Targeting Specific Inflammatory Cells May Offer Enhanced Pain Relief

PainRelief.com Interview with:
Prof. Dr. Halina Machelska
Department of Experimental Anesthesiology
Charité-Universitätsmedizin Berlin
Berlin, Germany

Prof. Dr. Halina Machelska
Department of Experimental Anesthesiology
Charité-Universitätsmedizin Berlin
Berlin, Germany

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

Response: Pathological pain such as pain resulting from nerve injury is often accompanied by inflammation. This is manifested by accumulation of immune cells, including macrophages, in the damaged tissue. Current research mostly emphasizes the role of these cells in the enhancement of pain. One of the suggested strategies in the basic research is to deplete immune cells from the affected tissue. However, several previous preclinical studies, including our own, have shown that this approach did not sufficiently decrease pain. We think that one of the reasons is that not all immune cells invading damaged tissue are detrimental and in fact, some are needed there to counteract pain.

Macrophages are very heterogeneous and they comprise at least two subpopulations, pro-inflammatory M1 and anti-inflammatory M2 macrophages. Our idea in this study was to promote the analgesic properties of macrophages. We took advantage of the cytokine interleukin-4 (IL-4) to switch macrophages from the M1 to the M2 state.

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Chiropractic Care Linked to Lower Use of Opioids for Spinal Pain Relief

PainRelief.com Interview with:
Jim Whedon DC, MS
Director of Health Services Research
SCU Health System
Southern California University of Health Sciences
Whittier, CA 

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

Response: Utilization of nonpharmacological pain management may prevent unnecessary use of opioids.

Our objective was to evaluate the impact of chiropractic utilization upon use of prescription opioids among patients with spinal pain. Overall, in the states of CT, MA and NH, at any particular time in the study period of 2012-2017, between 1.55 and 2.03 times more nonrecipients of chiropractic care.filled an opioid prescription, as compared with recipients.

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Animal Study Finds Ibuprofen for Pain Relief Can Cause Liver Damage

PainRelief.com Interview with:
Aldrin V. Gomes, Ph.D., FAHA
Professor and Vice-Chair for Teaching,
Department of Neurobiology, Physiology, and Behavior
University of California, Davis
Davis, CA 95616

Dr. Gomes

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

Response: While many over the counter non-steroidal anti-inflammatory drugs (NSAIDs) now include a warning about potential cardiovascular disease, warnings about liver injury are hardly mentioned. This is because most NSAIDs including ibuprofen is considered to have very little potential to cause liver toxicity.

However, a 2018 publication (doi: https://doi.org/10.1016/j.cgh.2017.07.037) showed a relatively high prevalence of ibuprofen -induced liver injury in Spanish and Latin-American DILI (Drug induced liver injury) registries. As such, we were interested in determining what effects, if any, ibuprofen had on mice liver.

Gene Responsible for Sensing Mechanical Pain Identified

PainRelief.com Interview with:
Reza Sharif Naeini, Ph.D.
Associate Professor
Department of Physiology & Cell Information Systems Group
McGill University
Life Sciences Complex (Bellini),
Montréal, Québec

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

Response: My lab is interested in understanding how our bodies detect signals from the environment, like our sense of touch and pain. This process is done by specialized sensors we have that detect mechanical stimuli, ranging from a hair deflecting under the wind, a gentle stroke, or a pinch. These sensors are called mechanosensitive ion channels and they convert mechanical forces into electrical signals that our nervous system can understand.

Their existence was first proposed in 1950 (to my knowledge) by Bernard Katz, and in 1999, researchers at the University of California in San Francisco, led by Dr. Jon Levine, demonstrated that pain-sensing neurons (termed nociceptors) express these channels. But their molecular identity remained elusive.

In 2010, the group of Dr. Ardem Patapoutian discovered the genes Piezo1 and Piezo2, with the latter being essential for our sense of touch and proprioception. While these findings were transformative to the field of somatosensation, mice lacking these genes were still able to respond to painful mechanical stimuli.

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Nebulized Ketamine May Offer Pain Relief to Emergency Room Patients

PainRelief.com Interview with:

Jefferson Drapkin BS
Research Associate
Maimonides Medical Center
Department of Emergency Medicine
Brooklyn, New York

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

Response: Nebulized administration of ketamine has been studied in the areas of palliative care, therapy for asthma, and acute postoperative management of sore throat. To our knowledge, there is no literature regarding analgesic efficacy and safety of nebulized ketamine’s role in managing acute painful conditions in the emergency department (ED).

As all five patients had a decrease in pain from baseline to 120 min, this case series demonstrates that the inhalation route of ketamine delivery via breath-actuated nebulizer may have utility for managing pain in the ED.

Safety And Efficacy Of The Unique Opioid Buprenorphine For Chronic Pain Relief

PainRelief.com Interview with:
Joseph V. Pergolizzi, Jr., M.D.

Co-Founder and Chief Operating OfficerNEMA Research Inc.

Joseph V. Pergolizzi, Jr., M.D.
 Co-Founder and Chief Operating OfficerNEMA Research Inc.

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

Response: Chronic low back pain (CLBP) is a leading cause of disability.

  • Acetaminophen and nonsteroidal anti-inflammatory drugs are first-line analgesic options or mild CLBP; however, when certain patients with moderate to severe CLBP do not achieve adequate pain relief, opioids are considered as an add-on therapy. Unfortunately, most opioid analgesics have the potential for adverse effects, abuse, and diversion.
  • Buprenorphine buccal film (Belbuca®) is an opioid analgesic classified as a Schedule III controlled substance in the United States and is a partial μ-opioid receptor agonist.
  • Buprenorphine buccal film is a unique analgesic that is approved by the US Food and Drug Administration for use in patients with chronic pain severe enough to require daily, around-the-clock, long-term opioid treatment for whom alternative treatment options are inadequate.
  • Two pivotal phase 3 clinical trials (Study 307, Clinical Trial ID NCT01675167, and Study 308, Clinical Trial ID NCT01633944) established the efficacy and safety profiles of buprenorphine buccal film.
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Older Adults More Likely to Misuse Opioids for Pain Relief

PainRelief.com Interview with:

Ty S. Schepis, PhD
Department of Psychology
Texas State University
San Marcos, TX

Ty S. Schepis, PhD
 Department of Psychology
 Texas State University
 San Marcos, TX
Dr. Schepis

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

Response: Prescription opioid misuse motives have been studied in adolescents, young adults, and across the population. One study across the population suggested that older adults differed from younger adults, but this was not fully clear.

We wanted to examine motives across age groups and to investigate the correlates of opioid motive groups in older adults (50 and older). We found that motives changed with aging, with increasing endorsement of pain relief motives, particularly pain relief without other motives.

In contrast, more recreational opioid misuse motives (e.g., to experiment, to get high) peaked in adolescents or young adults. Finally, non-pain relief motives in older adults (50 and older) were associated with higher rates of any past year substance use disorder and past year suicidal ideation.

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What Drugs Are Prescribed for Chronic Musculoskeletal Pain Relief?

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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Migraine: Aspirin Evaluated for Pain Relief and Prevention

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. 

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

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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