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Listening to Invisible Pain

Listening to Invisible Pain

Everyone agrees that doctors need to listen to their patients, but this becomes difficult when facing a patient like me, with my chronic and invisible pain. Doctors are trained to evaluate objective symptoms to reach a diagnosis, run tests to confirm it, and then prescribe treatment and/or medication to cure or mitigate it – all in 15 minute office visits. This isn’t possible with invisible pain.

Over the years, many doctors assumed I was either malingering, drug-seeking, or having psychological problems. Shamed and angry after such appointments, I’d limp back to my car and break down in tears of despair.

Because I had no diagnosis, many doctors seemed unwilling, or perhaps unable, to believe my pain was as severe and unrelenting as I reported. Even if they did and attempted to treat it, it was often only with methods and medications of limited efficacy, because they had been influenced by the media’s hype about the dangers of opioids.   Continue reading

Acetaminophen as an all-purpose emotion reliever

Your pain reliever may also be diminishing your joy: Acetaminophen (paracetamol) reduces both pain and pleasure, study finds | Medical News Today | 14 Apr 2015

Your pain reliever may also be diminishing your joy: Acetaminophen (paracetamol) reduces both pain and pleasure, study finds

Researchers studying the commonly used pain reliever acetaminophen found it has a previously unknown side effect: It blunts positive emotions

Acetaminophen, the main ingredient in the over-the-counter pain reliever Tylenol, has been in use for more than 70 years in the United States, but this is the first time that this side effect has been documented.  

Previous research had shown that acetaminophen works not only on physical pain, but also on psychological pain. This study takes those results one step further by showing that it also reduces how much users actually feel positive emotions, Continue reading

Neural mechanism responsible for chronic pain

Scientists identify neural mechanism responsible for chronic pain Medical News Today

Neurons in the gyrus cinguli create a ‘pain memory’.

Nevian and colleagues’ discovery is the identification of a cellular mechanism in a brain region called gyrus cinguli, which is typically associated with the emotional aspects of pain. In a mouse model, the researchers found that neurons in this region are modified by chronic pain, establishing a form of “pain memory.”

“The neurons are constantly activated by a noxious stimulus,” explains Nevian, “thus building a memory trace for pain that becomes irreversible. Our idea was to understand this mechanism better to derive potential new treatment strategies.”  Continue reading

Cholesterol drug stimulates the same receptors as marijuana

Common cholesterol drug stimulates the same receptors as marijuana Medical News Today

Fenofibrate [which is mainly used to reduce cholesterol levels in patients at risk of cardiovascular disease],activates cannabinoid receptors and may become a viable treatment option for relieving pain, stimulating appetite, reducing nausea and preventing depression

fenofibrate, also known by the brand name Tricor®, may benefit a wide range of health issues, such as pain, appetite stimulation, nausea, as well as immune and various psychiatric and neurological conditions. This suggests that fenofibrate may be the starting point for a new class of cannabis-like drugs to treat these types of conditions.

Despite the fact that fenofibrate has been used for many years, and its mechanism of action was presumed to be through a completely different family of receptors, this suggests that at least some of the effects of fenofibrate may be controlled by cannabinoid receptors.

Richard S. Priestley, Sarah A. Nickolls, Stephen P. H. Alexander, and David A. Kendall. A potential role for cannabinoid receptors in the therapeutic action of fenofibrate. FASEB J. April 2015 29:1446-1455; doi:10.1096/fj.14-263053

Urine Drug Test Often Gives False Results

Urine Drug Test Often Gives False Results — Pain News Network | April 13, 2015 | By Pat Anson, Editor

A urine drug test widely used by pain management and addiction treatment doctors to screen patients for illicit drug use is wrong about half the time – frequently giving false positive or false negative results for drugs like marijuana, oxycodone and methadone.

The “point-of-care” or POC tests come with immunoassay testing strips that use antibodies to detect signs of recent drug use. Physicians like the urine tests because they can be performed in their offices, are inexpensive, and give immediate results.

