Tag Archives: pain relief

Omega-3 fatty Acid Supplementation May Reduce Muscle Soreness After Exercise-Induced Muscle Damage

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MedicalResearch.com Interview with:

Yvoni Kyriakidou, BSc, MSc, RD, ANutr, AFHEA 
Dietitian-Sports Nutritionist
Doctoral Researcher in Exercise Physiology
Translational Physiology Research Group
School of Life Sciences, University of Westminster, England, UK

Yvoni Kyriakidou

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

Response: Exercise-induced muscle damage (EIMD) results in transient muscle inflammation, strength loss, muscle soreness and may cause subsequent exercise avoidance. Omega-3 (primarily found in oily fish) supplementation may minimise EIMD via its anti-inflammatory properties. However, its efficacy remains unclear.

In our study, we gave people omega-3 capsules three times a day for four weeks to build up their levels, or a matching placebo. They then took part in a very intense exercise aimed at causing severe muscle pain and physiologically safe muscle damage. We then measured blood levels of inflammation and muscle damage markers, physical pain and the ability of the participants to do forceful muscle contractions every day for the next three days.

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Opioids Not Only Option for Pain Relief After Cesarean Delivery

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PainRelief.com Interview with:
Cristina Wood, MD
Obstetric and Fetal Anesthesiologist
Children’s Hospital Colorado

Dr. Wood

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

Response: ​We all know that opiate abuse is a national crisis, but also is one of the top causes of maternal mortality in the state of Colorado. At the Colorado Fetal Care Center at Children’s Hospital Colorado, we wanted to see what we could do to reduce the need for opiate medications after cesarean delivery. We started by using wound soakers to reduce the opiate requirement and demonstrated an almost 30% reduction in postoperative opiate use. Then, when the Society of Obstetric Anesthesia and Perinatology (SOAP) published guidelines for Early Recovery

After Cesarean (ERAC), we incorporated these into our practice to determine if these interventions would decrease the opiate requirements further. We were so pleased to see that we could further reduce the opiate need for our moms postoperatively. In fact, we reduced it by approximately 80%, with 1/3 of our patients never taking a single narcotic medication after cesarean delivery. 

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Back Pain Relief: Skin Impedance Measurements Can Help Identify Trigger Points

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PainRelief.com Interview with:
Giovanni Barassi PhD
Center for Physiotherapy, Rehabilitation and Reeducation
Center of Sports Medicine
“G.d’Annnunzio” University
Chieti, Italy

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

Response: Our research started with the observations made during standard clinical practice concerning the inefficiency of standard physiotherapeutic procedures used for pain relief in chronic nonspecific low back pain, a scourge of modern times, particularly in industrialized countries. Therefore, the need has arisen to search for new approaches in the evaluation and treatment of musculoskeletal problems.

Chronic low back pain is clinically manifest as the pain between rib margins and folds of the inferior gluteus muscle. It usually results from an incorrect lifestyle, typical of modern society having too little physical activity, too much psycho-physical stress, and poor management of body weight. On the background of osteopathic medicine, we developed a concept of the dysfunctional flow of body fluids as a plausible underlier of low back pain, referring by and large to spine bony structures.

It has been shown that alterations in afferent activity coming from visceral, structural, and emotional nociception converge in the same metamers of the spinal cord, resulting in information noise and jam. The final motor output of the reflex arc encompasses somatic, myofascial, and connective tissue responses, with the inevitably added influence of the autonomic nervous system. There also are studies demonstrating the importance of interpreting myofascial dysfunction, not as an isolated local phenomenon but rather as an expression of the central nervous activity. Therefore, a concept has been shaped of somatic and myofascial dysfunction, currently gaining increasing recognition among physicians, osteopaths, and physiotherapists, the professionals dealing with tissue and joint manipulation. The practical crux of the issue is the identification of the “major dysfunction” site, expressing the specific spinal information jam.

