care cases are chronic and sad. Many are diabetics or with peripheral limb disease. The pain is excruciating for them. Funny, buy I don’t see many of the truly in pain wound patients addicted to the pain meds.
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The above is from the board of preventive medicine website. Is it possible that your training is leading to an observer bias? I now understand your perspective. As for your diabetics and peripheral vascular patients probably suffer from neuropathic pain and certainly could benefit from analgesics specific to that which or course are non narcotic. However I think that perhaps your training has lead to certain black and white stsremrs rendered above for which there is considerable debate in the literature. Certainly the science is not as accepted as you would lead others to believe in any event.