Author Archives: PainRelief.com

Opioid Epidemic for Pain Relief Has Waned But is Not Over

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PainRelief.com Interview with:
Mario Moric M.S.
Department of Anesthesiology
Rush University Medical
Center Department of Anesthesiology

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

  • Prescription Pain Medicine (PPM) abuse has become a national problem and is now consider an epidemic. In 2012, health care providers wrote 259 million prescriptions for opioid pain medication; enough for every American adult to have a bottle of opioids. 
  • With the recent public information campaign about the epidemic and the possible addictive nature of opioid prescription pain medications, the abuse rates have declined.  We examined data from the National Survey on Drug Use and Health (NSDUH) public data derived from a national survey. 
  • We have raw data (actual reported rates of PPM abuse, see attached image) and weighted data (corrected for the sampling design).  Looking at the raw data you can see that abuse rates for lifetime use (highest line), past year use (middle red line) and past month use (bottom green line) are all more or less stable until 1998 after which we saw huge increase. From 1998 to 2004 the lifetime use increased 186%, the past year use increased 193% and the past month use increased 183%.  Then the decrease, from 2009 to 2018 the lifetime use decreased 72%, the past year use decreased 90% and the past month use decreased 185%.
  • Using the weighted data, the past year use decreases 26% and was statistically significant, indicating a real world decrease in prescription pain medication abuse.
Prescription Pain Medicine
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COVID-19 Protein Provides Pain Relief, Opening Up Targets for Future Pain Treatments

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PainRelief.com Interview with:
Rajesh Khanna, PhD
Professor of Pharmacology, Anesthesiology and Neuroscience
University of Arizona 
Tucson, AZ 85724

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

Response: SARS-COV-2 infection can be spread by asymptomatic, presymptomatic, and symptomatic carriers. Transmission of SARS-CoV-2 by asymptomatic or presymptomatic individuals may account for half of the spread, which may be why the virus has been so difficult to contain. The data from our study shows that the Spike protein, the major surface antigen of SARS-CoV-2, is analgesic. Therefore, an explanation for the unabated spread may be that asymptomatic or presymptomatic individuals do not experience the pain and discomfort that act as early warning signs of infection.

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How Do Primary Care Physicians Handle Opioids For Patients Seeking Chronic Pain Relief?

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PainRelief.com Interview with:
Laura Militello
Unveil, LLC
Applied Decision Science, LLC

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

Response: Little is known about how primary care clinicians’ (PCC) approach chronic pain management in the current climate of rapidly changing guidelines and the growing body of research about risks and benefits of opioid therapy. When it comes to pain management, primary care clinicians (PCCs) find themselves in a somewhat unexpected role. Few conditions intersect with a range of specialties (i.e. mental health, orthopedics, endocrinology, etc.), disability, and aberrant behavior in the way that chronic pain does. PCCs find themselves in a position where they are asked to assess and diagnose sometimes vague and diffuse pain, and determine appropriate treatment often before the underlying cause of the pain is well-understood.

A recent cultural shift in the U.S. has created a situation in which a formerly default treatment, prescription opioid therapy, is no longer considered safe or appropriate for many patients with chronic pain. The addictive qualities and overall safety profile of opioid medications have come into sharp focus in recent years, leading to a push to reduce opioid use while also trying to achieve pain relief with little guidance for PCCs about how to manage this change in treatment plans. Others have documented the uneasiness many experience in managing patients with chronic pain. One participant in our study described the sense that opioid prescribing sometimes extends into unexpected and disconcerting territory in this way: “I never signed up to be an enforcer.” The complexity and moral uncertainty (6) associated with managing patients with chronic pain is an important backdrop for the findings from this study.

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Cognition in Adults Who Use Medical Marijuana for Chronic Pain Relief

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PainRelief.com Interview with:
Dr. Sharon R. Sznitman PhD and
Dr. Galit Weinstein, PhD
School of Public Health,
University of Haifa, Haifa, Israel

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

Response: Due to increased media attention related to the topic of medical cannabis and increasing public demand for the treatment, physicians often find themselves in situations where patients and caregivers request medical cannabis treatment. When this demand is from older patients, there is a dearth of studies of effectiveness and risk-benefit ratio as almost no studies have examined the potential therapeutic effects and potential risks of the treatment in this specific group. One of the main implications of cannabis use that researchers have grappled with is its long-term effect on cognitive function. It is well established that cannabis use has detrimental effects on the developing brain when consumed in early life, but detrimental effects of early-life cannabis use may not translate to use in older ages. Use of cannabis in old ages may have adverse effects on cognition but some evidence also exists showing beneficial effects.

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Mt. Sinai Study Identifies Lifestyle Changes That Provide Some Knee Pain Relief

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PainRelief.com Interview with:
Daniel A Charen MD
Leni and Peter May Department of Orthopaedic Surgery
Icahn School of Medicine at Mount Sinai, New York

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

Response: There is a well-established link between obesity and knee osteoarthritis, and recent research has implicated diabetes as a potential cause of cartilage degeneration. This study uses the National Health and Nutrition Examination Survey (NHANES) database to examine the association between knee pain and various metabolic factors.

