Category Archives: Pain-Relief

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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Opioid Use Disorder: Rutgers Study Demonstrates Improved Mood and Emotional Regulation with Guided Mindfulness

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PainRelief.com Interview with:
Suchismita Ray, Ph.D.
Associate Professor                                      
Department of Health Informatics            
Rutgers School of Health Professions
Rutgers Biomedical and Health Sciences
Rutgers, The State University of New Jersey
Newark, NJ 07101

Dr. Suchismita Ray
Photo by John O’Boyle

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

Response: In this pilot study, we examined longer-term changes after the Mindfulness-Oriented Recovery Enhancement (MORE) intervention and immediate effects of a brief MORE guided meditation session in women with opioid use disorder (OUD) who were on medications for OUD (MOUD). Participants completed the first assessment, then the 8-week MORE intervention (once weekly for two hours) during residential treatment, and then the second assessment.


The assessments were identical and conducted at Rutgers University Brain Imaging Center in Newark.

First, participants completed an emotion regulation questionnaire, and then they entered the magnetic resonance imaging (MRI) environment for scanning. Participants listened to a 10-minute guided MORE meditation in the scanner while viewing a picture of an outdoor garden, and brain images were recorded to measure functional connectivity (i.e., brain communication) during the meditation. We examined the immediate effects of a 10-minute guided MORE meditation on mood and craving. We further examined the effects of 8-week MORE intervention on changes in emotional regulation difficulty and brain communication.

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Cancer Doctors Prescribing Fewer Opioids Since Opioid Crisis

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PainRelief.com Interview with:
Joshua Kra, MD
Assistant Professor of Medicine, Rutgers NJMS
Division of Hematology/Oncology
Rutgers Cancer Institute of New Jersey at University Hospital

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

Response: We aimed to characterize pain management practices by medical oncologists to assess whether CDC guidelines from 2017 for nononcologic settings changed prescribing patterns for oncologists.

PainRelief.com: What are the main findings?

Response: There was a significant decrease in opioid prescriptions from medical oncologists starting in 2017, which coincided with the recognition of the opioid crisis as a national public health emergency and the publication of CDC guidelines for opiate prescribing in non-cancer settings. This would suggest these factors contributed to how oncologists changed their management of opioid prescriptions for cancer patients.

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Chronic Pain Extends Beyond Mere Physical Symptoms

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PainRelief.com Interview with:
Dahee Wi, PhD, RN
Department of Biobehavioral Nursing Science
University of Illinois Chicago
College of Nursing, Chicago, Illinois

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

Response: Chronic pain, defined as persistent or recurrent pain lasting longer than three months, is a significant health problem, particularly among U.S. active duty service members (ADSM). ADSMs are at an elevated risk for chronic pain due to the nature of military service and related job training. Chronic pain is a leading cause of disability and medical discharge in the military, significantly impacting readiness and mission capabilities.

Chronic pain is often accompanied by multiple comorbid conditions, making it essential to view it not just as a single symptom but in relation to co-occurring symptoms of other conditions. The study conducted network analysis, an analytic technique that provides graphical representations of the relationships between selected measures. This approach can offer new insights into the complex interplay of physical, emotional, and social factors in chronic pain

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WashU Study Surveys Cannabis Use for Sleep

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PainRelief.com Interview with:
Carrie Cuttler, Ph.D.
Associate Professor
The Health & Cognition (THC) Lab
Department of Psychology
Washington State University

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

Response: We know that one of the top 5 reasons cannabis users report using cannabis is for sleep disturbances, but we don’t know very much about the types of products they prefer to use for sleep or their perceptions of its effects and side effects relative to more conventional sleep aids (e.g., benzodiazepines, antihistamines, melatonin).

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Dental Pain: Progress Toward Reducing Opioids for Pain Relief Slowed During Pandemic

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PainRelief.com Interview with:
Kao-Ping Chua, MD, PhD
Susan B. Meister Child Health Evaluation and Research Center
Department of Pediatrics, University of Michigan Medical School
Ann Arbor MI 48109

Dr. Kao-Ping Chua
Dr. Kao-Ping Chua

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

Response: Using national data, we show that U.S. dental opioid prescribing decreased 45% between 2016-2022, but this decrease slowed during the COVID-19 pandemic.

If pre-pandemic trends had continued, we estimated that 6.1 million fewer opioid prescriptions from dentists would have been dispensed between June 2020 and December 2022.

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