The Neuroscience of Pain | The New Yorker
On a foggy February morning in Oxford, England, I arrived at the John Radcliffe Hospital, a shiplike nineteen-seventies complex moored on a hill east of the city center, for the express purpose of being hurt. I had an appointment with a scientist named Irene Tracey, a brisk woman in her early fifties who directs Oxford University's Nuffield Department of Clinical Neurosciences and has become known as the Queen of Pain."We might have a problem with you being a ginger," she warned when we met. Redheads typically perceive pain differently from those with other hair colors; many also flinch at the use of the G-wo...
Source: Psychology of Pain - June 25, 2018 Category: Anesthesiology Source Type: blogs

HEAL Initiative | National Institutes of Health (NIH)
In April 2018, NIH launched the HEAL (Helping to End Addiction Long-term) Initiative, an aggressive, trans-agency effort to speed scientific solutions to stem the national opioid public health crisis. This Initiative will build on extensive, well-established NIH research, including basic science of the complex neurological pathways involved in pain and addiction, implementation science to develop and test treatment models, and research to integrate behavioral interventions with Medication-Assisted Treatment (MAT) for opioid use disorder (OUD). Successes from this research include the development of the nasal form of naloxo...
Source: Psychology of Pain - June 12, 2018 Category: Anesthesiology Source Type: blogs

How health insurers are making America ’s opioid epidemic worse - Vox
Mandy has now been in recovery from her opioid addiction for more than two months — and she's ready to keep that going. But the 29-year-old in the Chicago area is now dealing with a big obstacle: her health insurer.Mandy, who asked I use only her first name, said she struggled with addiction for six years. It started with back pain, which a doctor tried to treat with Vicodin. " I had tried [opioids] in high school, " she said. " I had an older boyfriend, and I tried some of his wisdom teeth painkillers to get high off of. And I was like,'Whoa, this is awesome.'When I got a Vicodin prescription for...
Source: Psychology of Pain - June 5, 2018 Category: Anesthesiology Source Type: blogs

BBC - Future - Pain bias: The health inequality rarely discussed
In 2009, my doctor told me that, like"a lot of women", I was paying too much attention to my body. Saying there wasn't an issue, he suggested I just relax and try to ignore the symptoms.The decision seemed to run counter to what my records showed. A few weeks earlier, I had ended up in the emergency room with chest pains and a heart rate hitting 220 beats per minute. The ER crew told me it was a panic attack, gave me Xanax and told me to try to sleep.I'd had panic attacks before. I knew this episode was not one. So I went to my doctor.He put me on a heart monitor overnight. Bingo: I had another episode, t...
Source: Psychology of Pain - May 31, 2018 Category: Anesthesiology Source Type: blogs

NIH Pain Consortium
The NIH Pain Consortium was established to enhance pain research and promote collaboration among researchers across the many NIH Institutes and Centers that have programs and activities addressing pain. To this end, the following goals have been identified for the Pain Consortium:• To develop a comprehensive and forward-thinking pain research agenda for the NIH - one that builds on what we have learned from our past efforts.• To identify key opportunities in pain research, particularly those that provide for multidisciplinary and trans-NIH participation.• To increase visibility for pain research - both withi...
Source: Psychology of Pain - May 31, 2018 Category: Anesthesiology Source Type: blogs

Chronic pain treatment: Psychotherapy, not opioids, has been proven to work - Vox
When pain settled into Blair Golson's hands, it didn't let go.What started off as light throbbing in one wrist 10 years ago quickly engulfed the other. The discomfort then spread, producing a pain much"like slapping your hands against a concrete wall," he says. He was constantly stretching them, constantly shaking them, while looking for hot or cold surfaces to lay them on for relief.But worse was the deep sense of catastrophe that accompanied the pain. Working in tech-related startups, he depended on his hands to type."Every time the pain got bad, I would think some variation of,'Oh no, I'm ...
Source: Psychology of Pain - May 20, 2018 Category: Anesthesiology Source Type: blogs

