Tag Archives: pain relief

Neck and Back Pain More Common in Diabetes

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PainRelief.com Interview with:

Manuela L. Ferreira PhD
Institute of Bone and Joint Research
The Kolling Institute, Sydney Medical School

Paulo H. Ferreira PhD
Musculoskeletal Health Research Group
Faculty of Health Sciences
University of Sydney, Sydney, NSW, Australia

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

Response: One in four Australians experience back pain or neck pain. Diabetes is also a worldwide prevalent condition, and currently affects over 382 million people. These two diseases often co-exist and have very similar underlying mechanisms, such as obesity and physical inactivity. We were unsure whether having one condition would lead to developing the other, however.

We have found 11 studies published to date, and assessing the relation between back or neck pain and diabetes. The studies included over 165,000 participants published in the USA, Canada, Finland, Denmark, Iran and Spain.

When we pooled the results of these studies together, we observed that people with type 2 diabetes are 35% more likely to also have low back pain (compared to people without diabetes). The risk of having severe back pain symptoms in people with type 2 diabetes is 63% higher and the risk of having severe neck pain is almost 30% higher, than in people with no diabetes.  We could not identify, however, whether type 2 diabetes can lead to back or neck pain, and it is possible that the two conditions are associated via other underlying mechanisms such as obesity and physical inactivity.

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Opioid-Induced Constipation

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Chronic Pain Patients: Opioid Induced Constipation a Serious Concern After Surgery

PainRelief.com Interview with:

Jonathan Jahr, MD, DABA, FASA

Dr. Jonathan Jahr is an anesthesiologist in Los Angeles, California and is affiliated with multiple hospitals in the area, including UCLA Medical Center and UCLA Medical Center-Santa Monica. He received his medical degree from New York Medical College and has been in practice for more than 20 years.

Dr-Jonathan-Jahr

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

Response: I have worked in the hospital setting for the past 25 years and have conducted multiple studies on different opioid and non-opioid strategies for managing both chronic and acute pain. I also co-edited a textbook entitled Essence of Analgesia and Analgesics. My background and the research I’ve done sets the stage for newer pain management protocols that can provide patients with significant pain relief, and improved satisfaction and outcomes due to fewer or avoided opioid related side effects (ORADS) such as opioid-induced constipation (OIC).

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Pain and Substance Use Can Interact in a Vicious Cycle

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PainRelief.com Interview with:

Emily L. Zale PhD Department of Psychology Syracuse University Syracuse, New York

Dr. Zale

Emily L. Zale PhD
Department of Psychology
Syracuse University
Syracuse, New York

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

Response: When people think of pain and substance use, it’s common for opioids to come to mind. While the opioid crisis has rightfully garnered considerable attention, our research suggests that non-opioid substances, like nicotine/tobacco, alcohol, and cannabis, are also important to consider in relation to pain. In fact, nicotine/tobacco, alcohol, and cannabis are the most commonly used substances in the US, and research into associations between pain and these non-opioid substances is continuing to increase in popularity.

Research studies usually examine either how substance use affects pain or how pain affects substance use. We looked at results from over 100 studies and put these two different types of research together to understand how pain and substance use affect each other.

On one hand, substance use can be a risk factor for chronic pain and may worsen pain over time. On the other hand, experiencing pain can motivate people to use substances and might make it harder to quit. By putting these two types of studies together, we found that pain and substance use  interact in a vicious cycle that can ultimately worsen and maintain both chronic pain and addiction.

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Gabapentin For Pain Relief of Vulvodynia

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MedicalResearch.com Interview with:
Gloria A Bachmann, MD
Professor of Obstetrics and Gynecology and Medicine
Associate Dean for Women’s Health
Director, Women’s Health Institute
Rutgers Robert Wood Johnson Medical School

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

Response: Chronic pain is an extremely difficult symptom for anyone to deal with, regardless of the cause. However, when the pain involves the genital area, it exacerbates the pain condition, as it then becomes a more sensitive area for the person to talk about and to feel comfortable in asking for medical help. This is precisely the case for women with vulvodynia.

