What Drugs Are Prescribed for Chronic Musculoskeletal Pain Relief?

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PainRelief.com Interview with:
Debbie Feldman,, Ph.D.
Professeure titulaire/Full Professor
Faculté de médecine/Faculty of Medicine
École de réadaptation/School of Rehabilitation
Université de Montréal

Debbie Feldman,, Ph.D. Professeure titulaire/Full Professor Faculté de médecine/Faculty of Medicine École de réadaptation/School of Rehabilitation Université de Montréal
Dr. Feldman

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

Response: The goal was to explore clinical management of new cases of musculoskeletal conditions associated with chronic pain, at the population level. Few studies to date have addressed treatment at the population level and none explored initial management specifically. Furthermore, not much is known regarding patient and provider characteristics that are potentially associated with different treatment options (except for some information regarding prescription of opioids). Main findings are in the answer below.

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Adults 50+ More Likely to Misuse Opioids for Pain Relief

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PainRelief.com Interview with:
Ty S. Schepis, Ph.D.
Associate Professor
Department of Psychology
Texas State University

Ty S. Schepis, Ph.D. Associate Professor Department of Psychology Texas State University

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

Response: We were interested in examining the underlying reasons for prescription opioid misuse both across the population and in older adults specifically. Given that pain conditions and physical health limitations increase with aging, we wondered if different age groups would display different patterns of motives. Indeed, they did. Adults 50 and older were particularly likely to misuse opioid medication only for pain relief reasons (over 80%); in contrast, roughly 65% of young adults (18-25 years) endorsed only non-pain relief motives for misuse.

For older adults, opioid misuse involving any non-pain relief motives was associated with a greater rate of also having another substance use disorder and past-year suicidal thoughts.

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Acute Low Back Pain: Does Ibuprofen With or Without Acetaminophen offer Pain Relief?

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PainRelief.com Interview with:
Benjamin W. Friedman, MD, MS
Department of Emergency Medicine
Montefiore Medical Center, Albert Einstein College of Medicine
Bronx, NY, 10467

Benjamin W. Friedman, MD, MS Department of Emergency Medicine Montefiore Medical Center, Albert Einstein College of Medicine Bronx, NY, 10467

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

Response: Low back pain is a highly prevalent problem that causes more than 2 million visits to American emergency departments annually. Nonsteroidal anti-inflammatory drugs are first line medical management of this ailment, but are only modestly effective. We conducted an RCT to determine if adding acetaminophen to nonsteroidal anti-inflammatory drugs could improve outcomes two days and seven days after an ED visit for low back pain. Unfortunately, acetaminophen did not improve this outcomes.

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Migraine: Aspirin Evaluated for Pain Relief and Prevention

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PainRelief.com Interview with:

Charles Hennekens, MD, DrPH

Prof. Hennekens

Sir Richard Doll Professor
Senior Academic Advisor to the Dean
Charles E. Schmidt College of Medicine
Florida Atlantic University

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

Response: Migraine headaches are among the most common and potentially debilitating disorders encountered by primary healthcare providers. In the treatment of acute migraine as well as prevention of recurrent attacks there are prescription drugs of proven benefit. For those without health insurance or high co-pays, however, they may be neither available nor affordable and, for all patients, they may be either poorly tolerated or contraindicated. 

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Yoga and Physical Therapy Improved Sleep in Patients with Chronic Low Back Pain

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PainRelief.com Interview with:
Eric J. Roseen, DC, MSc
Assistant Professsor, Department of Family Medicine
Boston University School of Medicine and Boston Medical Center

Eric J. Roseen, DC, MSc Assistant Professsor, Department of Family Medicine Boston University School of Medicine and Boston Medical Center
Dr. Roseen

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

Response: Sleep disturbance and insomnia are common among people with chronic low back pain (cLBP). Previous research showed that 59% of people with cLBP experience poor sleep quality and 53% are diagnosed with insomnia disorder. Medication for both sleep and back pain can have serious side effects, and risk of opioid-related overdose and death increases with use of sleep medications. Given the serious risks of combining pain and sleep medications, we evaluated the use of nonpharmacologic approaches to manage sleep quality in adults with chronic low back pain.

Our randomized controlled trial included 320 adults with chronic low back pain from predominantly low-income racially diverse neighborhoods of Boston. At the beginning of the study, over 90 percent of participants with cLBP reported poor sleep quality. Participants were randomly assigned one of three different therapies for cLBP: physical therapy (PT), weekly yoga, or reading educational materials. Our previous research showed that yoga and PT are similarly effective for lowering pain and improving physical function, and reduced the need for pain medication. In this study, results for sleep improvements were compared over a 12-week intervention period and after 1 year of follow-up.

