Tag Archives: pain

Mt. Sinai Study Identifies Lifestyle Changes That Provide Some Knee Pain Relief

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PainRelief.com Interview with:
Daniel A Charen MD
Leni and Peter May Department of Orthopaedic Surgery
Icahn School of Medicine at Mount Sinai, New York

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

Response: There is a well-established link between obesity and knee osteoarthritis, and recent research has implicated diabetes as a potential cause of cartilage degeneration. This study uses the National Health and Nutrition Examination Survey (NHANES) database to examine the association between knee pain and various metabolic factors.

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Are Invasive Procedures Effective for Chronic Pain Relief? A Systematic Review

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PainRelief.com Interview with:
Wayne B. Jonas, MD
Executive Director
Samueli Integrative Health Programs, H&S Ventures,
Alexandria, VA

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

Response: The search for non-drug approaches to chronic pain is a major recommendation in many recent guidelines for both pain management and reduction in the use of opioids. Surgical and invasive procedures are non-drug approaches often used for pain conditions like back pain and arthritis, so good evidence is needed to determine the safety and efficacy of these procedures. Properly done randomized, placebo-controlled trials are the best way (the gold standard) to get that evidence, so we did a thorough evaluation of such research, using standard systematic review and meta-analysis methods.

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Progress Made Toward Electronic Skin That Senses Pain, Temperature and Touch

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PainRelief.com Interview with:
Md. Ataur Rahman
Research Fellow
Functional Materials and Microsystems Research Group
School of Engineering
RMIT University
Melbourne, Victoria Australia

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

Response: The most prevalent and critical skin receptors relate to pressure, temperature, and pain – the Pacinian corpuscle, thermoreceptor, and nociceptor, respectively. All these receptors detect stimuli, measure levels of stimuli, and transmit signals to the brain triggering reactions. The characteristic features of such human sensory system are quite complex to be mimicked by existing electronics. Development of such electronics will be a big step leading towards smart prosthetics and human-like robotics.

PainRelief.com:  What are the main findings? What are some of the potential uses for this ‘skin’?

Response: While some existing technologies have used electrical signals to mimic the skin receptors, these new devices can react to real mechanical pressure, temperature, and pain, and deliver the right electronic response.

This electronic skin enable replacement of affected human skin regions, augment skin sensitivity for agile applications in defense and sports, and drive advancements in intelligent robotics.

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Genetic Differences Distinguish Episodic Versus Chronic Migraine and May Open New Avenues of Pain Relief

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PainRelief.com Interview with:
Aliya Yakubova MD
OpenLab “Gene and Cell Technologies”
Institute of Fundamental Medicine, Kazan Federal University
Kazan, Russia

Dr. Yakubova

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

Response: Migraine is a common debilitating primary headache disorder with strong socio-economic effects. According to some estimates, migraine is the most costly neurological disease: for example, in the European Union, it costs more than 27 billion euros a year.

In this regard, chronic type of migraine (with more than 15 attacks per month for more than three months) is of special interest. Because of high prevalence and the burden of attacks, it is of great importance to improve diagnostic tools for patient stratification and choosing appropriate treatment strategies of migraine. For this purpose we investigated contribution of transient receptor potential vanilloid type 1 (TRPV1) receptors to migraine chronification. It is known that these receptors are directly involved in the disease pathogenesis being associated with the release of the key migraine pain mediator, the calcitonin gene – related peptide (CGRP). Moreover, recent studies have suggested that the non-synonymous TRPV1 single-nucleotide polymorphism (SNP) 1911A> G (rs8065080), resulting to the substitution of amino acids isoleucine to valine in the protein structure of receptor (Ile585Val), influences functional activity of these receptors in neuropathic pain syndromes. All this together was the starting point of our research in collaboration with colleagues from the University of Eastern Finland.

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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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