Tag Archives: pain

Physicians Differently Prescribe Pain Relief Medications to White and Minority Patients

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PainRelief.com Interview with:
Dan P. Ly M.D., M.P.P., Ph.D.
Division of General Internal Medicine and Health Services Research
David Geffen School of Medicine
University of California, Los Angeles

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

Response: We know that minority patients were less likely to receive opioids than white patients, but this could have been due to minority patients seeing lower opioid-prescribing physicians. As far as I could tell, nobody had been able to examine whether the same physician prescribed opioids differently to their minority patients.

I find that this is the case: the same physician was less likely to prescribe opioids to their minority patients with new low back pain, and instead was more likely to prescribe NSAIDs to their minority patients. And unfortunately, this differential prescribing may have had the consequence of leading to more chronic opioid use in white patients.  

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Medlab Clinical Developing New Buccal Spray for Chronic Cancer Pain Relief

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PainRelief.com Interview with:
Dr.  Jeremy Henson
Director of Medical Affairs
Medlab Clinical Ltd

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

Response: THC and CBD combination medicines have the potential to provide a non-opioid option for chronic pain that does not have the GIT or respiratory adverse reactions of opioids and allows better cognitive functioning.

Delivery across the oro-buccal membrane appears to be best method of administration of cannabinoids for chronic pain. Oro-buccal delivery has pharmacokinetics appropriate for 6-8 hourly maintenance dosing and avoids first pass metabolism and the slow erratic onset of ingestion; and the high serum THC peaks, frequent redosing and toxic oxidation products of vaping.

The problems with using a 50% ethanol vehicle to deliver cannabinoids across the oro-buccal membrane include local irritation, incomplete absorption and significant systemic ethanol levels. These issues could be solved by using a micellular nanoparticle to solubilise the cannabinoids and deliver them across the oro-buccal mucous membrane.

This study was a first in human study of a micellular nanoparticle formulation of 1:1 THC and CBD delivered as an oro-buccal spray for chronic cancer pain.

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Virtual Reality Can Provide Pain Relief for Children Getting IV Catheters

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PainRelief.com Interview with:
Dr. Jeffrey I. Gold PhD
Director Emeritus of the Pediatric Pain Medicine Clinic
Children’s Hospital Los Angeles and Investigator
The Saban Research Institute
Children’s Hospital Los Angeles

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

Response: Virtual Reality or digital therapeutics can have a profound impact on mitigating pain, anxiety, and distress associated with routine painful medical procedures, such as blood draw and IV placement. 

PainRelief.com:  What are the main findings? Would you explain what is meant by “triangulation of data”?

Response: Virtual Reality significantly reduces pain and anxiety in children undergoing PIVC placement compared to standard of care in two pediatric medical settings (radiology and the infusion center). The triangulation of data refers to collecting data on the patient, his/her caregiver, and the healthcare provider to examine the impact of the intervention from three different perspectives.

The current study demonstrated that an effective intervention for the patient can have a positive impact (ripple effect) on the caregiver and the healthcare provider, creating a more relaxed, calm, and less distressing medical experience.

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Study Identifies Three Patterns of Medical Cannabis Use for Pain

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Dr. Deepika Slawek,

PainRelief.com Interview with:
Deepika Slawek, MD, MS, MPH (she/hers)
Assistant Professor of Medicine, Division of General Internal Medicine
Montefiore Medical Center
Albert Einstein College of Medicine
Bronx, NY 10467

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

Response: Medical cannabis has become increasingly available in the United States over the past 25 years and is commonly used for the management of pain. Little is known about the patterns of medical cannabis use by patients with chronic pain. This information could help providers anticipate patients’ needs and identify potential disparities in access.

We followed 99 adults in New York State who were newly certified for medical cannabis use and who were prescribed opioids over the course of 1 year. Using a latent class trajectory analysis, we identified clusters of participants based on 14-day frequency of medical cannabis use. We used logistic regression to determine factors associated with cluster membership including sociodemographic characteristics, pain, substance use, and mental health symptoms.

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Synovial Stem Cells Injected into Knee Repaired Meniscus without Tumor Formation

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PainRelief.com Interview with:
Mitsuru Mizuno, DVM, Ph.D.
Assistant professor at CSCRM,
Principal investigator for this study
and Ichiro Sekiya, M.D., Ph.D..

PainRelief.com:  What is the background for this study?  What are the main findings? How are the stem cells obtained?

Response: We have developed a cell therapy for treating difficult-to-heal meniscus injury using mesenchymal stem cells (MSCs) derived from the synovium of the knee. However, trisomy 7 is often found in synovial cells obtained from patients with osteoarthritis, a disease that occurs with aging.

