tag:blogger.com,1999:blog-75793735892950530002012-01-28T11:05:04.286-06:00These <em>UPDATES</em> are a component of <em>Pain Treatment Topics</em> (http://Pain-Topics.org). Our mission is to serve as a noncommercial resource for healthcare professionals &amp; their patients, providing open access to clinical news, information, research, and education for a better understanding of evidence-based pain-management practices. <em>YOUR COMMENTS ARE WELCOMED.</em>SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.comBlogger3661100tag:blogger.com,1999:blog-7579373589295053000.post-40691577351237051032012-01-28T10:14:00.001-06:002012-01-28T10:14:15.039-06:00

A preponderance of research evidence suggests that there are profound differences between men and women in the prevalence, perception, reporting, and treatment of pain. A newly published study adds to that, finding at the least that women seem less shy than men about reporting their level of pain on standard assessment measures. Whether or not women actually feel greater pain and over a broad

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-59626411194142691502012-01-27T09:15:00.001-06:002012-01-27T09:15:48.324-06:00

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

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com2tag:blogger.com,1999:blog-7579373589295053000.post-8190416702677935242012-01-19T16:36:00.001-06:002012-01-20T14:29:01.324-06:00

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

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com1tag:blogger.com,1999:blog-7579373589295053000.post-13049936039220951032012-01-18T11:31:00.001-06:002012-01-22T20:54:07.219-06:00

By guest author, Dmitry M. Arbuck, MD The use of opioid antagonists in chronic pain management is gaining more recognition and increasing acceptance [7]. Application of these agents, such as naltrexone, is based on the notion that there are fundamental differences between mechanisms of chronic versus acute pain generation and perception. While pain is defined as “an experience” by the

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com2tag:blogger.com,1999:blog-7579373589295053000.post-64886202608421025912012-01-14T08:32:00.001-06:002012-01-14T08:33:55.229-06:00

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. Researchers at the

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com3tag:blogger.com,1999:blog-7579373589295053000.post-81510452522142887172012-01-13T22:25:00.000-06:002012-01-14T08:39:47.067-06:00

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

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com2tag:blogger.com,1999:blog-7579373589295053000.post-80430825700554280612012-01-12T12:06:00.001-06:002012-01-12T12:09:08.168-06:00

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

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-8144507460050245612012-01-06T16:32:00.001-06:002012-01-06T16:44:02.416-06:00

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

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com4tag:blogger.com,1999:blog-7579373589295053000.post-34698078302219885902012-01-05T11:24:00.000-06:002012-01-05T11:33:41.074-06:00

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 [here]. Nearly 9-million Americans received these interventional procedures during 2010 alone, and notices of serious adverse effects have prompted the U.S. Food

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com3tag:blogger.com,1999:blog-7579373589295053000.post-30576795806514107672012-01-01T11:59:00.001-06:002012-01-01T12:10:00.661-06:00

By guest author, Bob Twillman, PhD, FAPM On November 1, 2011, the Centers for Disease Control and Prevention (CDC) issued a Morbidity and Mortality Weekly Report (MMWR) titled “Vital Signs: Overdoses of Prescription Opioid Pain Relievers — United States, 1999-2008” [CDC 2011a]. In this document, CDC researchers report finding that opioid analgesics were involved in 14,800 prescription-drug

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com6tag:blogger.com,1999:blog-7579373589295053000.post-9035099663333545812012-01-01T11:54:00.001-06:002012-01-01T11:54:15.462-06:00

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. Research

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-1142322029905880582012-01-01T11:47:00.001-06:002012-01-01T11:47:21.849-06:00

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

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-67195251397363194062012-01-01T11:25:00.001-06:002012-01-01T11:25:42.855-06:00

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. Extended-Release Oxymorphone (Opana ER®) — New Crush-Resistant Formulation FDA Approved The U.S. Food and

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-57491881076323658382011-12-23T09:42:00.000-06:002011-12-23T09:43:23.014-06:00

During 2011, we posted 145 News/Research UPDATES articles, which were viewed in total more than 115,000 times by 67,000 visitors; a third of those persons were regular repeat visitors to the UPDATES site. And, we thank each and every one of you. Which were the most popular, frequently visited UPDATES this past year? Here is a recap of the Top 10 in our “Hit Parade” of articles that visitors

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-17185061122720723822011-12-17T11:28:00.001-06:002011-12-19T09:09:00.495-06:00

Part 10 – Interpreting Effect Sizes in Research Data One of the greatest and most frequent failings of pain research reports is authors presenting the statistical significance of outcome results, but not assessing the clinical importance of those findings. This is especially vexing when pain therapies are compared with each other or against placebo and there are differences between groups, as

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com4tag:blogger.com,1999:blog-7579373589295053000.post-25656908256027082372011-12-16T09:10:00.001-06:002011-12-16T09:10:25.237-06:00

Chronic noncancer-related abdominal pain is a frequent reason for outpatient healthcare visits and can be difficult to treat. A recently reported study found that during a 12-year period, through 2008, there was an increasing trend of opioid analgesic prescribing for this ailment. Although opioids have not been adequately assessed for this purpose and may complicate or worsen abdominal pain, the

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-80025746336678387472011-12-14T20:10:00.001-06:002011-12-14T20:10:49.129-06:00

Many patients with pain justifiably want to purchase prescribed medications online, for convenience and/or to save money. However, the Internet can be a hazardous place to buy medicines unless the source is legitimate and follows high standards for product quality and delivery. There are a number of resources available to help select suitable online pharmacies that healthcare professionals and

