Tag Archives: #painrelief

UTHealth SA Researchers Study Link Between Omega Fatty Acids and Peripheral Neuropathy

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PainRelief.com Interview with:
Ken M. Hargreaves, DDS, PhD
Professor and Chair
Department of Endodontics
The University of Texas Health Science Center at San Antonio

Dr. Hargreaves

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

  1. About ten years ago our lab found that the omega-6 lipids can generate pain-producing lipids by activating the capsaicin (found in red hot chili) receptor. At about that time, other scientists reported that a related lipid, the omega-3, can generate pain-relieving lipids. 
  2. Scientists have known for a long time that both omega-6 and omega-3 lipids are “essential fatty acids”, meaning that our body does not make them so they must come in our diet.
  3. So, we tested the idea that a high omega-6 diet would be a risk factor for pain. That is exactly what we found: mice fed a high omega-6 diet had greater pain-like responses after inflammatory or neuropathic injury.
  4. Mice with diabetic neuropathy actually had worsening of symptoms after a high-6 diet. Importantly, this was largely reversed in mice fed a high omega-3 diet.
  5. We also found a drug that blocked the release of the omega-6 lipids from cell membranes and this drug significantly reduced diabetic neuropathy pain in mice.
  6. We then transitioned to clinical research.  We collected ankle skin biopsies from participants with type II diabetic neuropathy and from age- and sex-matched controls.  The tissue levels of omega-6 lipids predicted pain levels, with higher omega-6 lipids associated with higher reports of pain.

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

  1. Dietary recommendations have been made for patients with many disorders such as cardiovascular disease, diabetes and autoimmune disease.  Our findings suggest that pain should be added to this list and that a diet enriched with a higher ratio of omega-3 to omega-6 lipids may help to reduce pain.
  2. Examples of foods with a high omega 3:6 ratio are tune (25:1 of omega 3:6), broccoli (6:1), flax seeds (4:1), mango (3:1), spinach (5:1) and lettuce (2:1).  Examples of foods with excessive omega-6:3 would include many processed foods cooked in vegetable oils such as French fries, hamburgers and the like.

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

Response: Our study has identified several paths for future research including a clinical trial evaluating the effects of a high omega 3:6 diet on pain, development of new drugs to block omega-6 release and the possible development of lipids as a biomarker for pain.

No disclosures.  

Citation:

Boyd, J.T., LoCoco, P.M., Furr, A.R. et al. Elevated dietary ω-6 polyunsaturated fatty acids induce reversible peripheral nerve dysfunction that exacerbates comorbid pain conditions. Nat Metab 3, 762–773 (2021). https://doi.org/10.1038/s42255-021-00410-x

The information on PainRelief.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

Green Light Therapy Can Augment Traditional Pain Relief Methods

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PainRelief.com Interview with:
Mohab Ibrahim, MD., Ph.D
Associate Professor, Departments of Anesthesiology, Neurosurgery, and Pharmacology.
Director, Chronic pain clinic. 
Director, Chronic pain fellowship. 
Medical Director, Comprehensive Pain and Addiction Center
Banner-University Medical Center
University of Arizona

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

Response: This study is the continuation of the green light story we first published in 2017. Our first paper in 2017 investigated the effect of green light on pain behavior in animals. This idea was inspired by my brother who suffers from headaches and finds relief in green spaces. My brother’s experience with green spaces inspired me to look initially into green light therapy for pain in rodents which resulted in our first publication in 2017.  Because green light therapy decreased pain behavior in animals coupled with the safety profile of green light (we use low-intensity green light), we obtained approval from the University of Arizona to conduct human trials. This has resulted in two clinical trial papers that were recently published.

We have shown that green light exposure decreased the severity of pain in patients with fibromyalgia and also decreased the intensity and frequency of migraine headaches in migraine patients. At this point, we wanted to explore the mechanism(s) of action and explain how green light works. We had some preliminary data from our initial publications pointing towards the endogenous opioid system. Therefore, we decided to explore the endogenous opioid system in more detail in the HIV-induced neuropathy model in rodents. Our findings indicate that green light reversed hypersensitivity in a model of HIV-related neuropathy in rodents by stimulating the endogenous opioid system. Green light exposure significantly increased the CSF levels of β-endorphin and proenkephalin, but not dynorphin. The µ- and δ-opioid receptors appeared to be key actors in green light-induced antinociception. 

