Tag Archives: #pain

New Implantable Technology Stimulates Spinal Cord for Pain Relief

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PainRelief.com Interview with:
Christopher M Proctor, PhD
Group Leader, Bionic Systems Group
BBSRC David Phillips Fellow
Electrical Engineering Division University of Cambridge
United Kingdom

Dr. Proctor

PainRelief.com:  What is the background for this study?  What types of pain might be amenable to treatment with this device?

Response: Spinal cord stimulation has been shown to be effective for patients with severe neuropathic pain. However, the most effective devices that are clinically available today require a rather invasive surgical procedure. Our innovation aims to reduce the surgical burden while providing the best possible treatment.

PainRelief.com: Would you describe the technology?

Spinal Implant – Unrolling

Response: Our minimally invasive spinal cord stimulator is an ultra thin implant that can be inserted into the epidural space within the spinal column through a needle. Once in place, the device can be expanded in a controlled way to cover a large area along the spinal cord.  Covering a large area allows for more precise targeting of the nerves that cause you to feel pain.

PainRelief.com: What recommendations do you have for future research as a result of this work?

Response: We believe that this technology could vastly expand the use of spinal cord stimulation for patients with chronic pain conditions.  We are currently fundraising to conduct further pre-clinical testing with an aim to be ready for clinical testing within 3 years.

Any disclosures? The main authors of this study are co-inventors on a related patent application.

Citation:

Electronics with shape actuation for minimally invasive spinal cord stimulation

BY BEN J. WOODINGTON, VINCENZO F. CURTO, YI-LIN YU, HÉCTOR MARTÍNEZ-DOMÍNGUEZ, LAWRENCE COLES, GEORGE G. MALLIARAS, CHRISTOPHER M. PROCTOR, DAMIANO G. BARONE

SCIENCE ADVANCES 25 JUN 2021 : EABG7833

The information on PainRelief.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

Genicular Artery Embolization: A Promising Therapy for Pain Relief from Knee Arthritis

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PainRelief.com Interview with:
Dr. Siddharth A. Padia, MD
Interventional Radiology
Ronald Reagan UCLA Medical Center
UCLA Santa Monica Medical Center

Dr. Padia, MD

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

Response: Osteoarthritis (OA) of the knee can be a debilitating condition with significant impact on a person’s overall quality of life. OA has historically been considered a “wear-and-tear” disease, resulting from years of stress induced cartilage degeneration. Recent data suggests that inflammation plays a role not only in the experience of pain secondary to osteoarthritis, but is a driver of OA itself. 

Genicular artery embolization (GAE) is a minimally invasive procedure where the arteries supplying the lining of the knee are selectively catheterized during an angiogram to target abnormally increased blood flow associated with knee osteoarthritis. Injection of small, microspheres results in a reduction in arterial flow, which may in turn reduce the synovial inflammation. 

PainRelief.com: What are the main findings?

Response: 40 subjects were enrolled in this trial. Technical success was achieved in 100% of subjects. Transient skin discoloration and transient mild post-procedure knee pain were common and expected. Pain scores decreased from a 8 (out of 10) at baseline to 3/10 (63% decrease) at 12 months. Twenty-seven patients (67.5%) had greater than a 50% reduction in pain scores. 

PainRelief.com: What should readers take away from your report?

Response: Genicular artery embolization is a highly promising therapy for people with knee arthritis, who are not surgical candidates or which to defer surgery. It is the first non-surgical treatment that has shown to have a significant reduction in pain with a duration of at least one year. It is minimally invasive, and most people can resume their everyday activities the evening after their procedure. 

PainRelief.com: What recommendations do you have for future research as a result of this work?

Response: This was a single arm trial, in that genicular artery embolization was not compared to other treatments. Future research needs to show a comparison to other treatments or placebo in order to prove its efficacy. Additionally, long-term result (2 and 4 years) would be beneficial to show the durability of GAE over time. 