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-81788519863675706902011-12-13T12:10:00.001-06:002011-12-13T12:10:52.851-06:00

Correspondent: Thomas Sachy, MD, MSc As mentioned in my first installment in this series [here], I will continue to comment on my personal experiences and knowledge regarding the continuing war on pain. Of course the Internet has made monitoring this conflict infinitely easier; similar to the general who, while safely removed from harm, is able to monitor the pitched battles taking place a

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com5tag:blogger.com,1999:blog-7579373589295053000.post-31497149222943116882011-12-09T17:21:00.000-06:002011-12-09T17:22:43.421-06:00

Even before new rules governing opioid prescribing in Washington state go into effect next month, in January 2012, access to adequate pain care is becoming scarce in the state. And, there are signs that this could be a harbinger of trouble and bad times ahead for persons with pain in other parts of the United States. Aggressive new laws for the management of chronic noncancer pain, intended to

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com9tag:blogger.com,1999:blog-7579373589295053000.post-87277868437444210032011-12-08T14:45:00.001-06:002011-12-27T21:29:42.093-06:00

Swearing can help to relieve acute pain, investigators have reported for a second time. Such is the state of research in the pain management field, that research of questionable importance is not only worth doing, but doing again. And, why it would merit a lengthy article in a supposedly sagacious pain journal is perplexing. Was this a joke? More than two years ago, in an UPDATE [here], we

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com3tag:blogger.com,1999:blog-7579373589295053000.post-21186794273257287642011-12-07T17:06:00.001-06:002011-12-07T22:16:00.239-06:00

We have long advocated for the potential benefits of supplementation with vitamin D3, not D2, in persons with musculoskeletal pain. While some authors claim the formulation of vitamin D does not make that much difference, recent feedback from an UPDATES reader, plus a research summary by two experts, point toward D3 as the definite choice. In fact, prescribing D2 supplements should be

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-462777954688900882011-12-02T09:47:00.000-06:002011-12-02T09:48:02.049-06:00

Two new surveys in the U.S. have found that nearly 45% of patients with acute pain may receive inadequate analgesia and a quarter of persons with cancer pain are not taking analgesics at all. Various factors contribute to insufficient pain relief, such as patient age, side effects of medications, fear of addiction, and inability to pay for analgesics. And, the problems are of worldwide crisis

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-36392849453366266262011-12-01T10:45:00.001-06:002011-12-01T10:53:11.790-06:00

Correspondent: Thomas Sachy, MD, MSc Although I practice child, adolescent, adult, and forensic neuropsychiatry, the majority of my clinical practice is in the field of pain management, and I am a strong supporter of using opioids for the treatment of chronic noncancer pain. I have come to this position after approximately 11 years of face-to-face patient interaction, along with ongoing

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com13tag:blogger.com,1999:blog-7579373589295053000.post-60852885343652045282011-12-01T10:11:00.001-06:002011-12-01T10:11:46.332-06:00

Featured Items: bupivacaine liposome injectable suspension (Exparel) approved for postsurgical pain; onabotulinumtoxinA (BOTOX) approved for chronic migraine prophylaxis; TNF Blockers, azathioprine, and/or mercaptopurine - FDA safety update; duloxetine (Cymbalta) approval denied in Europe for chronic musculoskeletal pain. — All brand names are trademarks of their respective manufacturers.

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-68191083158906916382011-11-25T18:02:00.001-06:002011-11-26T10:27:59.786-06:00

Acetaminophen poisoning has become the commonest cause of acute liver failure. Newly reported research now suggests that staggered acetaminophen overdose — that is, taking too much of the drug too frequently for pain relief — can be more life-threatening than a single, massive overdose. Diagnosing excessive acetaminophen (APAP, or paracetamol) ingestion can be a clinical challenge, because

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com1tag:blogger.com,1999:blog-7579373589295053000.post-32802741807500678882011-11-25T09:40:00.000-06:002011-11-26T10:37:13.811-06:00

An extensive review and analysis of research studies proposes that over-the-counter vitamin D3 is preferred rather than prescribed forms of vitamin D2. Although, an excellent paper offering guidelines for clinicians suggests that either D2 or D3 is acceptable, provided supplementation is sufficient to adequately raise deficient levels of the vitamin. In an ongoing series of Pain-Topics UPDATES

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-6519331887528832722011-11-22T16:15:00.000-06:002011-11-22T16:18:03.926-06:00

We have previously written in these UPDATES about naloxone for overdose rescue [eg, here and here] and in a journal article [PDF here]. Naloxone is an opioid antagonist that has been approved and used in the U.S. since 1971 as an antidote to respiratory failure during opioid overdose, primarily by emergency medical personnel. Today, there is considerable evidence that this agent can be

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-65655213766681835582011-11-18T16:11:00.001-06:002011-11-18T16:11:58.730-06:00

A new survey of cancer specialists, or oncologists, found that many have relatively little training and knowledge when it comes to assessing and managing their patients’ pain. A number of other barriers also prevent adequate pain care in patients with cancer, and only a minority of oncologists refer these patients to pain specialists. Investigators at Beth Israel Medical Center in New York City

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-21663463808147473912011-11-18T09:18:00.002-06:002011-11-18T18:02:39.961-06:00

Two recently reported studies explore the importance of adequate vitamin D for patients undergoing spine surgeries and in those with inflammatory spinal cord disease. Although further research is required to confirm the benefits, vitamin D supplementation in these patients could be an essential component of improved spine health and effective pain management. Vitamin D Deficiencies Hamper