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

Response: Chronic pain is a complicated medical condition with several dimensions. Chronic pain may affect sleep quality, life quality, and may result in depression.

The management of chronic pain requires a deep appreciation of the factors involved and necessitates the evaluation of a pain specialist and the collaboration of several medical specialists.

Non-pharmacological methods can be used to complement current pharmacological and procedural interventions to control pain.

Color and light therapy are still in their infancy and we still need to learn more about them. More research and more funding are needed to better understand the biological

Green light therapy can augment current traditional methods to control pain.

If you live in an area with trees or forests, you can enjoy free green light therapy while walking and exercising. It’s a win-win situation.

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

Response: We and other labs have shown that different colors of light have biological effects. It’s important that we start looking at new indications for light therapy as well as mechanisms of action. Light therapy is relatively a new field and there may be some or a lot of skepticism in the scientific community about its benefits. It may be time to start thinking about organizing regional/national annual meetings focused on the medical benefits of light therapy. This type of meeting will foster collaborations among physicians and scientists and attract more attention and interest in this field.

Finally, looking at the financial burden secondary to the price and cost of medications and the side effects associated with some of these interventions, light therapy may offer a safer complementary tool that is more affordable and has fewer side effects than a significant number of medications. While light therapy may not replace traditional medications, it may decrease the amount of medications needed.

PainRelief.com: Is there anything else you would like to add?

Response: Even though green light therapy is easy to do and relatively safe, I advise anyone who wishes to try it to consult their physicians first. Some medical conditions may not be suitable for extended visual light exposure. Always check with your doctor before you start any new therapy. Also, please do not stop ANY medication you are on without consulting with your physician first. Some medications should not be stopped abruptly.

Finally, as a disclosure, I have a patent for the green light therapy, and it is currently being commercialized.

Citation:

Laurent F. Martin, Aubin Moutal, Kevin Cheng, Stephanie M. Washington, Hugo Calligaro, Vasudha Goel, Tracy Kranz, Tally M. Largent-Milnes, Rajesh Khanna, Amol Patwardhan, Mohab M. Ibrahim,

Green light antinociceptive and reversal of thermal and mechanical hypersensitivity effects rely on endogenous opioid system stimulation,

The Journal of Pain, 2021,

The information on PainRelief.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

Playing Virtual Reality Games May Provide Some Pediatric Pain Relief

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PainRelief.com Interview with:
Henry Xiang MD MMBA
Professor of Medicine and
Director of Center for Pediatric Trauma Research
Nationwide Children’s Hospital
Professor of Pediatrics
The Ohio State University College of Medicine.

Dr. Xiang


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

Response: The rationale for the study is that burn dressing changes are very painful, and physicians/nurses sometimes must prescribe high dose of opioid pain medications to manage the pain. Because of the repeated painful dressing changes, a lot of children have anxiety about the upcoming burn dressings change.

PainRelief.com:  What are the main findings?

Response: Our main findings are:

1) Smartphone-based VR games could be an effective pain management tool for pediatric burn patients;

2) Actively playing the virtual reality games is more effective in managing the pain than just watching the same VR game.

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Ketorolac vs Ibuprofen for Acute Low Back Pain Relief

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PainRelief.com Interview with:
Benjamin W. Friedman, MD, MS, FAAEM, FACEP, FAHS
Professor of Emergency Medicine
Vice-chair for Clinical Investigation
Department of Emergency Medicine
Albert Einstein College of Medicine
Montefiore 
Bronx, NY 10467

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

Response: A very large number of patients present to US EDs annually with back pain. No medications have proven more effective than NSAIDs for low back pain. Similarly, combining other medications such as skeletal muscle relaxants or opioids with NSAIDs does not improve outcomes more than NSAIDs alone.

Prior to our study, little was known about which NSAIDs were most efficacious for acute low back pain.

