Author Archives: PainRelief.com

Cannabis Components Terpenes Tested for Neuropathic Pain

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PainRelief.com Interview with:
John M. Streicher, PhD
Member of the Graduate Faculty
Professor, Neuroscience – GIDP
Professor, Pharmacology
College of Medicine, Tucson
University of Arizona

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

Response: Cannabis has many chemical components that have potential therapeutic benefits, however, the great majority of research to date has focused on the major cannabinoids THC and CBD. In the past, different groups have tested the pharmacological effects of terpenes, which are small aromatic compounds in Cannabis and other plants that impart taste and aroma. They found pain relieving and anti-inflammatory effects, in both pre-clinical and clinical studies. However, those studies mostly did not test the therapeutic aspects of terpenes like side effects and dosing routes, and the mechanism of action in pain is also mostly unclear.

We thus began our studies by comprehensively testing a set of 5 terpenes for their pharmacological and therapeutic effects. In 2021, we published a paper showing the terpenes had cannabinoid-like behavioral effects, and also worked through the Cannabinoid Receptor 1 and the Adenosine A2a Receptor to carry out these effects. We also found that they had stronger effects when combined with a cannabinoid.

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Study Finds Women Who Had Epidural Had Lower Risk of Severe Maternal Complications

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PainRelief.com Interview with
Prof. Rachel Kearns
Consultant Anaesthetist, Glasgow Royal Infirmary
Honorary Professor, University of Glasgow
Senior NRS Fellow

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

Response: This was an observational study which looked at health data from over half a million mothers giving birth in Scotland. We compared women who had received an epidural in labour with those who had not and found that women who had an epidural had a lower risk of severe maternal morbidity (severe health complications during childbirth or the 6 weeks following birth).  

We found that women with a higher underlying risk for having complications, for example women delivering a baby pre-term or women with pre-existing health conditions, had an even greater reduction in risk.

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Study Finds Liposomal Bupivacaine Alone Not Sufficient to Control Pain During Surgery

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PainRelief.com Interview with:
Professor Peter Marhofer, MD
Director of Paediatric Anaesthesia
Senior Researcher Paediatric and Regional Anaesthesia
Medical University of Vienna
Department of Anaesthesia, Intensive Care Medicine and Pain Medicine
Vienna, Austria

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

Response: One of the major limitations in the use of local anaesthetics is their limited duration of action. In recent years, liposomal formulations with prolonged release kinetics have been developed with the idea to control the sensation of pain not only during but also after surgery and thus achieving an opioid-sparing effect. In this context “liposomal” means that the active ingredient is encapsulated in vesicles called liposomes, which should enable a slower release over a longer period of time. In our study we included 25 healthy volunteers. The study participants were randomly assigned to receive two nerve blocks with bupivacaine for pain control, one in the conventional and one in the liposomal form.

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NEJM: Despite Removal of DEA Waiver Requirement, Buprenorphine Still Widely Underprescribed for Opioid Addiction

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PainRelief.com Interview with:
Kao-Ping Chua, MD, PhD|
Susan B. Meister Child Health Evaluation and Research Center
Department of Pediatrics, University of Michigan Medical School
Ann Arbor MI 48109

Kao-Ping-Chua

PainRelief.com: What is the background for this study?
Response: Buprenorphine is one of 3 FDA-approved medications to treat opioid addiction. It is the only one of the 3 that can be prescribed during office visits. Although buprenorphine is highly effective in treating opioid addiction, it is widely underused. Addressing this underuse is a key step towards slowing the epidemic of U.S. opioid overdose deaths.

In 2000, the federal government allowed clinicians to prescribe buprenorphine if they obtained a waiver from the Drug Enforcement Administration. Clinicians have cited the waiver requirement as a key barrier to buprenorphine prescribing. In part because of this, the government eliminated this requirement on January 12, 2023.

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Acid Suppressing Drugs Associated with Increased Risk of Migraine

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PainRelief.com Interview with:
Margaret Slavin, PhD, RDN
Associate Professor
Department of Nutrition and Food Science
University of Maryland
College Park, MD 20742

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

Response: Headache is a common side effect for a lot of drugs, but there have been a few studies recently in the U.K., Taiwan, and the U.S. suggesting that proton pump inhibitors (the most common acid suppressing drugs) might be associated more specifically with migraine. We used a different data source from the U.S. National Health and Nutrition Examination Survey to further explore this topic, and to ask about other classes of acid suppressing drugs

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Cincinnati Children’s Hospital Study Addresses How Early Life Surgery Can Influence Later Responses to Pain

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PainRelief.com Interview with:
Michael P. Jankowski, PhD
Theodore W. Striker, MD Chair in Anesthesia Research
Professor and Director of Research
Department of Anesthesia, Division of Pain Management
Cincinnati Children’s Hospital Medical Center

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

Response: It is estimated that chronic pain can affect up to 20% of children undergoing surgery.  We know that alterations in sensory input during critical periods of development can have lasting effects on normal sensory processing later in life.  The developing peripheral nervous system undergoes substantial changes in function during the neonatal period as it receives information from the external environment.  Injuries, including surgery, that occur during this early developmental window can change the way a patient responds to re-injury in adolescence and young adulthood, a phenomenon called neonatal nociceptive priming. 