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No Decrease in Pain Relief With Less Opioids After Surgery

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PainRelief.com Interview with:
Ryan Howard, MD
Academic Development Time Year 1
Resident, General Surgery
University of Michigan

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

Response: Opioids are commonly prescribed to control pain after surgery, but they also carry significant risks such as overdose, long-term dependence, and diversion into the community. While some have advocated for decreasing or eliminating opioids from postoperative pain control regimens, others are concerned that this would lead to uncontrolled pain and dissatisfied patients. To study whether that’s true, we compared two groups of patients undergoing the same surgical procedures. One group received “opioid-sparing” prescriptions after surgery and the other group received “normal-sized” prescriptions.

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Conditioned Open-Label Placebos Provide Pain Relief in Some Post-Surgical Patients

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PainRelief.com Interview with:
Kristin Schreiber, MD, PhD
Neuroscientist and Clinical Regional Anesthesiologist
Brigham and Women’s Hospital
Assistant Professor of Anesthesia
Harvard Medical School

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

Response: Traditionally, the placebo effect has involved deceiving patients, where they think they may be taking a real medication. “Open-label placebos” are when placebos are given to patients, and patient are told that they are in fact a placebo. Recent research has suggested that these open-label placebos may actually reduce a number of symptoms in patients, including chronic low back pain. We were interested whether this strategy could be used to help reduce pain and opioid use around the time of surgery. We decided to combine the use of OLP with a conditioning approach, so that anytime a patient took an opioid analgesic, they would take the open-label placebo, so that the OLP pills would be associated with pain relief. That way when patients took them on their own, it would serve to trigger an expectation of pain relief, which is thought to at least partially explain the placebo effect.  

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Study Discusses Overlap of Opioid Therapy for Physical and Social Pain Relief

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PainRelief.com Interview with:
Mark Sullivan, MD, PhD
Professor, Psychiatry and Behavioral Sciences
Adjunct Professor, Anesthesiology and Pain Medicine, Bioethics and Humanities
Medical Co-Director, UW Telepain

Dr. Sullivan

University of Washington
Seattle, WA 98195

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

Response: This is a review paper than synthesizes neuroscience, pharmacological and epidemiological research on the opioid epidemic. It has been known since at least the 1970s that opioids treat not only pain due to physical damage, but also separation distress.

Functional neuroimaging (fMRI) studies have shown that physical pain (tissue injury) and social pain (social rejection) activate the same limbic brain centers (insula, cingulate cortex). Both chronic pain and depression are associated with dysfunction of the endogenous opioid system in the human brain. Studies of opioid prescribing have shown that patients with chronic pain, who also have anxiety and depressive disorders are more likely to be prescribed long-term opioid therapy at high doses and with concurrent sedatives.

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Challenges in Providing Osteoarthritis Pain Relief

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PainRelief.com Interview with:
Rebecca L Robinson
Patient Outcomes and Real-World Evidence
Eli Lilly and Company, Indianapolis, IN

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

Response: Osteoarthritis (OA) pain is unfortunately common and greatly affects patients’ quality of life. Treatment varies from patient to patient and can include nonpharmacologic therapies, over-the-counter (OTC) and prescription pain medications, as well as surgery. The combination of these treatment modalities and especially the use of acetaminophen, NSAIDs or opioids in OA patients has not been examined thoroughly. This study helps to address this gap while also demonstrating variations in treatment received by patients with different levels of pain severity. We analyzed data from the United States OA Adelphi Disease Specific Programme (DSP), which links patient and physician perspectives on the management of OA via cross-sectional surveys.

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Mindfulness-Based Stress Reduction for Chronic Pain in Breast Cancer Patients

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PainRelief.com Interview with:
Andra Smith, Ph.D.
Full Professor, School of Psychology
University of Ottawa, Ottawa, ON

Andra Smith, Ph.D. Full Professor, School of Psychology University of Ottawa, Ottawa, ON
Dr. Smith

