Where Does Chronic Pain Begin? Scientists Close In on Its Origins

A new study by researchers at The University of Texas at Dallas, UT MD Anderson Cancer Center, UT Health Science Center at Houston and Baylor College of Medicine has produced evidence of the source of chronic pain in humans, revealing several new targets for pain treatment.

The paper — published March 19 in Brain, one of the world’s oldest neurology journals — examined specialized nerve cells clustered near the base of the spine. Researchers took advantage of an exceedingly rare opportunity to study these nerves, called dorsal root ganglia (DRG), removed from cancer patients undergoing surgery at MD Anderson.

The researchers cataloged variations in RNA expression in the dorsal root ganglia cells of patients differing by pain state and sex. Using RNA sequencing, a specialized form of gene sequencing, on those DRG cells yielded a list of promising biochemical pathways for which researchers might be able to devise analgesic drugs.

Full story at utdallas.edu

How to stretch your hands and wrists

Wrist pain can be frustrating and inconvenient. It can also make work or basic day-to-day activities, such as using a computer or cooking a meal, more difficult.

Exercises can improve mobility and decrease the chance of injury or reinjury. Wrist stretches are easy to do at home or at the office. When done properly, they can benefit a person’s overall wrist and hand health.

Anyone experiencing chronic pain or pain with numbness should visit a doctor for a thorough diagnosis.

Full story at Medical News Today

Surprisingly, opioids may increase risk of chronic pain

After surgery, opioids — such as morphine — are routinely used to manage pain. However, according to a new study, the drugs could actually raise the likelihood of experiencing chronic pain.

Opioids are big news. The “opioid epidemic” in the United States is destroying lives from coast to coast.

More than 100 people die from opioid-related overdoses each and every day in the U.S.

Despite the horrors of addiction, one aspect of opioid use that is rarely questioned is just how effective they are at fulfilling their primary function: to quell pain.

Full story at Medical News Today

Rocker bottom shoes help reduce chronic low back pain

A new study confirms that rocker bottom shoes helps strengthen back muscles, improving the spine’s curvature and thus reducing low back pain.

Researchers of the Sports Physiotherapy master’s degree at Valencia’s CEU Cardenal Herrera university have confirmed, in a new study of their research work into back pain, that unstable shoes improve the strength of back muscles in order to maintain balance and stability when walking. This muscular strengthening contributes to reducing low-intensity chronic low back pain, which can be disabling for those who suffer it. The results of this new study, headed by CEU UCH teachers Juan Francisco Lisón and Pablo Salvador, co-authors of the first international study on this matter, have been published in the Q1 edition of scientific magazine Clinical Rehabilitation.

As the coordinator of the CEU UCH master’s degree, Pablo Salvador, explains, “patients with chronic low back pain are usually advised to perform exercises to strengthen the muscles in their back, which improve stability of the spine in the lower back area, although it is always hard to make sure they comply with this type of exercises. What this new study shows is that the use of unstable shoes for several hours during a patient’s day-to-day life, without any other specific exercises, effectively contributes to the muscular strengthening of their back and improves the degree of curvature of the spine in the lumbar area, thus helping to reduce chronic pain.”

Full story at Science Daily

THERE’S ONE SURE WAY TO FIX THE OPIOID CRISIS

Officials nationwide finally appear to be tackling America’s opioid crisis. Last week, President Trump declared the epidemic a public health emergency, which will give states more flexibility in responding.

A bill that would limit initial opioid prescriptions to one week is before the Florida state legislature. Maryland is making it more difficult to prescribe opioids, and Arizona is collecting data on the scope of the problem.

These efforts are commendable. But they’re unlikely to bring an end to the crisis because they fail to address one of the opioid epidemic’s root causes — chronic pain. Fortunately, there are plenty of new ways to treat patients suffering from chronic pain. It’s time to embrace them.

