Chronic Pain the Most Common Reason People Use Medical Cannabis

PainRelief.com Interview with:

cannabis wikipedia image

Kevin Boehnke, Ph.D. Research investigator
Department of Anesthesiology and the Chronic Pain and Fatigue Research Center
University of Michigan

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

Response: Medical cannabis is legal in 33 states, and people can obtain medical cannabis licenses to treat a wide swath of conditions, including cancer, anxiety, irritable bowel syndrome, chronic pain, complications of Alzheimer’s disease, and nausea. Many observational surveys have found that many people use cannabis for chronic pain, but whether these surveys were representative of national trends was uncertain. To our knowledge, this was the first study that examined nationwide trends of patient-reported qualifying conditions based on medical cannabis state registries.

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Study Shows Difficulty of Modifying Course of Chronic Pain

PainRelief.com Interview with:

Dr. Enric Aragonès, MD PhD
Family Physician. Catalan Health Institute and IDIAP Jordi Gol
Barcelona

Dr. Enric Aragonès, MD PhD
Family Physician. Catalan Health Institute and
IDIAP Jordi Gol
Barcelona

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

Response: Our team follows a line of research in the development, evaluation and implementation of new models of collaborative care to improve the management and outcomes of depression in primary care in Spain. Taking into account the close epidemiological, physiopathological and clinical relationships between depression and chronic pain, we designed a multicomponent care model at the integrated management of this comorbidity: the DROP (DepRession and Pain) program.

In the present RCT, our results show some effect in the improvement of depressive symptoms but, contrary to hypothesis, we have not demonstrated its efficacy in the evolution of chronic pain.

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New IR Treatment for ‘Tennis Elbow’ Offers Pain Relief Without Surgery

PainRelief.com Interview with:
Yuji Okuno, MD, PhD
Founder of the Okuno Clinic
Japan 

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

Response: Tennis elbow, also known as lateral epicondylitis, is a painful condition that affects nearly 3 percent of U.S. adults and can result in chronic pain.

It stems from repetitive stress injuries to the tendons and muscles around the elbow that occur from common activities such as cooking, sports, and childcare. Many people end up going through invasive surgery to try and treat the pain, but it doesn’t always help.

We wanted to test a current method used in cancer treatments, known as transcatheter arterial embolization (TAE), to see if it could be effective in treating the pain that stems from lateral epicondylitis.

Our team conducted a prospective study in 52 patients with tennis elbow who did not find relief from other forms of treatment. The patients received TAE between March 2013 and October 2016 and were followed for up to four years after the treatment.

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Many Patients Prescribed Medical Marijuana for Pain Relief, Use the Cannabis for Recreational Use

PainRelief.com Interview with:
Meghan Rabbitt Morean, Ph.D.

Assistant Professor of Psychology
Oberlin College
Adjunct Assistant Professor of Psychiatry
Department of Psychiatry 
Yale School of Medicine
New Haven, CT 04519

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

Response: Currently, medical marijuana is legal in 33 states and the District of Columbia and recreational marijuana is legal in 10 states and the District of Columbia (although it remains a Schedule I drug at the federal level).

Chronic pain is an approved condition for medical marijuana in all states in which medical marijuana is legal. However, there is concern that a sizeable percentage of medical marijuana patients also are using their medicine recreationally.

In the current study, we found that more than half (55.5%) of medical marijuana patients also reported using their medical marijuana for recreational purposes, which is similar to rates observed in a previous study.  

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Neck and Back Pain More Common in Diabetes

PainRelief.com Interview with:

Manuela L. Ferreira PhD
Institute of Bone and Joint Research
The Kolling Institute, Sydney Medical School

Paulo H. Ferreira PhD
Musculoskeletal Health Research Group
Faculty of Health Sciences
University of Sydney, Sydney, NSW, Australia

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

Response: One in four Australians experience back pain or neck pain. Diabetes is also a worldwide prevalent condition, and currently affects over 382 million people. These two diseases often co-exist and have very similar underlying mechanisms, such as obesity and physical inactivity. We were unsure whether having one condition would lead to developing the other, however.

We have found 11 studies published to date, and assessing the relation between back or neck pain and diabetes. The studies included over 165,000 participants published in the USA, Canada, Finland, Denmark, Iran and Spain.

When we pooled the results of these studies together, we observed that people with type 2 diabetes are 35% more likely to also have low back pain (compared to people without diabetes). The risk of having severe back pain symptoms in people with type 2 diabetes is 63% higher and the risk of having severe neck pain is almost 30% higher, than in people with no diabetes.  We could not identify, however, whether type 2 diabetes can lead to back or neck pain, and it is possible that the two conditions are associated via other underlying mechanisms such as obesity and physical inactivity.

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Opioid-Induced Constipation

Chronic Pain Patients: Opioid Induced Constipation a Serious Concern After Surgery

PainRelief.com Interview with:

Jonathan Jahr, MD, DABA, FASA

Dr. Jonathan Jahr is an anesthesiologist in Los Angeles, California and is affiliated with multiple hospitals in the area, including UCLA Medical Center and UCLA Medical Center-Santa Monica. He received his medical degree from New York Medical College and has been in practice for more than 20 years.

