I found this quite surprising: “…nociceptors that contain a protein called TRPV1 control the immune response”
There is a growing awareness among pain researchers that communication between the nervous system and the immune system contributes to pain.
Nociceptors are the nerve cells that detect potentially harmful things in the environment like excessive heat or dangerous chemicals, and relay information about those threats into the spinal cord and up to the brain, ultimately culminating in an experience of pain. Continue reading →
…relevant to the increasing use of statistics in science and health issues, statistician Stephen John Senn said that …data are often tortured until they confess to exactly what a scholar wants the numbers to say.
In a meta-analysis,
the scientific literature is searched,
a subset of papers is selected and then
a combined estimate is made.
It is essentially “conducting research about previous research.”
Thus, we face an even greater problem of “garbage in, garbage out” because the biomedical field is rife with awful reserach with poor design and methodologies. Continue reading →
I’ve long noticed that research on pain and opioids has become ridiculously biased to support the “opioids are evil” narrative, measuring milligrams of opioid instead of patient outcomes. (See Opioids Blamed for Side-Effects of Chronic Pain)
While there is evidence of ongoing research misconduct in all it’s forms, it is challenging to identify the actual occurrence of research misconduct, which is especially true for misconduct in clinical trials.
Research misconduct is challenging to measure and there are few studies reporting the prevalence or underlying causes of research misconduct among biomedical researchers. Continue reading →
It is just what it sounds like, an analysis of analyses. The first meta-analysis was in 1976 and as Gene Glass described it then, the goal was to integrate the findings of collections of analysis results from individual studies.
In other words, he wanted a way to try and compare apples to apples from different studies. He was using systematic review.
I can already see a huge problem with this because the apples are the results/endpoints of the different studies being combined. (This is reminiscent of how the CDC combined prescription medication with heroin and illicit fentanyl to acheive their alarming “opioid crisis” and totally mislead those who are trying to ease it.) Continue reading →
This study interested me because I can see how the cultural hype of the moment is affecting the kind of research studies that are done (or at least funded). A deep anti-opioid bias taints our politics, our policies, and even our science.
Example: I’ve always had a hunch that cholesterol-blocked arteries weren’t really caused by eating too much cholesterol-laden food, but some other factor that combined with or influenced the cholesterol to build up. Now research shows my hunch was right, that despite all the anti-cholesterol hype, it’s not only ok, but possibly beneficial, to eat butter and cheese.
This study shows how supposed “science” can be led astray by cultural “hype”, very similar to what’s happening with the scientific “research” on opioids.
While I agree with the basic results of this study, I have great qualms about how these studies (and there are apparently more than a few) are conducted.
There is inadequate evidence to justify surgical procedures to treat chronic pain, recent research shows.
“Given their high cost and safety concerns, more rigorous studies are required before invasive procedures are routinely used for patients with chronic pain,“ researchers reported in Pain Medicine.
Most pain specialists and researchers now understand chronic pain as a bio-psycho-social disorder and involving central sensitization, ruling out any structural or biochemical problems. This kind of pain, by definition, cannot be treated with surgery. Continue reading →
Here, again, is this seminal article by two high-profile pain/addiction doctors about the follies of current anti-opioid policies:
A rise in addiction and overdose deaths involving opioids in the United States has spurred a series of initiatives focused on reducing opioid risks, including several related to prescription of opioids in care of pain. Policy analytic scholarship provides a conceptual framework to assist in understanding this response.
Prior to 2011, a “policy monopoly” of regulators and pharmaceutical manufacturers allowed and encouraged high levels of opioid prescribing.
The authors then point out that the debate has been cornered by an “advocacy coalition” of anti-opioid fanatics. Continue reading →
For most people, pain eventually fades away as an injury heals. But for others, the pain persists beyond the initial healing and becomes chronic, hanging on for weeks, months, or even years.
Now, we may have uncovered an answer to help explain why: subtle differences in a gene that controls how the body responds to stress.
In a recent study of more than 1,600 people injured in traffic accidents, researchers discovered that individuals with a certain variant in a stress-controlling gene, called FKBP5, were more likely to develop chronic pain than those with other variants. Continue reading →
Tapentadol prolonged release (PR) for the treatment of moderate to severe chronic pain combines 2 modes of action.
These are μ-opioid receptor agonism and noradrenaline reuptake inhibition in a single molecule that allow higher analgesic potency through modulation of different pharmacological targets within the pain-transmitting systems. Continue reading →