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-78077560885168540432011-11-17T20:10:00.000-06:002011-11-21T21:07:28.754-06:00

Many readers have questioned the latest figure that 116 million American adults suffer from chronic pain, which represents more than a third of the total population. Yet, looking at the original source of this data, the evidence seems generally reliable and, furthermore, the U.S. is not unique in the world — chronic pain seems to be a truly huge problem of global proportions. That 116 million

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com2tag:blogger.com,1999:blog-7579373589295053000.post-13613830213299788152011-11-11T17:22:00.001-06:002011-11-13T15:01:27.161-06:00

Research presented at the recent American College of Rheumatology Annual Scientific Meeting examined whether a shift from nonopioid analgesics toward the use of opioids to treat arthritis pain in senior citizens also incurred an increase in falls and fractures. While, overall, there was a marked increase in the percentage of elderly patients who suffered a fall or fracture, a cause-effect

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com1tag:blogger.com,1999:blog-7579373589295053000.post-15203875154090221812011-11-10T16:57:00.001-06:002011-11-10T17:01:12.577-06:00

Ginger — from the underground stem of the plant Zingiber officinale — has been widely used in traditional medicine for a variety of therapeutic purposes, one of which is relieving pain. Researchers in the UK conducted a systematic review to evaluate evidence from all clinical trials assessing the efficacy of ginger as a sole agent for the treatment of any pain condition. They conclude that,

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-38421168480332309792011-11-09T17:22:00.001-06:002011-11-09T18:00:06.345-06:00

In a newly reported study, using nonsteroidal anti-inflammatory drugs (NSAIDs) during pregnancy more than doubled the odds for a miscarriage. Risks were greatest with diclofenac, and aspirin was not examined; however, the results suggest that all NSAIDs should be used cautiously in women who are or who may become pregnant. Writing in an early online edition of the Canadian Medical Association

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-53392102287003776412011-11-05T14:29:00.001-05:002012-01-22T12:54:41.830-06:00

The U.S. Centers for Disease Control and Prevention (CDC) recently launched a new campaign to alert the public about deadly risks of opioid analgesics. While the government’s systematic collection and skillful presentation of data are impressive and overwhelming, this may be tilting away from a balanced perspective in order to incite fears of a so-called “epidemic” of opioid misuse, overdoses,

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com8tag:blogger.com,1999:blog-7579373589295053000.post-69726661640040567952011-11-03T10:03:00.001-05:002011-11-03T10:03:30.923-05:00

Chronic, nonspecific lower back pain can be a difficult condition to treat and often cannot be managed with analgesics alone. Appropriate exercise has proven beneficial for many patients, and yoga — with an emphasis on both physical and mental aspects of pain relief — may be particularly appealing for some patients. In a recently reported clinical trial, patients with low back pain benefitted

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-20340573857901650632011-10-26T17:49:00.001-05:002011-11-03T20:23:55.064-05:00

Here is a lesson in evidence-based pain management. Researchers reported that intrathecal midazolam, a benzodiazepine, was a beneficial supplement to standard analgesic therapy for recalcitrant lower-back pain. However, because of the study design and limited data this is not valid evidence of treatment effects, which raises questions about why this study was published. Writing in the journal

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com2tag:blogger.com,1999:blog-7579373589295053000.post-43822523734777763552011-10-26T09:37:00.000-05:002011-10-26T09:38:23.167-05:00

While there are many treatments for chronic low back pain, none are effective in all cases and the search is ongoing for helpful therapies. There is limited evidence that yoga instruction can be helpful for some patients, but it could be that only the stretching component of yoga is most effective. Another possibility is that a self-help book for back-pain relief could be just as beneficial for

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-24425325563234187032011-10-21T16:05:00.001-05:002011-10-22T11:18:33.432-05:00

Past studies and commentary have claimed that higher opioid analgesic doses increase mortality rates; yet, the research methods used to establish this should be challenged by critical readers. A recent data-mining investigation from Canada is a good example of how evidence can be statistically manipulated to arrive at outcomes with questionable validity, perpetuating myths of opioid harms that

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com2tag:blogger.com,1999:blog-7579373589295053000.post-41227708108873864772011-10-21T15:10:00.001-05:002011-10-21T15:21:00.109-05:00

Chronic pain may be associated with too much or too little physical activity. New research finds that the right amount, duration, and intensity of leisure-time exercise can make a significant difference in who has long-lasting pain, but there also are differences between men and women and younger versus older age groups. In the October issue of the journal PAIN, Tormod Landmark and colleagues

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-92151515291048101822011-10-21T14:23:00.001-05:002011-10-21T14:24:07.415-05:00

Recent results from the 15th annual consumer survey conducted by the American Massage Therapy Association (AMTA) show that consumers have a growing awareness of the health benefits of massage. In fact, 90% of individuals perceive massage as effective in reducing pain and an increasing number of people consult physicians and other healthcare professionals about massage therapy. In a news

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com1tag:blogger.com,1999:blog-7579373589295053000.post-86183339768842392922011-10-14T11:14:00.000-05:002011-10-15T13:49:35.476-05:00

A newly-reported clinical trial from Sweden found that exercise is as effective as drug therapy, or as relaxation techniques, in preventing migraines. However, reductions in monthly frequency of migraines with all 3 treatments appear rather modest and may be disappointing to some patients. Yet, there were limitations of this research and the true value of these treatment approaches might not

