At some point, nearly 4 of every 10 American adults use complementary and alternative medicine, or CAM; often to treat various types of acute or chronic pain. Personal, out-of-pocket expenditures for CAM each year add up to roughly $43-billion, even though many CAM therapies have not been scientifically established as beneficial. So, it is somewhat surprising that a recent news report challenges expenditures by the U.S. government to evaluate the safety and effectiveness of those therapies.
Under the headline, “Funding of Alternative Treatments Questioned,” in a recent edition of the Los Angeles Times [January 23, 2012], writer Trine Tsouderos explains, “Some see tax dollar waste in spending by the National Center for Complementary and Alternative Medicine. The NCCAM director, though, sees a need for scientific attention.” Along with that, several examples of allegedly frivolous funding are provided in the article:
Yoga, of which there are numerous types, is an increasingly popular mind-body intervention for select pain conditions. The modality consists of specific physical postures, breathing techniques, and mental concentration or meditation exercises. A number of clinical studies have examined the benefits of yoga as an adjunct for chronic pain management, but until now there has not been a meta-analysis of results examining the relief of pain and associated disability. While, in principle, yoga may be a useful supportive intervention for many pain-associated conditions, a closer look reveals that current research is largely inadequate and potential harms of yoga need cautious consideration.
By guest author, Dmitry M. Arbuck, MD
According to recently reported research, patients with chronic pain require special consideration for pain management following any type of surgery. At the least, the postoperative pain is likely to linger longer in these patients, and the pain may be greater if patients were taking opioid analgesics prior to surgery. However, there are still some unanswered questions.
Contrary to concerns professed lately by opponents of opioid analgesia, higher than usual doses of these medications could be just the thing to prevent acute pain from becoming a chronic, life-changing malady. As was recently successfully demonstrated in a preclinical study, the concept of early, short-term, high-dose opioid administration to quickly manage pain is a radical departure from usual practice and may offer interesting possibilities for better pain care.
Fibromyalgia syndrome (FMS) is a chronic pain condition, primarily affecting women, that manifests as widespread musculoskeletal pain, fatigue, sleep disturbance, psychological distress, and cognitive disruptions. A new clinical study suggests that having excessively low levels of vitamin D might play an important role in FMS and ameliorating such deficiencies may be beneficial. However, this was a small, uncontrolled trial and it is important to understand its limitations.
Nonspecific neck pain is a common condition that affects an estimated 70% of persons at some point in their lives, and up to 1 in 5 persons each year. New research suggests that spinal manipulation therapy (chiropractic) or home exercises are equally better than medications for relieving pain. However, there are a number of limitations of this research to consider before leaping to a conclusion that the best medicine for neck pain is no medicine at all.
A surge in epidural steroid injections to alleviate back and neck pain in the United States is bringing with it an increase in severe and unexpected complications, including paralysis and death, according to a report in Bloomberg News [
In a multicenter clinical trial, acupuncture proved to be disappointing for the relief of musculoskeletal pain in women taking aromatase inhibitors for breast cancer. Consequently, after an interim analysis, the trial was stopped early. However, this study provides lessons in the complexities of pain research on acupuncture and how weaknesses of evidence preclude valid conclusions.
Knowledgeable and compassionate care regarding pain is a core responsibility of health professionals, and this also is associated with better medical outcomes, improved quality of life, and lower healthcare costs. However, according to a new study published in the December edition of the Journal of Pain, even though pain is a most common reason that people seek medical care, education on pain at North American medical schools is relatively minimal, variable, and often fragmentary.
Featured Items: extended-release oxymorphone (Opana ER) FDA approved in crush-resistant formulation; first-time generic FDA approval of morphine sulfate ER (Kadian equivalent). — All brand names are trademarks of their respective manufacturers. Compiled by: Winnie Dawson, MA, RN, BSN.
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