Full story at Newsweek

Study: 61% of Opioid-Related Deaths Linked to Chronic Pain Diagnosis

In a study that underscores the need to rethink pain treatment in the US, researchers have found that more than 6 out of 10 individuals who died of an opioid-related cause had received a diagnosis for a chronic noncancer pain condition within the preceding year. The same group was also more likely to have been diagnosed with psychiatric disorders and prescribed psychotropic medications–including benzodiazepines, which can increase the risk of death when combined with opioids.

The study, published in the American Journal of Psychiatry, focused on 13,089 opioid-related deaths among Medicaid patients under 65 years old. Researchers divided the decedents into 2 groups—those who had received a chronic noncancer pain diagnosis in the year preceding death, and those who didn’t—and looked at other clinical diagnoses, filled medical prescriptions, and nonfatal poisonings during the 12 months preceding death as well as 30 days before death.

Full story at APTA

Holistic Therapy Programs May Help Pain Sufferers Ditch Opioids

Each year, more than 300 patients with chronic pain take part in a three-week program at the Pain Rehabilitation Center at Mayo Clinic in Rochester, Minn. Their complaints range widely, from specific problems such as intractable lower-back pain to systemic issues such as fibromyalgia. By the time patients enroll, many have tried just about everything to get their chronic pain under control. Half are taking opioids.

But in this 40-year-old program, they can’t stay on them. Participants must agree to taper off pain medications during their time at Mayo.

Still, more than 80 percent of the patients who enroll remain through the entire program, says Wesley Gilliam, the center’s clinical director. And many previous opioid users who finish the treatment report six months later that they have been able to stay off those drugs. Just as important, he adds, they have learned strategies to deal with their pain.

Full story at NPR

Older, Sicker, and Stressed: Survey Analysis Looks at Individuals With Chronic Pain

An analysis of responses to a national health survey attempted to tease out the distinct characteristics of Americans with chronic pain. The portrait that emerged was of a chronic pain population that is older, under more financial stress, and more likely to live with 1 or more comorbidities compared with the average respondent.

Editorial staff at Medpage Today conducted the review, which analyzed the results of the 2016 National Health Interview Study (NHIS), an 805-question survey administered to 33,000 Americans. The Medpage staff focused specifically on data related to pain, comparing respondents who reported daily pain with NHIS averages. Here’s what they found:

The chronic pain group was older. The median age of the daily-pain group was 59, compared with 52 years for the entire survey group. Within the pain group, about 33% were over age 65—an age range that made up 25% of the whole.

Full story at APTA

What is Pain?

Last week I attended the SIP 2017 Conference in Malta where a meeting of stakeholders deeply considered the issue of pain in society. Pain is a societal problem and the way forward will emerge from considering pain in this light. Significant and exciting steps were taken, which will be covered in a forthcoming article on this site and the UP | understand pain site.
Chronic pain is the number one global health burden. The approaches used for pain are not working. We are seeing the figures increasing over the years as more and more people suffer ~ 100 million people in Europe. Why? The main reason is the misunderstanding of pain that results in unnecessary investigations, treatments that don’t work and low expectations. The predominant thinking remains ‘biomedical’ both in terms of healthcare delivered and society’s expectations. Pain is not a medical problem. It is a public health, or societal issue. We are in it together, all of us. Even clinicians are patients!

Your mind can be trained to control chronic pain. But it will cost you

There was plenty to blame: the car wreck that broke his back. The job pouring concrete that shattered his spine a second time. The way he tore up his insides with cigarettes, booze, cocaine, and opioids.

It all amounted to this: Carl White was in pain. All the time. And nothing helped — not the multiple surgeries, nor the self-medication, not the wife and daughter who supported him and relied on him.

Then White enrolled in a pain management clinic that taught him some of his physical torment was in his head — and he could train his brain to control it. It’s a philosophy that dates back decades, to the 1970s or even earlier. It fell out of vogue when new generations of potent pain pills came on the market; they were cheaper, worked faster, felt more modern.

Full story of training your mind on dealing chronic pain at Stat News