Beyond Opioids: The Future of Pain Management

March 14, 2018 — Cindi Scheib wanted to die.

A three-day weekend spent jumping and dancing on Labor Day 2014 had left her with a neck injury – specifically the cervical spine – that was possibly an exacerbation of an unrecognized mountain biking injury earlier that year. To make matters worse, her doctor performed the surgery to fix the injury on the wrong part of her spine.

Now 54, Scheib has lived with constant neck pain and other unusual sensations throughout her body ever since. These sensations, including electrical shocks down her spine, buzzing, vibrating, burning sensations, ringing in her ears and sensitivity to normal noises, had gotten so bad, she said, that “I wanted to go to bed and not wake up tomorrow. This life was so bad, so horrible, that I couldn’t imagine how I was going to live the rest of whatever life I had,” says the Harrisburg, PA, nurse.

Full story at WedMD

Magnetic nano-sized disks could restore function for Lou Gehrig’s disease patients

For decades the renowned English physicist Stephen Hawking lived with a motor neuron disease until his death last year. People who suffer from this condition lose functionality of brain cells that control essential muscle activity, such as speaking, walking, breathing and swallowing.

To help individuals afflicted by MNDs, UTSA has embarked on revolutionary research that uses magnetic nano-sized disks and magnetic fields to individually modulate functionality to crucial neurons. This research could open the door to reversal of degenerative conditions like Hawking’s to restore the quality of life for about 1 million adults across the globe.

Full story at Medical-News

Standard methods not adequate to detect prosthetic joint infections in rheumatic disease patients

Standard diagnostic methods are not adequate to identify prosthetic joint infections (PJIs) in patients with rheumatic diseases, according to findings from a new study by researchers from Hospital for Special Surgery (HSS) in New York City. The study was presented at the American College of Rheumatology/Association of Rheumatology Professionals annual meeting in Atlanta on November 12.

Lead study author Susan M. Goodman, MD, a rheumatologist at HSS, said that while patients with rheumatic diseases are more prone to developing PJIs, it is also harder to make a PJI diagnosis in this population because many of the typical inflammation features of PJIs are similar to those seen in inflammatory arthritis flares. “If a patient with osteoarthritis comes in with a swollen and inflamed prosthetic joint, it is an infection until proven otherwise, but for patients with rheumatoid arthritis, it can be very hard to sort out whether this is part of an overall flare of disease or if it is a true infection,” she said. “None of the available tests are that helpful.”

Full story at News-Medical

On the PTA Payment Battleground, We Are All APTA

I was working as a physical therapy technician when Congress instituted the Medicare cap on therapy services on January 1, 1999. I was to graduate as a physical therapist assistant (PTA) in May of that year, and, at that time, I had no idea or even much concern about what the cap would mean for our profession or my career.

I heard horror stories about layoffs of physical therapists (PTs) and PTAs due to the payment changes, but as a new graduate I was focused solely on finding a job in my chosen profession. It was not until years later, when I began working in outpatient care and seeing problems with payment, that I realized the importance of getting involved with advocacy.

Since that time, I have been as engaged as possible at the local, state, and national levels to be part of the solution to problems that arise for our profession, including payment for the services that we provide to our patients on a daily basis.

Full story at APTA

New Research: Prescriptions for Narcotics Are Surging for Knee Pain

Although physical therapy and lifestyle changes have been shown to bring significant improvements to those with knee osteoarthritis, new research suggests U.S. physicians may be leaning toward pain medications instead.

Published in Arthritis Care & Research, the study looks at 2,297 physician visits for the condition, data that’s kept in a national database. Researchers found that PT and lifestyle suggestions—like losing weight, quitting smoking, eating healthier foods, and getting more exercise—declined from 2007 to 2015, while prescriptions for nonsteroidal anti-inflammatory drugs, narcotics, and opioids increased.

In fact, during study period, lifestyle recommendations and referrals for physical therapists were reduced nearly by half, while prescriptions for narcotic pain relievers nearly tripled.