New Drug Offers Hope to Millions With Severe Migraines - The New York Times
The first medicine designed to prevent migraines was approved by the Food and Drug Administration on Thursday, ushering in what many experts believe will be a new era in treatment for people who suffer the most severe form of these headaches.The drug, Aimovig, made by Amgen and Novartis, is a monthly injection with a device similar to an insulin pen. The list price will be $6,900 a year, and Amgen said the drug will be available to patients within a week.Aimovig blocks a protein fragment, CGRP, that instigates and perpetuates migraines. Three other companies — Lilly, Teva and Alder — have similar medicines in t...
Source: Psychology of Pain - May 18, 2018 Category: Anesthesiology Source Type: blogs

Treatments Prescribed For Lower Back Pain Are Often Ineffective, Report Says : NPR
Chances are, you — or someone you know — has suffered from lower back pain.It can be debilitating. It's a leading cause of disability globally.And the number of people with the often-chronic condition is likely to increase.This warning comes via a series of articles published in the medical journal Lancet in March. They state that about 540 million people have lower back pain — and they predict that the number will jump as the world's population ages and as populations in lower- and middle-income countries move to urban centers and adopt more sedentary lives."We don't think about [back pa...
Source: Psychology of Pain - May 10, 2018 Category: Anesthesiology Source Type: blogs

Lack Of Research On Medical Marijuana Leaves Patients In The Dark : Shots - Health News : NPR
By the time Ann Marie Owen, 61, turned to marijuana to treat her pain, she was struggling to walk and talk. She was also hallucinating.For four years, her doctor prescribed a wide range of opioids for transverse myelitis, a debilitating disease that caused pain, muscle weakness and paralysis.The drugs not only failed to ease her symptoms, they hooked her.When her home state of New York legalized marijuana for the treatment of select medical ailments, Owens decided it was time to swap pills for pot. But her doctors refused to help."Even though medical marijuana is legal, none of my doctors were willing to talk to me ab...
Source: Psychology of Pain - April 10, 2018 Category: Anesthesiology Source Type: blogs

Naloxone Stops Opioid Overdoses. How Do You Use It? - The New York Times
The United States surgeon general issued a rare national advisory on Thursday urging more Americans to carry naloxone, a drug used to revive people overdosing on opioids.The last time a surgeon general issued such an urgent warning to the country was in 2005, when Richard H. Carmona advised women not to drink alcohol when pregnant.More ... (Source: Psychology of Pain)
Source: Psychology of Pain - April 7, 2018 Category: Anesthesiology Source Type: blogs

Medicare Is Cracking Down on Opioids. Doctors Fear Pain Patients Will Suffer. - The New York Times
Medicare officials thought they had finally figured out how to do their part to fix the troubling problem of opioids being overprescribed to the old and disabled: In 2016, a staggering one in three of 43.6 million beneficiaries of the federal health insurance program had been prescribed the painkillers.Medicare, they decided, would now refuse to pay for long-term, high-dose prescriptions; a rule to that effect is expected to be approved on April 2. Some medical experts have praised the regulation as a check on addiction.But the proposal has also drawn a broad and clamorous blowback from many people who ...
Source: Psychology of Pain - March 28, 2018 Category: Anesthesiology Source Type: blogs

America's War on Pain Pills Is Killing Addicts and Leaving Patients in Agony -
Craig, a middle-aged banking consultant who was on his school's lacrosse team in college and played professionally for half a dozen years after graduating, began developing back problems in his early 30s. " Degenerative disc disease runs in my family, and the constant pounding on AstroTurf probably did not help, " he says. One day, he recalls, " I was lifting a railroad tie out of the ground with a pick ax, straddled it, and felt the pop. That was my first herniation. "After struggling with herniated discs and neuropathy, Craig consulted with " about 10 different surgeons " and decided to have...
Source: Psychology of Pain - March 23, 2018 Category: Anesthesiology Source Type: blogs

