Which Adolescents Can Get Pain Relief from Cognitive-Behavioral Therapy?

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PainRelief.com Interview with:
Caitlin Murray, PhD
Research Fellow
Center for Child Health, Behavior and Development
Seattle Children’s Research Institute

Caitlin Murray, PhD Research Fellow Center for Child Health, Behavior and Development Seattle Children’s Research Institute
Dr. Murray

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

Response: We know that chronic pain is a significant problem among children and adolescents, and that cognitive-behavioral therapy (CBT) can be helpful. However, studies show that CBT doesn’t help every child or adolescent affected by chronic pain.

In this study, we explored what factors predicted adolescents’ response to internet-delivered CBT for chronic pain—that is, which factors made it more likely that adolescents would benefit from the CBT intervention. Our primary treatment outcome was pain-related disability, or the extent to which pain interfered with the adolescent’s daily activities.

We found that both adolescent age and parent emotional distress predicted treatment efficacy up to one year after treatment, such that adolescents who were younger and those whose parents expressed less distress were more likely to benefit from this form of cognitive-behavioral therapy.

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Acupuncture for Chronic Musculoskeletal Pain Relief: A Review of Randomized Trial

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PainRelief.com Interview with:
Chenchen Wang MD, MSc
Professor of Medicine
Tufts University School of Medicine
 Director, Center For Complementary And Integrative Medicine                                             
Division of Rheumatology
Tufts Medical Center, Boston, MA

Dr. Chenchen Wang
Dr. Chenchen Wang

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

Response: Chronic Musculoskeletal Pain is a complex disorder without effective treatment Acupuncture, originating in China more than 3,000 years ago, is one of the most popular sensory stimulation therapies. However, despite the fact that acupuncture is widely used for pain relief in a number of conditions including severe knee osteoarthritis, acute postoperative pain, musculoskeletal disorders, evidence of the effect of Chronic Musculoskeletal Pain relief is scarce.


Our study was to determine the efficacy of acupuncture for pain relief in this field.

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Opioids Commonly Prescribed for Pain Relief from Osteoarthritis

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PainRelief.com Interview with:

Dr. Jonas Bloch Thorlund  MSc, PhD
Professor of Musculoskeletal Health
Department of Sports Science and Clinical Biomechanics &
Research Unit for General Practice (Dept. of Public Health) 
Dr. Thorlund

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

Response: Opioids are commonly prescribed to patients with knee and hip osteoarthritis (OA). But for newly diagnosed patients’ clinical guidelines recommend exercise therapy, patient education and weight loss (if needed) as first line treatment. These treatments can be supplemented or replaced with biomechanical interventions (insoles, wedges, cane use, etc.), and paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) if needed. Generally, opioids are should only be used when other treatment options are exhausted, ineffective or contraindicated. Thus, treatment with opioids shortly after OA diagnosis is considered inappropriate according to guidelines.

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CBD Oil for Pain Relief Can Increase Chance of Positive Cannabis Drug Test

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PainRelief.com Interview with:

Tory R. Spindle, Ph.D. 
Postdoctoral Research Fellow
Behavioral Pharmacology Research Unit
Department of Psychiatry and Behavioral Sciences 
Johns Hopkins University School of Medicine

Dr. Spindle

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

Response: Cannabis and hemp products that contain CBD as the primary constituent have become widely available in the U.S. and are often used for various therapeutic purposes. However, there is presently little research to understand how such products could impact drug testing for cannabis which is commonly conducted in workplace, criminal justice, and other settings.

Drug testing for cannabis targets a common metabolite of THC called THCCOOH; THC is the primary psychoactive component of cannabis. Our results suggest that single use of a product that contains pure CBD would not produce a positive result on a standard urine drug test. However, we found that 2 of 6 participants tested positive for cannabis after they used a CBD-dominant strain of cannabis that contained a very low concentration of THC: only 0.39% THC.  

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Neck Pain: Deep Tissue Massage Can Offer Short Term Pain Relief

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PainRelief.com Interview with:

Oscar Javier Pico-Espinosa | MD, MSc, PhD (c) Epidemiology
Karolinska Institutet

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

Response: Persistent neck pain is a common condition and one of the main causes of sick leave worldwide. Patients often utilize non-pharmacological therapies such as massage or exercises. However, the evidence supporting the effectiveness of such treatments is either lacking or conflicting. With that in mind, we designed the Stockholm Neck (STONE) trial, where we compared deep tissue massage, strengthening and stretching exercises and a combination of those two (up to six sessions over six weeks), versus advice (up to three sessions of advice to stay active).

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Pain Medication Beliefs Can Enhance (or Impair) Pain Relief

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PainRelief.com Interview with:
Leon Timmerman, PhD
St Antonius Hospital, Department of Anesthesiology
Intensive Care and Pain Medicine
The Netherlands

Leon Timmerman, PhD St Antonius Hospital, Department of Anesthesiology Intensive Care and Pain Medicine The Netherlands
Dr. Timmerman

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

Response: Chronic pain is commonly treated with pain medication. However, the results of pharmacological treatment are often poor. One of the reasons might be that half of the patients do not use their medication as prescribed. Underuse as well as overuse are common and have been described to result in reduced treatment effect, health care risks and unnecessary treatment changes. The are many risks factors described for non-adherent behavior.