But experts say the tests are wrong so often that no doctor should base a treatment decision solely on the results of one test. 

Yet, this is exactly how many pain clinics operate: one dirty test and you’re out, no excuses, with a note in your medical record that virtually guarantees that no other doctors will dare treat you for pain either.   Continue reading

Possible Mitochondrial Enhancer for Fibromyalgia

Could A Mitochondrial Enhancer Replace Cymbalta in Fibromyalgia? – Health Rising

How a Mitochondrial Booster Became an Antidepressant

Acetyl L-carnitine (ALCAR) is best known as an energy supplement and mitochondrial booster the but folks in this  fibromyalgia clinical trial were looking for more than increased energy; they were looking for relief from pain and depression as well. They pinned ALCAR not as an energy booster per se, but as a central nervous system protectant – and they had good reason to do so.

Clin Exp Rheumatol. 2015 Mar-Apr;33(1 Suppl 88):82-5. Epub 2015 Mar 18. A randomised controlled trial comparing duloxetine and acetyl L-carnitine in fibromyalgia patients: preliminary data.

Acetyl L-carnitine

Continue reading

Collagen’s role in pelvic organ prolapse and incontinence

Association between pelvic organ prolapse and stress urinary incontinence with collagen | free full text PubMed aritcle

The aim of the present study was to investigate the ultrastructure and content of collagen in uterosacral ligaments and paraurethral tissues in patients with pelvic organ prolapse (POP) and stress urinary incontinence (SUI), analyzing the association between POP and collagen dysfunction

The study comprised three groups:

  • Control,
  • POP (pelvic organ prolapse) and
  • POP with SUI (stress urinary incontinence)

(n=30 per group).  Continue reading

Why Untreated Chronic Pain is a Medical Emergency

Why Untreated Chronic Pain is a Medical Emergency

Alex DeLuca, M.D., FASAM, MPH;Written testimony submitted to the Senate Subcommittee on Crime and Drugs regarding the “Gen Rx: Abuse of Prescription and OTC Drugs” hearing; 2008–03–08.

Untreated Chronic Pain is Acute Pain

The physiological changes associated with acute pain, and their intimate neurological relationship with brain centers controlling emotion, and the evolutionary purpose of these normal bodily responses, are classically understood as the “Fight or Flight” reaction,

When these adaptive physiologic responses outlive their usefulness the fight or flight response becomes pathological, leading to chronic cardiovascular stress, hyperglycemia which both predisposes to and worsens diabetes, splanchnic vasoconstriction leading to impaired digestive function and potentially to catastrophic consequences such as mesenteric insufficiency.  Continue reading

Neurosteroids: Promising Research Direction

Editor’s Memo: Neurosteroids—Gaining Ground In Pain Management Research

The term neurosteroid designates bioactive steroids that are endogenously synthesized in neurons and/or glial cells in the central nervous system (CNS) and peripheral nervous system (PNS) (Table 1)

neurosteroids

These agents offer great hope as possible adjuncts to our current pain treatment armamentarium.  Continue reading

Hip Pain: Interrelated Pain Syndromes

Here are 6 articles from the NIH PubMed discussing various aspects of femoral acetabular impingement, a cause of hip pain. The studies theorize that it could also be related to Meralgia Paresthetica and Sacroiliac joint dysfunction.

The hip is a complicated joint and lax connective tissue in ligaments can allow misalignment in the structures.

Femoro-acetabular impingement: the diagnosis-a review  | free full text article | J Child Orthop. 2012 Mar

The recognition of the importance of femoral acetabular impingement (FAI) as a potential cause of hip pain has been stimulated by major efforts to salvage hip joints by reconstruction in order to prevent or delay the need for replacement.

The purpose of this review is to define the nature of FAI, the various types, and how to make the diagnosis.  Continue reading