Feature Channels: Pain

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Scientists at Saint Louis University and Southern Illinois University Edwardsville will use federal stimulus money to search for new solutions to chronic pain.

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New discovery of spine disease will help back pain suffers, primarily younger women, who have been misdiagnosed with conditions that include restless leg syndrome, multiple sclerosis and myleopathy. Symptoms include severe middle back pain, leg spasms, loss of coordination and balance. Disease progression can lead to loss of function in lower extremities and possible paralysis. Minimally invasive outpatient microsurgery has shown effective in reversing symptoms and restoring patients back to healthy and active life.

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It is a fact known by every woman who has had a baby - the amount of pain experienced increases as labor progresses, but some women experience more pain during labor than others. A new study in the November issue of Anesthesiology further explores individual labor variables, reporting associations between ethnicity, and labor progress and pain.

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A lack of vitamin D, the sunshine vitamin, during dreary winter months often results in back aches and pains. The solution is as simple, safe, and inexpensive as an extra daily dose of vitamin D, says a research report from Pain Treatment Topics.

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A proactive ergonomic intervention reduces pain related to poor work postures in office employees, reports a study in the October Journal of Occupational and Environmental Medicine, official publication of the American College of Occupational and Environmental Medicine (ACOEM).

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A new study reports the side effects of oxycodone, a widely used opioid pain medication, are similar in healthy older adults as in younger age groups, therefore, clinicians should not shy away from prescribing the drug to relieve pain in older patients.

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Injections of the human papillomavirus (HPV) vaccine appear to be no more painful than other shots that prevent disease, according to a new study by researchers at the University of North Carolina at Chapel Hill.

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A study presented at the 2009 ASA Annual Meeting highlights the crucial importance of investigating multiple factors when designing studies that attempt to predict the development of persistent pain in patients.

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Anesthesiologists studying the occurrence of persistent postoperative pain have identified four independent risk factors for persistent postoperative pain development and recommend preventative treatment options.

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Migraine sufferers, beware. You may be more prone to an alcohol-induced headache after a night of drinking, according to researchers from the Jefferson Headache Center. The research will be presented at Neuroscience 2009, the Annual Meeting of the Society for Neuroscience, in Chicago.

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People who are overweight and lose just 5 percent of their weight reduce their risk of osteoarthritis of the knee, while maintaining weight has little benefit, a study from the Thurston Arthritis Research Center at the UNC Chapel Hill School of Medicine shows.

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A new review from Sweden finds that diclofenac -- a medication that works for some adults -- relieves acute pain in children after surgery. However, a U.S. researcher is not convinced that the drug is an improvement over standard treatment.

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A new review suggests, although not strongly, that four of 10 people patients with peripheral neuropathies experience some pain relief from topical capsaicin cream. Capsaicin is the active component of chili peppers.

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UPDATED WEBINAR LOGIN INFORMATION Attend a special press event at the 2009 ASA Annual Meeting discussing: 1) ASA’s position on responsible use of propofol; 2) ASA’s position on whether scheduling the medication would help curb abuse; 3) ASA’s proposed increases in patient monitoring techniques during specific endoscopic procedures in remote locations.

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To the patient, automated nerve conduction studies (NCSs) may sound appealing because they are less invasive than needle electromyography (EMG). To the physician with no formal electrodiagnostic (EDX) training, the ability to perform an automated test in their office is convenient for patients and may generate additional revenue for their practice.

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Should you take opioid drugs for hip and knee pain caused by osteoarthritis? Probably not, suggests a new review of the best research on the subject.

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A meniscus transplant, a rarely performed arthroscopic procedure, might help delay the onset of arthritis and relieve knee pain for young, active people.

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Todd Rozen knows you can’t just “pop a pill and deal with it.” He’s suffered from chronic migraines for more than three decades and it’s his fascination with understanding and treating this chronic condition – and the diminished quality of life that accompanies it – that led him to become a headache specialist, a relatively rare and emerging breed of doctor in America. Dr. Rozen, who knows first-hand the devastating effects of headaches, is the director of the new Geisinger Headache Center located in Wilkes-Barre, Pennsylvania.

