Benzodiazepines and risk of all-cause mortality in adults: cohort study | The BMJ – July 2017 – free full-text
Objectives: To evaluate the risk of all cause mortality associated with initiating compared with not initiating benzodiazepines in adults, and to address potential treatment barriers and confounding related to the use of a non-active comparator group.
Participants :1:1 high dimensional propensity score matched cohort of benzodiazepine initiators, and randomly selected benzodiazepine non-initiators with a medical visit within 14 days of the start of benzodiazepine treatment (n=1 252 988), between July 2004 and December 2013.
Main outcome measure: All cause mortality, determined by linkage with the Social Security Administration Death Master File. Continue reading
Forget Pills and Surgery for Back Pain – Scientific American – By Daisy Yuhas – Oct 2017
Although sudden pain in the lower back can be excruciating, it often feels more irrevocable than it truly is. Some 80 percent of people experience such distress at some point in their lifetime; the vast majority of cases pass without requiring any medical attention.
I was lucky—my travail resolved within 24 hours, and aside from a missed class, the incident had no notable repercussions.
That scenario is fairly typical: most cases of lower back pain subside on their own within 12 weeks. For some sufferers, however, the pain becomes chronic, seriously disrupting home and work life. Continue reading
Defense & Veterans Pain Rating Scale (DVPRS)
The DVPRS is a graphic tool clinicians can use to facilitate self-reported pain diagnoses from patients.
This sounds like a useful new tool, but I was disappointed to see it’s just a variation on the usual 1-10 McGill pain scale.
But it’s *in color*, and it shows *both* numbers *and* faces! Continue reading
Pain Cream Invented, But Untested: Shots – Health News : NPR – By Joe Palca – September 28, 2017
Let’s say you’re a scientist, and you’ve invented what you think is a useful treatment for pain. But you have a problem.
You don’t have the money to go through the regulatory approval process.
Should you try to sell it to consumers anyway, and run the risk of being accused of selling snake-oil? Continue reading
Terminology of chronic pain: the need to “level the playing field” – Free full-text /PMC4734783/ – Jan 2016 – John F Peppin and Michael E Schatman
This article, published in the Journal of Pain Research, makes it clear that there is NO biological/medical/physical difference between “chronic cancer pain” and “chronic noncancer pain”.
Pain medicine as a separate subspecialty is in its infancy, only fairly recently being recognized as such by the American Board of Medical Specialities. As it continues to find its way in the ever-changing world of medicine, terminology becomes an important consideration.
Terms carry tremendous impact: Continue reading
Difference between Lyrica and Gabapentin. What You Need To Know – Med Line Plus – Sept 2017
Pregabalin and Gabapentin are selective inhibitors of voltage- gated calcium channels, which act to inhibit these pumps at specific alpha2-delta site and inhibit calcium mediated release of neurotransmitters from synaptic vesicles.
The neurotransmitters that are inhibited are adrenaline and nor-adrenaline, which increases the sensitivity of neuropathic pain.
Neuropathic pain is caused due to damage, necrosis or compression that affects the nerves in our body. Continue reading
Ehlers-Danlos Syndrome: An Emerging Challenge for Pain Management – Editor’s Memo—September 2017 – By Forest Tennant, MD, DrPH
Thank you, Dr. Tenant, for drawing attention to this terribly painful genetic syndrome that is completely ignored by so many pain specialists, even as it clearly causes increasing physical pain.
Until recently, Ehlers-Danlos Syndrome (EDS) was a name that elicited little relevance or urgency in the pain world.
Little did I realize that I had been treating more cases of EDS in patients who had been referred to my practice initially for more commonly recognized diagnoses such as fibromyalgia, spine degeneration, and resistant migraine. Continue reading
The PPM Guide to Relieving Pain Without Medication – Sept 2017 – By Rosemary Black
For chronic pain, there are several effective non-opioid alternatives including mind-body techniques, biofeedback, devices and ancient Chinese therapies.
In fact, many agree that nonopioid medications and non-drug therapies are the preferred treatment, only prescribing stronger pain medications when these options have failed.
So what other options are available to those who suffer chronic pain? Are they effective? Are they a better alternative?
Not better, but somewhat effective sometimes for some people. Continue reading
Intravenous Lidocaine Safe, Effective for Chronic Pain – by Jessica Martin – August 30, 2017
Lidocaine infusions were shown to provide long-lasting and adequate analgesia in 41% of patients with chronic pain, and to be associated with mild side effects in a study recently published in Pain Medicine.
Researchers retrospectively reviewed the charts of 233 adult patients (average age, 51; 54% women) with chronic pain (average pain duration, 7.7 years; 80% with neuropathic pain) who had received an initial lidocaine challenge of 1000 mg/h for ≤30 minutes (infusion rate, 16.67 mg/min), followed by up to 2 more lidocaine infusions (average lidocaine administered during first infusion, 381.4 mg). Continue reading
These New Devices Promise to Fight Pain without Opioids – MIT Technology Review
While drug developers are trying to discover new nonaddictive medicine to treat pain, medical device manufacturers are racing to develop smaller, more comfortable implants as well as external devices that don’t require surgery.
The idea has been around since the 1960s, but in recent years the technology has undergone rapid innovation.
Michael Leong, a pain specialist at the Stanford University School of Medicine, says the benefit of these devices is that when patients use them, they’re able to take fewer drugs or no painkillers at all. That’s appealing to both doctors and patients. Continue reading