Tag Archives: research

Forced Exercise Less Beneficial than Voluntary

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.

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Modulation of pain by estrogens

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

The trouble with mice as behavioral models

The trouble with mice as behavioral models for Alzheimer’s – STATBy Adam Rosenberg – Apr 2019

It is becoming increasingly obvious that rodents cannot accurately model human diseases, let alone human behaviors.

I’ve always doubted the findings of pain studies that use rodents because these animals cannot possibly model what is claimed to be a bio-psycho-social syndrome.

There’s been a lot of talk about overinvestment in interventions aimed at amyloid in the weeks since Biogen discontinued a late-stage study of aducanumab, an experimental therapy for Alzheimer’s disease. Continue reading

Effects of opioids on cognition in older adults

The effects of opioids on cognition in older adults with cancer and chronic non-cancer pain: A systematic review. – PubMed – NCBI – J Pain Symptom Manage. Oct 2019

CONTEXT:
Opioids are prescribed to manage moderate to severe pain and can be used with older adults; however, they may lead to several adverse effects, including cognitive impairment.

OBJECTIVE:
To identify, appraise and synthesise evidence on

  • i) the impact of opioids on cognition in older adults with cancer/chronic non-cancer pain, and
  • ii) screening tools/neuropsychological assessments used to detect opioid-induced cognitive impairment.

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Fascia Research from the NIH

Because fascia is made from collagen, the genetic defect from EDS will often cause us problems with this tissue. It’s thin, fragile, stretches too much, and gives way too easily.

PubMed Central® (PMC) is a free full-text archive of biomedical and life sciences journal literature at the U.S. National Institutes of Health’s National Library of Medicine (NIH/NLM).

Research on the body’s fascia (connective tissue) is finding more and more of its functions and abilities, going far beyond just “holding stuff together”.  I’ve posted here the abstracts of the following 4 articles and you can decide for yourself if they’re worth reading in full.

  1. Smooth Muscle
  2. Visceral Fascia
  3. Bone Tissue
  4. Hormone Receptor Expression in Human Fascial Tissue

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The Tyranny of the Randomized Controlled Trial

Should we beware the tyranny of the randomized controlled trial? | Association of Health Care Journalistsby Tara Haelle (@TaraHaelle) – Jan 2017

The intersection of scientific research, evidence and expertise can be a dicey one, particularly in an age in which evidence-based medicine is replacing the clinical expertise of practitioners.

In The New York Times Sunday Review, Jamie Holmes wrote about how the challenge of assessing the quality of evidence against expertise and less stringently conducted research can lead readers to confusion and frustration.

It can lead to a further distrust of science, Holmes suggested, noting the example of dental flossing in the wake of an Associated Press story that questioned the evidence in favor of the practice.    Continue reading

Long-term opioid therapy for chronic pain

Long-term opioid therapy in chronic noncancer pain. NIH – Feb 2015 – a systematic review and meta-analysis of efficacy, tolerability, and safety in open-label extension trials with a study duration of at least 26 weeks (that’s 1/2 year).

This study confirms what pain patients all know: long-term opioids are effective for long-term pain, require few increases, and only rarely result in “opioid use disorder”. 

The efficacy and safety of long-term (≥ 6 months) opioid therapy (LtOT) in chronic noncancer pain (CNCP) is under debate.A systematic review with meta-analysis of the efficacy and harms of opioids in open-label extension studies of randomized controlled trials (RCTs) has not been conducted until now.   Continue reading

Opioids Continue to Be Effective Long Term

Opioids Continue to Be Effective Long Term Medscape – Fran Lowry – October 01, 2013

This is a good review with results that ring true in my experience,

Unfortunately, it’s fatally tainted by funding from Purdue.

An extensive literature review of studies evaluating the effectiveness of long-term opioid therapy in chronic noncancer pain (CNCP) concludes that the drugs continue to provide reliable and safe analgesia for 6 months or more.

“Due to FDA regulatory guidelines, most contemporary phase 3 randomized controlled trials of opioid analgesics for CNCP are 3 months long or less.   Continue reading

Hypermobility, EDS, and Chronic Pain

Hypermobility, the Ehlers-Danlos syndromes and chronic pain. – PubMed – Clin Exp Rheumatol. 2017 Sep-Oct;

This is yet another scientific paper adding to the evidence of how painful EDS (and other connective tissue disorders) can be.

Chronic widespread pain is a common complaint among individuals affected by generalised joint hypermobility.

In the absence of other conditions that cause chronic pain, these individuals are usually diagnosed with joint hypermobility syndrome (JHS). JHS is a multifactorial trait with a strong genetic basis, but no specific genetic markers.

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NGF Inhibitor leads to rapid joint destruction

NGF Inhibitor Reduces Joint Pain but Raises Risk for Deterioration – Pain Medicine News – Oct 2019

Tanezumab, an investigational monoclonal antibody that inhibits nerve growth factor, improved joint pain and physical function in patients with osteoarthritis, in a placebo-controlled clinical trial.

Although the agent demonstrated efficacy relative to placebo in study participants who had not obtained relief with conventional agents, the investigators characterized the improvement with tanezumab as modest, and found that it was associated with an increased incidence of rapidly progressive osteoarthritis (OA) and a requirement for total joint arthroplasty.

Such adverse effects would doom any other medication, but this one keeps getting promoted only because it’s not an opioid.  Continue reading