Tag Archives: pain relief

Inadequate Pain Control After Spine Surgery is Common

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PainRelief.com Interview with:
Michael M. H. Yang MD, MSc
Departments of Clinical Neurosciences, Section of Neurosurgery, 
Community Health Sciences
Icahn School of Medicine at Mount Sinai
New York, New York

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

Response: Spine surgery has been ranked as one of the most painful surgical procedures. Patients who experience poor pain control have delayed recovery, take more opioids, and stay in the hospital longer. The objective of our study was to determine patient and surgical factors that increased the chance for poorly controlled pain after spine surgery. These risk factors were incorporated into a score that can be used to determine the likelihood of a poor patient pain experience.

PainRelief.com: What are the main findings?

Response: Overall, 57% of patients experienced poorly controlled pain after their spinal operation in our study. We found 7 risk factors for poor pain control: younger age, female sex, daily use of opioid medication, higher neck or back pain intensity, higher depression score, surgery involving 3 or more levels, and fusion surgery. These risk factors were used to create the Calgary Postoperative Pain After Spine Surgery (CAPPS) Score. Patients identified as low-, high-, and extreme-risk by the CAPPS score had 32%, 63%, and 85% chance of experiencing poorly controlled pain, respectively.

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Voltaren® Arthritis Pain Provided Meaningful Pain Relief in Knee Osteoarthritis

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PainRelief.com Interview with:

Jeffrey Fudin, B.S., Pharm.D., FCCP, FASHP
Diplomate, American Academy of Pain Management
Section Editor, Pain Medicine

Dr. Fudin

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

Response: Osteoarthritis (OA) affects over 14% of the United States population. As such it is important to establish effective, well-tolerated, and safe medication options. Topical nonsteroidal anti-inflammatory drugs (NSAIDs) act locally and are strongly recommended for patients with knee osteoarthritis as a first line option prior to chronic oral NSAID use in an effort to minimize systemic exposure, as oral products, result in tremendously higher blood levels compared to their topical counterpart.

PainRelief.com: What are the main findings?

Response: Diclofenac sodium gel 1% (DSG 1%), a topical NSAID, provided better pain relief than non-drug vehicle alone for patients with knee osteoarthritis in 3 clinical trials. A post-hoc meta-analysis of these trials was conducted to determine the percentage of patients achieving a minimal clinically important improvement (MCII) in pain and other symptoms of OA to gain insight into the real world clinical impact of topical diclofenac for patients. The MCII is defined as the smallest improvement in symptoms viewed as clinically meaningful for patients. In short, the MCII represents an improvement of relevance in a clinical trial and the minimal meaningful change at an individual level.

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Wide Variation in Opioid Prescribing for Pain Relief Following Knee Arthroscopy

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PainRelief.com Interview with:
Benjamin Ukert PhD
Assistant Professor
Department of Health Policy and Management
Texas A&M

Mucio Kit Delgado, MD, MS
Department of Emergency Medicine
Perelman School of Medicine
University of Pennsylvania

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

Response: The opioid epidemic has received a lot of attention and many state policies have been passed to address excessive opioid prescribing and highlight the dangers of opioid use initiation for those who have never been exposed to opioids. We also now know that most patients prescribed opioids for post-operative pain have significant quantities of pills leftover. One study showed that after knee arthroscopy, 50% of patients took no opioids, and 90% took less than 5 pills (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7190545/).

We thought to investigate whether overprescribing is still common, and asked the question whether we now observe low levels of prescribing following knee arthroscopy and whether there are differences in prescribing practices across states.

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Study Finds Chronic Pain Patients Used More Opioids For Pain Relief When COVID-19 Cancelled Elective Procedures

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PainRelief.com Interview with:

Dr. Shantha Ganesan MD
 Pain Medicine Specialist
Kings County Hospital Center

David Kim, MD, PGY-2
SUNY Downstate Department of Anesthesiology 

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

Response: The opioid epidemic is a serious national crisis that has detrimental impacts on both public health, and social and economic welfare. Therefore, any efforts to combat the opioid epidemic, including minimizing or weaning opioid prescriptions, and using other modes of analgesia when possible are undeniably necessary in this day and age. With the onset of Covid-19 pandemic, healthcare providers abruptly changed their care delivery. In-person clinic visits were changed to telemedicine, and elective cases were cancelled.

Due to a growing concern that chronic pain patients may have limited resources from this unprecedented time of social and economic shutdown, organizations such as American Medical Association and Drug Enforcement Administration have supported implementing measures to ensure these patients achieve adequate pain control by increasing access to pain medications, but at the cost of reducing barriers and restrictions to controlled substances. Given the cancellation of elective interventional pain management procedures and relaxed regulations on controlled substances during the Covid-19 pandemic, it is reasonable to suspect a dramatic increase in opioid prescription during this time.

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Factors Affecting Adults’ Choice of Opioids for Pain Relief

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PainRelief.com Interview with:
Didem Bernard, Ph.D.
Senior Economist
Agency for Healthcare Research and Quality

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

Response: There had not been any studies on whether patient attitudes about health affect opioid use. A self-reliant health attitude is agreement with the following statements: “I do not need health insurance,” and “I can overcome illness without help from a medically trained person.”