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com1tag:blogger.com,1999:blog-7579373589295053000.post-30857204505048305422011-10-12T15:56:00.001-05:002011-10-12T15:56:09.975-05:00

Medication therapy is a mainstay for helping to relieve pain of all types, facilitate functionality, and improve quality of life. It is sometimes difficult for patients and practitioners alike to imagine ending a clinical encounter without a medication prescription. However, an important new article outlines 24 principles of prescribing that advocate for a paradigm shift from “more and newer” to

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com4tag:blogger.com,1999:blog-7579373589295053000.post-32959859891548140692011-10-08T09:59:00.001-05:002011-10-09T11:28:08.243-05:00

In a large study of elder adults, those taking opioid analgesics were found to have a higher risk of developing pneumonia than among similar persons not taking opioids. At the same time, the researchers found that benzodiazepines, often given for insomnia and anxiety, did not affect pneumonia risk in this population. However, one must question the validity of this study and whether it is merely

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com3tag:blogger.com,1999:blog-7579373589295053000.post-81324916750226082052011-10-05T18:06:00.001-05:002011-10-05T18:06:56.195-05:00

Patients taking oral steroids are twice as likely as the general population to have severe vitamin D deficiency, according to a study of more than 22,000 children and adults. This suggests that healthcare providers should closely monitor vitamin D levels in patients being treated with steroid medications for pain-related or other conditions. While vitamin D supplementation may be necessary, new

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com1tag:blogger.com,1999:blog-7579373589295053000.post-5872666967903831532011-10-01T08:34:00.002-05:002011-11-19T15:50:08.623-06:00

Recent news and research articles have been decrying escalating trends in overdoses and deaths from opioid analgesics and heroin. Yet, rarely is mention made of the fact that there is an effective and safe antidote for such tragedies — naloxone. Isn’t it time to stop the complaining, and conducting pilot studies, and to start using naloxone on a broad scale to address the problems?According to

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com2tag:blogger.com,1999:blog-7579373589295053000.post-2374784455535856172011-10-01T08:18:00.001-05:002011-10-01T08:18:17.372-05:00

Research consistently finds that patients’ beliefs and expectations of benefit from pain treatments can influence their responses, and that a considerable component of pain relief might relate to placebo effects. An often overlooked phenomenon is how the beliefs and expectations of healthcare providers and family members — engendering a placebo by proxy effect — also might affect a patient’s

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-53355412561907034412011-10-01T08:07:00.001-05:002011-10-01T08:07:34.721-05:00

Featured Items: infliximab (Remicade) approved for pediatric ulcerative colitis; tumor necrosis factor-alpha (TNFa) blocker safety warning; ondansetron (Zofran) safety warning. — All brand names are trademarks of their respective manufacturers. Compiled by Winnie Dawson, MA, RN, BSN. Infliximab (Remicade®) — FDA Approved for Pediatric Ulcerative Colitis Janssen Biotech announced a

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-12874658695436650422011-09-23T08:52:00.001-05:002011-09-23T09:14:59.408-05:00

A thought-provoking essay by a long-term pain practitioner presents a controversial indictment of current pain management perspectives and approaches. Of special concern are procedural techniques, or interventions, that may be driven more by economics than better patient care and, in the ongoing turf wars between interventionists and medical practitioners, patients with pain are in danger of

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com5tag:blogger.com,1999:blog-7579373589295053000.post-34743843763084812542011-09-22T10:48:00.001-05:002011-09-22T10:57:07.036-05:00

A recently reported clinical trial examined electroacupuncture — needles inserted at acupoints with electric current applied — for chronic, peripheral neuropathic pain. This therapy afforded no significant pain relief or other benefits; however, the study also serves as an example of poor-quality evidence garnering more attention in a pain journal than it probably deserves. Writing online ahead

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com5tag:blogger.com,1999:blog-7579373589295053000.post-46780634318225787482011-09-16T16:25:00.001-05:002011-10-22T11:25:13.634-05:00

After more than a decade of increasing opioid prescribing for chronic pain, the pendulum may be swinging the other way. A recent editorial in a major journal appears to reflect common misunderstandings and negative perspectives on the effectiveness and potential harms of opioids. So, it seems essential at this time to dispel the myths and shift the dialog back toward patient needs and benefits

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com23tag:blogger.com,1999:blog-7579373589295053000.post-58799994709668294522011-09-16T15:15:00.001-05:002011-09-16T15:17:43.913-05:00

A clinical trial of chondroitin sulfate for osteoarthritis of the hand reported modest improvements in pain and functionality, compared with placebo. However, realizing full benefits of active therapy required 6 months and there were no clinically important gains in morning stiffness or grip strength. While certain questions remain unanswered, it seems doubtful that chondroitin is a viable

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com2tag:blogger.com,1999:blog-7579373589295053000.post-44568654145866335722011-09-11T16:05:00.001-05:002011-09-11T16:12:49.302-05:00

A Cochrane Review of data from about 45,000 patients involved in approximately 350 individual clinical trials provides evidence of what to expect from commonly used pain relievers taken at specific doses for acute postoperative pain. The review also identifies analgesics for which there is only poor or no reliable evidence. Topping the list for pain relief were etoricoxib and

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com3tag:blogger.com,1999:blog-7579373589295053000.post-81707201317139649722011-09-10T21:02:00.001-05:002011-09-10T21:02:54.581-05:00

A new study demonstrates that high-dose vitamin D helps to relieve debilitating joint and muscle pain in women with breast cancer who are taking estrogen-lowering drugs to shrink the tumors. This is yet another demonstration of vitamin D’s possible role in maintaining bone health while also aiding musculoskeletal aches and pains. According to a news release from Washington University, St. Louis

