A recent national poll found that persons with neuropathy face delayed diagnoses, inadequate pain care, and distressing life changes due to their painful disorders. Peripheral neuropathy affects nearly 7% of Americans and from 2% to 8% of populations worldwide. The many types of neuropathy pose diverse challenges for patients, their families, and healthcare providers, yet relatively few resources are devoted to research and treatment of these disorders.
More than 1,900 patients responded to an online survey recently conducted by The Neuropathy Association [full results here]. A majority of survey participants indicated they experienced an extended period of time from symptom onset to diagnosis of their neurological disease — taking more than one year in 75% of cases, and more than 5 years for 20% of patients.
A nationwide study found that 3 in 5 patients may be noncompliant with prescribed drug regimens, as detected by urine drug testing. The findings further suggest a majority of persons treated for pain may be misusing medications in ways that pose health risks; from missing doses to taking unauthorized drugs. However, there are many factors that might account for these outcomes and should be considered before leaping to conclusions about patient misbehavior.
Persons with pain across America, and worldwide, lost a leading ally in the War on Pain. After 15 years, and without warning, the American Pain Foundation closed-down operations. And so, the lights went out on the largest national advocacy organization serving people living with pain, their caregivers and healthcare providers, and allied organizations. Who will fill the void?
According to a just-released large survey from the Gallup organization, nearly half (47%) of American adults reported having some type of chronic pain in 2011, which would amount to at least 111 million persons. This incredible prevalence of pain appears to confirm earlier estimates by the U.S. Institute of Medicine; although, despite the dissent of some doubters, the numbers actually may be underestimates.
Part 12 – How Critical Thinking Goes Awry
Featured Items: rotigotine transdermal system (Neupro) approved for RLS; adalimumab (Humira) European approval for colitis; fentanyl patch safety alert; proton pump inhibitor (PPI) alert for C. difficile-associated diarrhea; Savella and Neurontin added to FDA Watch list; morphine sulfate injectable recall. — All brand names are trademarks of their respective manufacturers. Compiled by Winnie Dawson, MA, RN, BSN.
Although botulinum toxin A (Botox®) injections are approved in the United States, Canada, the UK, and other countries for the preventive treatment of severe headache conditions, a recent review and meta-analysis of clinical trials found only small benefits in patients with chronic migraine or chronic daily headaches. At the same time, botulinum toxin A injections were no more beneficial than placebo for preventing episodic migraine or tension-type headaches.
Sciatica is a term often used to describe any low back and leg pain, but it more specifically applies to lumbosacral radiculopathy due to the impingement of nerve roots as they emerge from the spinal canal. Up to half of all cases of spinal pain may be neuropathic in origin, meaning they are caused by nerve compression, inflammation, and/or injury. A pair of recent studies examined treatments for sciatica and found that very few are helpful and they confer only modest and temporarily relief.
Despite guidelines and mandates calling for more aggressive management of pain associated with cancer, millions of persons with the disease still suffer needlessly because practitioners fail to adequately treat their pain, according to a new study. And, this is just the latest report pointing to this as a disgraceful neglect of pain in America and worldwide.
What are we to think of an editorial in this week’s edition of the British Medical Journal with the pithy title, “Opium, Opioids, and an Increased Risk of Death?” The author compares Middle-Eastern opium addicts with patients who have chronic noncancer pain and are prescribed opioid analgesics, claiming that both groups face similarly increased risks of death from their drug use. More than anything, this perspective is a remarkable display of wrong-headed reasoning, or sophistry, found too often in the pain literature these days.
Taking opioid analgesics with other central nervous system (CNS) depressants can increase risks of oversedation, respiratory depression, and death due to overdose. Yet, a new study finds that sedatives are somewhat commonly prescribed along with opioids for chronic noncancer pain, and a proportion of patients add alcohol to the mix. Whether or not patients have a history of a substance use disorder does not seem to make a difference, and practitioners need to be more vigilant when prescribing opioids and sedatives for any patients.
Recent examinations of acupuncture for various pain conditions suggest that influences other than needling may play essential roles in any efficacy of this modality. Yet, is that cause to cast it aside as a treatment for pain? Some would argue that acupuncture can still be a meaningful patient-centered option within the context of a multimodal approach to pain management.
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