Study Finds Chronic Pain Patients Used More Opioids For Pain Relief When COVID-19 Cancelled Elective Procedures Interview with:

Dr. Shantha Ganesan MD
 Pain Medicine Specialist
Kings County Hospital Center

David Kim, MD, PGY-2
SUNY Downstate Department of Anesthesiology  What is the background for this study?  What are the main findings?

Response: The opioid epidemic is a serious national crisis that has detrimental impacts on both public health, and social and economic welfare. Therefore, any efforts to combat the opioid epidemic, including minimizing or weaning opioid prescriptions, and using other modes of analgesia when possible are undeniably necessary in this day and age. With the onset of Covid-19 pandemic, healthcare providers abruptly changed their care delivery. In-person clinic visits were changed to telemedicine, and elective cases were cancelled.

Due to a growing concern that chronic pain patients may have limited resources from this unprecedented time of social and economic shutdown, organizations such as American Medical Association and Drug Enforcement Administration have supported implementing measures to ensure these patients achieve adequate pain control by increasing access to pain medications, but at the cost of reducing barriers and restrictions to controlled substances. Given the cancellation of elective interventional pain management procedures and relaxed regulations on controlled substances during the Covid-19 pandemic, it is reasonable to suspect a dramatic increase in opioid prescription during this time.

Continue reading

Factors Affecting Adults’ Choice of Opioids for Pain Relief Interview with:
Didem Bernard, Ph.D.
Senior Economist
Agency for Healthcare Research and Quality  What is the background for this study?  What are the main findings?

Response: There had not been any studies on whether patient attitudes about health affect opioid use. A self-reliant health attitude is agreement with the following statements: “I do not need health insurance,” and “I can overcome illness without help from a medically trained person.”

We find that health-related attitudes affect both adults with and without chronic pain treatment similarly. Adults with self-reliant health attitudes are less likely to start and more likely to discontinue opioid use. Exercise is also associated with a higher probability of choosing no analgesic treatments over using opioids. Similarly, among adults who are using opioids for pain treatment, exercise is associated with a higher probability of discontinuing opioid use in the year following opioid initiation.

Telehealth Coaching Program Provided Pain Relief in Chronic Pain Patients Interview with:

Zachary D. Rethorn, PT, DPT
Board Certified Clinical Specialist in Orthopaedic Physical Therapy
Certified Health Coach
Faculty Development Resident
Doctor of Physical Therapy Division
Duke University School of Medicine
Zachary D. Rethorn,
Dr. Rethorn  What is the background for this study?  How was the coaching delivered?  What types of pain were included in the study?

Response: The background for this study is that care for folks with persistent pain is complex and requires care that addresses the whole person. In line with this, health coaching may be an effective avenue for promoting healthy behaviors and helping patients to identify their personal values and goals related to persistent pain management.

The coaching was delivered telephonically and a more complete intervention description can be found here:

Participants with persistent pain were included in the study. A complete demographic description can be found in Table 1.

Pain Relief from NSAIDS and COVID-19 Outcomes Interview with:
Anton Pottegård DMSc PhD

Professor (MScPharm, PhD, DMSc)
Clinical Pharmacology and Pharmacy, Department of Public Health
University of Southern Denmark
Head of Research, Hospital Pharmacy Funen
Odense University Hospital  What is the background for this study?

Response: Early in the COVID-19 pandemic, concerns were raised that use of the common painkiller ibuprofen – a so-called NSAID – to treat symptoms of COVID-19 might lead to more severe disease. This started with tweets from the French health minister and culminated with a warning issued by the WHO. This warning was later retracted, but naturally patients and physicians were concerned regarding the safety of ibuprofen. We therefore established a nationwide Danish collaboration between researchers and regulators and established a prospective cohort of all Danish patients that contracted COVID-19, including data on what prescription medicines they used. We used these data to evaluate whether users of ibuprofen or other NSAIDs on average had a more severe course of COVID-19 than those not using these drugs.

Continue reading

Newly Discovered Molecule Causes Pain Relief and Cartilage Healing in Osteoarthritis Interview with:
Prof Francesco Dell’Accio and
Dr Suzanne E Eldridge
Department of Experimental Medicine and Rheumatology
William Harvey Research Institute
Barts and The London, Queen Mary’s School of Medicine and Dentistry,
London  What is the background for this study?

Response: Our main research focus is osteoarthritis. Osteoarthritis is the most common form of arthritis, affecting 10-30% of the population over the age of 60, causing joint pain and disability for many. In osteoarthritis, the cartilage that covers the bones in the joints is destroyed. Therefore, the bones grind over each other, causing pain and disability. Joint replacement surgery is often carried out.  

Continue reading

Take Courage Coaching® Offers Patients Pain Management Education and Tools for Pain Relief Interview with:
Becky Curtis
Founder & CEO — CPMC NBC-HWC
Take Courage Coaching®  How did you become interested in pain control? 