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-83371040531782370772011-09-06T15:21:00.001-05:002011-09-06T15:21:03.651-05:00

Recently reported research proposes that simple aspirin should be favored over triptan-class drugs as first-line therapy for both migraine and tension-type headaches, regardless of pretreatment pain intensity. While this may make sense for certain patients, there are some concerns with this particular research that merit closer inspection. Stepped care in migraine management generally relies on

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-75689723780977038222011-09-02T11:03:00.001-05:002011-09-02T11:07:27.712-05:00

A well-designed but small study of PENS (percutaneous electrical nerve stimulation) for superficial, chronic nerve-related pain found that the modality was effective in providing short-term relief. However, while this approach may be promising for certain manifestations of neuropathic pain, the many limitations of this trial and needs for further research should be taken into account. PENS is

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-28980658656213738682011-09-01T15:53:00.001-05:002011-09-06T10:55:56.866-05:00

Imagine having such tight regulations on prescribing a class of medications, such as anti-hypertensives, that practitioners stop using them altogether for patients with high blood pressure. In effect, something similar may be happening with opioid analgesics in Washington state where aggressive new pain-management laws, meant to curb opioid overdose deaths, have some prescribers shunning these

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com13tag:blogger.com,1999:blog-7579373589295053000.post-12638462176743199012011-09-01T15:12:00.001-05:002011-09-01T15:12:12.111-05:00

Featured Items: tapentadol extended-release tablets (Nucynta) approved for chronic pain; subcutaneous abatacept (Orencia) approved for rheumatoid arthritis; citalopram hydrobromide (Celexa) safety warning. — All brand names are trademarks of their respective manufacturers. Compiled by Winnie Dawson, MA, RN, BSN. Tapentadol-ER (Nucynta®) for Chronic Pain — FDA Approved Janssen

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-43266901575287393352011-08-26T09:45:00.001-05:002011-08-26T11:19:19.830-05:00

Addiction is a primary, chronic brain disease, not just bad behavior or bad choices, according to a new definition from the American Society of Addiction Medicine (ASAM). Pain practitioners need to understand the ramifications of addiction — especially involving Rx-opioid use — as a complicating factor in patient care. However, casual use of the term “addiction” or inaccurate diagnosis of the

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com4tag:blogger.com,1999:blog-7579373589295053000.post-57874124488406924972011-08-25T11:07:00.000-05:002011-08-25T11:08:04.853-05:00

Many chronic noncancer pain conditions afflict women more often than men, and the pain in women also can to be more severe and complex. A multifaceted cycle of pain-distress-pain is common in women and, while they are prescribed opioid analgesics more often than their male counterparts, this does not mean that their pain management needs are being met. A woman’s ability to cope with pain along

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com2tag:blogger.com,1999:blog-7579373589295053000.post-30600493460336967842011-08-24T14:48:00.001-05:002011-08-24T14:54:24.091-05:00

A recent editorial in the Baltimore Sun [August 18, 2011] recommends that a new proposal in Maryland allowing medical schools and teaching hospitals to administer medicinal marijuana appears to be a safe, practical way to help patients cope with chronic pain or illness. At the same time, this sort of approach could avoid the abuses of marijuana laws that have plagued some states and encourage

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com1tag:blogger.com,1999:blog-7579373589295053000.post-12658455865529417012011-08-18T10:41:00.001-05:002011-08-18T10:41:03.350-05:00

The terms “abuse” and “abuser,” in reference to persons who misuse opioid analgesics or other drugs in some way, appear rather casually in everyday conversation and published articles. Everyone thinks they know what is being described, but do they really? A recent essay challenges the continued use by healthcare providers, researchers, government agencies, and the public of these vague and

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com3tag:blogger.com,1999:blog-7579373589295053000.post-22950169322362473722011-08-17T09:24:00.001-05:002011-08-18T17:06:50.627-05:00

Homeopathy, a therapeutic modality incorporating botanical agents, has been used since the 18th century. It is believed that the administration of homeopathic preparations containing very small amounts of active substances can produce different effects based on their concentration or dilution; very low doses incur beneficial effects whereas higher doses of the same agents might produce harmful

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com2tag:blogger.com,1999:blog-7579373589295053000.post-82657150520055090042011-08-12T15:18:00.001-05:002011-08-12T15:24:34.339-05:00

With addiction reportedly on the rise due to the misuse of prescription opioid analgesics, drug makers are devising clever ways of discouraging such aberrant behaviors. Consequently, a new generation of “abuse-deterrent” opioid formulations is emerging. Questions remain, however, about whether these medications will better serve the needs of patients with pain. According to a recent online

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com3tag:blogger.com,1999:blog-7579373589295053000.post-47749294643112030772011-08-12T10:22:00.001-05:002011-08-12T10:22:42.821-05:00

The 2010 Patient Protection and Affordable Care Act required the U.S. Department of Health and Human Services (HHS) to enlist the prestigious Institute of Medicine (IOM) in examining pain as a public health problem. The lengthy report, released on June 30, 2011 — Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research — calls for a cultural

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com2tag:blogger.com,1999:blog-7579373589295053000.post-24720921216687722232011-08-10T18:16:00.001-05:002011-08-11T11:54:51.631-05:00

Part 9 — Why Size Really Does Matter A common failing of clinical research studies in the pain management field is having too few subjects enrolled and/or insufficient effect sizes to yield significant and valid results. An antidote to this is called “power analysis,” performed during study design; yet, relatively few researchers report having done this or they sometimes proceed with trials

