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

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.

Voltaren® Arthritis Pain Provided Meaningful Pain Relief in Knee Osteoarthritis

PainRelief.com Interview with:

Jeffrey Fudin, B.S., Pharm.D., FCCP, FASHP
Diplomate, American Academy of Pain Management
Section Editor, Pain Medicine

Dr. Fudin

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

Response: Osteoarthritis (OA) affects over 14% of the United States population. As such it is important to establish effective, well-tolerated, and safe medication options. Topical nonsteroidal anti-inflammatory drugs (NSAIDs) act locally and are strongly recommended for patients with knee osteoarthritis as a first line option prior to chronic oral NSAID use in an effort to minimize systemic exposure, as oral products, result in tremendously higher blood levels compared to their topical counterpart.

PainRelief.com: What are the main findings?

Response: Diclofenac sodium gel 1% (DSG 1%), a topical NSAID, provided better pain relief than non-drug vehicle alone for patients with knee osteoarthritis in 3 clinical trials. A post-hoc meta-analysis of these trials was conducted to determine the percentage of patients achieving a minimal clinically important improvement (MCII) in pain and other symptoms of OA to gain insight into the real world clinical impact of topical diclofenac for patients. The MCII is defined as the smallest improvement in symptoms viewed as clinically meaningful for patients. In short, the MCII represents an improvement of relevance in a clinical trial and the minimal meaningful change at an individual level.

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Newly Discovered Molecule Causes Pain Relief and Cartilage Healing in Osteoarthritis

PainRelief.com 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

PainRelief.com:  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.  

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Study Finds Tumeric Had Moderate Pain Relief Effect on Knee Osteoarthritis

PainRelief.com 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 https://onlinelibrary.wiley.com/journal/1756185x 

UTAS- Menzies Institute for Medical Research Benny Antony –  18/07/2017 Hobart Tasmania  photography  - Peter Mathew
Dr. Antony

PainRelief.com:  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 of Daily CBD for Pain Relief of Canine Osteoarthritis

PainRelief.com Interview with:
Matthew Halpert, Ph.D., B.S
Baylor College of Medicine

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

Response: The background will actually encompass my disclosure.  A little over a year ago, Medterra was one of a couple of CBD companies that approached me about conducting some small scale studies focused on CBD and its anti-inflammatory properties.  It became very obvious, very quickly that some (most) companies were not interested in actual science or data, but rather just wanted to try and increase their CBD-fad based revenue by using my name and affiliations. Medterra proved to be very different and genuinely wanted legitimate data and science to support and direct products, innovations, stories etc.  I always warned them that the ‘data will be the data’ and they agreed to live by that….even if the data wasn’t as supportive as they may have hoped.  Being a true academic researcher, I found this to be more than acceptable and Medterra and Baylor College of Medicine entered into a Sponsored Research Agreement (SRA) in which Medterra provides product and money for research, and my lab performs the research and reports back the data.

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Individualized Footwear Provided Pain Relief in Patients with Knee Osteoarthritis

PainRelief.com Interview with:
Peter Jüni, MD, FESC

Director, Applied Health Research Centre (AHRC)
Li Ka Shing Knowledge Institute of St. Michael’s Hospital
Canada Research Chair in Clinical Epidemiology of Chronic Diseases
Professor, Department of Medicine & 
Institute of Health Policy, Management and Evaluation 
University of Toronto

Dr-Peter Jüni
Dr. Peter Jüni

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

Response: Biomechanics plays an important role in the development of osteoarthritis of the knee. We did a 24-week randomized clinical trial of a novel individualized biomechanical footwear system.

The shoes have 2 convex pods on the outsoles that can be individually calibrated and may alter the biomechanics of the lower limb. The shoes should be used daily for progressively increasing amounts of time.

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Osteoarthritis: Review of Medications for Long Term Pain Control

PainRelief.com Interview with:
Dr. RovatiLucio Rovati, M.D.
Department of Medicine and Surgery
UNIVERSITY OF MILANO – BICOCCA
School of Medicine
Monza – Italy

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

Response: This is the first meta-analysis in osteoarthritis (OA) that takes into account only long-term (defined as at least 12-month duration) clinical trials. In addition, this is a network meta-analysis, i.e. we could take into account virtually all available medications and all experimental pharmacological treatments with published studies.

Analysis of long-term data is particularly important because OA is a chronic and progressive disease, but most medications are studied mainly for their short-term effects, i.e. mostly up to 3-6 months only. This creates troubles when physicians have to perform a chronic management of their patients. Continue reading

Knee Osteoarthritis: Physical Therapy vs Steroid Injection for Pain Relief

MedicalResearch.com Interview with:
Dr. Gail Deyle, PT, DSc, DPT, OCS, FAAOMPT
Professor with Baylor University Graduate School 

Dr. Gail Deyle, PT, DSc, DPT, OCS, FAAOMPT
Professor with Baylor University Graduate School

Study authors in addition to Gail Deyle are Chris Allen, Stephen Allison, Norman Gill, Benjamin
Hando, Evan Petersen, Douglas Dusenberry, and Daniel Rhon

Summary:

Physical therapy is superior to glucocorticoid (steroid) injections for stiff and aching knees says Dr Gail Deyle, a physical therapist specializing in orthopaedics and manual physical therapy. A study recently published in the New England Journal of Medicine directly compared physical therapy with glucocorticoid injections to determine which was better primarily at one year but also in the short term.

The research was a collaborative effort of providers from physical therapy, orthopaedics, and
rheumatology at two Army Medical Centers. Dr Deyle, who is a professor with Baylor University Graduate School, and the senior author of the study, states, our results leave no doubt that physical therapy should be strongly considered for patients with knee osteoarthritis. They will clearly benefit from a physical therapist’s hands-on treatment and decision making for exercise and activity selection.

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Knee Pain Relief by Emoblization of Joint Synovial Tissue

PainRelief.com Interview with:

Ari J. Isaacson MD
Director of Clinical Research
Clinical Associate Professor, Vascular Interventional Radiology
University of North Carolina

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

Response: The current treatments for pain due to osteoarthritis of the knee that does not respond to medication or physical therapy  include knee injections and knee replacement. However, some people are too young or unable to undergo knee replacement. Knee injections are often ineffective and need to repeated every few months. There is a need for a treatment option that can reliably relieve knee pain for a year or longer in patients who are not ready or able to undergo knee replacement.

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.