Category Archives: Pain Management

Catastrophizing NOT predictive of poor outcomes

Pain coping skills training doesn’t improve knee arthroplasty outcomes– by Bruce Jancin – June 2019

Here’s the research I’ve been waiting for to disprove the hype around the idea that “catastrophizing leads to more pain and worse outcomes”. In this study, they expected to get results confirming this “catastrophizing hypothesis“, but they found no such thing.

They did find that when patients’ pain was relieved after successful knee replacement (80% success rate), their catastrophizing score was also dramatically reduced, regardless of which trial arm they were in.

This is contradictory to many less rigorous studies that showed catastrophizing leading to worse outcomes. But this prospective randomized study shows what pain patients have always known:

When pain is relieved, so is catastrophizing.  Continue reading

The Price Tag of Living With Chronic Pain

The Price Tag of Living With Chronic PainBy R. Morgan Griffin – Aug 2007

Pain was once viewed only as a symptom, the consequence of another condition. It was often ignored as doctors focused on treating its underlying medical cause.

But for almost everyone, pain is what matters. “It’s pain that brings people into the doctor’s office,” says Penney Cowan, executive director of the American Chronic Pain Association. “It’s pain that they want treated.”

“The costs are incalculable,” says Christopher L. Edwards, PhD, assistant professor of psychiatry at Duke University School of Medicine. “How do you estimate the value of lost self-worth? How do you estimate the loss of family, friends, and a sense of accomplishment?”   Continue reading

Fined for withholding pain medication

St. Anthony’s fined $25K for withholding pain medication from two patients – by Sarah Hayden, Reporter – Jul 3, 2019

I’m thrilled to finally see some successful pushback from patients who are deliberately left in pain due to opioid restrictions.

According to the Illinois Department of Public Health (IDPH) first-quarter report, the nursing facility at 767 30th St., Rock Island, was cited for four license violations related to the abuse and neglect of the patients in December. 

The report, published in April, states the facility failed to monitor pain, establish control of severe pain and administer pain medication for two residents,” one suffering from arthritis and the other from chronic leg pain and open wounds.    Continue reading

Nerve Pain Drugs Linked To Serious Risks

Common Nerve Pain Drugs Linked To Suicide, Other Serious Risks | The FixBy Kelly Burch 06/20/19

These are the drugs that the anti-opioid crusaders would prefer we take instead of opioids, which only demonstrates their ignorance about medication and chronic pain.

A new study found that Lyrica and similar nerve pain meds were associated with increased suicide risk as well as unintentional overdose and traffic accidents. 

The popular prescription drug Lyrica and similar drugs that are used to treat muscle and nerve pain have been linked with suicidality, accidental overdose and increased risk of serious accidents, according to a new study.    Continue reading

Abuse Potential of Gabapentin & Pregabalin

Special Report: The Abuse Potential of Gabapentin & Pregabalin – By Max Buscaglia, PharmD Candidate, Haley Brandes, PharmD Candidate and Jacqueline Cleary, PharmD, BCACP June 2019

The inevitable dark side of these “preferable to opioids” medications is becoming harder to ignore:

Key Takeaways:

Gabapentinoid abuse may rise as the prescribing and use of opioids decreases, but the biggest concern may come when these agents are combined with other prescribed medications or illicit street drugs.    Continue reading

Cochrane Reveiws of Gabapentoids to Relieve Pain

Here are some Cochrane reviews on the efficacy (or lack thereof) of gabapentin (Neurontin) and pregabalin (Lyrica):

These medications seem mildly effective for their FDA-approved conditions, but much less so for chronic pain. Yet… I’ve found Lyrica helpful for episodic pain flares when I take it on an “as needed” basis.

Ethical Responsibility to Manage Pain and Suffering

The Ethical Responsibility to Manage Pain and the Suffering It Causes – Position Statement of the American Nurses Association, Apr 2018 – Repost

I’m reposting this from last year because it’s such a good (and rare) example of a reasonable attitude toward opioids. The Nurses Association gets credit for standing up for patients a year earlier than others.

The purpose of this position statement is to provide ethical guidance and support to nurses as they fulfill their responsibility to provide optimal care to persons experiencing pain. 

The national debate on the appropriate use of opioids highlights the complexities of providing optimal management of pain and the suffering it causes.

In these first sentences, the difference between nurses and doctors shine through:

Nurses are much more concerned with suffering, while doctors nit-pick about what is painful and what isn’t, who is “really” hurting and who is “catastrophizing”.   Continue reading

Intractable Pain versus Chronic Pain

What is Intractable Pain and How Does it Differ From Chronic PainBy Forest Tennant, MD, DrPH, John Liu, MD and Laura Hermann, RN, FNP – Aug 2017

Protocols for a lifetime of pain management for patients suffering constant, incurable, excruciating, unrelenting pain.

Since IP [Intractable Pain] patients always have an underlying, incurable disease or condition causing IP, their clinical management is complex and may require a specialized clinical setting.

Just as renal failure or insulin-dependent diabetes require lifetime care by a cadre of specialized medical personnel, IP likewise requires similar lifetime care due to its incurable nature.   Continue reading

A few new pain drugs in development

Spurred by opioid epidemic, new pain drugs may lower the risk of overdose and addiction | Science | AAAS By Robert F. ServiceAug 2018

This article gives a good summary of new opioid and non-opioid drugs being developed to treat our chronic pain.

multiple research groups are claiming progress in devising novel opioids—or alternatives—that seem to offer pain relief with far less risk of addiction or of the opioid-induced respiratory depression that all too commonly leads to death.

Most of these studies, reported at a meeting here and in a paper released this week, have only been done in animals, so the experimental compounds face significant hurdles before they can become approved medications.   Continue reading

Scant Evidence Gabapentin Works for Pain

Millions Take Gabapentin for Pain. But There’s Scant Evidence It Works. – The New York TimesBy Jane E. Brody – May 20, 2019

There is very little data to justify how these drugs are being used and why they should be in the top 10 in sales,” a researcher said.

One of the most widely prescribed prescription drugs, gabapentin, is being taken by millions of patients despite little or no evidence that it can relieve their pain.

In 2006, I wrote about gabapentin after discovering accidentally that it could counter hot flashes. [that article is posted below]    Continue reading