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com2tag:blogger.com,1999:blog-7579373589295053000.post-30777105176511180322011-08-04T15:31:00.001-05:002011-08-04T15:31:36.969-05:00

Patients with chronic pain are typically taking multiple products for their condition, whether prescribed medications or over-the-counter drugs and supplements. New research reveals that such drug-drug exposures are commonplace, are not necessarily related to patient age, and can incur harmful interactions that should be of concern to healthcare providers and their patients. Patients taking

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-84204381917133192892011-08-03T12:16:00.001-05:002011-08-03T12:16:30.100-05:00

A newly reported study claims that more than 1 in 5 teenagers medically misuse controlled medications — eg, pain, stimulant, sleeping, or anxiety drugs — for which they have legitimate prescriptions, and they also may be more likely to divert those medications and to abuse other substances. However, while news headlines decried a growing epidemic of drug problems among youth, an overly broad

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com1tag:blogger.com,1999:blog-7579373589295053000.post-12255518536673358552011-08-03T09:57:00.001-05:002011-08-03T09:57:23.142-05:00

Featured Items: fentanyl nasal spray (Lazanda) approved for cancer pain; mesalamine (Lialda) approved for ulcerative colitis remission maintenance; acetaminophen (Extra Strength Tylenol) maximum daily dosing change & recall; Actiq and Fentora REMS released. — All brand names are trademarks of their respective manufacturers. Compiled by Winnie Dawson, MA, RN, BSN. FDA Approves Fentanyl Nasal

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-86106204798206594622011-07-29T10:44:00.002-05:002011-08-16T14:05:14.239-05:00

The ongoing Pain-Topics series, “Making Sense of Pain Research,” has encouraged professionals and patients to develop a “healthy skepticism” toward everything they read in journals, hear at conferences, or see in the news. As it turns out, skepticism regarding modern science, including the field of pain medicine, is somewhat of an international movement. Its mantra might be “Stop the B.S.” (with

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com23tag:blogger.com,1999:blog-7579373589295053000.post-56739341975950647892011-07-27T09:55:00.001-05:002011-07-29T15:46:07.293-05:00

According to an increasingly vocal assembly of international health and human rights organizations, disparities in access to pain care worldwide are staggering. Instead of healthcare settings being places where human rights are preserved, they often are institutions where rights are abused and pain is mistreated or untreated to the point of being torture. While such problems might be smugly

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-30114005280071160992011-07-22T15:57:00.000-05:002011-07-22T16:00:03.920-05:00

A newly-reported imaging study found that oral morphine administration in patients with chronic low back pain altered gray matter thicknesses in several brain structures. While the authors imply that these neuroplastic changes might be detrimental, it seems equally likely that long-term opioid administration restores the pain-altered brain to a more normal, healthy state. As opioid analgesics

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com6tag:blogger.com,1999:blog-7579373589295053000.post-72915518452282638612011-07-22T14:44:00.000-05:002011-07-22T14:49:39.713-05:00

Part 8 — Precision, Accuracy, & Significance of Mean Values Research outcomes are commonly reported as average, or mean, values; however, averages can be misleading, so it is important that they are examined from perspectives of their precision and accuracy. And, better understandings of statistical measures such as the Standard Deviation (SD), Standard Error of the Mean (SEM), and Standardized

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com1tag:blogger.com,1999:blog-7579373589295053000.post-51252137964145839562011-07-15T17:59:00.001-05:002011-07-15T17:59:59.720-05:00

Even with all of the advances in medical science, patients in America only have a 1 in 4 chance of receiving adequate pain relief following surgery. It is even worse in many other parts of the world, according to recent commentary in The Lancet medical journal, and this unresolved acute postoperative pain often leads to problematic chronic pain conditions, affecting up to half of patients

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-26188797610984745702011-07-15T09:49:00.001-05:002011-07-15T09:49:47.331-05:00

A newly reported clinical trial found that patients experiencing mild migraine attacks achieved significant pain relief with a homeopathic preparation of ginger and the herb feverfew. However, this was a small study with numerous limitations and potential sources of bias. Writing in the journal Headache, from the American Headache Society, researchers report a multi-center trial involving

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com7tag:blogger.com,1999:blog-7579373589295053000.post-24889782416369899772011-07-14T14:43:00.000-05:002011-07-15T22:25:34.378-05:00

Words do make a difference and the language used to describe pain conditions, treatments, and affected persons can either perpetuate or dispel harmful misconceptions and negative stereotypes. An important reminder of this and helpful suggestions come from the American Pain Foundation. Previous research has shown that merely hearing certain pain-related words can fire-up the brain's pain centers

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com1tag:blogger.com,1999:blog-7579373589295053000.post-25608120479504482662011-07-09T15:21:00.001-05:002011-07-09T15:21:21.347-05:00

While much has been said and written about problems associated with opioid analgesics, relatively little has been effectively done as yet to stem the tide of misuse, abuse, overdoses, and deaths. Rather than waiting for federal or state agencies to come to their rescue, one rural coalition took control themselves in developing a successful opioid overdose prevention program. This truly

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-9896166435964991992011-07-08T16:54:00.001-05:002011-07-08T16:58:36.188-05:00

According to new research published in the British Medical Journal, commonly used medications to treat pain and inflammation are linked to an increased risk of irregular heart rhythm, known as atrial fibrillation or flutter. The implicated agents involve non-selective nonsteroidal anti-inflammatory drugs (NSAIDs) and selective COX-2 inhibitors. While absolute risk increases are modest, there