Full story at Runner’s World

Multicomponent home-based treatments improve mobility in older adults after hip fracture

Each year more than 260,000 older Americans are hospitalized for hip fractures, a debilitating injury that can severely and permanently impact mobility. Researchers at the University of Maryland School of Medicine (UMSOM) studied two types of home-based interventions and discovered that these treatments are effective in helping individuals regain their ability to walk, but not enough to do every day functions like crossing the street.

Jay Magaziner, PhD, MSHyg, Professor and Chair of the Department of Epidemiology and Public Health at UMSOM was the Principal Investigator for this research and Rebecca L Craik, PT, PhD, FAPTA, Dean of the College of Health Sciences at Arcadia University was Co-Principal Investigator. The research was a multidisciplinary partnership involving investigators from epidemiology, physical therapy, geriatrics, orthopedics, gerontology, health economics, biostatistics and health services research. It was conducted at UMSOM, Arcadia University and UConn Health at the University of Connecticut. The research compared two different types of multi-component home-based physical therapy programs, both of which showed significant improvements in the ability to walk but not enough to be independent in the wider community.

Full story at Science Daily

How the brain regulates variability in motor functions

Anyone who has ever tried to serve a tennis ball or flip a pancake or even play a video game knows, it is hard to perform the same motion over and over again. But don’t beat yourself up—errors resulting from variability in motor function is a feature, not a bug, of our nervous system and play a critical role in learning, research suggests.

Variability in a tennis serve, for example, allows a player to see the effects of changing the toss of the ball, the swing of the racket, or the angle of the serve—all of which may lead to a better performance. But what if you’re serving ace after ace after ace? Variability in this case would not be very helpful.

If variability is good for learning but bad when you want to repeat a successful action, the brain should be able to regulate variability based on recent performance. But how?

Full story at Medical Xpress

Immersion in virtual reality scenes of the Arctic helps to ease people’s pain

Watching immersive 360 videos of icy Arctic scenes helps to relieve burning pain and could hold hope for treating chronic pain, a study has found.

Scientists from Imperial College London have found that using virtual reality headsets could combat increased sensitivity to pain, by immersing people in scenes of icebergs, frigid oceans and sprawling icescapes.

In a small proof-of-concept study, published in Pain Reports, a team from Imperial used VR video to reduce peoples’ scores of perceived ongoing pain as well their sensitivity to painful stimuli.

According to the researchers, the findings add to the growing evidence for the potential of VR technology to help patients with chronic pain.

Full story at Imperial College London

CMS Rule on Hospital Price Transparency Sets the Stage for Major Shift in Public Access to Charges for Services

The big picture: Hospitals will face more stringent requirements to disclose charges for items and services—including physical therapy—in a consumer-friendly, online form. Hospitals aren’t happy about it.


A final rule from the US Centers for Medicare and Medicaid Services (CMS) makes it clear that the agency will move ahead in its efforts to make hospital cost data more accessible to consumers. Beginning January 1, 2021, hospitals will be required to share a much more detailed range of charges, including gross charges, charges negotiated with a third-party payer, charges for cash payment from individuals, and minimum and maximum negotiated charges. The publicly accessible data must cover at least 300 services that patients can schedule in advance—known as “shoppable” services—and while hospitals have some leeway as to which service charges are included, they are required to lists charges for a core set of 70 services, including physical therapy, specifically therapeutic exercise (CPT 97110).

Full story at APTA

Yoga and physical therapy effective in treating co-occurring sleep disturbance, back pain

Yoga and physical therapy (PT) are effective approaches to treating co-occurring sleep disturbance and back pain while reducing the need for medication, according to a new study from Boston Medical Center (BMC). Published in the Journal of General Internal Medicine, the research showed significant improvements in sleep quality lasting 52 weeks after 12 weeks of yoga classes or 1-on-1 PT, which suggests a long-term benefit of these non-pharmacologic approaches. In addition, participants with early improvements in pain after 6 weeks of treatment were three and a half times more likely to have improvements in sleep after the full, 12-week treatment, highlighting that pain and sleep are closely related.

Sleep disturbance and insomnia are common among people with chronic low back pain (cLBP). Previous research showed that 59% of people with cLBP experience poor sleep quality and 53% are diagnosed with insomnia disorder. Medication for both sleep and back pain can have serious side effects, and risk of opioid-related overdose and death increases with use of sleep medications.

Full story at News-Medical.net