Chronic Back and Knee Pain Relief: How Do Sham Procedures Compare to Surgery?

MedicalResearch.com Interview with:

Wayne B Jonas MD

Wayne B Jonas MD

H&S Ventures
Samueli Integrative Health Programs

MedicalResearch.com:  What is the background for this study?

Response: The findings of this study are based on a systematic review of 25 randomized clinical trials evaluating surgical type interventions (open surgeries, arthroscopic, endoscopic, laparoscopic, heart catheterization, radiofrequency, laser, and other interventions) for chronic back and knee pain. In each study, researchers had also performed sham procedures on a control group where they replicated the invasive procedure by omitting the step believed to be therapeutically necessary. The purpose of this it to determine how much of the effects are due to the placebo response.

Continue reading

Osteoarthritis: Poor Sleep Linked to More Pain

PainRelief.com Interview with:
Dr. Daniel Whibley PhD
Department of Physical Medicine and Rehabilitation
University of Michigan, Ann Arbor, Michigan
Epidemiology Group, School of Medicine, Medical Sciences and Nutrition
University of Aberdeen, Scotland, UK

PainRelief.com:  What is the background for this study?  What are the main findings?

Response: Older adults with osteoarthritis commonly report symptoms of pain, fatigue and poor sleep quality. Previous research has investigated how this symptoms are cross-sectionally and longitudinally associated with each other. However, no previous studies have investigated how the quality of a night’s sleep impacts on the next day’s course of pain and fatigue in this clinical population.

We found that poor sleep quality was associated with greater pain intensity and fatigue on awakening when compared to a good night’s sleep and that, over the course of the day, the effects were sustained. Although a night of better quality sleep was associated with less pain and fatigue on awakening,  these symptoms worsened more rapidly throughout the day, such that as the day progressed the effect of the previous night’s sleep became less and less important.

Continue reading

Painful Genital Condition in Women Linked to Tight Jeans, Hair Removal

PainRelief.com Interview with:

Bernard L Harlow, Ph.D.
Professor, Boston University School of Public Health
Adjunct Mayo Professor, University of Minnesota School of Public Health

Bernard L Harlow, Ph.D.
Professor, Boston University School of Public Health
Adjunct Mayo Professor, University of Minnesota School of Public Health

PainRelief.comWould you briefly explain what is meant by vulvodynia?

Response: Vulvodynia is a chronic pain condition characterized by debilitating vulvar discomfort due to burning pain or pain on contact that occurs in the absence of clinically visible pathological findings or other identifiable disorders. It is estimated to affect approximately 8% of women by the age of 40 based on our previous research.

PainRelief.com:  What is the background for this study?

Response: Little is known about this debilitating pain condition. However, previous studies suggest an association between urogynecological infections and vulvodynia. Given that personal hygienic behaviors, such as wearing tight fitting jeans or pants, and performing vaginal douching, increase the risk of gynecologic infections, we sought to determine whether these practices impact the risk of vulvodynia.

We studied approximately 200 women with and 200 women without clinically confirmed vulvodynia.

Who Teaches Faculty to Educate Medical Residents About Opioids for Chronic Pain?

PainRelief.com Interview with:

Payel Roy, MD
Section of General Internal Medicine
Department of Medicine
Boston University School of Medicine and Boston Medical Center
Boston, Massachusetts.

PainRelief.com:  What is the background for this study?  What are the main findings?

Response: Given the current opioid crisis, we know how important it is to educate physicians-in-training in safer opioid prescribing.  But we can’t educate them properly if their faculty mentors don’t feel comfortable prescribing opioids themselves.  Our study evaluated a program designed to improve faculty physicians’ comfort in prescribing opioids safely and teaching these practices to trainee physicians.  

We found that faculty development programs can improve their confidence in prescribing opioids safely and teaching their trainees about prescribing, however translating these attitudes into teaching practice remains a challenge.

Knee Osteoarthritis: NSAIDS Offer Short-Term Pain Relief

PainRelief.com Interview with:

Raveendhara R. Bannuru MD, PhD, FAGE

Raveendhara R. Bannuru MD, PhD, FAGE
Director, Center for Treatment Comparison and Integrative Analysis (CTCIA)
Deputy Director, Center for Complementary and Integrative Medicine (CCIM)
Asst Professor of Medicine, Tufts University School of Medicine
Asst Professor of Clinical & Translational Science
Sackler School of Graduate Biomedical Sciences
Division of Rheumatology, Tufts Medical Center
Boston, MA

Director, Center for Treatment Comparison and Integrative Analysis (CTCIA)
Deputy Director, Center for Complementary and Integrative Medicine (CCIM)
Asst Professor of Medicine, Tufts University School of Medicine
Asst Professor of Clinical & Translational Science
Sackler School of Graduate Biomedical Sciences
Division of Rheumatology, Tufts Medical Center
Boston, MA

PainRelief.com:  What is the background for this study?  What are the main findings?

Response: Though the higher rates of certain adverse events due to NSAIDs are well documented, we were curious about how soon these adverse events can begin to manifest. We were similarly interested in the efficacy trajectories of NSAIDs, because previous studies had conducted analyses of the last reported follow-up times for the drugs, but we noticed that many of the studies had only very short-term follow up ranging between 1-4 weeks which didn’t provide a more complete picture of the therapeutic effect over time.