Dr-Jonathan-Jahr

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

Response: I have worked in the hospital setting for the past 25 years and have conducted multiple studies on different opioid and non-opioid strategies for managing both chronic and acute pain. I also co-edited a textbook entitled Essence of Analgesia and Analgesics. My background and the research I’ve done sets the stage for newer pain management protocols that can provide patients with significant pain relief, and improved satisfaction and outcomes due to fewer or avoided opioid related side effects (ORADS) such as opioid-induced constipation (OIC).

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Pain and Substance Use Can Interact in a Vicious Cycle

PainRelief.com Interview with:

Emily L. Zale PhD Department of Psychology Syracuse University Syracuse, New York

Dr. Zale

Emily L. Zale PhD
Department of Psychology
Syracuse University
Syracuse, New York

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

Response: When people think of pain and substance use, it’s common for opioids to come to mind. While the opioid crisis has rightfully garnered considerable attention, our research suggests that non-opioid substances, like nicotine/tobacco, alcohol, and cannabis, are also important to consider in relation to pain. In fact, nicotine/tobacco, alcohol, and cannabis are the most commonly used substances in the US, and research into associations between pain and these non-opioid substances is continuing to increase in popularity.

Research studies usually examine either how substance use affects pain or how pain affects substance use. We looked at results from over 100 studies and put these two different types of research together to understand how pain and substance use affect each other.

On one hand, substance use can be a risk factor for chronic pain and may worsen pain over time. On the other hand, experiencing pain can motivate people to use substances and might make it harder to quit. By putting these two types of studies together, we found that pain and substance use  interact in a vicious cycle that can ultimately worsen and maintain both chronic pain and addiction.

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Gabapentin For Pain Relief of Vulvodynia

MedicalResearch.com Interview with:
Gloria A Bachmann, MD
Professor of Obstetrics and Gynecology and Medicine
Associate Dean for Women’s Health
Director, Women’s Health Institute
Rutgers Robert Wood Johnson Medical School

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

Response: Chronic pain is an extremely difficult symptom for anyone to deal with, regardless of the cause. However, when the pain involves the genital area, it exacerbates the pain condition, as it then becomes a more sensitive area for the person to talk about and to feel comfortable in asking for medical help. This is precisely the case for women with vulvodynia.

Vulvodynia is defined as a pain that persists over several months in the outer area of the vaginal opening. Symptoms women often have from this condition, in addition to the pain itself, include burning, pressure, itching and soreness. Some women note the pain in the entire area surrounding the vaginal opening, whereas others only note it in one or two sites. Further, for many women the pain interferes with their ability to engage in sexual exchange, the wearing of certain types of clothing and even the ability to start a family as coital activity may not be possible for them. Unfortunately, because the exact cause of vulvodynia has not been described, treatments are varied and aim at treating the pain rather than the underlying cause. One intervention that has been used for women with this condition is the medication, gabapentin. However, although it appears to be a successful intervention for some sufferers, there had not been a definitive clinical trial that looked at this medication as it compares to a placebo intervention.

Therefore, our Rutgers site, along with the University of Tennessee and the University of Rochester commenced a clinical trial to test how effective gabapentin was as compared to a placebo, or non-pharmacologic intervention in women with this condition. Continue reading

Study Suggest Opioids Should Not Be First Line Therapy for Chronic Non-Cancer Pain

PainRelief.com Interview with:

Dr. Jason Busse PhD Associate Professor McMaster University

Dr. Busse


Dr. Jason Busse PhD
Associate Professor
McMaster University

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

Response: The United States prescribes more opioids per capita than any other country in the world, and opioids are associated with addiction, overdose, and death. Many individuals living with chronic noncancer pain are managed with opioid therapy; however, we have limited knowledge regarding benefits and harms. We conducted a systematic review and meta-analysis to synthesize the evidence from all RCTs that explored an opioid vs. a non-opioid comparator for patients with chronic noncancer pain, and followed participants for at least 1 month. Continue reading

Massage for Osteoarthritis of Knee Reduced Pain and Improved Physical Functioning

Adam-Perlman-

Dr. Perlman

PainRelief.com Interview with:
Adam Perlman, MD, MPH

Program Director, Leadership Program in Integrative Healthcare
Duke Integrative Medicine 

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

Response: Current treatment options for knee osteoarthritis have limited effectiveness and potentially adverse side effects. Massage may offer a safe and effective complement to the management of knee osteoarthritis.

We investigated the effect of whole-body massage on knee osteoarthritis, compared to active control (light-touch), and usual care. Participants received 8 weeks of massage, light-touch or usual care and then were randomly assigned to maintenance every other week massage, light-touch or continuation of their usual care. At the end of 8 weeks, massage significantly improved symptoms, including pain, stiffness and physical function, while the other groups did not. At 52 weeks, every other week massage maintained the improvements, however the other groups also improved. Continue reading