We find that health-related attitudes affect both adults with and without chronic pain treatment similarly. Adults with self-reliant health attitudes are less likely to start and more likely to discontinue opioid use. Exercise is also associated with a higher probability of choosing no analgesic treatments over using opioids. Similarly, among adults who are using opioids for pain treatment, exercise is associated with a higher probability of discontinuing opioid use in the year following opioid initiation.

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Pain Relief from NSAIDS and COVID-19 Outcomes

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PainRelief.com Interview with:
Anton Pottegård DMSc PhD
Professor (MScPharm, PhD, DMSc)
Clinical Pharmacology and Pharmacy, Department of Public Health
University of Southern Denmark
Head of Research, Hospital Pharmacy Funen
Odense University Hospital

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

Response: Early in the COVID-19 pandemic, concerns were raised that use of the common painkiller ibuprofen – a so-called NSAID – to treat symptoms of COVID-19 might lead to more severe disease. This started with tweets from the French health minister and culminated with a warning issued by the WHO. This warning was later retracted, but naturally patients and physicians were concerned regarding the safety of ibuprofen. We therefore established a nationwide Danish collaboration between researchers and regulators and established a prospective cohort of all Danish patients that contracted COVID-19, including data on what prescription medicines they used. We used these data to evaluate whether users of ibuprofen or other NSAIDs on average had a more severe course of COVID-19 than those not using these drugs.

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Newly Discovered Molecule Causes Pain Relief and Cartilage Healing in Osteoarthritis

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PainRelief.com Interview with:
Prof Francesco Dell’Accio and
Dr Suzanne E Eldridge
Department of Experimental Medicine and Rheumatology
William Harvey Research Institute
Barts and The London, Queen Mary’s School of Medicine and Dentistry,
London

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

Response: Our main research focus is osteoarthritis. Osteoarthritis is the most common form of arthritis, affecting 10-30% of the population over the age of 60, causing joint pain and disability for many. In osteoarthritis, the cartilage that covers the bones in the joints is destroyed. Therefore, the bones grind over each other, causing pain and disability. Joint replacement surgery is often carried out.  

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Study Finds Tumeric Had Moderate Pain Relief Effect on Knee Osteoarthritis

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PainRelief.com Interview with:
Dr Benny Antony MD,PhD Senior Research Fellow
National Health and Medical Research Council of Australia Fellow 
Menzies Institute for Medical Research
Unit Coordinator, Lecturer & Examiner, College of Health & Medicine
University of Tasmania
Associate Editor, International Journal of Rheumatic Diseases https://onlinelibrary.wiley.com/journal/1756185x 

UTAS- Menzies Institute for Medical Research Benny Antony – 18/07/2017 Hobart Tasmania photography - Peter Mathew
Dr. Antony

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

Response: Osteoarthritis is the most common joint disorder in adults around the world, with more than 300 million people suffering from the disease. Considering the increasing prevalence of the disease and lack of effective treatment strategies, there is an urgent need for effective and safe treatment. Curcuma longa, commonly known as Turmeric, is a popular anti-inflammatory medication. Previous studies in osteoarthritis have shown that various formulations of turmeric extracts are effective and safe for the treatment of osteoarthritis.

We decided to select an inflammatory-phenotype of knee osteoarthritis patients who might benefit from a safe, natural anti-inflammatory therapy and randomised them to placebo and treatment groups.

Over, 12 weeks we found that the Turmeric extract group had a greater reduction in knee pain compared to the placebo group. We also looked at the effect of the treatment on knee structural abnormalities, but we did not find any significant difference between the treatment and placebo groups.

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Study Compares Dry Needling Techniques for Relief from Heel Pain

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PainRelief.com Interview with:
Dr. Pablo Herrero Gallego. PT, PhD.
Head of iPhysio Research Group.
Editor-in-Chief Journal of Invasive Techniques in Physical Therapy
Zaragoza, Spain

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

Response: The background of this study is that there has been an increasing use of minimally invasive techniques in physiotherapy in the last years, that apparently leading to very good results in the clinical practice, but there are no studies comparing the effectiveness of different treatment modalities. In the case of this study, about plantar heel pain (PHP), many physiotherapists use dry needling (DN) or percutaneous needle electrolysis (PNE) to treat myofascial trigger points when conservative treatment fails. However, although some clinicians claim that PNE has a superior effect to DN because it adds a galvanic current to the mechanical stimuli with the needle, there is no evidence to support this. Because of it, we decided to conduct this first study comparing these two treatment options for PHP.

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Contact Athletes Cope With Pain Better

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PainRelief.com Interview with:
Claire Thornton, PhD
Northumbria University
Newcastle upon Tyne, UK

Dr. Thornton

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

Response: There is evidence that high contact athletes (i.e. rugby players, martial artists) tolerate more pain and report pain as lees intense than other athletes. Being able to cope with pain is essential in risky, painful, collision-based sports, yet there is little research into the mechanisms behind intra-athlete differences in pain responses. Use of adaptive coping styles and/or being challenged may impact upon how an athlete performs while in pain.

We wanted to examine performance during pain among different athlete groups to try to understand how pain influences performance while manipulating challenge and threat states.

We split athletes into 3 groups: Experienced contact athletes [>3 years’ experience in the sport], novice contact athletes and non-contact athletes)  

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