Vulvodynia is defined as a pain that persists over several months in the outer area of the vaginal opening. Symptoms women often have from this condition, in addition to the pain itself, include burning, pressure, itching and soreness. Some women note the pain in the entire area surrounding the vaginal opening, whereas others only note it in one or two sites. Further, for many women the pain interferes with their ability to engage in sexual exchange, the wearing of certain types of clothing and even the ability to start a family as coital activity may not be possible for them. Unfortunately, because the exact cause of vulvodynia has not been described, treatments are varied and aim at treating the pain rather than the underlying cause. One intervention that has been used for women with this condition is the medication, gabapentin. However, although it appears to be a successful intervention for some sufferers, there had not been a definitive clinical trial that looked at this medication as it compares to a placebo intervention.

Therefore, our Rutgers site, along with the University of Tennessee and the University of Rochester commenced a clinical trial to test how effective gabapentin was as compared to a placebo, or non-pharmacologic intervention in women with this condition. Continue reading →

Massage for Osteoarthritis of Knee Reduced Pain and Improved Physical Functioning

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Adam-Perlman-

Dr. Perlman

PainRelief.com Interview with:
Adam Perlman, MD, MPH
Program Director, Leadership Program in Integrative Healthcare
Duke Integrative Medicine 

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

Response: Current treatment options for knee osteoarthritis have limited effectiveness and potentially adverse side effects. Massage may offer a safe and effective complement to the management of knee osteoarthritis.

We investigated the effect of whole-body massage on knee osteoarthritis, compared to active control (light-touch), and usual care. Participants received 8 weeks of massage, light-touch or usual care and then were randomly assigned to maintenance every other week massage, light-touch or continuation of their usual care. At the end of 8 weeks, massage significantly improved symptoms, including pain, stiffness and physical function, while the other groups did not. At 52 weeks, every other week massage maintained the improvements, however the other groups also improved. Continue reading →

Acupuncture Provided Pain Relief From Cancer and Related Symptoms

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PainRelief.com Interview with:
Jai N. Patel, PharmD, BCOP
Chief, Pharmacology Research
Associate Professor, Division of Hematology/Oncology
Department of Cancer Pharmacology
Levine Cancer Institute
Charlotte, NC 28204 

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

Response: Pain is one of the most prevalent and burdensome symptoms affecting patients with cancer. Cancer-related pain is most commonly treated with opioid analgesics; however, nearly two-thirds of patients have inadequate pain relief and/or experience opioid-related side effects.

Furthermore, the fear of opioid abuse/addiction and toxicity deters some from prescribing opioids and reduces patient compliance. Thus, nonpharmacologic interventions such as acupuncture may be safer approaches to cancer-related pain.  Randomized controlled trials suggest acupuncture reduces chronic neuropathic and postoperative pain in patients with cancer. It is unknown whether any patient characteristics predict post-acupuncture pain response.

We assessed acupuncture’s effectiveness for cancer-related pain, identified patient characteristics associated with pain response, and determined its effect on other concurrent cancer-related symptoms in palliative medicine outpatients. We identified significant benefits in pain scores immediately after the first treatment and across multiple treatments. Significant pain reduction was associated with higher baseline pain and more advanced disease stage.

We also identified significant changes in anxiety, depression, drowsiness, dyspnea, fatigue, nausea and well-being. Improvements in fatigue and depression also correlated with significant pain reduction after acupuncture.  Continue reading →

Headache an Immense Public Health Problem, for Rich and Poor Countries

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PainRelief.com Interview with:

Lars Jacob Stovner MD PhD Professor of Neurology Department of Neuromedicine and Movement Science NTNU, Norwegian University of Science and Technology Head of the Norwegian Advisory Unit on Headaches, St. Olavs Hospital Trondheim, Norway

Prof. Stovner

Lars Jacob Stovner MD PhD
Professor of Neurology
Department of Neuromedicine and Movement Science
NTNU, Norwegian University of Science and Technology
Head of the Norwegian Advisory Unit on Headaches,
St. Olavs Hospital Trondheim, Norway

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

Response: The study focuses on prevalence and burden of migraine and tension-type headache in the Global Burden of Disease project from 2016.

Previous analyses has shown that migraine is the second most disabling disorder in terms of years lived with disability. This particular analysis shows that more than 1 billion people suffered from migraine in 2016 and 1.9 billion from tension-type headache, and it gives estimates each country and different world regions.

Headache is particularly burdensome in young and middle-aged women, but the impact is also quite marked also in men, children and elderly.