What's in a Name for Chronic Pain? | Pain Research Forum
For decades, pain researchers have set their sights on understanding pain mechanisms —the cellular and molecular machinery underlying chronic pain. In doing so, they became increasingly aware that the terms they used to describe the neurobiological workings of pain did not always match what they had learned.But now, official adoption by the International Association for the Study of Pain (IASP) of an IASP terminology task force recommendation for a so-called"third mechanistic descriptor" of chronic pain could move the field forward in its efforts to more fully characterize the known pathophysiological mecha...
Source: Psychology of Pain - March 23, 2018 Category: Anesthesiology Source Type: blogs

Handing out naloxone doesn ’t fix opioid crisis | Dalla Lana School of Public Health
In the midst of a national opioid crisis, take-home naloxone programs have expanded rapidly. Ontario's Minister of Health and Long Term Care Dr. Eric Hoskins recently announced that naloxone kits will be provided to fire and police departments across the province, but U of T researchers are questioning whether naloxone distribution might distance people from health-care services or worsen health inequities.More ... (Source: Psychology of Pain)
Source: Psychology of Pain - March 13, 2018 Category: Anesthesiology Source Type: blogs

“Brave Men” and “Emotional Women”: A Theory-Guided Literature Review on Gender Bias in Health Care and Gendered Norms towards Patients with Chronic Pain - Pain Research and Management
Conclusions. Awareness about gendered norms is important, both in research and clinical practice, in order to counteract gender bias in health care and to support health-care professionals in providing more equitable care that is more capable to meet the need of all patients, men and women. (Source: Psychology of Pain)
Source: Psychology of Pain - February 26, 2018 Category: Anesthesiology Source Type: blogs

Migraine Relief May Be On The Way With New Therapies In Development : Shots - Health News : NPR
Humans have suffered from migraines for millennia. Yet, despite decades of research, there isn't a drug on the market today that prevents them by targeting the underlying cause. All of that could change in a few months when the FDA is expected to announce its decision about new therapies that have the potential to turn migraine treatment on its head.The new therapies are based on research begun in the 1980s showing that people in the throes of a migraine attack have high levels of a protein called calcitonin gene –related peptide (CGRP) in their blood.Step by step, researchers tracked and studied this neurochemic...
Source: Psychology of Pain - February 8, 2018 Category: Anesthesiology Source Type: blogs

PAS-18-624: Mechanistic investigations of psychosocial stress effects on opioid use patterns (R01- Clinical Trial Optional)
Psychosocial stress, defined here as socioenvironmental demands that tax the adaptive capacity of the individual (e.g., low socioeconomic status, childhood adversity, bullying), has repeatedly been linked to substance use disorders (SUDs). Neighborhood poverty and social support are shown to influence substance use patterns. Among smokers, multiple psychosocial stressors are associated with relapse, and acute psychosocial stress has been demonstrated to enhance cigarette craving and smoking behavior. Similarly, psychosocial stress has been associated with greater risk of relapse in individuals with alcohol and cocaine use ...
Source: Psychology of Pain - February 5, 2018 Category: Anesthesiology Source Type: blogs

A Doctor ’s Painful Struggle With an Opioid-Addicted Patient - Siddhartha Mukherjee - The New York Times
I once found myself entrapped by a patient as much as she felt trapped by me. It was the summer of 2001, and I was running a small internal-medicine clinic, supervised by a preceptor, on the fourth floor of a perpetually chilly Boston building. Most of the work involved routine primary care — the management of diabetes, blood pressure and heart disease. It was soft, gratifying labor; the night before a new patient's visit, I would usually sift through any notes that were sent ahead and jot my remarks in the margins. The patient's name was S., I learned. She had made four visits to the emergency room complaini...
Source: Psychology of Pain - February 5, 2018 Category: Anesthesiology Source Type: blogs

