PainRelief.com Interview with: Patience Moyo, Ph.D Assistant Professor of Health Services, Policy and Practice Center for Gerontology and Healthcare Research Department of Health Services, Policy, and Practice Brown University School of Public Health
PainRelief.com: What is the background for this study?
Response: Clinical practice guidelines recommend nonpharmacologic treatments as first-line therapies for managing chronic pain. However, little is known about the use of guideline-recommended pain therapies and whether use varies in demographic subgroups. Individuals with co-occurring chronic pain and opioid use disorder deserve particular consideration because of their increased risk of harm from opioids and other pharmacologic therapies combined with their susceptibility to social and structural barriers to accessing health care.
We sought to understand whether the well-established racial and ethnic inequities in pain management extend to individuals with opioid use disorder and to nonpharmacologic pain treatments, specifically physical therapy and chiropractic care.
PainRelief.com Interview with: Peter Kent Adjunct Associate Professor Curtin School of Allied Health Curtin University, Perth WA, Australia
PainRelief.com: What is the background for this study?
Response: Although there had been clinical trials of Cognitive Functional Therapy (CFT) with promising results, there had not been a fully powered trial comparing CFT with usual care, nor any trials in Australia. Previous trials had included a maximum of 3 CFT clinicians, whereas the RESTORE trial included the training of 18 physiotherapists to CFT competency who had minimal prior exposure to CFT. No previous CFT trial had included an evaluation of 6161615g8cost effectiveness of CFT, nor examined whether the use of wearable motion sensor biofeedback might enhance the effect of CFT.
PainRelief.com Interview with: Chang Liu Researcher, PHD Student University of Sydney
PainRelief.com: What is the background for this study?
Response: Sciatica is a common condition caused by lumbar nerve root compression and/or inflammation, usually due to a herniated disc. Non-surgical treatments, such as exercise, are recommended as the first step, with pharmacological and interventional options available if needed.
Surgery, specifically discectomy, is a common treatment for sciatica but evidence supporting its effectiveness is uncertain.
PainRelief.com Interview with: Prof. Dr. Alberto De Vitta Department of Physical Therapy Centro Universitário das Faculdades Integradas de Ourinhos Água do Cateto, Ourinhos Brazil
PainRelief.com: What is the background for this study?
Response: This research is part of a line of research that addresses the intersectoriality between education and health, in which it seeks to study the various risk factors of the educational environment that can influence the health of schoolchildren.
PainRelief.com: What are the main findings?
Response: In this study the main results were: There is high prevalence and incidence of Thoracic Spine Pain (TSP) in high school students and the TSP is associated with the female sex, mental health problems, and body posture while using cell phones, tablets, and PCs as well as with the duration of use of cell phone and tablet.
Dr Michael Wewege, PhD Research Fellow – Neuroscience Research Australia
Prof. McAuley
Prof James McAuley, PhD Director – Centre for Pain IMPACT, Neuroscience Research Australia, Professor – School of Health Sciences, University of New South Wales Sydney, Australia
PainRelief.com: What is the background for this study?
Response: We conducted this study because medicines are the most common treatment for adults with acute non-specific low back pain. One of the most important questions is “What is the best medicine to use?” We wanted to compare the medicines with each other because this is the information patients and physicians want to know, but previous research has focused on only comparing medicines to placebo. Physicians are deciding between these medicines based on their clinical expertise; we hoped to support their decision making with a rigorous piece of research.
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.
PainRelief.com Interview with: Richard L. Skolasky, Jr., Sc.D. Professor, Orthopaedic Surgery and Physical Medicine & Rehabilitation Vice Chair of Research, Orthopaedic Surgery Director, Surgical Outcomes Research Center Johns Hopkins University 601 North Caroline Street, Room 5244 Baltimore, MD 21287
Dr. Skolasky
PainRelief.com: What is the background for this study?
Response: Low back pain (LBP) affects a sizeable proportion of the US population (from 1.4 to 20%), and accounts for substantial healthcare expenditures (between $12 billion and $91 billion, not accounting for indirect costs associated with loss of productivity and unemployment). Current recommendations for initial treatment of acute low back pain include physical therapy. Earlier initiation of physical therapy has been associated with less healthcare utilization and spending; however, these studies have been limited to single institutions or health systems. Research is needed to evaluate the effects of early physical therapy on healthcare use, particularly within the first 30 days after initial presentation for acute low back pain, when they are most likely to experience pain and seek care.
Michael Perloff, MD PhD Director, Neurology Pain Medicine, Boston Medical Center Assistant Professor, Boston University Medical School
PainRelief.com: What is the background for this study?
Response: Spine-related pain (low back pain/neck pain) is very common in older adults. Physicians can be reluctant to use pain medications older patients due to reduced liver and kidney function, comorbid medical problems and background polypharmacy. We performed an extensive review of the medical literature with a focus on double-blind, placebo controlled, clinical trials.
PainRelief.com Interview with: Douglas P. Beall, MD, FSIR Chief of Radiology Services Clinical Radiology of Oklahoma
Dr. Bealll
PainRelief.com: What is the background for this study?
Response: Degenerative disc disease (DDD) is the leading cause of chronic low back pain and one of the world’s most common medical conditions contributing to high medical and disability costs. Healthy spinal discs act aids spine movement and distributes force which allows for spine flexibility and even distribution of the load that is placed on the spine. Each has a firm outer layer and a soft, jelly-like core. With normal aging, discs tend to become dry, thin, cracked or torn, which can cause pain and abnormal motion.
Substances called hydrogels, with biochemical similarities to the intervertebral disc designed to augment both the core and outer layer, have been used for years to help repair degenerated discs. First-generation hydrogels are placed as a soft solid, through a surgical incision, but were not simple to place and had a tendency to migrate from where they were originally placed.
For a first-in-human trial, our team conducted a prospective, single-arm feasibility study to evaluate an experimental, injectable hydrogel for safety and performance in relieving chronic low back pain caused by DDD. We used a second-generation hydrogel (Hydrafil™) developed by ReGelTec, Inc.. Unlike earlier hydrogels, it can be temporarily modified into a liquid and injected rather than placed through a small incision. In 2020, this product received FDA’s breakthrough device designation, allowing expedited review based on promising early evidence.
We recruited 20 patients, aged 22 to 69, who each described their pain as four or higher on a zero to 10 scale. None had found more than mild relief from non-surgical management, which includes rest, analgesics, physical therapy, and back braces. Patients were sedated for the procedure, and the gel was heated to become a thick liquid. Guided by fluoroscopic imaging, an interventional radiologist used a 17-gauge needle to inject the gel directly into the affected disc(s). The gel filled in cracks and tears and adhered to the disc’s core and outer layer.
PainRelief.com Interview with: Donatella Bagagiolo Osteopath D.O. BSc. (Hons) Ost. Director of Research Department, Scuola Superiore di Osteopatia Italiana Torino Italy
PainRelief.com: What is the background for this study?
Response:Osteopathic medicine, depending on different legal and regulatory structures around the world, is a medical profession (e.g. USA), an allied health profession (e.g. UK) or a part of complementary and alternative medicine (e.g. Italy or France). Osteopathic medicine plays an important role primarily in musculoskeletal healthcare. In recent years, systematic reviews have been published to evaluate the clinical efficacy and safety of osteopathic medicine for conditions such as low back pain, neck pain and migraine. However, due to differences in methodologies and the quality of systematic reviews, no clear conclusions were achieved. The aim of our overview was to summarize the available clinical evidence on the efficacy and safety of osteopathic medicine for different conditions.
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