Category Archives: Pain-Relief

Chronic Pain Conditions Among Women in the Military Health System

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PainRelief.com Interview with:
Andrew J. Schoenfeld, MD
Professor, Harvard Medical School
Orthopaedic Surgery
Brigham and Women’s Hospital 

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

Response: The impetus for this research stems from my time as the Director of the Medical Evaluation Board at Fort Bliss Texas during my time on active duty with the Army between 2009-13 and my time in Ann Arbor VA between 2013-15.  We wanted to understand the impact that repeated exposure to the high intensity deployment to combat theaters during 2006-2013  had on women active duty servicemembers and women civilian dependents of active duty servicemembers who were deploying

PainRelief.com: What are the main findings?

Response: Significant increases in the diagnosis of Chronic Pain conditions among women active duty service members as well as women civilian dependents who were affiliated with the military between 2006-13.

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WalkBack Trial: Simple Exercise Strategy plus Education Can Help Prevent Recurrence of Low Back Pain

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PainRelief.com Interview with:
Natasha C Pocovi
Department of Health Sciences
Macquarie University, Sydney
NSW, Australia

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

Response: Approximately 620 million people globally, reported suffering low back pain in 2020. While it’s not considered a life-threatening disease, we can see the very serious impacts it can have on people’s lifestyle, ability to work, and overall quality of life. While much work is being done to treat low back pain, ‘prevention’ is mostly unchartered territory. This is particularly important given the high rates of recurrent low back pain, where 7 in 10 people who recover from an episode of low back pain will have a new episode in the next 12 months.

A small number of studies have examined exercise to prevent the recurrence of low back pain. These have primarily focused on group-based, complex exercises focusing on a combination of strengthening and improving the endurance and flexibility of the spine. Some of these were delivered over several supervised sessions, some as many as 20 x 1-hour sessions. This becomes less feasible for patients to engage in.

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Chronic Pain Improved in TBI Patients Receiving Collaborative Care

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PainRelief.com Interview with:
Jeanne M. Hoffman, PhD, ABP
Professor, Department of Rehabilitation Medicine
University of Washington School of Medicine  

dr_jeanne_m_hoffman

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

Response: We were interested in finding a way to improve the treatment of pain for individuals with traumatic brain injury who often struggle with chronic pain, but may not always be able to benefit from the therapies that are available. 

PainRelief.com: What are the main findings?

Response: We found that using an approach called “collaborative care”, which is an integrated, team-driven approach to delivering patient-centered evidenced based care that, in our study, included 12 sessions of cognitive behavioral treatment of pain, led to improvements in pain interference at the end of treatment, which lasted an additional 4 months after treatment ended. 

We also found improvements in pain intensity after treatment as well as reductions in the collaborative care group in symptoms of anxiety and depression and increases in satisfaction with care.

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EULAR 2024: Non-Articular Pain Common in Patients with Rheumatoid Arthritis

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PainRelief.com Interview with:

Charis F. Meng, MD
Rheumatologist, Inflammatory Arthritis Center
Assistant Attending Physician
Hospital for Special Surgery
Assistant Professor of Clinical Medicine
Weill Cornell Medical College

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

Response: Non-articular pain (NAP) is common in our patients with rheumatoid arthritis (RA) and may impact remission outcomes.  However, it is challenging for busy rheumatologists to address specific pain types in our patients with RA, as it is not well defined in the literature, nor has it been validated in RA.  NAP in RA care thus is an unmet need for both our patients with RA and rheumatologists caring for them. 

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Pain Perception May Occur Differently in Men and Women

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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

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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.

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

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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

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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

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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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