Ethos Develops Biomarkers to Personalize Chronic Pain Relief

PainRelief.com Interview with:

Brian Kincaid
Chief Executive Officer of Ethos Laboratories

https://www.ethos-labs.com/

How can reducing healthcare costs be achieved by the identification and validation of biomarkers through diagnosis and treatment of chronic pain?

Response:  Medicine has been evolving over the past couple of decades with a shift to personalized or targeted medicine.  As technology has improved and equipment capabilities have increased, the ability to identify and measure biomarkers is more affordable and accessible than ever before. Physicians now have access to more information specific to each individual patient, and as a result, can personalize treatment for each patient. 

Chronic pain is a very difficult disease for physicians to treat. The majority of assessments used by the physician are subjective in nature and rely heavily on accurate information provided by the patient, which can lead to unnecessary treatments. By adding an objective measurement as part of the chronic pain assessment, unnecessary treatments can be avoided and targeted treatments can be pursued. By reducing the number of unnecessary treatments, not only does the cost of care for the patient go down, but the quality of the care is improved. 

Using objective biomarkers as part of the chronic pain assessment will also provide some information on the viability of prescribing opioids at that time. Opioids will not help improve a patient’s biochemistry, and in some cases, opioids can have a negative effect on biochemistry. By treating abnormal biochemistry with safe inexpensive options first, it may be possible to avoid long term opioid prescribing for some patients, which would eliminate the costs associated with opioids in that patient subset.

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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

Gene Responsible for Sensing Mechanical Pain Identified

PainRelief.com Interview with:
Reza Sharif Naeini, Ph.D.
Associate Professor
Department of Physiology & Cell Information Systems Group
McGill University
Life Sciences Complex (Bellini),
Montréal, Québec

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

Response: My lab is interested in understanding how our bodies detect signals from the environment, like our sense of touch and pain. This process is done by specialized sensors we have that detect mechanical stimuli, ranging from a hair deflecting under the wind, a gentle stroke, or a pinch. These sensors are called mechanosensitive ion channels and they convert mechanical forces into electrical signals that our nervous system can understand.

Their existence was first proposed in 1950 (to my knowledge) by Bernard Katz, and in 1999, researchers at the University of California in San Francisco, led by Dr. Jon Levine, demonstrated that pain-sensing neurons (termed nociceptors) express these channels. But their molecular identity remained elusive.

In 2010, the group of Dr. Ardem Patapoutian discovered the genes Piezo1 and Piezo2, with the latter being essential for our sense of touch and proprioception. While these findings were transformative to the field of somatosensation, mice lacking these genes were still able to respond to painful mechanical stimuli.

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What Drugs Are Prescribed for Chronic Musculoskeletal Pain Relief?

PainRelief.com Interview with:
Debbie Feldman
,, Ph.D.
Professeure titulaire/Full Professor
Faculté de médecine/Faculty of Medicine
École de réadaptation/School of Rehabilitation
Université de Montréal

Debbie Feldman,, Ph.D.
 Professeure titulaire/Full Professor
 Faculté de médecine/Faculty of Medicine
 École de réadaptation/School of Rehabilitation
 Université de Montréal
Dr. Feldman

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

Response: The goal was to explore clinical management of new cases of musculoskeletal conditions associated with chronic pain, at the population level. Few studies to date have addressed treatment at the population level and none explored initial management specifically. Furthermore, not much is known regarding patient and provider characteristics that are potentially associated with different treatment options (except for some information regarding prescription of opioids). Main findings are in the answer below.

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Adults 50+ More Likely to Misuse Opioids for Pain Relief

PainRelief.com Interview with:
Ty S. Schepis, Ph.D.

Associate Professor
Department of Psychology
Texas State University

 Ty S. Schepis, Ph.D.
 Associate Professor
 Department of Psychology
 Texas State University

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

Response: We were interested in examining the underlying reasons for prescription opioid misuse both across the population and in older adults specifically. Given that pain conditions and physical health limitations increase with aging, we wondered if different age groups would display different patterns of motives. Indeed, they did. Adults 50 and older were particularly likely to misuse opioid medication only for pain relief reasons (over 80%); in contrast, roughly 65% of young adults (18-25 years) endorsed only non-pain relief motives for misuse.