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-36494091291024983382011-07-08T10:42:00.000-05:002011-07-08T10:45:38.709-05:00

When it comes to treating chronic lower back pain, a new U.S. government funded study suggests that massage therapy may be better than medication or exercise for easing discomfort and improving function — at least in the short term. However, the type of massage that is best, duration of therapy, and who might benefit most need further consideration. At an integrated healthcare delivery system

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com3tag:blogger.com,1999:blog-7579373589295053000.post-10363891022659090642011-07-01T11:06:00.001-05:002011-07-01T11:06:14.073-05:00

A virtual avalanche of articles has appeared in the medical literature recently discussing opioid analgesics for chronic pain. Almost without exception, the news and views are disparaging; in some cases reflecting a poor quality of evidence and, in others, conveying biases of the authors. Ongoing concerns about opioid misuse, abuse, and fatalities may be obscuring a problem of equal or greater

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com14tag:blogger.com,1999:blog-7579373589295053000.post-73868416892242423252011-07-01T10:42:00.001-05:002011-07-01T10:42:12.230-05:00

Chronic pain affects more than a third of all citizens, it is widely undertreated or mistreated, patients are stigmatized, physicians are inadequately educated, and it costs more than half a trillion dollars each year in medical expenses and lost productivity alone. Those are just a few of the startling findings of a newly released report from the U.S. Institute of Medicine (IOM), which also

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com3tag:blogger.com,1999:blog-7579373589295053000.post-17125584091129706222011-07-01T10:27:00.001-05:002011-07-01T10:27:22.883-05:00

Featured Items: tamper-resistant oxycodone (Oxecta) approved; painful fissure ointment (Rectiv) approved; proton pump inhibitors (PPIs) class safety alert; oxycodone/acetaminophen tablets (Endocet) recalled; two combination products (butalbital-APAP-caffeine tablets and hydrocodone bitartrate-APAP) recalled; Tylenol caplets safety recall. — All brand names are trademarks of their respective

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-16130968988263976172011-06-24T16:59:00.000-05:002011-06-24T17:00:05.956-05:00

According to recent commentary, a regrettable reality is that currently available treatments for chronic noncancer pain are unable to alleviate pain or restore functioning in a majority of patients. Those observations, from a new series on pain appearing in The Lancet, highlight large gaps in the evidence base and call for more research to assess the effectiveness of combination therapies to

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com11tag:blogger.com,1999:blog-7579373589295053000.post-91237294487457258232011-06-24T12:32:00.000-05:002011-06-24T12:33:20.400-05:00

Researchers from the University of Maryland conducted a longitudinal study to examine the extent to which medication nonadherence was related to diversion of prescription analgesics by young adults. Surprisingly, more than 4 in 10 misused their pain relievers, and a quarter diverted analgesics to others, which suggests that healthcare providers need to take a stronger role in counseling young

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com2tag:blogger.com,1999:blog-7579373589295053000.post-87854973982297476452011-06-24T09:42:00.001-05:002011-06-24T09:42:15.868-05:00

Prior research has found that adequate vitamin D levels may play an important role in the moderation of painful conditions, and this can be of special consequence in elderly patients. A newly reported prospective, randomized, double-blind, placebo-controlled trial examined benefits of vitamin D supplementation on quality of life, functional mobility, and pain relief in the elderly. While the

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com1tag:blogger.com,1999:blog-7579373589295053000.post-83510612228707635522011-06-23T21:33:00.000-05:002011-06-23T21:34:38.355-05:00

A research team from France and Brazil conducted the first long-term trial of repetitive transcranial magnetic stimulation (rTMS) for pain relief in patients with chronic widespread pain due to fibromyalgia. There were favorable outcomes on pain and quality of life indicators but there also were limitations of this study that must be considered. In this trial reported in the June edition of the

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-46709140018918795122011-06-16T17:19:00.001-05:002011-06-16T17:19:50.111-05:00

There is increasing interest in exploring nonpharmacologic and non-interventional approaches for the management of pain. According to a study reported in the Journal of Neuroscience, even a brief course in meditative techniques may significantly reduce a person's sensitivity to pain [Zeidan et al. 2011]. While there are considerable limitations in the research to date, meditation might be a

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com1tag:blogger.com,1999:blog-7579373589295053000.post-24692927344373145632011-06-15T17:26:00.001-05:002011-06-15T17:26:23.102-05:00

The June 2011 Clinical Digest from the U.S. National Center for Complementary and Alternative Medicine (NCCAM) offers a review and assessment of research on Complementary and Alternative Medicine (CAM) therapies for treating fibromyalgia syndrome. Much of the research on CAM for fibromyalgia is preliminary and evidence for the effectiveness of various modalities is for the most part limited.