The way people think about their pain medication have been shown to be related to the way they use their medication. With this study, we confirmed this relation with a prospective study. Baseline beliefs about pain medication, measured by ‘Pain Medication Attitudes Questionnaire’,  were found to be related to underuse of pain medication, the occurrence of side effects and patient satisfaction after three months.  

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Off-Label Gabapentinoid Prescriptions for Cancer Pain Relief Double

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PainRelief.com Interview with:
Alex Fauer, RN, OCN®
Ph.D. Candidate
University of Michigan School of Nursing

PainRelief.com Interview with: Alex Fauer, RN, OCN® Ph.D. Candidate University of Michigan School of Nursing

PainRelief.com:  What are the main findings?

Response: Our primary finding of the paper is that the age-, sex-, and US region-adjusted percentage of adults who used a gabapentinoid increased from 2.34% to 5.60% from 2005 to 2015. The total number of gabapentinoid prescriptions  filled  among  US  adults diagnosed with  cancer was  approximately  1.19  million in 2005, but increased to 3.52 million in 2015.

We also found that adults aged 18-44 were the highest users of gabapentinoids.

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Over-the-counter Medical Device Offers Promise for Long Term Chronic Pain Relief

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Ian Rawe Ph.D
BioElectronic Corporation
Frederick, MD

http://www.bielcorp.com/products/actipatch/
ActiPatch

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

Response: The aim of this study was to investigate the long-term effectiveness of a neuromodulation medical device (ActiPatch®) in relieving chronic pain. The device is topically applied, paresthesia-free and uses high-frequency electromagnetic fields to mitigate nerve sensitization and provide pain relief. Identified as Pulsed Short Wave Therapy (PSWT), this technology is available over-the counter in many countries, including the US, Canada, EU and Australia.

While existing randomized, placebo controlled clinical trials demonstrated PSWT treatment effectiveness over several weeks, data on long-term effectiveness was unavailable. In this study, a sample of 240 chronic pain subjects, who reported clinically significant pain relief (reduction ≥ 2 VAS points) following a 7-day trial of the medical device, agreed to participate in a six-month study to investigate treatment durability. These subjects indicated an average chronic pain duration of 6.5 years, in multiple locations and from a wide spectrum of causes (etiologies). Moreover, these subjects reported that their existing pain management regimen (often multimodal therapy) provided inadequate relief, and that they experienced severe to moderate pain (≥ VAS of 8/10), daily.

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Non-Viral Gene Therapy Offers Hope for Pain Relief from Diabetic Neuropathy

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PainRelief.com Interview with:  
Sheila Yi, Helixmith

PainRelief.com: What is the background for this study? Would you explain how VM202 is unique?

  • Response: Diabetic peripheral neuropathy is one of the most common complications of diabetes and many of DPN patients suffer from severe pain that affects their daily activities and life quality. Though there are medications, both Rx and OTC drugs, used to ameliorate pains from diabetic peripheral neuropathy, many of them fall short of analgesic efficacy or often lead to not so trivial side effects. 
  • Engensis (VM202) is plasmid DNA therapy, non-viral gene therapy, which encodes hepatocyte growth factor (HGF) gene that is designed to simultaneously express two isoforms of HGF protein at high levels. HGF is known to have angiogenic and neurotrophic effects and, when expressed in the human body, induces formation of new micro vessels and nerve regeneration through remyelination and axon outgrowth, resulting in improvement in peripheral neuropathy condition. Engensis does not integrate into the human genome.
  • Historically, our research first focused on therapeutic angiogenesis of HGF with a proof of concept research in critical limb ischemia, an extreme form of peripheral artery disease. In the process, we realized that Engensis would also be effective for peripheral neuropathy, and a coffee chat with the current PI, Dr. Kessler of Northwestern University, led to an idea of using Engensis in neurological diseases.
  • Throughout Phase 1 through 3 clinical trials for DPN in the US, Engensis has been observed safe and well-tolerated in patients, and, during the Phase 3 study, received RMAT (regenerative medicine advanced therapy) designation from the FDA.
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Knee Osteoarthritis: Orthopedists Prescribing More NSAIDS and Less Lifestyle Management for Pain Relief

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PainRelief.com Interview with:

Samannaaz Khoja, PT, PhD
Research Assistant Professor
Department of Physical Therapy
University of Pittsburgh School of Health and Rehabilitation Sciences

Samannaaz Khoja, PT, PhD Research Assistant Professor Department of Physical Therapy University of Pittsburgh School of Health and Rehabilitation Sciences
Dr. Khoja

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

Response: The purpose of this study was to describe and compare rates of physicians’ recommendation for physical therapy (PT), lifestyle-counseling, and pain medication for knee osteoarthritis (KOA) between 2007 and 2015. The study also aimed to identify patient, physician and practice-level factors associated with each treatment recommendation.   We used survey data from the National Ambulatory Medical Care Survey, data from this survey is publicly available and is housed within the CDC. We identified 2297 knee OA related visits, which approximated to 67 (±4) million weighted physician visits between 2007 and 2015 (around 8 million visits/year).

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