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Patients suffering from back pain, sciatica, or a herniated disc, sometimes find relief with epidural steroid injections (ESI). Recent research has found that needle electromyography (EMG) can reliably predict, among other factors, the patient’s potential pain relief from these injections.

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Clinicians treating patients with chronic pain must assess their alcohol use and, if necessary, provide counseling regarding problems associated with mixing alcohol and pain medications, according to a study published in The Journal of Pain, the peer review publication of the American Pain Society.

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Physically fit military recruits occasionally develop an “exertional heat illness” (EHI), which can cause them to collapse during training, or even on the battlefield. Emerging research evidence suggests a potentially important link between EHI and malignant hyperthermia—a rare but feared complication of anesthesia, according to an article in the October issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).

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Memory loss and other cognitive problems after heart surgery may not be related to the use of cardiopulmonary bypass (CPB), or to 'flotsam' in the bloodstream caused by the CPB pump, according to a study in the October issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).

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After evaluating a cluster of deaths most likely related to intrathecal (spinal) opioid infusions in non-cancer pain patients, a group of researchers is confident that such future complications are preventable.

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At the Johns Hopkins University School of Nursing (JHUSON) and the Johns Hopkins Hospital (JHH), research and staff nurses strive to better understand what pain is all about, how it affects body and mind both in the short-term and over time, and how it can be reduced or prevented altogether.

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In July 2009, the U.S. Food and Drug Administration approved ONSOLIS, also known as fentanyl buccal soluble film, from North Carolina-based BioDelivery Sciences International, Inc. (BDSI), for the management of breakthrough pain in patients with cancer, 18 years of age and older, who are already receiving and who are tolerant to opioid therapy for their underlying persistent cancer pain. This opioid analgesic is anticipated to be available in the October of 2009 and will be commercialized in the U.S. by Meda Pharmaceuticals, the U.S. subsidiary of Meda AB.

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Watching a loved one try to cope with debilitating pain can be agonizing. However, doing small things may make a big difference in the quality of life of a person coping with great pain, whether that person is in his or her own home or in a nursing home.

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Cancer and its treatment causes discomfort on many levels, but controlling pain can speed recovery for children battling the disease, say pain management experts at St. Jude Children's Research Hospital.

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News/Research UPDATES take a hard look at soft evidence behind many of today’s pain management practices and beliefs. This new offering from Pain Treatment Topics helps healthcare providers and the public to develop an educated skepticism.

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Coubital tunnel syndrome is caused by the compression of the ulnar nerve in the elbow. The ulnar nerve is one of the main nerves of the forearm and hand. Most patients with this condition typically experience numbness and tingling in their fingers, along with weakness of grip. Those most affected by this condition often include office workers and others who operate machinery with a bent elbow.

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Unlike “acute pain,” which generally results from specific injury or illness, chronic pain can result from any number of conditions and can persist for, in some cases, years. Among the most common forms of chronic pain are headache; cancer pain; low back pain; arthritis; and psychogenic pain, which is not rooted in any specific injury or condition. Treatments for chronic pain are numerous as well—medication, surgery, acupuncture and psychotherapy are among the techniques doctors can use to treat chronic pain.

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In a recent study published in JRRD, Volume 46, Issue 1, researchers assessed the short-term effects of high- and low-frequency transcutaneous electrical nerve stimulation (TENS) on neuropathic pain following SCI.

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Two leading experts in the diagnosis and treatment of fibromyalgia are available for interviews about the signs, symptoms, current treatment landscape and other important aspects of the condition.

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One year ago, former U.S. Army parachutist Adam Hammond became the first patient in the world implanted with an Eon Mini neurostimulator, the world’s smallest neurostimulator for chronic pain. Adam is just one of the many chronic pain sufferers who have been helped with neurostimulation, an FDA-approved therapy that uses electrical pulses to interrupt pain signals to the brain.