PainRelief.com:  What is the background for this study?
Response: The process of going through breast cancer treatment is challenging enough on its own and can continue to impact cancer survivors long after treatment ends. One of the common side effects of breast cancer treatment is the development of chronic neuropathic pain (CNP), which for many women is debilitating and difficult to manage. Medications are not always effective and quality of life, cognitive abilities, and overall well-being can be reduced due to this pain. Knowing personally and from previous research how effective mindfulness can be for well-being, it made sense to introduce a mindfulness-based stress reduction program (MBSR) to these women going through chronic neuropathic pain due to breast cancer treatment. Mindfulness has occasionally been dismissed as a ‘fad’ so it was important to investigate the impact of an MBSR program with objective measures that could provide empirical evidence of its effects within this population. Dr. Poulin had the clinical resources and participants for the study while Dr. Smith had the imaging expertise. Together we performed a brain imaging (MRI/fMRI) study with women more than a year following treatment for breast cancer, suffering from chronic neuropathic pain. We scanned them all before and after either an MBSR program or usual care, assessing brain health, resting-state brain activity, and neurophysiological responses to emotional/pain-related words (Emotional Stroop task).    

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Withdrawal Symptoms Common in People Using Cannabis for Pain Relief

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PainRelief.com Interview with:
Lara Coughlin, Ph.D.
Assistant Professor | Addiction Center
Department of Psychiatry
University of Michigan

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

Response: In this study we followed people that were seeking certification for medical cannabis use for chronic pain over the course of two years. We assessed the prevalence and progression of cannabis withdrawal.

We found that most people experienced multiple withdrawal symptoms, such as craving cannabis, anxiety, and irritability, when they went without cannabis. People that used cannabis more frequently, used larger amounts, and reported smoking cannabis had more withdrawal symptoms. Over time, people that were younger were more likely to experience increasing withdrawal symptoms and people that vaped cannabis tended not to experience improvement in their withdrawal symptoms.  

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Chiropractic Manual Therapy for Chronic Low Back Pain Relief

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PainRelief.com Interview with:
Kylie Isenburg
Athinoula A. Martinos Center for Biomedical Imaging
Massachusetts General Hospital, Boston, MA

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

Response: Chronic low back pain (cLBP) is the leading cause for disability worldwide, with a lack of efficacious non-pharmacological treatments. Back pain doesn’t just effect the back. Recent investigations using brain imaging have shown changes in brain structure and function in cLBP patients. Therefore, there is a growing interest in how different non-pharmacological therapies might impact cLBP by studying alterations in brain function that follow such therapies.

For our project, we assessed resting brain connectivity for a specific set of regions known as the Salience Network, a network involved in detection of salient information that arises from continuous sensory input. We assessed Salience network connectivity pre- and post- a single session of Manual Therapy (MT), a chiropractic manipulation technique used to treat a range of musculoskeletal disorders. We found that manual therapy reduced clinical low back pain intensity after a single-session. Additionally, assessment of two different grades of MT; Spinal Manipulation and Spinal Mobilization, suggested that Manipulation increases connectivity of the Salience Network to the Primary Motor Cortex and the Thalamus. Furthermore, the reduction in low back pain post-MT was associated with increased Salience connectivity to the lateral Prefrontal Cortex. These findings suggest modulation of sensorimotor, affective, and cognitive regions of the brain via Manual Therapy may play an important role in reducing Chronic low back pain. 

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

Response: Our report suggests that non-pharmacological therapies, specifically Manual Therapy, can be successful in reducing chronic low back pain intensity. It also suggests that brain changes following Manual Therapy are important, and specifically that changes in Salience network connectivity to brain regions important for processing sensory, affective, and cognitive information might underly this reduction in low back pain.

Altogether this work promotes increased investigation into brain-based mechanisms by which Manual Therapy can reduce chronic low back pain.

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

Response: Following this study, we have a better idea of what a single manual therapy session can accomplish, but assessment of the long-term effects of a series of MT sessions will be useful in allowing for a better understanding of its efficacy in treating low back pain. Additionally, clinical trials assessing manual therapy against other treatment modalities can allow for direct comparisons against the current standard of care approaches. 

Citation:

Kylie Isenburg, Ishtiaq Mawla, Marco L. Loggia, Dan-Mikael Ellingsen, Ekaterina Protsenko, Matthew H. Kowalski, David Swensen, Deanna O’Dwyer-Swensen, Robert R. Edwards, Vitaly Napadow, Norman Kettner,

Increased salience network connectivity following manual therapy is associated with reduced pain in chronic low back pain patients,
The Journal of Pain, 202

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