Opioids Commonly Prescribed for Pain Relief from Osteoarthritis

PainRelief.com Interview with:

Dr. Jonas Bloch Thorlund  MSc, PhD
Professor of Musculoskeletal Health
Department of Sports Science and Clinical Biomechanics &
Research Unit for General Practice (Dept. of Public Health) 
Dr. Thorlund

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

Response: Opioids are commonly prescribed to patients with knee and hip osteoarthritis (OA). But for newly diagnosed patients’ clinical guidelines recommend exercise therapy, patient education and weight loss (if needed) as first line treatment. These treatments can be supplemented or replaced with biomechanical interventions (insoles, wedges, cane use, etc.), and paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) if needed. Generally, opioids are should only be used when other treatment options are exhausted, ineffective or contraindicated. Thus, treatment with opioids shortly after OA diagnosis is considered inappropriate according to guidelines.

CBD Oil for Pain Relief Can Increase Chance of Positive Cannabis Drug Test

PainRelief.com Interview with:

Tory R. Spindle, Ph.D
Postdoctoral Research Fellow
Behavioral Pharmacology Research Unit
Department of Psychiatry and Behavioral Sciences 
Johns Hopkins University School of Medicine

Dr. Spindle

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

Response: Cannabis and hemp products that contain CBD as the primary constituent have become widely available in the U.S. and are often used for various therapeutic purposes. However, there is presently little research to understand how such products could impact drug testing for cannabis which is commonly conducted in workplace, criminal justice, and other settings.

Drug testing for cannabis targets a common metabolite of THC called THCCOOH; THC is the primary psychoactive component of cannabis. Our results suggest that single use of a product that contains pure CBD would not produce a positive result on a standard urine drug test. However, we found that 2 of 6 participants tested positive for cannabis after they used a CBD-dominant strain of cannabis that contained a very low concentration of THC: only 0.39% THC.  

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Neck Pain: Deep Tissue Massage Can Offer Short Term Pain Relief

PainRelief.com Interview with:

Oscar Javier Pico-Espinosa | MD, MSc, PhD (c) Epidemiology
Karolinska Institutet

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

Response: Persistent neck pain is a common condition and one of the main causes of sick leave worldwide. Patients often utilize non-pharmacological therapies such as massage or exercises. However, the evidence supporting the effectiveness of such treatments is either lacking or conflicting. With that in mind, we designed the Stockholm Neck (STONE) trial, where we compared deep tissue massage, strengthening and stretching exercises and a combination of those two (up to six sessions over six weeks), versus advice (up to three sessions of advice to stay active).

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Pain Medication Beliefs Can Enhance (or Impair) Pain Relief

PainRelief.com Interview with:
Leon Timmerman, PhD
St Antonius Hospital, Department of Anesthesiology
Intensive Care and Pain Medicine
The Netherlands

Leon Timmerman, PhD St Antonius Hospital, Department of Anesthesiology Intensive Care and Pain Medicine The Netherlands
Dr. Timmerman

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

Response: Chronic pain is commonly treated with pain medication. However, the results of pharmacological treatment are often poor. One of the reasons might be that half of the patients do not use their medication as prescribed. Underuse as well as overuse are common and have been described to result in reduced treatment effect, health care risks and unnecessary treatment changes. The are many risks factors described for non-adherent behavior.

The way people think about their pain medication have been shown to be related to the way they use their medication. With this study, we confirmed this relation with a prospective study. Baseline beliefs about pain medication, measured by ‘Pain Medication Attitudes Questionnaire’,  were found to be related to underuse of pain medication, the occurrence of side effects and patient satisfaction after three months.  

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Off-Label Gabapentinoid Prescriptions for Cancer Pain Relief Double

PainRelief.com Interview with:
Alex Fauer, RN, OCN®
Ph.D. Candidate
University of Michigan School of Nursing

PainRelief.com Interview with: Alex Fauer, RN, OCN® Ph.D. Candidate University of Michigan School of Nursing

PainRelief.com:  What are the main findings?

Response: Our primary finding of the paper is that the age-, sex-, and US region-adjusted percentage of adults who used a gabapentinoid increased from 2.34% to 5.60% from 2005 to 2015. The total number of gabapentinoid prescriptions  filled  among  US  adults diagnosed with  cancer was  approximately  1.19  million in 2005, but increased to 3.52 million in 2015.

We also found that adults aged 18-44 were the highest users of gabapentinoids.

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Over-the-counter Medical Device Offers Promise for Long Term Chronic Pain Relief

Ian Rawe Ph.D
BioElectronic Corporation
Frederick, MD

http://www.bielcorp.com/products/actipatch/
ActiPatch

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

Response: The aim of this study was to investigate the long-term effectiveness of a neuromodulation medical device (ActiPatch®) in relieving chronic pain. The device is topically applied, paresthesia-free and uses high-frequency electromagnetic fields to mitigate nerve sensitization and provide pain relief. Identified as Pulsed Short Wave Therapy (PSWT), this technology is available over-the counter in many countries, including the US, Canada, EU and Australia.