For older adults, opioid misuse involving any non-pain relief motives was associated with a greater rate of also having another substance use disorder and past-year suicidal thoughts.

Pain a Risk Factor for Frailty in Older Mexican Americans

PainRelief.com Interview with:
Jaspreet K. Sodhi, PT, MPT, MPH, PhD
Division of Rehabilitation Sciences
University of Texas Medical Branch
Galveston, TX

Jaspreet K. Sodhi, PT, MPT, MPH, PhD
Division of Rehabilitation Sciences
University of Texas Medical Branch
 Galveston, TX
Dr. Sodhi

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

Response: Little is known about the effect of pain and the long-term risk of becoming frail among older Mexican Americans, a population with high rates of frailty. The current study examined whether pain in older Mexican Americans is a risk factor for frailty among those who were non-frail at baseline.

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Self-Reported Prescription Drug Use for Pain Relief and Sleep Linked to Frailty.

PainRelief.com Interview with:
Andrew W Bergen, PhD
Senior Scientist
Oregon Research Institute
Eugene, OR 97403

Dr. Bergen

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

Response: The background to the study is examination of the incident frailty risks of two classes of prescription drugs commonly co-prescribed in response to pain and sleep indications.

The dataset consisted of N=7,201 non-frail, age 65+, community-living individuals from the Health and Retirement Study, a nationally representative longitudinal cohort interviewed every two years.

The drug exposure measures are based on responses to the two questions: “Do you regularly take prescription medications for any of the following common health problems:

For pain in your joints or muscles?” and “Do you regularly take prescription medications for any of the following common health problems: To help you sleep?”.

The outcome measure was the Burden Model of frailty using the conventional threshold of >0.2 for frailty.

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Which Adolescents Can Get Pain Relief from Cognitive-Behavioral Therapy?

PainRelief.com Interview with:
Caitlin Murray, PhD
Research Fellow
Center for Child Health, Behavior and Development
Seattle Children’s Research Institute

Caitlin Murray, PhD  Research Fellow  Center for Child Health, Behavior and Development  Seattle Children’s Research Institute
Dr. Murray

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

Response: We know that chronic pain is a significant problem among children and adolescents, and that cognitive-behavioral therapy (CBT) can be helpful. However, studies show that CBT doesn’t help every child or adolescent affected by chronic pain.

In this study, we explored what factors predicted adolescents’ response to internet-delivered CBT for chronic pain—that is, which factors made it more likely that adolescents would benefit from the CBT intervention. Our primary treatment outcome was pain-related disability, or the extent to which pain interfered with the adolescent’s daily activities.

We found that both adolescent age and parent emotional distress predicted treatment efficacy up to one year after treatment, such that adolescents who were younger and those whose parents expressed less distress were more likely to benefit from this form of cognitive-behavioral therapy.

Acupuncture for Chronic Musculoskeletal Pain Relief: A Review of Randomized Trial

PainRelief.com Interview with:
Chenchen Wang MD, MSc
Professor of Medicine
Tufts University School of Medicine
 Director, Center For Complementary And Integrative Medicine                                             
Division of Rheumatology
Tufts Medical Center, Boston, MA

Dr. Chenchen Wang
Dr. Chenchen Wang

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

Response: Chronic Musculoskeletal Pain is a complex disorder without effective treatment Acupuncture, originating in China more than 3,000 years ago, is one of the most popular sensory stimulation therapies. However, despite the fact that acupuncture is widely used for pain relief in a number of conditions including severe knee osteoarthritis, acute postoperative pain, musculoskeletal disorders, evidence of the effect of Chronic Musculoskeletal Pain relief is scarce.


Our study was to determine the efficacy of acupuncture for pain relief in this field.

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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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