Study Finds Opioids No Better Than Placebo for Back or Neck Pain Relief

PainRelief.com Interview with:
Christine Lin | Professor
The University of Sydney                                           
Sydney Musculoskeletal Heatlh
Faculty of Medicine and Health, Sydney School of Public Health
Institute for Musculoskeletal Health                             
Gadigal Country King George V Building
Royal Prince Alfred Hospital NSW Australia

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

Response: Opioids are one of the most commonly prescribed pain medicines for low back pain and neck pain, but before this trial we did not have robust, direct evidence that they are effective for acute low back pain and neck pain.

PainRelief.com: What are the main findings?

Response: We found that taking opioids did not relieve acute low back pain and neck pain in the short term, and led to worse outcomes in the long term. We randomly assigned people with acute low back pain or neck pain to take opioids or placebo (identical tablets but with no active ingredients) for up to 6 weeks, in addition to getting the best advise on how to manage their pain from their doctor. We followed these people up for 1 year.

At 6 weeks, people in the opioid group did not report lower pain levels compared to people in the placebo group. Nor were there differences in pain outcomes at 2 and 4 weeks, or in other outcomes such as physical function, recovery time, or quality of life.

Surprisingly at 1 year, people who took opioids had slightly worse pain and an increased risk of opioid misuse.

Racial Differences in Chronic Pain Among Football Players

PainRelief.com Interview with:
Robert R Edwards, Ph.D.
Associate Professor of Anaesthesia
Pain Management Center
Brigham and Women’s Hospital

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

Response: Chronic pain affects over 100 million American adults, and is a leading cause of reduced quality of life. However, in the US, the of burden of pain falls most heavily on members of racial and ethnic minority groups who frequently report more pervasive and severe pain compared with those in the majority.

In this study we evaluated race differences in pain among nearly 4,000 former professional American-style football players who self-identified as either Black or white.

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Study Finds More Than 10 Million New Cases of Adult Chronic Pain Per Year

PainRelief.com Interview with:
Richard L. Nahin, MPH, PhD

National Center for Complementary and Integrative Health
National Institutes of Health, Bethesda, Maryland

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

Response: While there has been extensive research examining the prevalence of chronic pain, far less is known about the incidence of chronic pain.  Understanding the incidence of chronic pain is critical to understanding how such pain manifests and evolves over time.

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Key Driver of Neuropathic Pain Identified by Baylor College of Medicine Scientists

PainRelief.com Interview with:
Kimberley Tolias, Ph.D.
Professor
Department of Neuroscience
Biochemistry & Molecular Biology
Baylor College of Medicine
Houston, TX 77030

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

Response: Neuropathic pain is a chronic pain condition that affects millions of people worldwide, significantly impairing their quality of life.  Symptoms of neuropathic pain include spontaneous shooting or burning pain, pain from activities that don’t normally cause pain (allodynia), and heightened pain sensitivity (hyperalgesia).  Current treatment options for neuropathic pain, such as opioids, focus on symptom suppression and are generally ineffective and often cause unwanted side effect.  In order to develop safer, more effective chronic pain treatments, we need to better understand the processes that lead to neuropathic pain.

Neuropathic pain is caused by nerve damage from a variety of insults (e.g., injury, disease, infection, chemotherapy drugs), which trigger structural and functional changes in the neurons and synaptic connections that transmit pain signals.  These activity-dependent alterations in somatosensory neural circuits are thought to be responsible for the persistent symptoms associated with chronic pain, but how they are induced and maintained following nerve injury or disease remains unclear.  To address this problem, our research team, including lead and co-corresponding author Dr. Lingyong Li (now at University of Alabama at Birmingham), investigated the mechanisms that underlie neuropathic pain, with the goal of identifying strategies to prevent or control it.

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COCHRANE: Poor Evidence for Prescription Antidepressants for Pain Relief

PainRelief.com Interview with:
Professor Tamar Pincus PhD
Professor in Health Psychology
Dean of the Faculty of the Environment and Life Sciences
University of Southampton

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

Response: Antidepressants are recommended by guidelines for many chronic pain conditions. The most common prescribed antidepressant in amitriptyline. We carried out the largest and most systematic review of all antidepressants for all pain condition, at any dose, to test whether they were effective at reducing pain, increasing physical function, and improving mood and sleep. We reviewed 176 trials with almost 30,000 participants. We rated each study for its methodology so we could rank each drug according to how much we could be certain of the evidence.

Cognitive Functional Therapy: Clinical and Cost-Effective Pain Reduction For Chronic, Disabling Low Back Pain

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.

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COVID Effects on Nerves May Lead to Better Pain Relief Medications

PainRelief.com Interview with:
Venetia Zachariou PhD
Edward Avedisian Professor
Chair of Pharmacology, Physiology & Biophysics
Boston University Chobanian & Avedisian School of Medicine

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

Response: COVID-19, the disease resulting from SARS-CoV-2 infection, is associated with highly variable clinical outcomes that range from asymptomatic disease to death. For those with milder infections, COVID-19 can produce respiratory infection symptoms (cough, congestion, fever)  as well as loss of the sense of smell.

A substantial number of actively infected patients suffering from both mild and severe infections experience sensory-related symptoms, such as headache, visceral pain, Guillain-Barre syndrome (GBS), nerve pain and inflammation. In most patients these symptoms subside after the infection ends, but, for other patients, they can persist. 

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Patient Preferred Music Therapy Reduced Pain in Real World Settings

PainRelief.com Interview with:
Seneca Block, Ph.D(c), MT-BC  
Board Certified Music Therapist and
The Lauren Rich Fine Endowed Director for Expressive Therapies

University Hospitals Connor Whole Health

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

Response: University Hospitals Connor Whole Health has developed an extensive network of inpatient music therapy programs through out 8 major community medical centers across North Eastern Ohio. Music therapy is an evidence-based practice that was used through out these locations to provide front-line non pharmacological treatment of pain, stress and anxiety.

Sciatica: Surgical Treatment May Provide Only Temporary Pain Relief

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. 

JAMA Study Finds Clinicians Not Maximizing Opportunities to Initiate Buprenorphine Treatment For Patients With Opioid Addiction

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

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

Response: Opioid overdose deaths are at a record high in the U.S. Many opioid overdose deaths can be prevented by medications for opioid use disorder, such as buprenorphine, a drug that can prescribed in office settings. However, buprenorphine cannot prevent opioid overdose deaths if patients are never started on the medication or only stay on the medication for a short time. For that reason, rates of buprenorphine initiation and retention are critical metrics for measuring how well the U.S. health care system is responding to the opioid epidemic.

At the time we started our study, several other research groups had evaluated U.S. rates of buprenorphine initiation and retention using data through 2020. However, more recent national data were lacking. We felt that this was an important knowledge gap given the many changes in society that have occurred since 2020. For example, it was possible that the relaxation of social distancing measures during 2021 and 2022 might have reduced barriers to health care visits, thereby increasing opportunities to initiate treatment for opioid addiction with buprenorphine.