         At the same neonatal time, the immune system is also developing and responding to changes in the body.  Surgery is known to cause an immune response that is normally activated to facilitate wound healing and regulate acute pain so that the tissues can undergo proper repair after damage.  However, it was not clear how early life surgery could affect the developing immune system to influence pain responses later in life. 

         Since we knew that one particular type of immune cell, the macrophage (which regulates inflammation and tissue repair in addition to acute pain), can play a role in long term responses to surgery, we investigated how this cell type may play a role in the transition from acute post-surgical pain in neonates to prolonged responses to reinjury later in adolescence. 

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UCSD Study Evaluates Self-Treatment with Cannabis for Migraine

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PainRelief.com Interview with:

Nathaniel M. Schuster, MD
Pain and Headache Neurologist
Associate Professor
Center for Pain Medicine
Department of Anesthesiology
UC San Diego Health

Schuster, Nathaniel, MD, Pain Medecine

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

Response: Many Americans self-treat migraine with cannabis. It is one of the most common reasons Americans use medicinal cannabis.

PainRelief.com: What are the main findings?

Response: The main finding is that 4 puffs of THC 6%+CBD 11% was effective for migraine pain relief, pain freedom, and most bothersome symptom freedom at 2 hours. 

THC 6% without CBD provided pain relief but not pain freedom or most bothersome symptom freedom and performed less-well than THC+CBD at numerous outcomes.

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Annals of IM: Both Resistance Training and Neuromuscular Exercise Improved Function and Pain in Hip Osteoarthritis

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PainRelief.com Interview with:
Troels Kjeldsen
PhD Student, MSc
Department of Orthopedic Surgery, Aarhus University Hospital
Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Indgang J, J501 
Department of Clinical Medicine, Aarhus University
The Research Unit PROgrez,
Department of Physiotherapy and Occupational Therapy
Næstved-Slagelse-Ringsted Hospitals

Troels-Kjeldsen

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

Response: Hip osteoarthritis (OA) is a very common degenerative joint disease that results in hip pain and impaired physical function among other consequences for the individual.

Systematic reviews of randomized controlled trials of exercise and hip OA have established that exercise is an effective conservative treatment option for reducing pain and improving physical function. In most clinical guidelines, exercise is the recommended first line treatment in combination with patient education and a weight loss intervention if necessary.

However, we know very little about which types of exercise are most effective and there is currently not an evidence basis on which doctors and physiotherapists can make recommendations of one type of exercise over another type.

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Empathetic Care By Physicians Provides Better Pain Relief Than Most Other Modalities

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PainRelief.com Interview with:
John C. Licciardone, DO, MS, MBA, FACPM
Regents Professor and Richards-Cohen Distinguished Chair in Clinical Research
Department of Family Medicine, MET-568
University of North Texas Health Science Center
Fort Worth, TX 76107

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

Response: The Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation focuses on the patient-physician relationship and its association with chronic pain treatment and outcomes.

Previous studies involving physician empathy often have been limited to pain clinics and involved short-term follow-up. Our study aimed to study the impact of physician empathy on outcomes among patients with chronic low back pain in community settings throughout the United States over 12 months of follow-up.

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Adolescents View Overwhelming Lack of Empathy for Popular TV Characters Experiencing Pain

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PainRelief.com Interview with:
Melanie Noel, PhD, RPsych
Professor of Clinical Psychology
University of Calgary
Full Member of the Alberta Children’s Hospital Research Institute and
Hotchkiss Brain Institute
Director, Alberta Children’s Pain Research Lab
at the Vi Riddell Pain & Rehabilitation Centre
Alberta Children’s Hospital in Canada.

PainRelief.com: What are the main findings of the study?

Response: We examined 10 movies and the first seasons of 6 TV Netflix shows based on popularity among adolescents.  

Across the 616 scenes showing painful events, the majority showed violence and injuries and not the kinds of pain kids experience in real life (e.g., medical procedures, chronic pain. Characters from marginalized (gender diverse, girls) and minoritized groups (individuals with racialized identities) were underrepresented.

Overall, there was an overwhelming LACK of empathy shown to characters observing others in pain. The media perpetuated gender and racialized stereotypes.

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