The key findings of our study are that the widely used NSAIDs are very effective for short-term pain relief but their efficacy wanes over a period of 12 weeks. The adverse events though mild in nature start appearing within 4 weeks of treatment.

Continue reading

New IR Treatment for ‘Tennis Elbow’ Offers Pain Relief Without Surgery

PainRelief.com Interview with:
Yuji Okuno, MD, PhD
Founder of the Okuno Clinic
Japan 

PainRelief.com:  What is the background for this study?

Response: Tennis elbow, also known as lateral epicondylitis, is a painful condition that affects nearly 3 percent of U.S. adults and can result in chronic pain.

It stems from repetitive stress injuries to the tendons and muscles around the elbow that occur from common activities such as cooking, sports, and childcare. Many people end up going through invasive surgery to try and treat the pain, but it doesn’t always help.

We wanted to test a current method used in cancer treatments, known as transcatheter arterial embolization (TAE), to see if it could be effective in treating the pain that stems from lateral epicondylitis.

Our team conducted a prospective study in 52 patients with tennis elbow who did not find relief from other forms of treatment. The patients received TAE between March 2013 and October 2016 and were followed for up to four years after the treatment.

Continue reading

Many Patients Prescribed Medical Marijuana for Pain Relief, Use the Cannabis for Recreational Use

PainRelief.com Interview with:
Meghan Rabbitt Morean, Ph.D.

Assistant Professor of Psychology
Oberlin College
Adjunct Assistant Professor of Psychiatry
Department of Psychiatry 
Yale School of Medicine
New Haven, CT 04519

PainRelief.com:  What is the background for this study?

Response: Currently, medical marijuana is legal in 33 states and the District of Columbia and recreational marijuana is legal in 10 states and the District of Columbia (although it remains a Schedule I drug at the federal level).

Chronic pain is an approved condition for medical marijuana in all states in which medical marijuana is legal. However, there is concern that a sizeable percentage of medical marijuana patients also are using their medicine recreationally.

In the current study, we found that more than half (55.5%) of medical marijuana patients also reported using their medical marijuana for recreational purposes, which is similar to rates observed in a previous study.  

Continue reading

National Trends in Prescription Opioid Risk Reduction Practices

PainRelief.com Interview with:
Daniel P. Alford, MD, MPH
Professor of Medicine
Associate Dean, Continuing Medical Education
Director, Clinical Addiction Research and Education (CARE) Unit
Director, Safe and Competent Opioid Prescribing Education (SCOPE of Pain) Program
Boston University School of Medicine
Boston Medical Center, Boston MA 02118

PainRelief.com: What is the background for this study?

Response: Boston University School of Medicine’s Safe and Competent Opioid Prescribing Education (SCOPE of Pain) is the longest-running safer opioid prescribing educational program under the FDA’s opioid Risk Evaluation and Mitigation Strategy (REMS). 

This study analyzed clinicians’, who were registering to attend a SCOPE of Pain training, self-report of performing five opioid prescribing risk-mitigation practices with patients prescribed opioids for chronic pain including:

  1. Use of patient-prescriber agreements,

2) Informing patients about taking opioids exactly as prescribed,

3) Discussing safe opioid storage and disposal,

4) Discussing risks of opioid-associated respiratory depression and overdose, and

5) Monitoring for misuse including urine drug test and/or pill counts, prior to participating in the training.

Continue reading

Variety of Pain Relief Medications Reduced Opioid Usage in Trauma Patients

PainRelief.com Interview with:
Christine S. Cocanour, M.D., F.A.C.S., F.C.C.M.
Division of Trauma, Acute Care Surgery and Surgical Critical Care 
UC Davis Health

PainRelief.com:  What is the background for this study?

Response: Our critical care pharmacists (Duby, Hamrick and Lee) and surgeons (Cocanour, Beyer) wanted to decrease our use of opioids without compromising pain control in our trauma patients—especially those that were admitted to the ICU.  To help make more appropriate choices we put together an order set that was a multimodal approach to pain management. 

Continue reading

Opioid-Induced Constipation

Chronic Pain Patients: Opioid Induced Constipation a Serious Concern After Surgery

PainRelief.com Interview with:

Jonathan Jahr, MD, DABA, FASA

Dr. Jonathan Jahr is an anesthesiologist in Los Angeles, California and is affiliated with multiple hospitals in the area, including UCLA Medical Center and UCLA Medical Center-Santa Monica. He received his medical degree from New York Medical College and has been in practice for more than 20 years.

Dr-Jonathan-Jahr

PainRelief.com:  What is the background for this study?  Why is it important?

Response: I have worked in the hospital setting for the past 25 years and have conducted multiple studies on different opioid and non-opioid strategies for managing both chronic and acute pain. I also co-edited a textbook entitled Essence of Analgesia and Analgesics. My background and the research I’ve done sets the stage for newer pain management protocols that can provide patients with significant pain relief, and improved satisfaction and outcomes due to fewer or avoided opioid related side effects (ORADS) such as opioid-induced constipation (OIC).

Continue reading