The main finding of our study is that ketorolac was more efficacious than ibuprofen for some two and five day outcomes that are important for patients.

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Infused VYEPTI Provided Pain Relief When Initiated During a Migraine Attack

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PainRelief.com Interview with:
Roger Cady, MD
VP Neurology
Lundbeck Pharmaceutical
La Jolla Research Center
San Diego, CA 92121

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

Response: The RELIEF study evaluated how preventive migraine candidates may benefit from a VYEPTI infusion during an active migraine attack when administered within 1 to 6 hours of a moderate to severe migraine attack. VYEPTI is the first and only intravenous (IV) infusion approved for the preventive treatment of migraine in adults.

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Chronic Pain Increasing in Every Age and Demographic Group

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PainRelief.com Interview with:
Hanna Grol-Prokopczyk PhD
Associate Professor
Department of Sociology
University at Buffalo, SUNY

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

Response: Although chronic pain is recognized as an extremely common and costly health problem, little research has explored temporal trends in pain prevalence.  Indeed, as recently as 5-6 years ago, there was no published research using general population data examining whether pain prevalence in the U.S. was going up, going down, or staying constant.  (This can be contrasted to conditions such as diabetes and cancer, for which information about long-term trends is readily available.  Of note, chronic pain affects more Americans than diabetes, cancer, and heart disease combined.)  In recent years, a few studies have documented rising pain prevalence in the U.S., but most have used data on middle-aged or older adults.

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Fusion vs Replacement for Pain Relief from Ankle Arthritis

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PainRelief.com Interview with:
Bruce J. Sangeorzan, M.D., Professor
Director, RR&D Center for Excellence in Limb Loss Prevention and Prosthetic Engineering
Veterans Affairs
University of Washington

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

Response: We began a series of studies in the early 2000’s when ankle replacement was limited to a few centers like our own. We knew that ankle arthrodesis– or fusion—was an effective treatment for ankle arthritis. But ankle fusion is not appropriate for some people and it also results in loss of ankle motion. There were a growing number of ankle replacements being done but little was known about their effectiveness or how long they last.

We wanted to study whether replacement and fusion were comparable for pain relief and activity and wanted to know if maintaining motion of the ankle (by using a replacement) would have an advantage without additional risk. Three studies were done involving more than 800 patients from 6 centers.

This most recent study compared two groups of patients who had similar amount of pain and activity before treatment. All of the patients had already tried non -surgical solutions such as activity modification, bracing and injections with out improvement. One group had fusion of the ankle and the other had replacement of the ankle. Patients were questioned and examined four years or more after surgery and compared to their condition before treatment.

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No Pain Relief Found With Paracetamol (acetaminophen) for Acute Back Pain

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PainRelief.com Interview with:
Christina Abdel Shaheed PhD
Researcher and Academic
University of Sydney

Dr. Abdel Shaheed

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

Response: Paracetamol (acetaminophen) is one of the most widely used drugs for pain relief globally. Our study (https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.50992) examined the evidence on the efficacy of paracetamol versus placebo for 44 different pain conditions. There is strong evidence paracetamol provides greater pain relief than placebo for four conditions: craniotomy, knee or hip osteoarthritis, tension headache and perineal pain following childbirth, however sometimes the effects were very small.

Paracetamol was no more effective than placebo for acute low back pain. There is uncertainty regarding the benefits of paracetamol for the remaining 39 pain conditions. To note, most studies evaluated single doses of the pain reliever, which does not reflect typical use of the medicine.

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

Response: If people are considering paracetamol for their pain, the recommendation is to:

  • Stick within the safe limits for using paracetamol (maximum 4 g daily for adults, which will vary depending on the formulation used).
  • Bear in mind there are different types of paracetamol products (long-acting, which should be taken less frequently, versus short-acting); and cold and flu preparations (including decongestant) and popular over-the-counter products for pain relief (including ibuprofen) can also contain paracetamol.
  • Do not use paracetamol for more than a few days at a time unless specifically advised to by a doctor or pharmacist.
  • Consider combining the medicine with other non-drug strategies to optimise pain relief, particularly for conditions like osteoarthritis e.g. exercise and healthy eating.

