Pain Perception May Occur Differently in Men and Women

PainRelief.com Interview with:
Frank Porreca, PhD
Associate Department Head, Pharmacology
Member of the Graduate Faculty
Professor, Anesthesiology
Professor, Cancer Biology – GIDP
Professor, Neuroscience – GIDP
Professor, Pharmacology
College of Medicine
University of Arizona

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

Response: Our research concerns the mechanisms that initiate perception of pain rather than the experience of pain itself. 

Pain commonly results from activation of sensory fibers called nociceptors.  Nociceptors normally are activated by high intensity stimuli (e.g., like touching a hot stove) but not by low intensity stimuli (like touch itself). But, when there is an injury like a mild inflammation such as a sunburn, then light touch like the rubbing of your shirt on your sunburned neck can produce activation of nociceptors and the perception of pain.  This indicates that the thresholds for activation of the nociceptors has decreased so that normally innocuous stimuli can now result in pain.  The mechanisms by which the thresholds for activation of nociceptors are decreased are important as this can promote instances of pain from normally nonpainful stimuli, movement of joints, migraine, irritable bowel syndrome, temporomandibular disorder etc… 

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Cannabis Components Terpenes Tested for Neuropathic Pain

PainRelief.com Interview with:
John M. Streicher, PhD
Member of the Graduate Faculty
Professor, Neuroscience – GIDP
Professor, Pharmacology
College of Medicine, Tucson
University of Arizona

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

Response: Cannabis has many chemical components that have potential therapeutic benefits, however, the great majority of research to date has focused on the major cannabinoids THC and CBD. In the past, different groups have tested the pharmacological effects of terpenes, which are small aromatic compounds in Cannabis and other plants that impart taste and aroma. They found pain relieving and anti-inflammatory effects, in both pre-clinical and clinical studies. However, those studies mostly did not test the therapeutic aspects of terpenes like side effects and dosing routes, and the mechanism of action in pain is also mostly unclear.

We thus began our studies by comprehensively testing a set of 5 terpenes for their pharmacological and therapeutic effects. In 2021, we published a paper showing the terpenes had cannabinoid-like behavioral effects, and also worked through the Cannabinoid Receptor 1 and the Adenosine A2a Receptor to carry out these effects. We also found that they had stronger effects when combined with a cannabinoid.

Study Finds Women Who Had Epidural Had Lower Risk of Severe Maternal Complications

PainRelief.com Interview with
Prof. Rachel Kearns
Consultant Anaesthetist, Glasgow Royal Infirmary
Honorary Professor, University of Glasgow
Senior NRS Fellow

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

Response: This was an observational study which looked at health data from over half a million mothers giving birth in Scotland. We compared women who had received an epidural in labour with those who had not and found that women who had an epidural had a lower risk of severe maternal morbidity (severe health complications during childbirth or the 6 weeks following birth).  

We found that women with a higher underlying risk for having complications, for example women delivering a baby pre-term or women with pre-existing health conditions, had an even greater reduction in risk.

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Study Finds Liposomal Bupivacaine Alone Not Sufficient to Control Pain During Surgery

PainRelief.com Interview with:
Professor Peter Marhofer, MD
Director of Paediatric Anaesthesia
Senior Researcher Paediatric and Regional Anaesthesia
Medical University of Vienna
Department of Anaesthesia, Intensive Care Medicine and Pain Medicine
Vienna, Austria

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

Response: One of the major limitations in the use of local anaesthetics is their limited duration of action. In recent years, liposomal formulations with prolonged release kinetics have been developed with the idea to control the sensation of pain not only during but also after surgery and thus achieving an opioid-sparing effect. In this context “liposomal” means that the active ingredient is encapsulated in vesicles called liposomes, which should enable a slower release over a longer period of time. In our study we included 25 healthy volunteers. The study participants were randomly assigned to receive two nerve blocks with bupivacaine for pain control, one in the conventional and one in the liposomal form.

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UCSD Study Evaluates Self-Treatment with Cannabis for Migraine

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.

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

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.

Socially Disadvantaged Women Received Fewer Epidurals for Pain Relief During Childbirth

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

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

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

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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