Back Pain: Web-Based Self-help Intervention to Prevent Depression

Posted on by

PainRelief.com Interview with:

Lasse B. Sander, PhD
Institute of Psychology
Department of Rehabilitation Psychology and Psychotherapy
Albert-Ludwigs-University of Freiburg
Freiburg, Germany

Lasse B. Sander, PhD Institute of Psychology Department of Rehabilitation Psychology and Psychotherapy Albert-Ludwigs-University of Freiburg Freiburg, Germany
Dr. Sander

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

Response: People with chronic pain have a significantly increased risk of developing depression. When depression and pain collide, this is a considerable burden for those affected. In addition, pain management is made more difficult due to comorbidity.

We have known for some years now that the onset of depression can be delayed or even completely prevented by means of early psychological therapies. However, until now there has been no scalable application option available for routine healthcare.

In our study we were able to show that this can be achieved by a digital self-help intervention.

Pages: 1 2

Trial of Desipramine, Cognitive Behavioral Therapy, and Placebo for Low Back Pain Relief

Posted on by

PainRelief.com Interview with:
Thomas Rutledge, PhD, ABPP
Staff Psychologist, VA San Diego Healthcare System
Professor of Psychiatry
UC San Diego

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

Response: The goal of this study was to combine our team’s pharmacy, psychiatry, and psychology expertise with chronic pain to conduct a rigorous, head-to-head efficacy trial. The clinical trial literature for chronic back pain is enormous. On the surface, this literature suggests that many medication and pain psychology treatments are effective by standards of statistical significance. These findings are difficult to interpret, however, because there are few trials comparing statistically effective chronic back pain treatments with active control treatments and nearly no trials randomizing patients with chronic back pain to medication versus pain psychology treatments. We hoped that our trial could offer data to help fill these gaps. Mindful of the increasing concerns about long-term opioid use for chronic pain, we also believed the study could have value by focusing on non-opioid agents (Desipramine) and cognitive behavioral therapy.

Pages: 1 2

Study of Daily CBD for Pain Relief of Canine Osteoarthritis

Posted on by

PainRelief.com Interview with:
Matthew Halpert, Ph.D., B.S
Baylor College of Medicine

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

Response: The background will actually encompass my disclosure.  A little over a year ago, Medterra was one of a couple of CBD companies that approached me about conducting some small scale studies focused on CBD and its anti-inflammatory properties.  It became very obvious, very quickly that some (most) companies were not interested in actual science or data, but rather just wanted to try and increase their CBD-fad based revenue by using my name and affiliations. Medterra proved to be very different and genuinely wanted legitimate data and science to support and direct products, innovations, stories etc.  I always warned them that the ‘data will be the data’ and they agreed to live by that….even if the data wasn’t as supportive as they may have hoped.  Being a true academic researcher, I found this to be more than acceptable and Medterra and Baylor College of Medicine entered into a Sponsored Research Agreement (SRA) in which Medterra provides product and money for research, and my lab performs the research and reports back the data.

Continue reading →

Hemp Oil Studies for Pain Relief of Neuropathic Pain

Posted on by

PainRelief.com Interview with:
Karin Westlund High, PhD
Professor and Vice-Chair for Research
Department of Anesthesiology & Critical Care Medicine
University of New Mexico Health Sciences Center
Albuquerque, NM 87106

PainRelief.com: What are the main findings?

Response: Nearly 1 in 5 Americans recently reported that their level of pain interferes with their daily lives. Treatment options for persons with chronic pain are not optimal, particularly opioid therapies found to exacerbate pain or become ineffective over time in patients and in animal studies. While some have turned to marijuana to relieve pain where it has been legalized, benefits of the pain relieving cannabinols are not suitable for many given the psychotropic effects of its tetrahydrocannabinol (THC) content.

The Hemp Farming Act in 2019 effectively began legal cultivation in some states of a variety of the Cannabis plant—conventionally referred to as ‘hemp’. The primary components of hemp are the pain relieving cannabidiol (CBD) chemicals, differing from the content in their federally illegal counterparts which contain levels over 0.3% of the psychoactive THC. In  fact, it is reported that the content of CBD was bred down while THC bred up in marijuana seized in California  between 2001-2008.

