Mucosal Breaks from Periodontal Disease Likely Promotes Rheumatoid Arthritis

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PainRelief.com Interview with:
Dana Orange MD
Associate Professor of Clinical Investigation
The Rockefeller Institute and
William H. Robinson, MD PhD
James W. Raitt, M.D., Professor Medicine
Immunology & Rheumatology
Stanford Health Care

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

Response: Periodontitis is more common in patients with rheumatoid arthritis than those without.  

Of patients with rheumatoid arthritis, those with current periodontitis are less likely to receive benefit from treatment with biologic agents than those without periodontitis.

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Kidney Stones: Mayo Clinic Study Evaluates CBD Oil for Post-Procedure Kidney Stone Pain Relief

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PainRelief.com Interview with:
Karen L. Stern M.D.
Associate Professor of Urology
Mayo Clinic Arizona
Phoenix, AZ 85054

Dr. Stern

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

Response: Kidney stones are not rare and often require surgical intervention. One of the most popular and effective surgical interventions is ureteroscopy with laser lithotripsy. Essentially, the Urologist goes up to the kidney with a small scope and lasers the stone.

It is common after this procedure to leave a temporary stent – a small flexible tube that goes from the kidney to the bladder – which allows for urine to drain unobstructed during the healing process.

Unfortunately, that stent is associated with significant morbidity including urinary symptoms and pain.

There have been many studies looking at ways to alleviate this pain and discomfort, but this is the first to assess CBD in that capacity. We tested a low-dose FDA-approved CBD oil. We found it to be safe and well tolerated but we did not find any significant difference in postoperative pain.

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Promising Pain Relief with Injectable Allograft for Chronic Low Back Pain

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PainRelief.com Interview with:
Dr. Douglas Beall, MD
Chief of Radiology Services
Clinical Radiology of Oklahoma
Oklahoma City, OK

Dr. Beall

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

Response: Discogenic low back pain is typically caused by damaged discs in the spine. Viable disc allograft supplementation is a minimally invasive treatment that injects specialized cells and fluid into a damaged disc. The cells of the injected fluid encourage the cells in the damaged disc to regenerate with healthy tissue.

As for the study itself, 50 patients at nine sites participated in an extension of the randomized control Viable Allograft Supplemented Disc Regeneration in the Treatment of Patients With Low Back Pain (VAST) Trial. Of these, 46 received allograft treatment and four received saline. The treatment group was similar to the patient population at the start of the VAST trial in age, sex, race, ethnicity, body mass index and smoking status. Pain levels were evaluated using the VAS Analog Scale, and functionality was measured using the Oswestery Disability Index (ODI).

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Knee OsteoArthritis: Study Finds Radiofrequency Nerve Ablation Provides Pain Relief

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PainRelief.com Interview with:
Kaitlin Carrato, M.D., Chief Resident in Interventional Radiology
MedStar Georgetown University Hospital, and
John B. Smirniotopoulos, M.D., Interventional Radiologist
MedStar Georgetown University Hospital

PainRelief.com: What is the background for this study? What is the main indication for the RFA procedure?

Response: Roughly one in four U.S. adults have knee pain due to arthritis that interferes with their everyday lives and activities. A treatment called genicular nerve radiofrequency ablation (RFA) is a safe and effective option for reducing pain from osteoarthritis of the knee, one of the most common joints affected by osteoarthritis. Interventional radiologists perform genicular nerve RFA using image guidance to place probe needles next to nerves around the knee that send pain signals to the brain. The primary indication for this procedure is chronic pain that has not been sufficiently managed by other treatments, prescription medications, physical therapy, or for patients with persistent pain even after knee replacement.

This study examined patient demographics, prior surgical history, degree of osteoarthritis and other clinical characteristics that may affect how well RFA reduces knee pain. We measured post-procedure pain in 36 patients using the visual analog scale (VAS) and the Western Ontario McMaster Universities Osteoarthritis (WOMAC) pain scale. We then evaluated whether pain reduction levels were influenced by demographics and clinical characteristics.

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Chronic Multifocal Pain Linked to Accelerated Cognitive Decline

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PainRelief.com Interview with:
Yiheng Tu
CAS Key Laboratory of Mental Health
Institute of Psychology
Chinese Academy of Sciences
Department of Psychology
University of Chinese Academy of Sciences
Beijing, China

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

Response: Chronic pain (CP) is a leading source of disability worldwide. Multisite chronic pain, where pain is experienced in multiple anatomical locations, affects almost half of chronic pain patients and has been found to have a greater burden on patients’ overall health. However, However, it has not been clear whether people with multisite chronic pain suffered from aggravated neurocognitive abnormalities.

