Category Archives: Pain Management

Chronic Pain Rehab Reduces Central Sensitization

Interdisciplinary Chronic Pain Rehabilitation Program Reduces Central Sensitization – Pain Medicine News – July 2017

Patients with chronic pain who participated in an interdisciplinary chronic pain rehabilitation program achieved a significant reduction in central sensitization, according to a preliminary assessment.

When managing the most refractory of chronic pain patients in clinical practice, “we have noticed high overlap in various conditions like fibromyalgia, irritable bowel syndrome, pelvic pain, migraine, temporomandibular joint disorder and back pain,said principal investigator Xavier Jimenez, MD, medical director of the Cleveland Clinic Chronic Pain Rehabilitation Program

“patients seem to improve with interdisciplinary chronic pain rehabilitation program (iCPRP) treatment,” Dr. Jimenez said.   Continue reading

Pregabalin for acute and chronic pain in adults

Pregabalin for acute and chronic pain in adults – free full-text PMC4167351 – 2009 Jul 8.

Background: Antiepileptic drugs have been used in pain management since the 1960s. Pregabalin is a recently developed antiepileptic drug also used in management of chronic neuropathic pain conditions.

Objectives: To assess analgesic efficacy and associated adverse events of pregabalin in acute and chronic pain.

Main results:

There was no clear evidence of beneficial effects of pregabalin in established acute postoperative pain.  Continue reading

MSM, Strenuous Exercise, Cytokine Release

The Influence of Methylsulfonylmethane on Inflammation-Associated Cytokine Release before and following Strenuous Exercise – Oct 2016 – free full-text PMC5097813

Inflammation is associated with strenuous exercise and methylsulfonylmethane (MSM) has been shown to have anti-inflammatory properties.

Methods. A total of 40 men began the study and completed testing.

Subjects were healthy, physically active, and nonsmokers and did not have any cardiovascular or metabolic disorders.

Physically active men were supplemented with either placebo or MSM (3 grams per day) for 28 days before performing 100 repetitions of eccentric knee extension exercise.   Continue reading

FDA Declares CBD ‘Beneficial,’ Wants Your Input ASAP

FDA Declares CBD ‘Beneficial,’ Wants Your Input ASAP – by Bruce Barcott –  August 14, 2017

The United Nations is trying to figure out how to categorize cannabidiol (CBD), a non-psychoactive and medically beneficial cannabinoid contained in cannabis. And UN officials, through the US Food and Drug Administration (FDA), are asking for your help.

The FDA declared that
‘CBD has been shown to be beneficial
.’
Now the agency needs your comments to back it up.

All those who have information on, or experience with, the use of CBD as a healing substance are encouraged to comment at this federal website Continue reading

Doctors over-prescribing seizure drugs to treat pain

Doctors may be over-prescribing seizure drugs to treat pain – chicagotribune.com – Dennis Thompson – Aug 2017

Physicians might be relying too heavily on “off-label” use of epilepsy drugs as an alternative to prescribing narcotic painkillers, two experts in internal medicine contend.

Doctors are prescribing the anti-seizure drugs gabapentin (Neurontin) and pregabalin (Lyrica) to treat pain more frequently, partly in response to the opioid epidemic in the United States, said Dr. Allan Brett. He’s a professor of clinical internal medicine with the University of South Carolina School of Medicine in Columbia.

However, the drugs might not be doing any good for many people suffering from chronic pain, Brett said.  Continue reading

Applications and Safety of Methylsulfonylmethane (MSM)

Methylsulfonylmethane: Applications and Safety of a Novel Dietary Supplement –  free full-text PMC5372953

Description and History of MSM

Methylsulfonylmethane (MSM) is a naturally occurring organosulfur compound. Prior to being used as a clinical application, MSM primarily served as a high-temperature, polar, aprotic, commercial solvent, as did its parent compound, dimethyl sulfoxide (DMSO).

Throughout the mid-1950s to 1970s, DMSO was extensively studied for its unique biological properties including its membrane penetrability with and without the co-transport of other agents,

  • its antioxidant capabilities,
  • its anti-inflammatory effects,
  • its anticholinesterase activity, and
  • its ability to induce histamine release from mast cells  Continue reading

Occupational vs Athletic Use of Muscles

Muscle activity pattern dependent pain development and alleviation. – NCBI – 2014 Dec

The folly of standardization: recommendations based on invalid generalizations.

Muscle activity is for decades considered to provide health benefits irrespectively of the muscle activity pattern performed and whether it is during e.g. sports, transportation, or occupational work tasks.

Accordingly, the international recommendations for public health-promoting physical activity do not distinguish between occupational and leisure time physical activity.

However, in this body of literature, attention has not been paid to the extensive documentation on occupational physical activity imposing a risk of impairment of health – in particular musculoskeletal health in terms of muscle pain Continue reading

Medical Foods for Chronic Pain Patients

Medical Foods Hold Promise In Chronic Pain Patients – Practical Pain Management – By Michael J. Brennan, MDSteve H. Yoon, MD and Todd Lininger, MD – Sept 2016

Despite the inherent differences in patient populations and their pathologies, there are common approaches to the medical management of chronic pain

The clinician’s goal is to maximize the patient’s functionality by enhancing the analgesic response, and to minimize treatment-related side effects or toxicities.

For the right patients, incorporating an inherently safe option with documented efficacy—like medical foods—into a regimen that includes active exercises, nonopioid and minimal opioid analgesic therapies, and cognitive and behavioral approaches can offer the most effective approach to pain of numerous etiologies.   Continue reading

Pain and Distress Circuit in Fibromyalgia Identified

Connections: the Pain and Distress Circuit in Fibromyalgia Identified – Health Rising – by Cort Johnson | Feb 6, 2015

This article points out the further consequences of pain in Fibromyalgia patients, which are different than in normal people.

Fibromyalgia (FM), of course, is much more than about pain.  

Called the “prototypical functional pain syndrome,” people with fibromyalgia often experience problems thinking (fibro-fog), sleep and autonomic nervous system problems, depression and catastrophizing.  

The multidimensional aspects of fibromyalgia suggest that more than one part of the brain must be  involved.   Continue reading

The Dangers of Guidelines & Recommendations

Guidelines are wonderful. Guidelines are dangerous – KevinMD.com – ROBERT CENTOR, MD | July 2017

Over the past decade, I have thought often about the benefits and the problems of clinical guidelines. The first concept that attracted my attention was reading about conflicting guidelines.  

Given the same data, different guideline committees would have significantly different recommendations.  At the least, this problem raises questions about guideline validity.

It makes clear that committee perspective could influence recommendations.  

This is exactly what happened when the CDC opioid prescribing guidelines were ghost written by addiction specialists from PROP.   Continue reading