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Back Pain: SelfBACK app To Help Patients Find Pain Relief From Self-Managed Program

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PainRelief.com Interview with:
Louise Fleng Sandal PhD
Adjunkt, Institut for Idræt og Biomekanik
SDU University of Southern Denmark

Dr. Sandal

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

Response: Low back pain is a globally prevalent condition with a high economic cost. Many people seek help with primary care from their general practitioner, physiotherapist or chiropractor. Evidence-based guidelines on first line treatment include learning to self-manage, staying active, exercising and learning about the condition. However, many find this difficult without advice and support, but primary care physicians often lack the time and resources to support self-management.

Digital solutions, such as smartphone technology, utilizing artificial intelligence can be used to tailor self-management support to the individual and be available at the individuals convenience.

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Cognitive-Behavioral Couple Therapy Provided Pain Relief from Vulvar Pain

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PainRelief.com Interview with:
Sophie Bergeron, Ph.D.
Canada Research Chair in Intimate Relationships and Sexual Wellbeing
Past-President, Society for Sex Therapy and Research
Professeure titulaire/Professor
Département de psychologie 
Université de Montréal 

Dr. Bergeron

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

Response: Chronic pain problems involving the female reproductive system are major health concerns in women of all ages. As conditions which are poorly understood and often misdiagnosed or ignored, they entail a great personal cost to patients and a significant financial cost to society.

One such condition is vulvodynia, or chronic unexplained vulvar pain. Up to 8% of women under 40 may experience idiopathic vulvar pain during their lifetimes. Provoked vestibulodynia (PVD) – an acute recurrent pain localized within the vulvar vestibule and experienced primarily during sexual intercourse – is suspected to be the most frequent cause of vulvodynia in premenopausal women.

Despite its high prevalence and negative impact on psychosexual functioning of both affected women and their partners, there has been a paucity of controlled research to provide empirically validated treatments for afflicted couples. This randomized clinical trial compared a novel cognitive-behavioral couple therapy (CBCT) and topical lidocaine for PVD.

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Routine Lumbar X-Rays of Limited Value in Assessing Low Back Pain

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PainRelief.com Interview with:
Lingxiao Chen | MBBS, MMed, PhD Candidate
The University of Sydney
Institute of Bone and Joint Research | The Kolling Institute
Sydney Medical School | Faculty of Medicine and Health
Statistical Editor of BMJ Open Sport & Exercise Medicine

back pain

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

Response: Current guidelines for treatment of low back pain (LBP) do not recommend routinely using diagnostic imaging, except when patients either present with severe, progressive neurologic deficits or with signs or symptoms indicative of a serious or specific underlying condition (eg, fracture or cancer). Nonetheless, diagnostic imaging is still widely used in clinical practice for low back pain. Previous studies, using mostly cross-sectional data, provide conflicting evidence of an association between lumbar spine radiographic changes and the severity of back pain–related disability. Such conflicting evidence may be associated with widely unnecessary diagnostic imaging of the lumbar spine.

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Diabetic Neuropathy: High-Frequency Spinal Cord Stimulation Offers Pain Relief

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PainRelief.com Interview with:
Erika A. Petersen, MD, FAANS, FACS
Professor of Neurosurgery
Residency Program Director
UAMS Department of Neurosurgery

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

Response: Painful diabetic neuropathy is a common occurrence for patients with diabetes and can have a tremendous negative impact on their quality of life. Currently, the best available treatments include several types of medications and topical solutions, but there are many patients who do not achieve adequate pain relief or cannot tolerate side effects from these treatments. We need new options for patients who have tried the recommended first- and second-line treatments but still suffer with severe pain.

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Targeted Smartphone Exercise Program Can Provide Pain Relief from Knee Arthritis

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PainRelief.com Interview with:
Ana M Valdes MA PhD
Professor in Molecular and Genetic Epidemiology
NIHR Nottingham Biomedical Research Centre – Research Area Lead
Associate Editor European Journal of Clinical Nutrition
School of Medicine
University of Nottingham

Dr. Valdes

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

Response: Knee osteoarthritis and knee pain affect a large proportion of middle age and aging individuals and this are  an increasing problem. Physical exercises aimed at strengthening and stabilising the muscles in the legs and hips  are known to be highly effective in reducing pain and improving the ability to walk and get on with life. But a key challenge is how to deliver such gradual exercises in a way that does not require people to travel to see a physiotherapist or a doctor, particularly given the issues raised by  lockdown both in terms of the Covid-secure challenges face to face visits and also given the strain that the pandemic has put on health services.  

Our  study was the first randomised controlled trial in the UK where we were had people with painful knee osteoarthritis either do only what their doctors normally recommend or, in addition, follow a programme of exercised developed in Sweden delivered via  smartphone app. The research participants were assessed for knee inflammation, knee pain, pain sensitivity around the knee, muscle strength, and ability to walk and get up from a chair both before and after the 6 week smartphone delivered intervention (or a 6 week period simply following any advice they had from their family doctor).

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