Natural painkiller nasal spray could replace addictive opioids, trial indicates | The Guardian
A nasal spray that delivers a natural painkiller to the brain could transform the lives of patients by replacing the dangerous and addictive prescription opioids that have wreaked havoc in the US and claimed the lives of thousands of people.Scientists at University College London found they could alleviate pain in animals with a nasal spray that delivered millions of soluble nanoparticles filled with a natural opioid directly into the brain. In lab tests, the animals showed no signs of becoming tolerant to the compound's pain-relieving effects, meaning the risk of overdose should be far lower.The researchers are now ra...
Source: Psychology of Pain - February 3, 2018 Category: Anesthesiology Source Type: blogs

News Archive | Pain Research Forum
All of our news and discussion content, research resources and member services are provided free to researchers, clinicians and others interested in the problem of chronic pain. (Source: Psychology of Pain)
Source: Psychology of Pain - January 30, 2018 Category: Anesthesiology Source Type: blogs

After Surgery in Germany, I Wanted Vicodin, Not Herbal Tea - The New York Times
MUNICH — I recently had a hysterectomy here in Munich, where we moved from California four years ago for my husband's job. Even though his job ended a year ago, we decided to stay while he tries to start a business. Thanks to the German health care system, our insurance remained in force. This, however, is not a story about the benefits of universal health care.Thanks to modern medicine, my hysterectomy was performed laparoscopically, without an overnight hospital stay. My only concern about this early release was pain management. The fibroids that necessitated the surgery were particularly large and painful, and...
Source: Psychology of Pain - January 27, 2018 Category: Anesthesiology Source Type: blogs

Sourcing Painkillers from Scorpions ’ Stings | The Scientist Magazine
Studying scorpions comes with its share of danger, as biologist Bryan Fry of the University of Queensland knows all too well. On a 2009 trip to the Brazilian Amazon, Fry was stung while trying to collect the lethal Brazilian yellow scorpion (Tityus serrulatus), and for eight hours he says it felt as though his finger was in a candle flame. Meanwhile, his heart flipped between racing and stopping for up to five seconds at a time."At least the insane levels of pain helped keep my mind off my failing heart," Fry writes in an email to The Scientist.More ...
Source: Psychology of Pain - January 24, 2018 Category: Anesthesiology Source Type: blogs

Scientists Just Solved a Major Piece of the Opioid Puzzle | WIRED
When it comes to tackling the opioid crisis, public health workers start with the drugs: fentanyl, morphine, heroin. But biochemists have a different focus: Not the opioids, but opioid receptors —the proteins the drugs latch onto within the body.These receptors embed themselves in the walls of cells throughout the brain and peripheral nervous system. There, they serve as cellular gatekeepers, unlocking not just the painkilling properties for which opioids are prized, but the severe, addictive, and often lethal side effects that, in 2016, contributed to the deaths of more than 50,000 people in the US.But it doesn'...
Source: Psychology of Pain - January 22, 2018 Category: Anesthesiology Source Type: blogs

The Quest for Safer Opioid Drugs | The Scientist Magazine
Opioid drugs are well-established double-edged swords. Extremely effective at analgesia, they cause an array of harmful side effects throughout the body, including itching, constipation, and respiratory depression —the slowed breathing that ultimately causes death in overdose cases. What's more, the body's interaction with opioids is dynamic: our receptors for these compounds become desensitized to the drugs' activity over time, requiring ever larger doses to suppress pain and eventually provoking severe dependence and protracted withdrawal.In the past few years, these side effects have plagued growing nu...
Source: Psychology of Pain - January 22, 2018 Category: Anesthesiology Source Type: blogs

Her Chronic Pain Was a Medical Mystery. Was It an Unexplained Condition? - The Daily Beast
Leslie Levine's searing pains started the day after Thanksgiving in 2006. They began in her toes, which turned strangely dark. Then the agony crept upward."It felt like my legs were being dipped in boiling oil 24/7," she said.The emergency room and a series of doctors could do little but scratch their heads and offer her painkillers."I was living on oxycodone and very grateful for it," Levine said, then Harvard University's chief patent attorney. But it wasn't enough."By January, I was on disability, because I was in such pain and could hardly walk."Her internet search for answers ...
Source: Psychology of Pain - December 7, 2017 Category: Anesthesiology Source Type: blogs