Continue reading →

Review of Compounded Topical Creams for Pain Relief

Posted on by

PainRelief.com Interview with:


Debra A. Schwinn, M.D. (Committee Chair) – President-Elect of Palm Beach Atlantic University; former professor of anesthesiology, pharmacology, and biochemistry at the University of Iowa

Edmund J. Elder, Ph.D., R.Ph. – Director of the Zeeh Pharmaceutical Experiment Station, School of Pharmacy at the University of Wisconsin–Madison

·John T. Farrar, M.D., Ph.D. -Associate Professor of epidemiology and neurology, University of Pennsylvania School of Medicine 

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

Response: Compounding is the process of altering or combining ingredients to create medications that are tailored for an individual. Typically, compounded topical pain creams – which are applied to the skin in the form of gels, lotions, or ointments – are used by patients who cannot tolerate oral pain medications.

However, compounded topical preparations are not subject to the same level of extensive testing and stringent regulatory oversight as FDA-approved products. There are a number of safety concerns associated with their use, ranging from minor skin irritations to drug toxicity.

In response, FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to make recommendations for how the available scientific data on safety and effectiveness should inform future prescribing decisions.

PainRelief.com: What are the main findings?

Response: The report found there is limited scientific evidence to support the safety and effectiveness of compounded topical pain creams in adults. The committee assessed 20 Active Pharmaceutical Ingredients (APIs) that are commonly used in compounded topical pain creams. Out of the 20 APIs reviewed, 3 individual APIs and 1 two-drug combination demonstrate potential clinical effectiveness in compounded topical pain creams.

When possible, providers should prescribe FDA-approved products. Pharmacists and providers who prescribe compounded topical pain creams should also educate their patients about how much to use, which conditions to use it for, and the potential risks.

Among the report’s other findings about safety and effectiveness:

·         The rate and extent of the drug’s absorption into the skin and beyond is often unknown

·         There is no clear clinical rationale for specific combinations of APIs and dosages used

·         Labeling requirements for compounded preparations are often inadequate

Continue reading →

Individualized Footwear Provided Pain Relief in Patients with Knee Osteoarthritis

Posted on by

PainRelief.com Interview with:
Peter Jüni, MD, FESC
Director, Applied Health Research Centre (AHRC)
Li Ka Shing Knowledge Institute of St. Michael’s Hospital
Canada Research Chair in Clinical Epidemiology of Chronic Diseases
Professor, Department of Medicine & 
Institute of Health Policy, Management and Evaluation 
University of Toronto

Dr-Peter Jüni
Dr. Peter Jüni

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

Response: Biomechanics plays an important role in the development of osteoarthritis of the knee. We did a 24-week randomized clinical trial of a novel individualized biomechanical footwear system.

The shoes have 2 convex pods on the outsoles that can be individually calibrated and may alter the biomechanics of the lower limb. The shoes should be used daily for progressively increasing amounts of time.

Continue reading →

At Home Therapy with Alpha-Stim Electrotherapy for Acute and Chronic Pain Relief

Posted on by

PainRelief.com Interview with:
Steve Haltiwanger, MD, CCN, FAIS
Chief Medical Officer of Electromedical Products International, Inc.

PainRelief.com:  What is the background for the Alpha-Stim M CES/microcurrent therapy device? Where does the name come from?

Response: Before 1978 when the FDA changed the terminology, cranial electrotherapy stimulation (CES) was referred to as “electrosleep.” Early CES devices were used to induce sleep through the application of small amounts of electrical stimulation to the brain. As research progressed, many other effects were identified, including treatment of anxiety, depression, and pain./

Alpha-Stim M
Alpha-Stim M

A 1965 CES EEG study found that CES treatments increase the production of alpha rhythms in the brain (Magora et al., 1965). Increased alpha correlates with improved relaxation and increased mental alertness or clarity. In 2004 it was reported that Alpha-Stim CES treatments induced changes in the EEG, increasing alpha (8-12 Hz) relative power and decreasing relative power in the delta (0–3.5 Hz) and beta (12.5-30 Hz) frequencies (Kennerly, 2004).

In 1970 (Jarzembski et al.) determined that when CES was applied to the head of a primate, the electrical current penetrated every region of the brain with the flow notably channeled through the limbic system.

Many symptoms seen in psychiatric conditions, such as anxiety and insomnia, are found to be exacerbated by excess cortical activation (Yassa et al., 2012; Bonnet et al., 2010). An Alpha-Stim fMRI study in an anxiety population showed that CES, after one 20-minute treatment, causes cortical brain deactivation in the midline frontal and parietal regions of the brain (Feusner et al., 2012). Another fMRI study was conducted as part of a randomized, double-blind study in a pain population revealed more significant decreases in average pain levels (P=.023) than those using a sham device or receiving usual care without CES. The active CES device was shown to significantly decrease activation of central pain processing regions of the brain, such as the cingulate gyrus, insula, and prefrontal cortex, compared to the sham device (Taylor et al., 2013).

