Tag Archives: pain

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 →

Study Suggest Opioids Should Not Be First Line Therapy for Chronic Non-Cancer Pain

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PainRelief.com Interview with:

Dr. Jason Busse PhD Associate Professor McMaster University

Dr. Busse


Dr. Jason Busse PhD
Associate Professor
McMaster University

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

Response: The United States prescribes more opioids per capita than any other country in the world, and opioids are associated with addiction, overdose, and death. Many individuals living with chronic noncancer pain are managed with opioid therapy; however, we have limited knowledge regarding benefits and harms. We conducted a systematic review and meta-analysis to synthesize the evidence from all RCTs that explored an opioid vs. a non-opioid comparator for patients with chronic noncancer pain, and followed participants for at least 1 month. 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 →

Early Physical Therapy Can Be Protective Against Chronic Opioid Use

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PainRelief.com Interview with:

Steven Z. George, PT, PhD  Professor Director of Musculoskeletal Research Duke Clinical Research Institute Vice Chair of Clinical Research Orthopaedic Surgery

Dr. George

Steven Z. George, PT, PhD 
Professor
Director of Musculoskeletal Research
Duke Clinical Research Institute
Vice Chair of Clinical Research
Orthopaedic Surgery

PainRelief.com: What is the background for this study? What are the main findings?Response: This study adds to existing health services research investigating the sequence of services/providers for musculoskeletal pain and its impact on opioid use.

The study suggest that early physical therapy (PT) for the 4 most common musculoskeletal conditions (back, neck, shoulder, and knee) can be protective of chronic/long term opioid use for individuals that were opioid naïve when presenting for their care.  What is different about this study is that the 4 conditions were studied in the same cohort and the same definition of early PT was used (many of the previous studies just looked at 1 conditions, and used different definitions of early physical therapy).  The other thing that was different is that we used a larger dataset of private insurance providers, so this study cuts across different regions of the study (many of the previous studies included one health system).

There was notable consistency in the findings for the 4 conditions and protection of any opioid use, but there were some contingencies.

First was that there was no benefit on decreased dosage for individuals with neck pain – as that was not expected.

Second was that in a follow up sensitivity analysis it looked like the largest benefit of early physical therapy may be for those with back and knee pain.  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 →

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.

Continue reading →

Exercise Longer With Less Pain Using Virtual Reality

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PainRelief.com Interview with:

This is a visual of VR exercise environment during test.

This is a visual of VR exercise environment during test.
Credit Maria Matsangidou

Maria Matsangidou, PhD
School of Engineering and Digital Arts
University of Kent

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

Response: The results show that Virtual Reality (VR) technology can influence the perception of task difficulty, endurance performance and pain experienced during exercise. Most importantly, exercising through the use of VR technology revealed a significant decrease in Pain Intensity and Perceived Exertion reports, and a significant increase in Time to Exhaustion. This was contrary to conventional non-VR exercise which was found to have a significantly higher Pain Intensity and Perceived Exertion reports, and a significantly lower Time to Exhaustion.

In addition the results show that personal characteristics of internal body awareness, such as Private Body Consciousness, does not influence the efficiency VR has on the time to and the perceived pain and exhaustion. This means that the effectiveness of VR technology on time and the perception of pain and exhaustion could not be influenced by personal characteristics of internal body awareness.

A possible explanation could be that the attention of the participants is shifted from the observation of internal functions onto the virtual room and exercise.

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

Response: That VR provides a new form of reality, where the individual’s is able to exercise for longer with less pain and effort, and by extension this can increase physical activity. One can imagine how beneficial it would be for specific populations, such as athletes or individuals who are reluctant to engage in physical activity, as well as clinical populations where their recovery can be enhanced through physical physiotherapy.

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

Response: Future research may investigate the conditions under which Private Body Consciousness may influence immersion and potentially the effectiveness of VR. For example, more research is needed to determine whether the virtual environments representing natural and photorealistic environments are more or less effective than ones presented in cartoonish form.  Furthermore, it would be worthwhile adopting a mixed-methods approach (questionnaire and interview) in order to address user preferences for the design of VR environments.  Finally,  this  study utilized participants who  were  both  active  and  inactive,  therefore  future  work  should  seek  to replicate  this  study  with  a  group  of  sedentary  participants,  as  this  is  where  the  greatest potential for positive impact on behavior may be. 

No disclosures 

Citation:

Maria Matsangidou, Chee Siang Ang, Alexis R. Mauger, Jittrapol Intarasirisawat, Boris Otkhmezuri, Marios N. Avraamides. Is your virtual self as sensational as your real? Virtual Reality: The effect of body consciousness on the experience of exercise sensations. Psychology of Sport and Exercise, 2018; DOI: 10.1016/j.psychsport.2018.07.004

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Fixed-Dose Combination Acetaminophen/Ibuprofen for Postoperative Dental Pain

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PainRelief.com Interview with:

Prof Chris Frampton PhD Department of Medicine University of Otago Christchurch, New Zealand

Prof. Frampton

Prof Chris Frampton PhD
Department of Medicine
University of Otago
Christchurch, New Zealand

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

Response: Acute pain is a significant burden to the individual and to society. In light of the ongoing opioid crisis, there is a need for effective nonopioid pain medications that provide improved analgesia over common analgesics, without compromising tolerability. Multimodal analgesia combines multiple drugs with different mechanisms of action to improve pain relief while limiting side effects. Fixed-dose combination tablets containing acetaminophen and ibuprofen are already available in many countries; however, the therapeutic advantages of such products are not available to patients in the United States. The US Food and Drug Administration (FDA) has restricted the dose of acetaminophen in prescription drugs to 325 mg per tablet, therefore an existing product containing acetaminophen 500 mg + ibuprofen 150 mg per tablet (two tablets per dose) has been downscaled to comply with FDA restrictions (acetaminophen 325 mg + ibuprofen 97.5 mg, three tablets per dose). The goal of this study was to determine the efficacy of the new fixed-dose combination of acetaminophen 975 mg and ibuprofen 292.5 mg (FDC 975/292.5) relative to acetaminophen or ibuprofen monotherapy, or placebo following the surgical removal of at least two impacted third molars.

Continue reading →

Three Genes Linked To Chronic Back Pain

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PainRelief.com Interview with:
"Back Pain" by betterhealthosteopathy is licensed under CC PDM 3.0cDr. Frances MK Williams PhD
Department of Twin Research and Genetic Epidemiology
Division of Genetics & Molecular Medicine
Reader, King’s College London
Honorary Consultant in Rheumatology
Guy’s and St Thomas’ NHS Foundation Trust

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

Response: This study was led by scientists at King’s College London and the University of Washington. It has identified three new genes associated with the development of chronic back pain.

The findings, which are published in PLOS Genetics, could pave the way for the creation of more effective treatments for the condition, the leading cause of disability worldwide.

Part funded by the European Union, the research project focussed on understanding why in most people an episode of back pain gets better, while in around 20% of people it can persist for many months – chronic back pain is defined as pain that persists for more than three months.

To better understand the origins of the chronic condition, researchers conducted a genome-wide association meta-analysis (GWAS) of chronic back pain studies comprising a total of 440,000 individuals. The average age of the study’s participants ranged from 50 to 76 years, and the genders were approximately balanced.  Continue reading →