What We Lose When We Undertreat Pain | Kate Nicholson | TEDxBoulder - YouTube
Kate Nicholson was working as a civil rights attorney for the Justice Department when a surgical error left her unable to sit or stand, largely bedridden, and in severe pain for almost 20 years. Using opioids as an appropriate pain management tool, she continued to function as a high-level federal prosecutor. In this talk, Kate pivots from her inspiring and excruciating story to examine the under-treatment of pain, showing how our approach to opioid abuse by 2.5 million Americans is hurting 50 million people in severe or persistent pain. (Source: Psychology of Pain)
Source: Psychology of Pain - November 29, 2017 Category: Anesthesiology Source Type: blogs

Opioid crisis: Could the'pain-o-meter' be a solution? - USA Today
Every year, millions of Americans will go to their doctors complaining of pain, and their doctors will ask them to rate their degree of discomfort on a zero-to-10 scale, or using a range of smiley-face symbols.The doctor will have to take their word for it. And then, all too often, the doctor will prescribe a powerful and addictive opioid painkiller.It's a longstanding — if imprecise and subjective — way of measuring and treating pain. And it's at least partly responsible for starting an opioid addiction crisis that killed 64,000 people last year."One of the things we heard from many physicians is ...
Source: Psychology of Pain - November 23, 2017 Category: Anesthesiology Source Type: blogs

The Power of the Placebo - Slate
Every so often, a new study comes along that challenges conventional wisdom in medicine or science. When the conditions are right, these studies can generate a lot of attention in both the popular press and the medical community. In early November, one of these such studies, called the ORBITA study, was published in the Lancet by a group of cardiologists.The authors had set out to ask and answer a simple question: Does placement of a small wire mesh (called a stent) inside the artery that feeds blood to the heart (the coronary artery) relieve chest pain? One might ask what was novel about this question. The truth is that t...
Source: Psychology of Pain - November 21, 2017 Category: Anesthesiology Source Type: blogs

New painkillers could thwart opioids ’ fatal flaw | Science | AAAS
When people die from overdoses of opioids, whether prescription pain medications or street drugs, it is the suppression of breathing that almost always kills them. The drugs act on neuronal receptors to dull pain, but those in the brain stem also control breathing. When activated, they can signal respiration to slow, and then stop. The results are well-known: an epidemic of deaths —about 64,000 people in the United States alone last year.Countering this lethal side effect without losing opioids' potent pain relief is a challenge that has enticed drug developers for years. Now, for the first time, the U.S. Food an...
Source: Psychology of Pain - November 17, 2017 Category: Anesthesiology Source Type: blogs

Drugstore pain pills as effective as opioids in ER patients - AP
Emergency rooms are where many patients are first introduced to powerful opioid painkillers, but what if doctors offered over-the-counter pills instead? A new study tested that approach on patients with broken bones and sprains and found pain relievers sold as Tylenol and Motrin worked as well as opioids at reducing severe pain.The results challenge common ER practice for treating short-term, severe pain and could prompt changes that would help prevent new patients from becoming addicted.The study has limitations: It only looked at short-term pain relief in the emergency room and researchers didn't evaluate how patient...
Source: Psychology of Pain - November 7, 2017 Category: Anesthesiology Source Type: blogs

Why opioids are such an American problem - BBC News
For every one million Americans, almost 50,000 doses of opioids are taken every day. That's four times the rate in the UK.There are often good reasons for taking opioids. Cancer patients use them for pain relief, as do patients recovering from surgery (codeine and morphine are opioids, for example).But take too many and you have a problem. And America certainly has a problem.More ... (Source: Psychology of Pain)
Source: Psychology of Pain - October 29, 2017 Category: Anesthesiology Source Type: blogs