There is considerable variation between countries, but the burden is relatively stable over time (from 1990), and there is no obvious relation to the socioeconomic level of the country.  Continue reading →

New Opioid Ligands May Provide Pain Relief Without Addiction Risk

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PainRelief.com Interview with:

Prof. Dr. Christoph Stein Direktor Institut für Experimentelle Anaesthesiologie Charité Campus Benjamin Franklin Freie Universität Berlin 

Prof. Stein

Prof. Dr. Christoph Stein
Direktor
Institut für Experimentelle Anaesthesiologie
Charité Campus Benjamin Franklin
Freie Universität Berlin 

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

Response: Our group has studied the biology and pharmacology of opioid receptors on peripheral sensory neurons (i.e. outside the central or intestinal nervous system) for over 25 years. We have always aimed at finding mechanisms and opioid receptor ligands that can be developed into drugs inhibiting pain without eliciting typical adverse effects of conventional opioids such as apnoea, addiction, sedation or constipation.

From our previous work we knew that the selective activation of opioid receptors on peripheral sensory neurons can produce powerful pain relief in animals and human patients. Those analgesic effects are particularly strong in pain caused by tissue injury and inflammation (e.g. postoperative pain, arthritis). Together with mathematicians (Dr. Marcus Weber) at the Zuse Institute Berlin, we started out with computer simulations examining the interaction between opioid ligands and receptors in normal (noninflamed) and inflamed environments. These studies indicated a stronger binding of conventional opioid ligands (morphine, fentanyl) to opioid receptors at increased proton concentrations (i.e. low pH, as present in acidotic/inflamed tissue). We also knew that the protonation of a tertiary amine in the ligand is required for opioid receptor activation. Using those in silico simulations, we now designed a new ligand (NFEPP) that is only protonated (and capable of activating opioid receptors) at low pH, but not at normal pH (as in brain and intestinal wall). After synthesis of NFEPP (and similar derivatives) by a contractor we tested them in vitro and in vivo. NFEPP produced opioid receptor activation and analgesia selectively at low pH/tissue inflammation (as present in nerve injury/neuropathy and abdominal inflammation) without eliciting respiratory depression, addiction potential, sedation or constipation. 

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SEAL Procedure Gives Pain Relief To Some After Failed Back Surgery

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MedicalResearch.com Interview with:
"Personal Injury Back Pain" by SanDiego PersonalInjuryAttorney is licensed under CC BY-SA 2.0
Michael Perloff, MD PhD
Assistant Professor of Neurology
Interventional Pain Management
Boston University School of Medicine

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

Response: Low back pain is very common. Patients with chronic low back pain that does not benefit from physical therapy, medications, or injections, often get spine surgery. If surgery fails to help (Failed back surgery syndrome-i.e. continued low back and leg pain after surgery), options for pain relief become more complex.

Typically, patients with failed low back surgery syndrome have tried complex procedures, repeat surgery or technology implants as their main options.

The SEAL procedure is a shortened, simple procedure (done in about 20 minutes) that can help as treatment for failed back surgery symptoms. In the published case series of 30 patients, some patients achieved very good, sustained, pain relief. Continue reading →

FDA Approved Emgality Offers New Hope For Migraine Prevention

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PainRelief.com Interview with:
Gudarz Davar, M.D., Vice President
Neuroscience Platform Leader
Eli Lilly and Company

PainRelief.com: What is the background for this announcement?  How big a problem is migraine in the US?  Who is primarily affected? 

Response: Migraine is a disabling, neurologic disease that affects more than 30 million American adults. According to the Medical Expenditures Panel Survey, the total unadjusted cost associated with migraine in the U.S. is estimated to be as high as $56 billion annually. People with migraine can miss out on significant moments in their lives—birthdays and anniversaries—and there remains an unmet need for treatment options that can help patients achieve significant reductions in the overall frequency of migraine attacks.

Emgality (galcanezumab-gnlm) was approved by the FDA on Thursday, September 27, for the preventive treatment of migraine in adults. Emgality is a humanized monoclonal antibody indicated for the preventive treatment of migraine in adults that binds to CGRP ligand and blocks its binding to the receptor, which is believed to play a role in migraine. It is offered as a self-administered, once-monthly subcutaneous injection. Emgality offers new hope to people living with migraine as one of the first medicines developed specifically for the prevention of migraine.

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