Oregon officials to revisit back pain guidelines and revise chronic pain proposal

Oregon health officials are rethinking their approach to chronic pain coverage and mandatory tapering off of opioids for Medicaid patients. The Oregon Health Authority on Friday announced two major developments in a saga that has left patient advocates up in arms. The first is that the Health Evidence Review Commission will reconsider the coverage guidelines related to neck and back pain that went into effect in 2016. Secondly, OHA s taff is offering a revised proposal to the commission that would…
Source: bizjournals.com Health Care:Physician Practices headlines - Category: American Health Authors: Source Type: news

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Recent experimental research has suggested that spinal manipulative therapy (SMT) may reduce pain through modulation of the ascending pain signals and/or the central pain-regulating mechanisms. People with per...
Source: Trials - Category: General Medicine Authors: Tags: Study protocol Source Type: research
CONCLUSIONS: One year after elective cervical spine surgery, patients with preoperative opioid use were significantly more likely to report ongoing opioid use. However, patients in both groups reported similar improvements in patient-reported outcomes and satisfaction with pain relief. Interventions targeted at decreasing opioid use may need to focus on patient factors such as preoperative opioid use or duration of symptoms before surgery. PMID: 31604325 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery.Spine - Category: Neurosurgery Authors: Tags: J Neurosurg Spine Source Type: research
This article will review this evidence in the context of its implications for pain. We first provide a brief overview of CB1R's role in the regulation of nociception, followed by a review of the evidence that the peripheral endocannabinoid system modulates nociception. We then look in detail at regulation of central-mediated analgesia, followed up with evidence that cannabinoidmediated modulation of pain involves modulation of GABAergic and glutamatergic neurotransmission in key brain regions. Finally, we discuss cannabinoid action on non-neuronal cells in the context of inflammation and direct modulation of neurons. This ...
Source: Journal of Dual Diagnosis - Category: Addiction Tags: J Dual Diagn Source Type: research
A new study evaluates treatment-related costs and the use of opioids among high-impact versus low-impact chronic spinal pain patients.Spine
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Neurology & Neurosurgery Journal Article Source Type: news
Authors: Chang MC, Lee DG Abstract BACKGROUND AND OBJECTIVE: We evaluated the effect of caudal epidural pulsed radiofrequency stimulation in patients with chronic lumbosacral radicular pain due to postlumbar surgery syndrome who were unresponsive to at least two epidural steroid injections through the interlaminar, transforaminal, or caudal route. METHODS: We recruited 25 patients with chronic persistent radicular pain in one or both legs (⩾ 4 on the Numeric Rating Scale [NRS]) despite spinal surgery. They were unresponsive to at least two epidural steroid injections. We retrospectively conducted this study. ...
Source: Journal of Back and Musculoskeletal Rehabilitation - Category: Orthopaedics Tags: J Back Musculoskelet Rehabil Source Type: research
CONCLUSIONS: Given its positive effect on shoulder pain, function, ROM and the isokinetic strength of the external and internal rotators, we recommend the application of the Neurac technique in PASIS. PMID: 31594195 [PubMed - as supplied by publisher]
Source: Journal of Back and Musculoskeletal Rehabilitation - Category: Orthopaedics Tags: J Back Musculoskelet Rehabil Source Type: research
Chronic low back pain (LBP) is a leading cause of disability worldwide. Biopsychosocial rehabilitation programs have been advocated for its management, especially since the widespread acceptance of the biopsyc...
Source: BMC Musculoskeletal Disorders - Category: Orthopaedics Authors: Tags: Research article Source Type: research
US photographer Justin J Wee has chronic back pain and uses images to depict living with pain.
Source: BBC News | Health | UK Edition - Category: Consumer Health News Source Type: news
ObjectivesSpinal cord stimulation (SCS) has gained traction as an alternative to chronic opioid therapy in light of the opioid crisis. Prior reports vary widely in their estimates of its effect on opioid consumption. We therefore aimed to address the following questions: 1) Does chronic opioid use change after SCS? 2) Which patient characteristics predict reduced opioid consumption after SCS?Materials and MethodsClaims from a private health insurance company were used to identify patients with SCS implantation from 2003 to 2014. We required 12  months of continuous data before and after surgery (i.e., a minimum tota...
Source: Neuromodulation: Technology at the Neural Interface - Category: Biotechnology Authors: Tags: Clinical Research Source Type: research
Conclusion: The European Portuguese version of the FDI has very good internal consistency, good test-retest reliability, and construct validity when used in a sample of community adolescents with chronic pain. Implications for rehabilitation One of the most widely instruments used to assess functional disability is the Functional Disability Inventory (FDI), which in its original version has good psychometric properties and is recommended by the Pediatric Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials; However, the FDI has not been translated yet into European Portuguese language and its psychome...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
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