Federal Pain Research Strategy Overview | Interagency Pain Research Coordinating Committee
The NIH Office of Pain Policy is pleased to announce the release of the Federal Pain Research Strategy.The Federal Pain Research Strategy (FPRS) is an effort of the Interagency Pain Research Coordinating Committee (IPRCC) and the National Institutes of Health, Office of Pain Policy to oversee development of a long-term strategic plan to advance the federal pain research agenda. The strategy is relevant to the missions all federal agencies and departments that support pain research. The research priorities of the FPRS are intended to guide strategic research planning and to support funding decisions that will fill cruc...
Source: Psychology of Pain - October 21, 2017 Category: Anesthesiology Source Type: blogs

Interagency Pain Research Portfolio -The Federal Government's Pain Research Database
The Interagency Pain Research Portfolio database provides information on pain research and training activities supported by the Federal Government. The participating agencies – AHRQ, CDC, DoD, FDA, NIH, and VA – are represented on the Interagency Pain Research Coordinating Committee (IPRCC), a Federal advisory committee to enhance pain research efforts and promote collaboration across the government. (Source: Psychology of Pain)
Source: Psychology of Pain - October 21, 2017 Category: Anesthesiology Source Type: blogs

The Latest Jaw-Dropping Numbers From the Opioid Crisis – Mother Jones
About 64,000 Americans died from drug overdoses last year —a staggering 21 percent increase from the 52,404 in 2015—according to the first government estimate of drug deaths in 2016. Overdoses now kill more Americans than HIV did at its peak in 1995, and far more than guns or cars do today.The numbers, released by the Centers for Disease Control and Prevention, are provisional and will be updated monthly, according to the agency.Fueling the rise in deaths is fentanyl, a synthetic opioid up to 100 times more potent than morphine, and fentanyl analogs, or slight tweaks on the fentanyl molecule. This has not alway...
Source: Psychology of Pain - September 26, 2017 Category: Anesthesiology Source Type: blogs

Giving Migraine Treatments the Best Chance - The New York Times
If you've never had a migraine, I have two things to say to you:1) You're damn lucky.2) You can't begin to imagine how awful they are.I had migraines – three times a month, each lasting three days — starting from age 11 and finally ending at menopause.Although my migraines were not nearly as bad as those that afflict many other people, they took a toll on my work, family life and recreation. Atypically, they were not accompanied by nausea or neck pain, nor did I always have to retreat to a dark, soundless room and lie motionless until they abated. But they were not just"bad headaches" &mda...
Source: Psychology of Pain - September 25, 2017 Category: Anesthesiology Source Type: blogs

The Cost of the Opioid Crisis | The New Yorker
In September, 2016, Donald Trump delivered a speech at the Economic Club of New York."Today, I'm going to outline a plan for American economic revival," he said."It is a bold, ambitious, forward-looking plan to massively increase jobs, wages, incomes, and opportunities for the people of our country." He went on to talk about lowering taxes and removing regulations, renegotiating trade deals and building a border wall. But he overlooked one of the most pressing issues facing the American economy today: the opioid crisis.Politicians tend to talk about the crisis in moral terms, focussing on the ways i...
Source: Psychology of Pain - September 24, 2017 Category: Anesthesiology Source Type: blogs

To treat back pain, look to the brain not the spine | Aeon Essays
For patient after patient seeking to cure chronic back pain, the experience is years of frustration. Whether they strive to treat their aching muscles, bones and ligaments through physical therapy, massage or rounds of surgery, relief is often elusive – if the pain has not been made even worse. Now a new working hypothesis explains why: persistent back pain with no obvious mechanical source does not always result from tissue damage. Instead, that pain is generated by the central nervous system (CNS) and lives within the brain itself.I caught my first whiff of this news about eight years ago, when I was starting the r...
Source: Psychology of Pain - September 24, 2017 Category: Anesthesiology Source Type: blogs