Citation:

Abstract No. 16 Genicular artery embolization for the treatment of knee osteoarthritis: final results from a prospective investigational device exemption trial
Padia, S. et al. Journal of Vascular and Interventional Radiology, Volume 32, Issue 5, S8

https://www.jvir.org/article/S1051-0443(18)31829-3/fulltext

The information on PainRelief.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

UTHealth SA Researchers Study Link Between Omega Fatty Acids and Peripheral Neuropathy

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PainRelief.com Interview with:
Ken M. Hargreaves, DDS, PhD
Professor and Chair
Department of Endodontics
The University of Texas Health Science Center at San Antonio

Dr. Hargreaves

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

  1. About ten years ago our lab found that the omega-6 lipids can generate pain-producing lipids by activating the capsaicin (found in red hot chili) receptor. At about that time, other scientists reported that a related lipid, the omega-3, can generate pain-relieving lipids. 
  2. Scientists have known for a long time that both omega-6 and omega-3 lipids are “essential fatty acids”, meaning that our body does not make them so they must come in our diet.
  3. So, we tested the idea that a high omega-6 diet would be a risk factor for pain. That is exactly what we found: mice fed a high omega-6 diet had greater pain-like responses after inflammatory or neuropathic injury.
  4. Mice with diabetic neuropathy actually had worsening of symptoms after a high-6 diet. Importantly, this was largely reversed in mice fed a high omega-3 diet.
  5. We also found a drug that blocked the release of the omega-6 lipids from cell membranes and this drug significantly reduced diabetic neuropathy pain in mice.
  6. We then transitioned to clinical research.  We collected ankle skin biopsies from participants with type II diabetic neuropathy and from age- and sex-matched controls.  The tissue levels of omega-6 lipids predicted pain levels, with higher omega-6 lipids associated with higher reports of pain.

PainRelief.com: What should readers take away from your report?

  1. Dietary recommendations have been made for patients with many disorders such as cardiovascular disease, diabetes and autoimmune disease.  Our findings suggest that pain should be added to this list and that a diet enriched with a higher ratio of omega-3 to omega-6 lipids may help to reduce pain.
  2. Examples of foods with a high omega 3:6 ratio are tune (25:1 of omega 3:6), broccoli (6:1), flax seeds (4:1), mango (3:1), spinach (5:1) and lettuce (2:1).  Examples of foods with excessive omega-6:3 would include many processed foods cooked in vegetable oils such as French fries, hamburgers and the like.

PainRelief.com: What recommendations do you have for future research as a result of this study?

Response: Our study has identified several paths for future research including a clinical trial evaluating the effects of a high omega 3:6 diet on pain, development of new drugs to block omega-6 release and the possible development of lipids as a biomarker for pain.

No disclosures.  

Citation:

Boyd, J.T., LoCoco, P.M., Furr, A.R. et al. Elevated dietary ω-6 polyunsaturated fatty acids induce reversible peripheral nerve dysfunction that exacerbates comorbid pain conditions. Nat Metab 3, 762–773 (2021). https://doi.org/10.1038/s42255-021-00410-x

The information on PainRelief.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

Green Light Therapy Can Augment Traditional Pain Relief Methods

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PainRelief.com Interview with:
Mohab Ibrahim, MD., Ph.D
Associate Professor, Departments of Anesthesiology, Neurosurgery, and Pharmacology.
Director, Chronic pain clinic. 
Director, Chronic pain fellowship. 
Medical Director, Comprehensive Pain and Addiction Center
Banner-University Medical Center
University of Arizona

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

Response: This study is the continuation of the green light story we first published in 2017. Our first paper in 2017 investigated the effect of green light on pain behavior in animals. This idea was inspired by my brother who suffers from headaches and finds relief in green spaces. My brother’s experience with green spaces inspired me to look initially into green light therapy for pain in rodents which resulted in our first publication in 2017.  Because green light therapy decreased pain behavior in animals coupled with the safety profile of green light (we use low-intensity green light), we obtained approval from the University of Arizona to conduct human trials. This has resulted in two clinical trial papers that were recently published.

We have shown that green light exposure decreased the severity of pain in patients with fibromyalgia and also decreased the intensity and frequency of migraine headaches in migraine patients. At this point, we wanted to explore the mechanism(s) of action and explain how green light works. We had some preliminary data from our initial publications pointing towards the endogenous opioid system. Therefore, we decided to explore the endogenous opioid system in more detail in the HIV-induced neuropathy model in rodents. Our findings indicate that green light reversed hypersensitivity in a model of HIV-related neuropathy in rodents by stimulating the endogenous opioid system. Green light exposure significantly increased the CSF levels of β-endorphin and proenkephalin, but not dynorphin. The µ- and δ-opioid receptors appeared to be key actors in green light-induced antinociception. 