Continue reading →

Ethos Develops Biomarkers to Personalize Chronic Pain Relief

Posted on by

PainRelief.com Interview with:

Brian Kincaid
Chief Executive Officer of Ethos Laboratories

https://www.ethos-labs.com/

How can reducing healthcare costs be achieved by the identification and validation of biomarkers through diagnosis and treatment of chronic pain?

Response:  Medicine has been evolving over the past couple of decades with a shift to personalized or targeted medicine.  As technology has improved and equipment capabilities have increased, the ability to identify and measure biomarkers is more affordable and accessible than ever before. Physicians now have access to more information specific to each individual patient, and as a result, can personalize treatment for each patient. 

Chronic pain is a very difficult disease for physicians to treat. The majority of assessments used by the physician are subjective in nature and rely heavily on accurate information provided by the patient, which can lead to unnecessary treatments. By adding an objective measurement as part of the chronic pain assessment, unnecessary treatments can be avoided and targeted treatments can be pursued. By reducing the number of unnecessary treatments, not only does the cost of care for the patient go down, but the quality of the care is improved. 

Using objective biomarkers as part of the chronic pain assessment will also provide some information on the viability of prescribing opioids at that time. Opioids will not help improve a patient’s biochemistry, and in some cases, opioids can have a negative effect on biochemistry. By treating abnormal biochemistry with safe inexpensive options first, it may be possible to avoid long term opioid prescribing for some patients, which would eliminate the costs associated with opioids in that patient subset.

Continue reading →

Acupuncture for Migraine Pain Relief

Posted on by

PainRelief.com Interview with:

Prof. Wei Wang
Department of Neurology,
Tongji Hospital, Tongji Medical College,
Huazhong University of Science and Technology,
Wuhan, Hubei, P.R. China

acupuncture

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

Response: The burden of migraine is substantial, resulting in considerable economic and social losses. The latest Global Burden of Disease Study showed that 1.25 billion people had migraine in 2017. A significant number of patients are still not responding well to drug therapy, or cannot tolerate the adverse effects of drugs, or have contraindications, which can lead to low medication compliance, headache chronification and acute medication overuse. Prophylactic drugs should be recommended for migraineurs who have at least four headache days per month, but only 13% of patients reported current use of preventive drugs. Besides, ineffectiveness of and/or contraindications to migraine medication affect 10-15% of people with migraine. Hence, a need exists to investigate non-drug interventions.

Previous studies suggest that acupuncture works particularly well on a range of pain disorders. However, clinical evidence for the benefit of manual acupuncture for migraine prophylaxis remains scarce. Appropriate placebo control settings and successful blinding are two critical elements in addressing this challenge. Sham acupuncture involving penetrating needles should be avoided in clinical trials. Previous acupuncture research has often used penetrating sham acupuncture, involving needling non-acupuncture points, needling irrelevant acupuncture points, or superficial needling. However, whether the needle is inserted into an acupuncture point or a non-acupuncture point, it could produce a physiological effect. Comparisons between true acupuncture and sham acupuncture might also be biased by unsuccessful blinding. To ensure an inert placebo control and successful blinding, we recruited acupuncture-naive patients, using non-penetrating sham acupuncture at heterosegmental non-acupuncture points as the control, and designed the same procedures to perform the same rituals as much as possible in the manual and sham acupuncture groups.

Continue reading →

Osteoarthritis: Review of Medications for Long Term Pain Control

Posted on by

PainRelief.com Interview with:
Dr. RovatiLucio Rovati, M.D.
Department of Medicine and Surgery
UNIVERSITY OF MILANO – BICOCCA
School of Medicine
Monza – Italy

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

Response: This is the first meta-analysis in osteoarthritis (OA) that takes into account only long-term (defined as at least 12-month duration) clinical trials. In addition, this is a network meta-analysis, i.e. we could take into account virtually all available medications and all experimental pharmacological treatments with published studies.

Analysis of long-term data is particularly important because OA is a chronic and progressive disease, but most medications are studied mainly for their short-term effects, i.e. mostly up to 3-6 months only. This creates troubles when physicians have to perform a chronic management of their patients. Continue reading →