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Are Invasive Procedures Effective for Chronic Pain Relief? A Systematic Review

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PainRelief.com Interview with:
Wayne B. Jonas, MD
Executive Director
Samueli Integrative Health Programs, H&S Ventures,
Alexandria, VA

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

Response: The search for non-drug approaches to chronic pain is a major recommendation in many recent guidelines for both pain management and reduction in the use of opioids. Surgical and invasive procedures are non-drug approaches often used for pain conditions like back pain and arthritis, so good evidence is needed to determine the safety and efficacy of these procedures. Properly done randomized, placebo-controlled trials are the best way (the gold standard) to get that evidence, so we did a thorough evaluation of such research, using standard systematic review and meta-analysis methods.

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Progress Made Toward Electronic Skin That Senses Pain, Temperature and Touch

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PainRelief.com Interview with:
Md. Ataur Rahman
Research Fellow
Functional Materials and Microsystems Research Group
School of Engineering
RMIT University
Melbourne, Victoria Australia

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

Response: The most prevalent and critical skin receptors relate to pressure, temperature, and pain – the Pacinian corpuscle, thermoreceptor, and nociceptor, respectively. All these receptors detect stimuli, measure levels of stimuli, and transmit signals to the brain triggering reactions. The characteristic features of such human sensory system are quite complex to be mimicked by existing electronics. Development of such electronics will be a big step leading towards smart prosthetics and human-like robotics.

PainRelief.com:  What are the main findings? What are some of the potential uses for this ‘skin’?

Response: While some existing technologies have used electrical signals to mimic the skin receptors, these new devices can react to real mechanical pressure, temperature, and pain, and deliver the right electronic response.

This electronic skin enable replacement of affected human skin regions, augment skin sensitivity for agile applications in defense and sports, and drive advancements in intelligent robotics.

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Orthopedic Surgeon Discusses iovera Cold Therapy For Pain Relief from Knee Osteoarthritis

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PainRelief.com Interview with:
Dr. Sean McMillan DO
Chief of Orthopedics and Director of Orthopedic Sports Medicine
Lourdes Medical Center of Burlington County, Burlington, NJ
Assistant Professor of Orthopedic Surgery at Rowan University –
School of Osteopathic Medicine

Dr. McMillan discusses the iovera° system which is used to provide pain relief from knee osteoarthritis, using extreme cold therapy.


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

Response: I see many patients dealing with osteoarthritis (OA) pain, many of whom need total knee replacements. In fact, OA is the most common joint disorder in the United States and one of the primary reasons people seek knee replacement surgery. iovera° is a non-opioid, nonpharmacologic treatment that can alleviate knee pain by delivering extreme cold therapy (cryoanalgesia) to a targeted nerve. The iovera° treatment uses the body’s natural response to cold to treat nerves and immediately reduce pain for patients dealing with OA and/or surgical pain from knee replacement procedures. One treatment with the iovera° system can provide pain relief for up to 90 days.

Unaddressed knee pain can have many consequences such as increased discomfort, reduced mobility, and irreversible damage. This non-opioid treatment helps to stave off pain both prior to surgery and for postsurgical pain when surgery becomes necessary, making for a smoother recovery process with limited opioid use.

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Genetic Differences Distinguish Episodic Versus Chronic Migraine and May Open New Avenues of Pain Relief

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PainRelief.com Interview with:
Aliya Yakubova MD
OpenLab “Gene and Cell Technologies”
Institute of Fundamental Medicine, Kazan Federal University
Kazan, Russia

Dr. Yakubova

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

Response: Migraine is a common debilitating primary headache disorder with strong socio-economic effects. According to some estimates, migraine is the most costly neurological disease: for example, in the European Union, it costs more than 27 billion euros a year.

In this regard, chronic type of migraine (with more than 15 attacks per month for more than three months) is of special interest. Because of high prevalence and the burden of attacks, it is of great importance to improve diagnostic tools for patient stratification and choosing appropriate treatment strategies of migraine. For this purpose we investigated contribution of transient receptor potential vanilloid type 1 (TRPV1) receptors to migraine chronification. It is known that these receptors are directly involved in the disease pathogenesis being associated with the release of the key migraine pain mediator, the calcitonin gene – related peptide (CGRP). Moreover, recent studies have suggested that the non-synonymous TRPV1 single-nucleotide polymorphism (SNP) 1911A> G (rs8065080), resulting to the substitution of amino acids isoleucine to valine in the protein structure of receptor (Ile585Val), influences functional activity of these receptors in neuropathic pain syndromes. All this together was the starting point of our research in collaboration with colleagues from the University of Eastern Finland.

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Inadequate Pain Control After Spine Surgery is Common

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PainRelief.com Interview with:
Michael M. H. Yang MD, MSc
Departments of Clinical Neurosciences, Section of Neurosurgery, 
Community Health Sciences
Icahn School of Medicine at Mount Sinai
New York, New York

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

Response: Spine surgery has been ranked as one of the most painful surgical procedures. Patients who experience poor pain control have delayed recovery, take more opioids, and stay in the hospital longer. The objective of our study was to determine patient and surgical factors that increased the chance for poorly controlled pain after spine surgery. These risk factors were incorporated into a score that can be used to determine the likelihood of a poor patient pain experience.

PainRelief.com: What are the main findings?

Response: Overall, 57% of patients experienced poorly controlled pain after their spinal operation in our study. We found 7 risk factors for poor pain control: younger age, female sex, daily use of opioid medication, higher neck or back pain intensity, higher depression score, surgery involving 3 or more levels, and fusion surgery. These risk factors were used to create the Calgary Postoperative Pain After Spine Surgery (CAPPS) Score. Patients identified as low-, high-, and extreme-risk by the CAPPS score had 32%, 63%, and 85% chance of experiencing poorly controlled pain, respectively.

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