PainRelief.com: What should readers take away from your report?

Response: Chronic pain is a complicated medical condition with several dimensions. Chronic pain may affect sleep quality, life quality, and may result in depression.

The management of chronic pain requires a deep appreciation of the factors involved and necessitates the evaluation of a pain specialist and the collaboration of several medical specialists.

Non-pharmacological methods can be used to complement current pharmacological and procedural interventions to control pain.

Color and light therapy are still in their infancy and we still need to learn more about them. More research and more funding are needed to better understand the biological

Green light therapy can augment current traditional methods to control pain.

If you live in an area with trees or forests, you can enjoy free green light therapy while walking and exercising. It’s a win-win situation.

PainRelief.com: What recommendations do you have for future research as a result of this work?

Response: We and other labs have shown that different colors of light have biological effects. It’s important that we start looking at new indications for light therapy as well as mechanisms of action. Light therapy is relatively a new field and there may be some or a lot of skepticism in the scientific community about its benefits. It may be time to start thinking about organizing regional/national annual meetings focused on the medical benefits of light therapy. This type of meeting will foster collaborations among physicians and scientists and attract more attention and interest in this field.

Finally, looking at the financial burden secondary to the price and cost of medications and the side effects associated with some of these interventions, light therapy may offer a safer complementary tool that is more affordable and has fewer side effects than a significant number of medications. While light therapy may not replace traditional medications, it may decrease the amount of medications needed.

PainRelief.com: Is there anything else you would like to add?

Response: Even though green light therapy is easy to do and relatively safe, I advise anyone who wishes to try it to consult their physicians first. Some medical conditions may not be suitable for extended visual light exposure. Always check with your doctor before you start any new therapy. Also, please do not stop ANY medication you are on without consulting with your physician first. Some medications should not be stopped abruptly.

Finally, as a disclosure, I have a patent for the green light therapy, and it is currently being commercialized.

Citation:

Laurent F. Martin, Aubin Moutal, Kevin Cheng, Stephanie M. Washington, Hugo Calligaro, Vasudha Goel, Tracy Kranz, Tally M. Largent-Milnes, Rajesh Khanna, Amol Patwardhan, Mohab M. Ibrahim,

Green light antinociceptive and reversal of thermal and mechanical hypersensitivity effects rely on endogenous opioid system stimulation,

The Journal of Pain, 2021,

The information on PainRelief.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

Playing Virtual Reality Games May Provide Some Pediatric Pain Relief

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PainRelief.com Interview with:
Henry Xiang MD MMBA
Professor of Medicine and
Director of Center for Pediatric Trauma Research
Nationwide Children’s Hospital
Professor of Pediatrics
The Ohio State University College of Medicine.

Dr. Xiang


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

Response: The rationale for the study is that burn dressing changes are very painful, and physicians/nurses sometimes must prescribe high dose of opioid pain medications to manage the pain. Because of the repeated painful dressing changes, a lot of children have anxiety about the upcoming burn dressings change.

PainRelief.com:  What are the main findings?

Response: Our main findings are:

1) Smartphone-based VR games could be an effective pain management tool for pediatric burn patients;

2) Actively playing the virtual reality games is more effective in managing the pain than just watching the same VR game.

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Ketorolac vs Ibuprofen for Acute Low Back Pain Relief

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PainRelief.com Interview with:
Benjamin W. Friedman, MD, MS, FAAEM, FACEP, FAHS
Professor of Emergency Medicine
Vice-chair for Clinical Investigation
Department of Emergency Medicine
Albert Einstein College of Medicine
Montefiore 
Bronx, NY 10467

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

Response: A very large number of patients present to US EDs annually with back pain. No medications have proven more effective than NSAIDs for low back pain. Similarly, combining other medications such as skeletal muscle relaxants or opioids with NSAIDs does not improve outcomes more than NSAIDs alone.

Prior to our study, little was known about which NSAIDs were most efficacious for acute low back pain.

