Tag Archives: #pain

Both High and Low Dose Exercise Beneficial for Knee Osteoarthritis

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PainRelief.com Interview with:
Tom Arild Torstensen
Department of Neurobiology, Care Sciences and Society
Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden, and
Holten Institute, Stockholm, Sweden 

Tom Arild Torstensen

PainRelief.com: What are the main findings?
Response: The results from our study (1) show that both high-dose and low-dose exercise therapy is beneficial for knee osteoarthritis. At a glance, it would be natural to think that I should choose a low-dose because it takes only 30 minutes and consists of 5 different exercises compared to the high-dose lasting 70 to 90 minutes consisting of 11 exercises. But because our study was designed as a superiority trial, meaning that even though we failed to show that high-dose treatment is superior to low-dose, our results do not imply that a low-dose exercise regimen is as beneficial as a high-dose regimen. 

Both groups improved over time, but there were no benefits of high-dose therapy in most comparisons. One exception was the KOOS score function in sports and recreation, where high-dose therapy was superior at the end of treatment and the 6-month follow-up. A small benefit in QoL at 6 months was also observed. Notably, most variables numerically favored the high-dose group, albeit not in a statistically or clinically meaningful way.

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Twin Study Finds Cannabis Legalization Did Not Cause Substantial Psychological Harm in Adults

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PainRelief.com Interview with:
Stephanie Zellers PhD
Postdoctoral Researcher, Kaprio Group, FIMM
Dr. Zellers began this research as a graduate student at the
University of Colorado Boulder’s Institute for Behavioral Genetics (IBG)

Dr. Zellers PhD

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

Response: Proponents and opponents of cannabis legalization respectively cite various potential benefits and harms that these policies may cause. Many studies have evaluated these outcomes, but drawing causal conclusions is challenging due to the many confounds that may better explain observed effects.

 We investigated the effects of cannabis legalization on a broad range of psychological outcomes, like substance use, psychiatric symptoms, general functioning in daily life, and cognitive ability. We used a longitudinal twin sample with twin pairs living in different types of states (recreationally legal vs. recreationally illegal) to draw causally informative conclusions. Because identical twins share 100% of their genes, as well as environmental factors like the family rearing, SES, and community norms, co-twin control studies can rule out many alternative explanations for an observed relationship.

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Bisexuals Found to Use More and Varied Cannabis Products

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PainRelief.com Interview with:
Carrie Cuttler, Ph.D.
Assistant Professor
The Health & Cognition (THC) Lab
Department of Psychology
Washington State University

Dr. Cuttler

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

Response: While we know that sexual minorities (such as gay, lesbian, bisexual, etc.) individuals use many substances, including cannabis, more than heterosexual individuals, we don’t know very much about patterns of sexual minorities’ cannabis use or why sexual minorities are motivated to use cannabis. We also don’t know as much as we should about how cannabis use is related to mental health among sexual minorities. Our study used data from Project ART (Addictions Research Team) to examine these questions. The data were collected from 10 different universities across the United States, and we included data from almost 5,000 young adults (aged 18-30) in this study. People answered questions about their cannabis use, motivations for using cannabis, mental health symptoms, and also indicated their sexual attraction on a scale. The majority of our sample identified their sexual attraction as exclusively heterosexual, a small number indicated exclusively same-sex attraction, and almost a quarter indicated that their sexual attraction was somewhere between those two (the group classified as bisexual).

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Acupuncture During Gynecology Cancer Surgery Reduced Post-Op Pain

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PainRelief.com Interview with:
Prof. Eran Ben-Arye MD
Co-founder and director of the Unit of Complementary and Traditional Medicine
Department of Family Medicine, Haifa
Director of the Integrative Oncology Program within the Haifa and Western Galilee Oncology Service, Lin Medical Center, Clalit Health Services
Chairperson of the Israel Society for Complementary Medicine of the Israel Medical Association

Prof. Ben-Arye

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

Response: The study was part of an initiative whose stated goal was providing continuity of integrative oncology care to patients with gynecology cancer. Over the past 14 years we have been offering patients undergoing chemotherapy with integrative oncology treatments without charge, helping improve their quality of life and increasing their adherence to the conventional oncology treatment protocol.

The research presented in the current paper examined the introduction of the integrative treatment from as early as the time of cancer diagnosis and throughout the pre-surgical, surgical and post-surgical inpatient setting.
The integrative process was a collaborative effort, taking place together with a team of surgeons, anesthesiologists and nurses throughout all stages of peri-operative care of the gynecology oncology patient. 

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Medical Clowns Help Patients Deal With Emotional and Physical Pain

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PainRelief.com Interview with:
Orit Karnieli-Miller, PhD
Associate Professor
Head of the Department of Medical Education,
Sackler Faculty of Medicine, Tel Aviv University, Israel

Dr. Karnieli-Miller

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

Response: In recent years Medical clowns have been more and more integrated into hospitals. Still, there needs to be more understanding of their roles, therapeutic goals, and skills. This understanding is necessary both to help professionalize medical clowning and train them and allow other health professionals to work well with them.