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Review of Non-Opioid Pain Medications for Back Pain Relief

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PainRelief.com Interview with:
Filippo Migliorini MD, PhD, MBA
Department of Orthopedic, Trauma, and Reconstructive Surgery
RWTH University Hospital of Aachen

Dr. Migliorini

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

Response: Acute low back pain imposes a significant socioeconomic burden worldwide. The pharmacological management of acute low back pain aims to restore daily activities and improve the quality of life. No magic bullet exists: interventions to reduce pain and disability are available, but long-term results are unpredictable. This is often hard to accept for clinicians and patients and provides fertile soil to quacks, faith healers, and gurus to promote miraculous non-evidence-based solutions. Education in this regard needs to improve.

Acute low back pain management is not well codified and extremely heterogeneous, and residual symptoms are common. Depending on the individual severity, pharmacological management may range from nonopioid to opioid analgesics. The literature regarding the best non-opioid pharmacological management of acute low back pain is limited, and the indications available in the literature are conflicting. Our investigation aimed to systematically review the level I evidence on the administration of myorelaxants, nonsteroidal anti-inflammatory drugs, and paracetamol in patients with low back pain.  

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Painful Bunions: Risk Factors for Failure of Corrective Surgery

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Dr. Johnson

PainRelief.com Interview with:
Matthew Johnson, D.P.M.
Assistant Professor
Department of Orthopaedic Surgery
University of Texas Southwestern Medical Center

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

Response: There is a paucity of literature attempting to characterize risk factors for nonunion of the Lapidus bunionectomy.

PainRelief.com: Would you briefly describe what is meant by a bunion?

Bunion with cornDermNet NZ image

Response: Bunions are a chronic painful bump that forms on the base of the big toe when the long metatarsal bone shifts toward the inside of the foot and the phalanx bones of the big toe angle toward the second toe.



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Both High and Low Dose Exercise Beneficial for Knee Osteoarthritis

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PainRelief.com Interview with:
Tom Arild Torstensen
Department of Neurobiology, Care Sciences and Society
Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden, and
Holten Institute, Stockholm, Sweden 

Tom Arild Torstensen

PainRelief.com: What are the main findings?
Response: The results from our study (1) show that both high-dose and low-dose exercise therapy is beneficial for knee osteoarthritis. At a glance, it would be natural to think that I should choose a low-dose because it takes only 30 minutes and consists of 5 different exercises compared to the high-dose lasting 70 to 90 minutes consisting of 11 exercises. But because our study was designed as a superiority trial, meaning that even though we failed to show that high-dose treatment is superior to low-dose, our results do not imply that a low-dose exercise regimen is as beneficial as a high-dose regimen. 

Both groups improved over time, but there were no benefits of high-dose therapy in most comparisons. One exception was the KOOS score function in sports and recreation, where high-dose therapy was superior at the end of treatment and the 6-month follow-up. A small benefit in QoL at 6 months was also observed. Notably, most variables numerically favored the high-dose group, albeit not in a statistically or clinically meaningful way.

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Twin Study Finds Cannabis Legalization Did Not Cause Substantial Psychological Harm in Adults

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PainRelief.com Interview with:
Stephanie Zellers PhD
Postdoctoral Researcher, Kaprio Group, FIMM
Dr. Zellers began this research as a graduate student at the
University of Colorado Boulder’s Institute for Behavioral Genetics (IBG)

Dr. Zellers PhD

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

Response: Proponents and opponents of cannabis legalization respectively cite various potential benefits and harms that these policies may cause. Many studies have evaluated these outcomes, but drawing causal conclusions is challenging due to the many confounds that may better explain observed effects.

 We investigated the effects of cannabis legalization on a broad range of psychological outcomes, like substance use, psychiatric symptoms, general functioning in daily life, and cognitive ability. We used a longitudinal twin sample with twin pairs living in different types of states (recreationally legal vs. recreationally illegal) to draw causally informative conclusions. Because identical twins share 100% of their genes, as well as environmental factors like the family rearing, SES, and community norms, co-twin control studies can rule out many alternative explanations for an observed relationship.

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Effect of Arthritis on Employment Varies Among Socioeconomic Groups

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PainRelief.com Interview with:
Adam Martin PhD
Academic Unit of Health Economics and
Edward Webb, PhD Economist
University of Leeds, UK

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

Response: We wanted to find out how arthritis affects people’s employment. We expected that some people with arthritis might experience poorer work outcomes than those without the condition, such as by losing their job or having a slower career progression.  This study set out to find out how large the differences in work outcomes were for people living with arthritis, and if particular age groups or genders doing specific jobs were especially at risk.

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