Opioid Prescriptions Differ Between Surgeons and Advanced Practice Clinicians

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.

Altered Body Perception in Stroke Survivors with Chronic Pain

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.

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

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.

Wake Forest Study Finds Diet and Exercise Can Lead to Pain Relief from Knee Arthritis

PainRelief.com Interview with:
Stephen P. Messier, Ph.D.
Professor J.B. Snow Biomechanics Laboratory
Department of Health and Exercise Science
Worrell Professional Center
Wake Forest University
Winston Salem, NC 27109

Dr. Messier

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

Response: Some weight loss and exercise programs that have been successful in academic center-based trials have not been evaluated in community settings.  The results showed that among patients with knee osteoarthritis and overweight or obesity, diet and exercise compared with an attention control led to statistically significant differences in pain, function, mobility, body weight, waist circumference, and quality of life.

Potential Unintended Harms of Discontinuing Opioid Treatment For Chronic Pain

PainRelief.com Interview with:
Mary Clare Kennedy, PhD
Canada Research Chair in Substance Use Policy and Practice Research
Assistant Professor, School of Social Work
University of British Columbia | Okanagan Campus
Research Scientist, British Columbia Centre on Substance Use

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

Response: In an effort to reduce opioid-related harms, Canada and the United States have implemented guidelines for prescribing opioids for chronic pain. One of the recommendations in these guidelines is that prescribers reduce opioid doses and potentially discontinue treatment when risks outweigh benefits. Concerns have been raised that these guidelines could result in more clinicians inappropriately reducing doses or cutting patients off of prescribed opioids, which could increase the risk of harms such as overdose. However, the effects of discontinuing and tapering opioid treatment for pain on overdose risk have been understudied. 

Marijuana May Be Substituting for Opioids for Cancer-Related Pain Relief

PainRelief.com Interview with:
Yuhua Bao, PhD
Department of Population Health Sciences, Department of Psychiatry
Weill Cornell Medicine, New York, New York

Dr. Yuhua Bao

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

Response: We know that opioid use is declining among cancer patients. We also know that marijuana use is increasing among cancer patients; this increase is related to the recent wave of medical marijuana legalization (adopted by 37 states and D.C. as of Feb 2022).

We do not know if medical marijuana legalization has led to changes in opioid use for cancer patients and what were the implications for cancer pain outcomes.

Ultrasound Guided Dry Needling Boosts Pain Relief for Patients with Knee Osteoarthritis

PainRelief.com Interview with:
Dr PANG Chun Yiu Johnson
Assistant Professor
School of Health Sciences
Caritas Institute of Higher Education
Hong Kong

Mr PANG

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

Response: As a practicing physiotherapist for over 20 years in an outpatient setting at a government-based hospital, I had encountered difficult situations where patients were suffered with long-term pain that pervious treatments were ineffective or wasn’t long lasting.

Dry needling is a treatment technique that I had always been interested and practicing even during my college times. With years of practice, it has become a skill that I specialized in and received promising results from most of my patients.

However, like most techniques, it has its limitations. Microtrauma inducted by the puncturing of the needles elicit inflammatory response that activate mast cells proliferation to promote tissues healing. As a result, the effectiveness of dry needling depends on the expertise and skill of the practitioners to accurately locate the problematic structure for the insertion of needles.

The inconsistency results of studies with dry needling can be attributed to the absence of a standardized approach and inaccuracies related to needle targeting and advancement.

With that in mind, I wanted to investigate and validate a method that can enhance the accuracy of needle advancement and improve the effectiveness of dry needling. Through constantly researching evidence-based publications, coincidently I came across an article that incorporated ultrasound guidance into dry needling on treating shoulder impairments. The results were promising, both in patient’s feedback and ultrasound imaging, since the practitioner was able to clearly identify the problematic structure under ultrasound guidance. This had inspired me to further investigate the effectiveness of ultrasound-guided dry needling on different musculoskeletal conditions.

Pain Relief from Osteoarthritis Achieved Through Digital and Face-to-Face Interventions

PainRelief.com Interview with:
Thérése Jönsson, PT, PhD
Research group, Sport Sciences
Department of Health Sciences
Lund University

Dr. Jönsson

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

Response: Osteoarthritis (OA) is the most common joint disease and affects more than 300 million people worldwide. Exercise combined with patient education and weight control, if needed is the first-line treatment for OA. Traditionally, first-line treatment has been provided as a face-to-face intervention, requiring the patient to physically visit a primary care clinic or similar.

To increase access to healthcare for the wider community, digital health care interventions are recommended by the World Health Organization to complement traditional care. Digital care platforms have been introduced, but there is limited evidence for their efficacy compared with traditional face-to-face treatment modalities.

Chronic Pain Linked to Later Life Pessimism and Joblessness

PainRelief.com Interview with:
Alex Bryson PhD
Professor of Quantitative Social Science
UCL Social Research Institute
University College London  London

Prof. Bryson

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

Response: The authors were concerned to know more about both the incidence of chronic pain and its implications for health, wellbeing and labour market prospects later in life.  So we turned to a birth cohort study (The National Child Development Study) tracking all those born in Britain in a single week in 1958 through to age 62 to take a life-course approach.

Yoga for Knee Arthritis: Some Improvement in Function but No Pain Reduction

PainRelief.com Interview with:
Professor Kim Bennell FAHM
Barry Distinguished Professor | NHMRC Leadership Fellow
Dame Kate Campbell Fellow
Centre for Health Exercise and Sports Medicine
Department of Physiotherapy
Melbourne School of Health Sciences
The University of Melbourne, Victoria Australia

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

Response: Osteoarthritis is very common, and a major contributor to disability and decreased function. Exercise is a key treatment for osteoarthritis, but many people admit to not undertaking exercise. We investigated whether a free, online 12-week unsupervised yoga program (“My Joint Yoga”) could improve pain and function in people with knee osteoarthritis. Our team worked with yoga therapists, physiotherapists and people with lived experience of osteoarthritis to design an online yoga program tailored specifically to those with knee osteoarthritis.