To do this, we systematically analyzed medical clowns’ skills within three typical challenging encounters: with an adolescent who is in pain, not willing to do recommended treatment exercise; with an adolescent and a physiotherapist in a painful treatment session; and with a mother of a sick child.

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State Opioid Prescribing Limits Did Little to Reduce Length of Dental Prescriptions

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PainRelief.com Interview with:
Kao-Ping Chua, MD, PhD
Susan B. Meister Child Health Evaluation and Research Center
Department of Pediatrics, University of Michigan Medical School
Ann Arbor MI 48109.

Kao-Ping Chua
Dr. Kao-Ping Chua

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

Response: U.S. dentists account for approximately 11 million opioid prescriptions each year. Excessive opioid prescriptions from dentists can result in leftover opioids that can be diverted or misused. In part to prevent this, most states enacted policies between 2016 and 2018 that restricted the duration of opioid prescriptions for acute pain, such as dental pain.

The objective of this study was to evaluate whether these state opioid prescribing limits were associated with reductions in the duration of opioid prescriptions from dentists. Using national prescription dispensing data from 2014-2020 and a rigorous quasi-experimental study design, we found that this duration did not change after limit enactment. A likely explanation is that most limits allow up to a 7-day supply of opioids, but the typical duration of dental opioid prescriptions during the study period was about a 3-day supply. For this reason, state limits had little ability to reduce this duration in the first place.

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Patients Report Substituting Cannabis for Pain Relief Medications

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PainRelief.com Interview with:
Mark Christopher Bicket, MD, PhD
Assistant Professor,Department of Anesthesiology
Assistant Professor,Health Management and Policy
School of Public Health
University of MichiganAnn Arbor, MI 48109

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

  • Most states have laws that allow people with chronic pain to use cannabis as a treatment. But evidence about whether medical cannabis use lowers the use of other treatments for chronic pain is not clear. 
  • We conducted a rigorous survey of adults living in the 36 states and D.C. in the spring of 2022.
  • Among the 1,661 adults who had chronic pain, we asked about their use of cannabis, prescription opioids, and non-opioid treatments for chronic pain. 
  • Cannabis use for chronic pain was common, reported in roughly 3 in 10 people at any time and 1 in 4 in the past year.
  • In contrast, a minority said cannabis use decreased their use of non-pharmacologic treatments like physical therapy or meditation, and some reported their use increased.
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Opioid Prescriptions Differ Between Surgeons and Advanced Practice Clinicians

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PainRelief.com Interview with:
Caitlin Priest, MD
Integrated Plastic Surgery Residency
Department of Surgery
Michigan Medicine

Dr. Priest

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

Response: Opioid pain medications are commonly provided after surgery to help with acute postsurgical pain, however, these prescriptions often exceed what is used by most patients, resulting in excess opioids. Advanced practice clinicians (nurse practitioners and physicians assistants) are becoming an increasingly important part of surgical care teams. Despite their growing role in providing care for surgical patients, there is little data on the perioperative opioid prescribing practices of advanced practice clinicians.

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Altered Body Perception in Stroke Survivors with Chronic Pain

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PainRelief.com Interview with:
Dr Brendon Haslam PhD
La Trobe University and The Florey Institute of Neuroscience and Mental Health
University of Melbourne
On behalf of the research team that is a collaboration of researchers from the University of South Australia, La Trobe University, University of Melbourne and University of California, San Francisco

Dr Haslam PhD

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

Response: People who experience a stroke are three times more likely to experience chronic pain than the general population. Chronic pain following stroke has additional impact on stroke survivors, making it even harder for them to carry out everyday tasks related to their personal care, occupational and recreational activities. As a result, stroke survivors with chronic pain suffer additional disorders of mood, including depression, that further reduce their quality of life beyond that that is caused by the stroke itself.

Unfortunately, there is currently very little evidence to show effective treatments for stroke survivors with chronic pain. This includes the use of medications and other health therapies. In looking to understand chronic pain following stroke, and be able to develop new therapy approaches for this population, we explored how stroke survivors with and without pain perceive their own bodies. For this study, we particularly explored how they perceived their hand size to be.

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CMAJ Study Finds Metformin Associated with Reduced Risk of Joint Replacement in Diabetic Patients

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PainRelief.com Interview with:
Zhaohua Zhu (Alex)
PhD, Associated Professor
Clinical Research Center
Zhujiang Hospital of Southern Medical University

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

Osteoarthritis is a leading cause of pain and disability in older adults, but there are no effective drugs in preventing or reversing osteoarthritis progression.

•Metformin is the first-line pharmacologic treatment and the most commonly prescribed drug worldwide for diabetes mellitus.

•Recent experimental studies have showed that both intragastric and intraarticular metformin use can attenuate cartilage degradation and modulated pain in osteoarthritis mouse models. However, it is unclear whether metformin use is associated with reduced risk of total joint replacement in patients with type 2 diabetes mellitus.

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