The main finding of our study is that ketorolac was more efficacious than ibuprofen for some two and five day outcomes that are important for patients.

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Infused VYEPTI Provided Pain Relief When Initiated During a Migraine Attack

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PainRelief.com Interview with:
Roger Cady, MD
VP Neurology
Lundbeck Pharmaceutical
La Jolla Research Center
San Diego, CA 92121

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

Response: The RELIEF study evaluated how preventive migraine candidates may benefit from a VYEPTI infusion during an active migraine attack when administered within 1 to 6 hours of a moderate to severe migraine attack. VYEPTI is the first and only intravenous (IV) infusion approved for the preventive treatment of migraine in adults.

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Chronic Pain Increasing in Every Age and Demographic Group

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PainRelief.com Interview with:
Hanna Grol-Prokopczyk PhD
Associate Professor
Department of Sociology
University at Buffalo, SUNY

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

Response: Although chronic pain is recognized as an extremely common and costly health problem, little research has explored temporal trends in pain prevalence.  Indeed, as recently as 5-6 years ago, there was no published research using general population data examining whether pain prevalence in the U.S. was going up, going down, or staying constant.  (This can be contrasted to conditions such as diabetes and cancer, for which information about long-term trends is readily available.  Of note, chronic pain affects more Americans than diabetes, cancer, and heart disease combined.)  In recent years, a few studies have documented rising pain prevalence in the U.S., but most have used data on middle-aged or older adults.

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Fusion vs Replacement for Pain Relief from Ankle Arthritis

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PainRelief.com Interview with:
Bruce J. Sangeorzan, M.D., Professor
Director, RR&D Center for Excellence in Limb Loss Prevention and Prosthetic Engineering
Veterans Affairs
University of Washington

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

Response: We began a series of studies in the early 2000’s when ankle replacement was limited to a few centers like our own. We knew that ankle arthrodesis– or fusion—was an effective treatment for ankle arthritis. But ankle fusion is not appropriate for some people and it also results in loss of ankle motion. There were a growing number of ankle replacements being done but little was known about their effectiveness or how long they last.

We wanted to study whether replacement and fusion were comparable for pain relief and activity and wanted to know if maintaining motion of the ankle (by using a replacement) would have an advantage without additional risk. Three studies were done involving more than 800 patients from 6 centers.

This most recent study compared two groups of patients who had similar amount of pain and activity before treatment. All of the patients had already tried non -surgical solutions such as activity modification, bracing and injections with out improvement. One group had fusion of the ankle and the other had replacement of the ankle. Patients were questioned and examined four years or more after surgery and compared to their condition before treatment.

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Study Evaluates Placebo Effect of CBD on Pain Relief

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PainRelief.com Interview with:
Martin De Vita, CPT, MS, USA
Doctoral Candidate
Clinical Psychology Department
Syracuse University

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

Response: Seemingly out of nowhere, cannabidiol (CBD) products became immensely popular. Cross-sectional studies showed widespread use among the public for various clinical conditions. Pain was by far the most commonly reason cited for using CBD. However, no human experimental pain studies had been conducted to evaluate the analgesic effects of CBD. A lot of people questioned whether CBD effects on pain were just a placebo.

To answer this question, we tested people’s baseline pain responding using sophisticated equipment capable of delivering safe, but painful stimulation that activates and evaluates human nervous system processes. Then we administered either CBD or a placebo and re-tested these pain outcomes to see how they changed. We took it a step further and manipulated the information that participants were given about which substance they received. So in some conditions, participants were told they got CBD, even though it was just a placebo. In other conditions, participants were told they got an inactive substance, despite actually receiving CBD. This way, we could test whether simply telling someone that they had received CBD would have an effect on their pain. These are called expectancy effects and there is a large body of literature that supports this phenomenon.

When we looked at the data, we found that CBD analgesia was actually driven by both expectancies (placebo analgesia) and pharmacological action. We also found that these manipulations affected different pain outcomes. We found that both CBD and expectancies reduced pain unpleasantness but not pain intensity. The results were complex in that CBD and expectancies for receiving CBD differentially affected various outcomes. This was exciting because we are left with even more questions to investigate in future research.

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