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

Response: High quality clinical trials evaluating typical use of paracetamol are needed to resolve the uncertainty around its effectiveness for the majority of pain conditions.

Disclosures: Some of the authors on this study were also involved in the PACE trial which evaluated the efficacy of paracetamol vs placebo for acute low back pain.

Citation:

Abdel Shaheed, C., Ferreira, G.E., Dmitritchenko, A., McLachlan, A.J., Day, R.O., Saragiotto, B., Lin, C., Langendyk, V., Stanaway, F., Latimer, J., Kamper, S., McLachlan, H., Ahedi, H. and Maher, C.G. (2021), The efficacy and safety of paracetamol for pain relief: an overview of systematic reviews. Med J Aust, 214: 324-331. https://doi.org/10.5694/mja2.50992

The information on PainRelief.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

Tapentadol Provided Pain Relief and Improved Sleep in Patients with Chronic Musculoskeletal Pain

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PainRelief.com Interview with:
Dr Renato Vellucci
Contract Professor University of Florence
Pain and Palliative care Clinic
University Hospital of Careggi
Florence, Italy

Dr. Vellucci

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

Response: Chronic low back pain (CLBP) is the most prevalent chronic pain (CP) condition and the leading global cause of years lived with disability. According to the axiom pain as a biopsychosocial issue, mood and sleep disturbances represent key issues. However, the impact of different analgesic therapies on quality of life (QoL) and functional recovery has been poorly assessed to date. Focusing on combination of chronic pain and sleep, they both perform a mutual reinforcement.

Pain disorganizes the sleep architecture, and disturbed and unrefreshed sleep increases spontaneous pain and lowers pain thresholds. Sleep disorders may augment stress levels, thus making it difficult for patients to perform simple tasks impairing their cognitive ability. Poor sleep may predict the growth and intensification of pain over time, with increased insomnia symptoms being both a predictor and an indicator of worse pain outcomes and physical functioning status over time. Epidemiology of chronic pain unequivocally demonstrates the role of sleep quality in the development of chronic pain.

Notwithstanding this strong two-way relationship between chronic pain and sleep, little knowledge is available about the neurochemical determinants of this interplay and therapeutical strategies to break this vicious circle. Fifty percent of people with chronic low back pain have sleeping disturbances, with an 18-fold increase in insomnia versus healthy people. A recent study investigated the relationship between sleep disturbances and back pain and found that it is two sided with sleep disturbance being associated with risk of back pain whilst back pain can also lead to sleep disturbances. Thus, it can be hypothesized that, by reducing pain and physical dysfunction, sleep quality could be improved, thus enriching the QoL of people with CLBP.

Similarly, improvements in sleep after cognitive behavioral therapy in patients with chronic pain due to osteoarthritis were associated with reduced pain. Earlier evidence suggested that tapentadol prolonged-release treatment ameliorate in parallel QoL and sleep quality in a greater proportion of patients compared to that of patients following oxycodone/naloxone prolonged- release treatment (50% versus 37.7%). Other tapentadol studies conducted in a real-life context documented, along with effective pain control, similar improvements in mental and physical health and suggested beneficial effects in terms of less night awakenings and greater percentages of patients reporting restful sleep.

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Peptide May Allow Cannabis to Provide Pain Relief Without Unwanted Side Effects

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PainRelief.com Interview with:
David Andreu, PhD
Professor of Chemistry
Department of Experimental & Health Sciences
Pompeu Fabra University
Barcelona Biomedical Research Park
Barcelona, Spain

Prof. David Andreu (right)
Maria Gallo, (first author)
Prof. Rafael Maldonado

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

Response: Background is the (earlier) finding of a cross-talk between CB1 and 5HT2A receptors (two GPCRs forming a heterodimer) that can be acted upon (disrupted) by peptides that allow to dissociate analgesic (CB1-mediated) from (unwanted) cognitive effects ( CB1/5HT2A heterodimer-mediated, memory impairment etc); this is reference 18 of our paper.

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