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Social Robots Can Provide Pain Relief For Some Patients with Dementia

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PainRelief.com Interview with:

Lihui (Sara) Pu RN, PhD Candidate
School of Nursing and Midwifery & Menzies Health Institute Queensland  
Griffith University
Queensland, Australia

animal therapy to be administered to patients in environments such as hospitals and extended care facilities where live animals present treatment or logistical difficulties.
“PARO allows animal therapy to be administered to patients in environments such as hospitals and extended care facilities where live animals present treatment or logistical difficulties.”

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

Response: With the development of technologies, there is a growing body of research on social robots aiming to meet the care needs of people with dementia. The use of a robotic seal PARO has been shown to improve mood and acute pain for people with dementia. However, little attention has been paid to the effect of PARO on people with dementia and chronic pain.

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No Current Credible Evidence Cannabis Use is Helpful in Opioid Addiction

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PainRelief.com Interview with:

Dr. Zena Samaan , MBChB, MSc, DMMD, MRCPsych (UK), PhD
Associate Professor
Program Director
Clinician Investigator Program
Faculty of Health Sciences
Department of Psychiatry
Dr. Zena Samaan , MBChB, MSc, DMMD, MRCPsych (UK), PhD

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

Response: The study background: the interest in cannabis use as a replacement for opioid use was sparked by reports suggesting that cannabis is a safer alternative and the public perception of cannabis as the answer for many health problems is growingly fueling the debate on the potential use of cannabis to help in the opioid crisis. Reports from USA for example in 2014 using administrative data suggested that in States were there is medical cannabis law, the rate of death attributed to opioids was lower, generating wide media attention. Since then however an updated study using the same data published in 2019 showed that when the data were re-analyzed and the time frame was extended, the opposite was seen, in that states with cannabis law had higher opioid related mortality.

Our study came form the observations that patients with opioid use disorder are commonly using cannabis (~50% of patients used cannabis while on treatment for opioid addiction) and given the recent public interest, our goal was to provide evidence informed conclusions on the potential effects of cannabis on opioid use in patients with opioid addiction.

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Pain a Risk Factor for Frailty in Older Mexican Americans

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PainRelief.com Interview with:
Jaspreet K. Sodhi, PT, MPT, MPH, PhD
Division of Rehabilitation Sciences
University of Texas Medical Branch
Galveston, TX

Jaspreet K. Sodhi, PT, MPT, MPH, PhD Division of Rehabilitation Sciences University of Texas Medical Branch Galveston, TX
Dr. Sodhi

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

Response: Little is known about the effect of pain and the long-term risk of becoming frail among older Mexican Americans, a population with high rates of frailty. The current study examined whether pain in older Mexican Americans is a risk factor for frailty among those who were non-frail at baseline.

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Short and Long-Term Effects of Cannabis For Headache and Migraine Pain Relief

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PainRelief.com Interview with:
Carrie Cuttler, Ph.D.
Assistant Professor
Washington State University
Department of Psychology
Pullman, WA, 99164-4820

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

Response: Use of cannabis for headache and migraine is relatively common yet there have been few studies examining the effectiveness of medical cannabis for these purposes.

PainRelief.com: What should readers take away from your report?

Response: We analyzed data from nearly 20,000 cannabis use sessions tracked using the medical cannabis app Strainprint. The results show that headache and migraine severity ratings were reduced by nearly 50% from before to immediately after cannabis use. The results further revealed that men report larger reductions in headache severity following cannabis use than do women and that use of cannabis concentrates was associated with larger reductions in headache severity ratings than use of more traditional cannabis flower.

We also demonstrate that dose of cannabis used to manage these conditions increases across time and that efficacy of cannabis in reducing headache decreases across time. This indicates that there is some evidence of tolerance to the acute effects of cannabis on ameliorating headache across time. More encouragingly we found that baseline ratings of headache and migraine remained stable across time/cannabis use sessions which indicates that cannabis is not associated with the medication overuse headaches (i.e., increases in baseline headache and migraine severity across time as a function of the use of medications to treat these conditions) that more conventional treatments tend to produce.

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Self-Reported Prescription Drug Use for Pain Relief and Sleep Linked to Frailty.

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PainRelief.com Interview with:
Andrew W Bergen, PhD
Senior Scientist
Oregon Research Institute
Eugene, OR 97403

Dr. Bergen

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

Response: The background to the study is examination of the incident frailty risks of two classes of prescription drugs commonly co-prescribed in response to pain and sleep indications.

The dataset consisted of N=7,201 non-frail, age 65+, community-living individuals from the Health and Retirement Study, a nationally representative longitudinal cohort interviewed every two years.

The drug exposure measures are based on responses to the two questions: “Do you regularly take prescription medications for any of the following common health problems:

For pain in your joints or muscles?” and “Do you regularly take prescription medications for any of the following common health problems: To help you sleep?”.

The outcome measure was the Burden Model of frailty using the conventional threshold of >0.2 for frailty.

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