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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NCCIH Study Finds Marked Increase in Complementary Health Approaches Among US Adults, Including for Pain Management

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PainRelief.com Interview with:
Richard L. Nahin, Ph.D., M.P.H
Lead Epidemiologist
National Center for Complementary and Integration Health
NCCIH

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

Response: Millions of US adults use complementary health approaches (CHAs) each year. CHAs are health approaches typically not part of conventional medical care or with origins outside of Western medicine that are used together with conventional medical practice.

Some of the most well-known complementary health approaches include meditation, acupuncture, and yoga. While the safety and efficacy of many of these approaches previously lacked rigorous clinical trials, the last two decades saw an increase in evidence supporting the use of select approaches to manage health and pain.

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Back Pain: Study Analyzes Course of Acute, Subacute and Chronic Low Back Pain

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PainRelief.com Interview with:
Prof. Lorimer Moseley PhD
DSc, FAAHMS, FACP, HonFFPMANZCA, HonMAPA, BAppSc(Phty)(Hons)
Professor of Clinical Neurosciences
Foundation Chair in Physiotherapy
University of South Australia 
Chair of PainAdelaide Stakeholders’ Consortium

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

Response: 12 years ago, members of our group gathered all the research studies that had followed people with back pain for a year and used all the combined data to get an idea of how well people with back pain do. That big study concluded that if you have had back pain for less than 6 weeks, you were highly likely to do really well and that if you had back pain for more than 6 weeks, things were still likely to go pretty well. That made us think ’so why do so many people have chronic back pain?’

Perhaps, by lumping sub-acute back pain (6-12 weeks) in with chronic back pain (>12 weeks) that study 12 years ago made outcomes for people with over 12 weeks of back pain look better than they really were. We decided to repeat that big study from 12 years ago but because there were likely to be many more research studies, we decided to divide the participants into three groups: those with back pain for less than 6 weeks, those with back pain for 6-12 weeks and those with back pain for more than 12 weeks. 

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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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Prenatal Opioids Increase Risk of Multiple Adverse Health Effects

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PainRelief.com Interview with:
Erin Kelty PhD
Research Fellow
NHMRC Emerging Leader
School of Population & Global Health

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


Response: Recent research from Dr Lauren Jantzie at John Hopkins found that in mice prenatal opioid exposure altered the immune system.
Our research aimed to see if the same was true in children who had been exposed to opioids in utero.

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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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New Migraine Headaches Linked to Increased Motor Vehicle Crashes in Older Adults

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PainRelief.com Interview with:
Carolyn DiGuiseppi, MD, MPH, PhD
Professor of Epidemiology
Colorado School of Public Health
University of Colorado Denver
Aurora, CO 80045

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

Response: Migraine headache is a leading cause of disability worldwide and affects many older adults in the US and globally.

Some of the symptoms of an acute migraine, like fatigue, impaired concentration, headache, or dizziness, could affect older adults’ ability to drive safely.  In fact, past research has suggested that people with migraine are at higher risk of having injuries resulting from motor vehicle crashes (compared to people without this diagnosis). We wanted to learn whether the risk of crashes depends on whether people have had a migraine diagnosis for some time or have been recently diagnosed, and whether being treated with migraine medications affects the risk of crashes.

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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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