Category Archives: Pain-Relief

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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Virgina Tech Study Demonstrates Focused Brain Ultrasound Can Reduce Both Pain Perception and Response to Pain

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PainRelief.com Interview with:
Wynn Legon, Ph.D.
Assistant professor at the Fralin Biomedical Research Institute at VTC and in the
School of Neuroscience in Virginia Tech’s College of Science.
The Fralin Biomedical Research Institute, located in Roanoke, Virginia, is a top-level research institute of Virginia Tech.

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

Response: My lab is focused on identifying new indications for which low-intensity focused ultrasound, or LIFU, might provide a benefit. In particular, we are focused on the insula and dorsal anterior cingulate, areas deep inside the brain implicated in a range of conditions. Chronic pain is among these.

These two papers provide proof-of-principle to confirm that focused ultrasound energy applied to these regions can impact both the perception of pain and the body’s reaction to a painful stimulus. Participants in the studies reported a reduction in perceived pain that depended on which site was targeted. Further, the application of low-intensity focused ultrasound also reduced physical responses to pain as measured by heart rate variability, again depending on which site was targeted.

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Socially Disadvantaged Women Received Fewer Epidurals for Pain Relief During Childbirth

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MedicalResearch.com Interview with:
Dr Lucy Halliday
School of Medicine, Dentistry and Nursing
University of Glasgow
Glasgow, UK

pregnancy-woman-belly-hands-46207 (1)

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

Response: Socioeconomic deprivation is associated with adverse maternal and childhood outcomes. Epidural analgesia is the gold standard for labour analgesia, and is associated with improved maternal pain scores and satisfaction, reduced rates of post-traumatic stress disorder and postnatal depression and may reduce severe maternal morbidity. Scotland is a country with a fully publicly funded national health service that aims to provide equitable treatment that is free at the point of care. We wanted to look at the association between socioeconomic deprivation and utilisation of labour epidural analgesia.

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Migraines: IPhones Allow Monitoring of Sleep, Eating and Mood Triggers

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PainRelief.com Interview with:
Kathleen R. Merikangas, Ph.D.
NIH Distinguished Investigator
Chief of the Genetic Epidemiology Research Branch
Intramural Research Program at the National Institute of Mental Health
Adjunct Professor of Epidemiology
Johns Hopkins Bloomberg School of Public Health 

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

Response: We have been studying differences in patterns of migraine in males and females and how it changes across the life span. We focus on recruiting people from the general community rather than those who come to clinical settings who tend to have more severe cases of headaches. This allows us to gather information that can generalize to the community.  We have taken advantage of the widespread use of mobile phones to administer assessments of physical and mental health in real time naturalistic settings.

The question that we addressed in this paper was whether we could identify changes in mental or physical health that may be related to the onset of headache on the next day. identifying potential triggers of headache attacks can help us to avoid them when possible, to intervene as early as possible in the progression of headache attacks, and to gain insight into the underlying biologic and environmental factors involved in migraine.

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Neuropathy: Repeated High Concentration Capsaicin Patches Provided Back Pain Relief and Reduced Need for Opioids

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PainRelief.com Interview with:
Kai-Uwe Kern MD, PhD
Institute of Pain Medicine/Pain Practice
Wiesbaden, Germany

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

Response: In recent studies a progressive response to high-concentration capsaicin patch (HCCP) with repeated treatment was observed, meaning that patients with insufficient pain relief after the first application of HCCP, still may respond to a second, third, or even fourth application. Based on these latest findings, and also on my personal clinical experience, we aimed to systematically analyse the pool of patients in my Pain Practice with at least two HCCP treatments.

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Multiple Sclerosis: Widespread Pain with Nociplastic Features (WPNF) Linked to Low Physical Activity

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PainRelief.com Interview with:
Libak Abou PhD, MPT
Department of Physical Medicine & Rehabilitation
Michigan Medicine
Institute for Healthcare Policy and Innovation
University of Michigan, Ann Arbor, Michigan

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

Response: Chronic pain is a common symptom experienced by persons with multiple sclerosis (MS) that affects their daily living functioning including physical activity. Growing evidence indicates that persons with MS may experience various types of chronic pain including widespread pain with nociplastic features (WPNF), nociceptive pain, and/or neuropathic pain. WPNF is a chronic and diffuse pain which can be challenging to localize or describe precisely. In person with multiple sclerosis, this type of pain arises from altered processing signals within the central nervous system. This is opposed to pain that arises from specific tissue damage, classified as nociceptive pain, or pain related to demyelination and axonal damage, classified as neuropathic pain.