Response: I did not become interested in pain control until pain controlled my life. After my rollover car accident in 2005, rehabilitation, and severe chronic pain, I went to a pain clinic and got training in the science of pain and started to learn tools that helped me make behavioral changes. I started to research on my own and collaborate with medical specialists and decided that most people with chronic pain need ongoing support, the tools to manage their pain, and accountability to make goals and stick to them.

Study Finds Tumeric Had Moderate Pain Relief Effect on Knee Osteoarthritis Interview with:
Dr Benny Antony MD,PhD Senior Research Fellow

National Health and Medical Research Council of Australia Fellow 
Menzies Institute for Medical Research
Unit Coordinator, Lecturer & Examiner, College of Health & Medicine
University of Tasmania
Associate Editor, International Journal of Rheumatic Diseases 

UTAS- Menzies Institute for Medical Research Benny Antony –  18/07/2017 Hobart Tasmania  photography  - Peter Mathew
Dr. Antony  What is the background for this study?  What are the main findings?

Response: Osteoarthritis is the most common joint disorder in adults around the world, with more than 300 million people suffering from the disease. Considering the increasing prevalence of the disease and lack of effective treatment strategies, there is an urgent need for effective and safe treatment. Curcuma longa, commonly known as Turmeric, is a popular anti-inflammatory medication. Previous studies in osteoarthritis have shown that various formulations of turmeric extracts are effective and safe for the treatment of osteoarthritis.

We decided to select an inflammatory-phenotype of knee osteoarthritis patients who might benefit from a safe, natural anti-inflammatory therapy and randomised them to placebo and treatment groups.

Over, 12 weeks we found that the Turmeric extract group had a greater reduction in knee pain compared to the placebo group. We also looked at the effect of the treatment on knee structural abnormalities, but we did not find any significant difference between the treatment and placebo groups.

Study Finds Millions of Adults Could Reduce Pain and Improve Physical Function with Exercise Interview with:
George A. Kelley, DA, FACSM
Professor & Director, Meta-Analytic Research Group
2019 WVU SPH Excellence in Graduate Teaching Recipient
School of Public Health
Department of Biostatistics
West Virginia University
Morgantown, WV 

George A. Kelley, DA, FACSM
Professor & Director, Meta-Analytic Research Group
2019 WVU SPH Excellence in Graduate Teaching Recipient
School of Public Health
Department of Biostatistics
West Virginia University
Morgantown, WV
Dr. Kelley  What is the background for this study?  What are the main findings?

Response: Given that arthritis effects 54.4 million US adults and more than 23 million have arthritis-attributable activity limitations and another 14.6 million report severe joint pain, we estimated the number of physically inactive US adults with arthritis who could improve their physical function and pain by exercising. Using data from our previously published meta-analytic study as well as published data from the Centers for Disease Control (CDC) and US Census Bureau, we found that overall, more than 4 million adults could improve their physical function and more than 2 million could improve their pain control by starting and maintaining a regular program of exercise, for example, walking briskly for 150 minutes per week, i.e., 5 days per week, 30 minutes per session. Current recommendations regarding physical activity and exercise in adults with arthritis can be found on the CDC Arthritis Program homepage:    

Continue reading

Study Compares Dry Needling Techniques for Relief from Heel Pain Interview with:
Dr. Pablo Herrero Gallego. PT, PhD.
Head of iPhysio Research Group.
Editor-in-Chief Journal of Invasive Techniques in Physical Therapy
Zaragoza, Spain  What is the background for this study?

Response: The background of this study is that there has been an increasing use of minimally invasive techniques in physiotherapy in the last years, that apparently leading to very good results in the clinical practice, but there are no studies comparing the effectiveness of different treatment modalities. In the case of this study, about plantar heel pain (PHP), many physiotherapists use dry needling (DN) or percutaneous needle electrolysis (PNE) to treat myofascial trigger points when conservative treatment fails. However, although some clinicians claim that PNE has a superior effect to DN because it adds a galvanic current to the mechanical stimuli with the needle, there is no evidence to support this. Because of it, we decided to conduct this first study comparing these two treatment options for PHP.

Contact Athletes Cope With Pain Better Interview with:
Claire Thornton, PhD
Northumbria University
Newcastle upon Tyne, UK

Dr. Thornton  What is the background for this study?  What are the main findings?

Response: There is evidence that high contact athletes (i.e. rugby players, martial artists) tolerate more pain and report pain as lees intense than other athletes. Being able to cope with pain is essential in risky, painful, collision-based sports, yet there is little research into the mechanisms behind intra-athlete differences in pain responses. Use of adaptive coping styles and/or being challenged may impact upon how an athlete performs while in pain.

We wanted to examine performance during pain among different athlete groups to try to understand how pain influences performance while manipulating challenge and threat states.

We split athletes into 3 groups: Experienced contact athletes [>3 years’ experience in the sport], novice contact athletes and non-contact athletes)