The First Count of Fentanyl Deaths in 2016: Up 540% in Three Years - The New York Times
Drug overdoses killed roughly 64,000 people in the United States last year, according to the first governmental account of nationwide drug deaths to cover all of 2016. It's a staggering rise of more than 22 percent over the 52,404 drug deaths recorded the previous year — and even higher than The New York Times's estimatein June, which was based on earlier preliminary data.Drug overdoses are expected to remain the leading cause of death for Americans under 50, as synthetic opioids — primarily fentanyl and its analogues — continue to push the death count higher. Drug deaths involving fentanyl more t...
Source: Psychology of Pain - September 5, 2017 Category: Anesthesiology Source Type: blogs

Pain News - Medical Xpress (Source: Psychology of Pain)
Source: Psychology of Pain - September 5, 2017 Category: Anesthesiology Source Type: blogs

Opioids Aren ’t the Only Pain Drugs to Fear - The New York Times
Last month, a White House panel declared the nation's epidemic of opioid abuse and deaths"a national public health emergency," a designation usually assigned to natural disasters.A disaster is indeed what it is, with 142 Americans dying daily from drug overdoses, a fourfold increase since 1999, more than the number of people killed by gun homicides and vehicular crashes combined. A 2015 National Survey on Drug Use and Health estimated that 3.8 million Americans use opioids for nonmedical reasons every month.Lest you think that people seeking chemically induced highs are solely responsible for the problem, phy...
Source: Psychology of Pain - September 4, 2017 Category: Anesthesiology Source Type: blogs

Cutting down on opioids has made life miserable for chronic pain patients - Slate
On July 26, Todd Graham, 56, a well-respected rehabilitation specialist in Mishawaka, Indiana, lost his life. Earlier that day, a woman complaining of chronic pain had come to Graham's office in hope of receiving an opioid such as Percocet, Vicodin, or long-acting OxyContin. He reportedly told her that opioids were not an appropriate first-line treatment for long-term pain —a view now shared by professionals—and she, reportedly, accepted his opinion. Her husband, however, became irate. Later, he tracked down the doctor and shot him twice in the head.This horrific story has been showcased to confirm that phy...
Source: Psychology of Pain - August 30, 2017 Category: Anesthesiology Source Type: blogs

The Conversation Placebo - The New York Times
In my daily work as a primary care internist, I see no letup from pain. Every single patient, it seems, has an aching shoulder or a bum knee or a painful back."Our bodies evolved to live about 40 years," I always explain,"and then be finished off by a mammoth or a microbe." Thanks to a century of staggering medical progress, we now live past 80, but evolution hasn't caught up; the cartilage in our joints still wears down in our 40s, and we are more obese and more sedentary than we used to be, which doesn't help.So it's no surprise that chronic arthritis and back pain are the second and third...
Source: Psychology of Pain - August 29, 2017 Category: Anesthesiology Source Type: blogs

A New Brain Measure of Nociception in Infants | Pain Research Forum
Unlike adults, infants can't tell you if they're in pain. Instead, clinicians must interpret behaviors such as crying and physiological measures such as heart rate to determine what a newborn is experiencing. Since these can occur for reasons unrelated to nociception, the pain field has long sought more objective ways to measure pain in this nonverbal population. Now, in a new study, investigators have identified pain-related brain activity in infants that could be measured with a simple electroencephalogram (EEG) recording and used the activity to create an EEG template that allowed them to test the efficacy of an...
Source: Psychology of Pain - August 24, 2017 Category: Anesthesiology Source Type: blogs

Women are flocking to wellness because modern medicine still doesn ’t take them seriously - Quartz
The wellness movement is having a moment. The more luxurious aspects of it were on full display last weekend at the inaugural summitof Gwyneth Paltrow's lifestyle brand Goop, from crystal therapy to $66 jade eggs meant to be worn in the vagina. Meanwhile, juice cleanses,"clean eating," and hand-carved lamps made of pink Himalayan salthave all gone decidedly mainstream. I myself will cop to having participated in a sound bath —basically meditating for 90 minutes in a dark room while listening to gongs and singing bowls. (I felt amazingly weird afterward, in the best possible way.)It seems that privileged...
Source: Psychology of Pain - August 20, 2017 Category: Anesthesiology Source Type: blogs