While existing randomized, placebo controlled clinical trials demonstrated PSWT treatment effectiveness over several weeks, data on long-term effectiveness was unavailable. In this study, a sample of 240 chronic pain subjects, who reported clinically significant pain relief (reduction ≥ 2 VAS points) following a 7-day trial of the medical device, agreed to participate in a six-month study to investigate treatment durability. These subjects indicated an average chronic pain duration of 6.5 years, in multiple locations and from a wide spectrum of causes (etiologies). Moreover, these subjects reported that their existing pain management regimen (often multimodal therapy) provided inadequate relief, and that they experienced severe to moderate pain (≥ VAS of 8/10), daily.

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Non-Viral Gene Therapy Offers Hope for Pain Relief from Diabetic Neuropathy

PainRelief.com Interview with:  
Sheila Yi, Helixmith

PainRelief.com: What is the background for this study? Would you explain how VM202 is unique?

  • ResponseDiabetic peripheral neuropathy is one of the most common complications of diabetes and many of DPN patients suffer from severe pain that affects their daily activities and life quality. Though there are medications, both Rx and OTC drugs, used to ameliorate pains from diabetic peripheral neuropathy, many of them fall short of analgesic efficacy or often lead to not so trivial side effects. 
  • Engensis (VM202) is plasmid DNA therapy, non-viral gene therapy, which encodes hepatocyte growth factor (HGF) gene that is designed to simultaneously express two isoforms of HGF protein at high levels. HGF is known to have angiogenic and neurotrophic effects and, when expressed in the human body, induces formation of new micro vessels and nerve regeneration through remyelination and axon outgrowth, resulting in improvement in peripheral neuropathy condition. Engensis does not integrate into the human genome.
  • Historically, our research first focused on therapeutic angiogenesis of HGF with a proof of concept research in critical limb ischemia, an extreme form of peripheral artery disease. In the process, we realized that Engensis would also be effective for peripheral neuropathy, and a coffee chat with the current PI, Dr. Kessler of Northwestern University, led to an idea of using Engensis in neurological diseases.
  • Throughout Phase 1 through 3 clinical trials for DPN in the US, Engensis has been observed safe and well-tolerated in patients, and, during the Phase 3 study, received RMAT (regenerative medicine advanced therapy) designation from the FDA.
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Knee Osteoarthritis: Orthopedists Prescribing More NSAIDS and Less Lifestyle Management for Pain Relief

PainRelief.com Interview with:

Samannaaz Khoja, PT, PhD
Research Assistant Professor
Department of Physical Therapy
University of Pittsburgh School of Health and Rehabilitation Sciences

Samannaaz Khoja, PT, PhD Research Assistant Professor Department of Physical Therapy University of Pittsburgh School of Health and Rehabilitation Sciences
Dr. Khoja

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

ResponseThe purpose of this study was to describe and compare rates of physicians’ recommendation for physical therapy (PT), lifestyle-counseling, and pain medication for knee osteoarthritis (KOA) between 2007 and 2015. The study also aimed to identify patient, physician and practice-level factors associated with each treatment recommendation.   We used survey data from the National Ambulatory Medical Care Survey, data from this survey is publicly available and is housed within the CDC. We identified 2297 knee OA related visits, which approximated to 67 (±4) million weighted physician visits between 2007 and 2015 (around 8 million visits/year).

Do Psychological Approaches Offer Pain Relief to Hospitalized Patients?

PainRelief.com Interview with:
Dr.-Ing. Marcus Komann
IT-Coordinator
Jena University Hospital
Jena, Germany

Ing. Marcus Komann
 IT-Coordinator
 Jena University Hospital
 Jena, Germany

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

Response: A lot of non-pharmacological methods (like relaxation, cold packs, prayer and so on) for post-operative pain relief are used in today’s hospitals. There is also some literature out there on this topic. However, the literature mostly concerns single methods and very specific patient groups. Further, for most methods, the literature is not clear on the pain soothing effects.



We looked at a real-life registry to study the effects of a large number of such methods on a big sample of patients.

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Chronic Back Pain and Headache Often Occur in Same Patient

PainRelief.com Interview with:

Arani Vivekanantham, MBChB, MPhil
University of Warwick
University Hospitals Coventry and Warwickshire NHS Trust
Coventry, UK
Centre for Epidemiology Versus Arthritis
University of Manchester, Manchester, UK

ni Vivekanantham, MBChB, MPhil
 University of Warwick
 University Hospitals Coventry and Warwickshire NHS Trust
 Coventry, UK
 Centre for Epidemiology Versus Arthritis
 University of Manchester, Manchester, UK

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

Response: Around one in five people have persistent low back pain and one in thirty have chronic headaches. People with low back pain are usually managed by musculoskeletal services whilst those with headaches are typically treated by primary care doctors and neurologists. There may be particular challenges in treating people with both disorders because of the risk of medication overuse headache in people taking regular pain killers for back pain.

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