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Endothelin may play a role in the pain of sickle cell disease because of a change in the endothelin B receptor. The activated receptor releases endorphins to help alleviate pain. Males who experience repeated pain may not have as much of the receptor and therefore do not release as much of the endorphins. Dr. Sarah Sweitzer discusses her team’s work.

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A surgical procedure known as LUNA (laparoscopic uterosacral nerve ablation) did not result in improvements in chronic pelvic pain, painful menstruation, painful sexual intercourse or quality of life when compared with laparoscopic surgery that does not interrupt pelvic nerve connections, according to a study in the September 2 issue of JAMA.

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As children and teens begin school again, they are more susceptible to the pain and discomfort of headaches and migraines. The change in schedule, new teachers, new friends and schoolwork can increase stress and consequently, increase headaches. Doctors at Nationwide Children’s Hospital say there are some steps parents can take to help prevent the onset of their headaches during this hectic time of year.

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Study of nearly 1 million pain medication monitoring tests highlights an important opportunity to improve patient care and doctor-patient communication.

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The prospect of surgery for a child is a frightening unknown for child and parent alike, and the pre-operative process that most children go through only heightens their anxiety. Research on how hospitals can minimize the anxiety and trauma children face both before and after surgery was recently published in the journal Anesthesiology.

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On rare occasions, anesthesiologists are required to treat severe local anesthetic toxicity, a rare but dangerous complication of regional anesthesia or nerve block that can cause cardiac arrest. Research in the September Anesthesiology explores optimal treatments for severe local anesthetic toxicity and question the use of epinephrine in such cases.

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Women with incontinence, respiratory disorders and gastrointestinal problems have increased risk for development of back pain, according to research reported in The Journal of Pain, the peer review publication of the American Pain Society.

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Experiments in volunteers confirm that electroacupuncture—applying electrical current to acupuncture needles—has pain-reducing effects, reports a study in the September issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).

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University of Maryland School of Pharmacy's McPherson guides medical professionals through the art and science of managing pain treatments.

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A new study conducted at the Jefferson Headache Center at Thomas Jefferson University Hospital in Philadelphia, Pennsylvania shows an investigational, orally-inhaled therapy is effective in treating migraines. The multi-center, phase three FREEDOM-301 trial for the orally-inhaled migraine therapy, LEVADEX, shows study participants had significant relief from symptoms such as pain, nausea and light and sound sensitivity when compared to placebo treatment.

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Researchers at Washington University School of Medicine in St. Louis have discovered that itch-specific neurons exist in mice, and their studies suggest that itch and pain signals are transmitted along different pathways in the spinal cord. The researchers say they can knock out an animal's itch response without affecting its ability to sense pain.

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In a letter to the U.S. Food and Drug Administration, the American Pain Society (APS, www.ampainsoc.org) petitioned the agency, on behalf of the terminally ill and their families, to modify a restricted distribution program for the newly approved pain medication Onsolis, a short acting product that delivers fentanyl through the mouth's mucous membranes.

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Adding a drug called neostigmine to epidural analgesia during labor can reduce the amount of anesthetic drug required, while avoiding potential complications caused by morphine-like "opioid" drugs, according to a study in the August issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).

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Researchers at Massachusetts General Hospital (MGH) have developed a new anesthetic agent, which they think could be a breakthrough in the quest to discover drugs that retain beneficial anesthetic properties while reducing unwanted and occasionally dangerous side effects.

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For centuries, acupuncturists have inserted and manipulated needles at prescribed points to achieve therapeutic benefit, such as pain relief. Research reported in The Journal of Pain shows that ancient acupuncture meridians coincide with known myofacial trigger point regions, as described in the Trigger Point Manual, and may provide potential for novel approaches for treating chronic myofacial pain.

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Australian researchers writing in The Journal of Pain reported there is significant improvement in pain management for hospitalized infants undergoing painful procedures, such as heel lances to draw blood.

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Chemical dependency and recovery in patients and physicians are closely examined in a series of articles and editorials in the July 2009 issue of Mayo Clinic Proceedings.