Our main goal with this study was to investigate whether differences exists on the level of physical activity achieved by persons with MS based on the type of chronic pain they experience

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UCLA Study Finds Distinctive Vascular Eye Changes During Migraines

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PainRelief.com Interview with:
Katherine Podraza MD, PhD
Headache medicine specialist at Hartford HealthCare Headache Center
Assistant Professor of Neurology
University of Connecticut School of Medicine

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

Response: We know migraine is a complex and disabling neurovascular neurological disorder that has to do with the dysfunction of cortical networks in the brain. The eye given its direct connections to the brain through neuronal and vascular supply may also show changes related to migraine.

We studied changes in blood vessel structure and perfusion in the eye during migraine attacks using a non-invasive imaging technology called OCTA (Optical Coherence Tomography Angiography). As part of the study, patients with migraine (both with and without aura) were scanned both during an attack as well as between migraine attacks. In addition, we scanned healthy controls for comparison.

Our goal with the interictal scan (scans done when patients are not having an attack) was to find out if we can find imaging biomarkers for migraine. Our second goal was to use OCTA to find out if there are any changes in perfusion during a migraine attack. This could lead to a better understanding of the pathophysiology of migraine.

For the analysis, we specifically focused on two important regions in the retina, the fovea which processes our highest acuity vision and the parafovea which is the surrounding area and provides additional visual processing support. The fovea has the largest density of cone photoreceptors and also includes the foveal avascular zone which is devoid of blood vessels.

The parafovea surrounds the foveal region and is an area that has the thickest layer of retinal ganglion cells which transmit inputs from photoreceptors to various regions of the brain via the optic nerve. This region, given the complex interaction of neuronal cells and vascular inputs, was a perfect location to investigate migraine mechanisms.

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Gabapentinoids, Used for Epilepsy and Pain Relief, Associated with Exacerbation of Pulmonary Disease

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PainRelief.com Interview with:
Christel Renoux,  MD, PhD
Associate Professor
Dept. of Neurology & Neurosurgery
McGill University
Centre For Clinical Epidemiology H-416.1
Jewish General Hospital – Lady Davis Research Institute
Montreal Canada and
Alvi Rahman MSc
Pharmacoepidemiologist | HEOR Consulting
McGill University
Montreal, Quebec, Canada 

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

Response: . Gabapentinoids are anticonvulsant drugs that include the two drugs, gabapentin and pregabalin. They are indicated for the treatment of epilepsy and neuropathic pain, with minor variations between countries (pregabalin is also indicated for generalized anxiety disorders in some countries). However, they are often prescribed off-label for any type of pain, sometimes with the perception that they may be a safer alternative to opioids. Yet, gabapentinoids also may have serious adverse effects owing to the depressant effect they have on the central nervous system, which can lead to sedation or respiratory depression.

Several public health agencies have warned of breathing problems related to gabapentinoids, including the U.S. Food and Drug Administration (FDA), Health Canada, and the European Medicines Agency. Specifically, the FDA suggested that patients with respiratory risk factors, including those with chronic obstructive pulmonary disease (COPD) may be at higher risk. These warnings were based mainly on case reports, and there was a lack of large population-based studies on this topic, which led us to conduct this study assessing the association between gabapentinoid use and severe exacerbation of COPD (hospitalization).

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Cannabis for Chronic Pain Linked to Increased Risk of Arrhythmia

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PainRelief.com Interview with:
Anders Holt
Department of Cardiology
Copenhagen University Hospital—Herlev and Gentofte
Gentofte Hospitalsve
Hellerup, Denmark
Department of Epidemiology and Biostatistics
School of Population Health, University of Aucklan
Auckland, New Zealand

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

cannabis-marijuana

Response: The motivation for this study was the fact that medical cannabis is being made available as medical treatment for chronic pain in an increasing number of countries worldwide. Meanwhile, robust evidence on possible cardiovascular side-effects is very scarce. This could be worrisome since recreational cannabis previously have been associated with an elevated risk of arrhythmia and acute coronary syndromes.

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Study Aims to Improve Responsiveness to Hypnosis, Better Able to Treat Pain and Other Conditions

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PainRelief.com Interview with:
Afik Faerman, PhD
NIMH T32 Postdoctoral Fellow
Psychiatry and Behavioral Sciences
Stanford University
President-elect
Division 30 (Psychological Hypnosis)
American Psychological Association

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

Response: Hypnosis offers an effective drug-free approach to treat a variety of psychophysiological symptoms, particularly pain. Unfortunately, not everyone benefits equally from hypnosis. The ability to experience suggestions in hypnosis (hypnotizability) is distributed in a bell-shaped curve across the population, with only about 20% considered highly hypnotizable. We wanted to test if we could make the brains of people who were not highly hypnotizable act and function as if they were, hoping such a possibility would open the door for improving therapy.

Several brain structures were previously linked to responsiveness to hypnosis, and modulating them could, theoretically, increase hypnotizability. Based on previous work, we created an approach (termed SHIFT) using individual brain scans to find the best part of the brain to stimulate.

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