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-33817542017441445142011-06-15T12:32:00.000-05:002011-06-15T12:33:25.161-05:00

As noted in a previous UPDATE [here], on April 19, 2011 the U.S. Food and Drug Administration (FDA) announced requirements of their new Risk Evaluation and Mitigation Strategy (REMS) that will apply to all long-acting and extended-release (LA/ER) opioid medications. This multi-pronged program is intended to reduce the misprescribing, misuse, and abuse of opioid analgesics. However, as more

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com4tag:blogger.com,1999:blog-7579373589295053000.post-68475118360307536422011-06-11T18:00:00.000-05:002011-06-11T18:01:11.360-05:00

Writing in the June edition of the Journal of Manipulative and Physiological Therapeutics, a research team from The Netherlands examine trials of therapies for tension-type headache and migraine to assess benefits among patients in placebo and “no treatment” control groups. Surprisingly, on average, more than a third of patients in control groups — not receiving any therapy expected to be

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com4tag:blogger.com,1999:blog-7579373589295053000.post-20379848470031056592011-06-07T11:45:00.001-05:002011-06-08T10:28:35.204-05:00

Part 7 – Beware of Odds Posing as Risks While the presentation of data as odds and Odds Ratios is favored by gamblers and some statisticians, many authorities on evidence-based medicine disparage their use in pain research reports as being unhelpful and potentially misleading for clinical decision-making purposes. Knowing the odds may be essential for successful betting on horse races but an

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-62386219205413254562011-06-03T18:03:00.000-05:002011-06-03T18:07:59.238-05:00

In recalcitrant cases, chronic osteoarthritis (OA) pain in the knee may not be effectively managed by either pharmacologic or non-drug therapies. A more successful pain-relieving alternative in such cases might be radiofrequency (RF) ablation of certain nerves serving the knee joint, according to recently reported research. Writing in the journal Pain, researchers from Seoul, Republic of Korea,

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com1tag:blogger.com,1999:blog-7579373589295053000.post-40659059525653296882011-06-02T12:02:00.001-05:002011-06-02T12:02:30.884-05:00

Adverse effects of chronic pain on neurobiological structure and function are increasingly being recognized due to ongoing research using brain-imaging technology. A new study helps to confirm the neuroanatomical and functional abnormalities associated with chronic low back pain, but it also offers hope that these brain changes can be reversed with effective pain therapies. In a prospective,

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com2tag:blogger.com,1999:blog-7579373589295053000.post-16358062015764109232011-06-01T10:23:00.001-05:002011-06-01T10:23:45.279-05:00

Featured Items: ibuprofen and famotidine tablets (Duexis) approved; Bayer advanced aspirin available; intranasal ketorolac (Sprix Nasal Spray) now available — All brand names are trademarks of their respective manufacturers. Compiled by Winnie Dawson, MA, RN, BSN. Ibuprofen and Famotidine Tablets (Duexis®) — FDA Approved Horizon Pharma, Inc. received an April 2011 U.S. Food and Drug

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-25234147458040632252011-05-27T09:32:00.001-05:002011-05-27T09:32:18.444-05:00

Convincing new evidence demonstrates how patients’ beliefs and expectations of benefit or adverse effects can directly influence response to opioid analgesic therapy. This has important implications for the role of healthcare providers in helping to shape and optimize patient response to any pain relieving treatment. Researchers from Britain and Germany examined how divergent expectancies may

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-70891318311120517632011-05-26T15:55:00.001-05:002011-05-26T15:55:32.939-05:00

With all the emphasis lately on the alleged epidemic of overdoses and deaths associated with prescription opioids an overlooked dark secret is that pain relievers — both Rx and over-the-counter — are increasingly used in suicide attempts, particularly by women. Better strategies than prescriber education and restricting access to these medications are needed for effectively dealing with this

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com1tag:blogger.com,1999:blog-7579373589295053000.post-40166867011920224012011-05-25T16:46:00.001-05:002011-05-25T16:51:41.958-05:00

New research suggests that if your hand hurts, simply crossing your arms will confuse the brain and reduce the pain intensity. However, don’t go smashing your thumb to put this to the test — there were limitations of this research to consider first. Writing in the June 2011 edition of the journal Pain, an international team of researchers report using a laser to produce brief pin pricks of “

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com2tag:blogger.com,1999:blog-7579373589295053000.post-30151395707101755972011-05-25T09:35:00.001-05:002011-05-25T09:38:33.217-05:00

Crohn's disease is a chronic inflammatory condition of the gastrointestinal tract causing abdominal pain, diarrhea, GI bleeding, and weight loss. Current therapies for the condition reduce the inflammation but some are expensive and may incur rare but serious side effects, including infections and lymphoma. Prior research has suggested that endorphins and enkephalins, components of the

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com2tag:blogger.com,1999:blog-7579373589295053000.post-45579346740888782982011-05-20T15:17:00.000-05:002011-05-20T15:29:13.068-05:00

Part 6 – Understanding RR, RRR, ARR, & NNT An understanding of outcomes presented in pain research studies as “risk statistics,” which are special estimates of effect, is central to evidence-based medicine approaches. Yet, this can be confusing, since authors often do not portray or discuss study results involving these measures in everyday terms that can be applied in pain practice. Therefore,

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-73887818912913968822011-05-19T12:08:00.001-05:002011-05-19T12:11:02.627-05:00

The healing art of homeopathy dates back several centuries, yet it remains controversial. A recently reported clinical trial demonstrated that homeopathic remedies were of no help for treating painful rheumatoid arthritis (RA), but benefits of the homeopathic consultation itself were substantial. Yet, there are serious deficiencies in this research that leave open the question of whether

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0tag:blogger.com,1999:blog-7579373589295053000.post-31840330596011600752011-05-13T17:40:00.001-05:002011-05-13T17:46:33.749-05:00

When heart attack survivors or those with heart disease take nonsteroidal anti-inflammatory drugs, or NSAIDs, it puts them at higher risk for recurring heart attack or death, according to a new study in Circulation, a journal of the American Heart Association. Results of the new research suggest that even short-term use of these pain relievers is unsafe for these patients with pain. The

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.com0