A comprehensive guide to the new science of treating lower back pain - Vox
Cathryn Jakobson Ramin's back pain started when she was 16, on the day she flew off her horse and landed on her right hip.For the next four decades, Ramin says her back pain was like a small rodent nibbling at the base of her spine. The aching left her bedridden on some days and made it difficult to work, run a household, and raise her two boys.By 2008, after Ramin had exhausted what seemed like all her options, she elected to have a"minimally invasive" nerve decompression procedure. But the $8,000 operation didn't fix her back, either. The same pain remained, along with new neck aches.More ...https://www...
Source: Psychology of Pain - August 13, 2017 Category: Anesthesiology Source Type: blogs

Surgery Is One Hell Of A Placebo | FiveThirtyEight
The guy's desperate. The pain in his knee has made it impossible to play basketball or walk down stairs. In search of a cure, he makes a journey to a healing place, where he'll undergo a fasting rite, don ceremonial garb, ingest mind-altering substances and be anointed with liquids before a masked healer takes him through a physical ritual intended to vanquish his pain.Seen through different eyes, the process of modern surgery may look more more spiritual than scientific, said orthopedic surgeon Stuart Green, a professor at the University of California, Irvine. Our hypothetical patient is undergoing arthroscopic kn...
Source: Psychology of Pain - August 13, 2017 Category: Anesthesiology Source Type: blogs

Almost half of all opioid misuse starts with a friend or family member's prescription | PBS NewsHour
More than half of adults who misused opioids did not have a prescription, and many obtained drugs for free from friends or relatives, according to a national survey of more than 50,000 adults.Although many people need medical narcotics for legitimate reasons, the National Survey on Drug Use and Health reported Monday that regular access to prescription opioids can facilitate misuse. The results, outlined in the Annals of Internal Medicine, indicate when the medical community overprescribes opioids, unused drugs are then available for abuse.More ...
Source: Psychology of Pain - August 2, 2017 Category: Anesthesiology Source Type: blogs

‘Extreme’ Use of Painkillers and Doctor Shopping Plague Medicare, New Report Says - ProPublica
In Washington, D.C., a Medicare beneficiary filled prescriptions for 2,330 pills of oxycodone, hydromorphone and morphine in a single month last year — written by just one of the 42 health providers who prescribed the person such drugs.In Illinois, a different Medicare enrollee received 73 prescriptions for opioid drugs from 11 prescribers and filled them at 20 different pharmacies. He sometimes filled prescriptions at multiple pharmacies on the same day.These are among the examples cited in a sobering new report released today by the inspector general of the U.S. Department of Health and Human Services. Th...
Source: Psychology of Pain - July 14, 2017 Category: Anesthesiology Source Type: blogs

The weird power of the placebo effect, explained - Vox
Over the last several years, doctors noticed a mystifying trend: Fewer and fewer new pain drugs were getting through double-blind placebo control trials, the gold standard for testing a drug's effectiveness.In these trials, neither doctors nor patients know who is on the active drug and who is taking an inert pill. At the end of the trial, the two groups are compared. If those who actually took the drug report significantly greater improvement than those on placebo, then it's worth prescribing.When researchers started looking closely at pain-drug clinical trials, they found that an average of 27 percent of patients in 1996...
Source: Psychology of Pain - July 14, 2017 Category: Anesthesiology Source Type: blogs

Bring On the Exercise, Hold the Painkillers - The New York Times
Taking ibuprofen and related over-the-counter painkillers could have unintended and worrisome consequences for people who vigorously exercise. These popular medicines, known as nonsteroidal anti-inflammatory drugs, or NSAIDs, work by suppressing inflammation. But according to two new studies, in the process they potentially may also overtax the kidneys during prolonged exercise and reduce muscles' ability to recover afterward.Anyone who spends time around people who exercise knows that painkiller use is common among them. Some athletes joke about taking"vitamin I," or ibuprofen, to blunt the pain of strenuous...
Source: Psychology of Pain - July 6, 2017 Category: Anesthesiology Source Type: blogs