How to Talk to Your Doctor About Pain – Health Essentials from Cleveland Clinic – June 2020
This article contains an excellent list of many descriptive words to help us describe very specific aspects of our pain.
There are many causes and types of pain, and everyone experiences it differently. Effective communication with your doctor is a key piece of the pain management puzzle.
“While most people think pain is all the same, there are actually several different types of pain,” explains pain management specialist Robert Bolash, MD.
It seems most scientists, researchers, and even doctors assume that chronic pain is some generic entity, and that’s a ridiculous assumption. Continue reading
Biomarkers May Indicate Chronic Pain, Aid Personalized Treatment – Pain Medicine News – by Kaitlin Sullivan – Apr 2020
People who suffer from chronic pain may have abnormal levels of 11 biomarkers related to metabolites and nutrient deficiencies, according to a retrospective observational study published in Pain Physician (2020;23:E41-E49).
Although the research is still in its early phase, these findings provide a snapshot of physiologic abnormalities found in a subset of patients with chronic pain.
“Subset” is the critical word here. If these “abnormalities” aren’t found in ALL patients with pain, how can they be used as “biomarkers” for pain?
Clinical trial sponsors must publish 10 years of missing data, judge rules – By Lev Facher – Feb 2020
This shows how bad of a problem we have with scientific research, now that it’s been used and manipulated by financial interests. If a study can’t find the results the “payor” wants to “prove”, it simply disappears like it never happened.
For years, government research agencies have misinterpreted a law that requires them to collect and post clinical trial data, a federal judge ruled this week, leaving behind a 10-year gap in data that now must be made publicly available.
The ruling affects trials conducted for as-yet-unapproved drugs and devices in that 10-year stretch, according to a lawyer for the plaintiffs — meaning hundreds or even upwards of 1,000 noncompliant trials would be forced to post data. Continue reading
Long‐term opioid management for chronic noncancer pain – free full-text /PMC6494200/ – Cochrane Review: Jan 2010
I’ll start with these two key findings in the author’s conclusions from this extremely long Cochrane Review:
1. Many patients discontinue long‐term opioid therapy (especially oral opioids) due to adverse events or insufficient pain relief; however, weak evidence suggests that patients who are able to continue opioids long‐term experience clinically significant pain relief.
2. Whether quality of life or functioning improves is inconclusive. Many minor adverse events (like nausea and headache) occurred, but serious adverse events, including iatrogenic opioid addiction, were rare. Continue reading
Why depth therapy is more enduring than a quick fix of CBT | Aeon Essays – by Linda Michaels – Mar 2020
Ever since I learned about Cognitive Behavior Therapy years ago, I haven’t been able to believe it’s the solution to anything but immediate, superficial problems.
The grounding belief of Cognitive Behavior Therapy is that it’s our thinking that drives our feelings and that by changing what we think we can change what we feel. Oh, so clever, aren’t we?
But thinking and feeling are interdependent: how we feel affects how we think, which then affects how we feel, which then affects how we think, and so on and on. I find this disregard for the state of organic human feelings a fatal flaw; we are not such simplistic “computing machines”. Continue reading
When more information may not lead to better decisions | National Institutes of Health (NIH) – March 3, 2020
Every day we use information about cause and effect to help make decisions. With advances in machine learning, computers are now able to turn data into sophisticated models of causation.
These models have the potential to help inform the choices that people make in their daily lives. However, it’s unclear how well people can use such models to make real-world decisions.
To me, this is about the difference between data, like raw numbers, and real information, like how the numbers interact with each other (causation, influence, etc.) Continue reading
Microglia may be the missing clue to solve the opioid epidemic – Sara Whitestone – Neuroscience – Université de Bordeaux – May 2019
…neuroscientists have discovered a new therapeutic target for managing pain: microglia.
Pain, as an acute sensation, serves as a warning to help your body prevent injury or avoid further harm.
the message from your stubbed toe is forced to go through a series of checkpoints—or gates—which will either open or shut to control the intensity of pain you perceive.
When pain becomes chronic, this signaling and the gate controls go haywire. Nerves become hyper-sensitive, firing off messages to the brain even in the absence of an injury. Continue reading
Protein Waves In Blood Linked To Aging Process: Shots – Health News : NPR – by Richard Harris – Dec 2019
Scientists know that if they transfuse blood from a young mouse to an old one, then they can stave off or even reverse some signs of aging. But they don’t know what in the blood is responsible for this remarkable effect.
Researchers now report that they’ve identified hundreds of proteins in human blood that wax and wane in surprising ways as we age.
Wyss-Coray and his colleagues report in Nature Medicine on Thursday that these proteins change in three distinct waves, the first of which happens “very surprisingly” during our 30s, peaking around age 34. Continue reading
The Effects of Voluntary, Involuntary, and Forced Exercises on Brain-Derived Neurotrophic Factor and Motor Function Recovery: A Rat Brain Ischemia Model – free full-text /PMC3035657/ – Feb 2011
I was happy to find that what I have personally experienced has been proven to be true: forced exercise is not as beneficial as voluntary. Sometimes science actually proves our intuitions correct – surprise!
Stroke rehabilitation with different exercise paradigms has been investigated, but which one is more effective in facilitating motor recovery and up-regulating brain neurotrophic factor (BDNF) after brain ischemia would be interesting to clinicians and patients.
Here are 4 PubMed scientific studies exploring how estrogen affects all different aspects of pain: its sensation, its interaction with opioid receptors, and its memory. Estrogen is clearly important, but the interactions with pain sensation are very complex.
Just like with hormone replacement therapy, the effects of estrogen on pain probably differ a great deal between individuals.
Pronociceptive and Antinociceptive Effects of Estradiol through Endogenous Opioid Neurotransmission in Women – NCBI – May 2006
Prominent interindividual and sex-dependent differences have been described in responses to sustained pain and other stressful stimuli. Variations in μ-opioid receptor-mediated endogenous opioid neurotransmission may underlie some of these processes. Continue reading