Tag Archives: surgery

Spinal Surgery Does Not End Opioid Use for Pain

Expectations Versus Reality: Spinal Surgery Does Not End Opioid Use for Pain – RELIEF: PAIN RESEARCH NEWS, INSIGHTS AND IDEAS By Stephani Sutherland – July 2018

People seeking medical treatment for back pain often end up in a surgeon’s office.

Most of those individuals hope—and expect—that surgery will reduce their pain enough to make opioid painkillers unnecessary after the operation.

But that scenario seems to be the exception rather than the rule, according to a new report published in the journal PAIN.   Continue reading

The Pain Industry’s New & Dangerous Fall-Back

Opinion: The Pain Industry’s New & Dangerous FALL-BACK – June 27, 2018 – By Dennis J. Capolongo / Director ENDC

From my perspective, preventative measures to reduce iatrogenic harm should be among the list of alternatives to help reduce opioid consumption.

Recently published reviews authored by outspoken physicians Dr. Martin Makary of John’s Hopkins and Dr. Jana Friedly of the U.W. Medical Center have pointed a finger at an industry that has literally run amok.

Here’s the other nightmare being foisted upon pain patients: “interventional” pain management, with needles and knives that leave patients in even more agony afterward.   Continue reading

Many Orthopedic Surgeries Don’t Work

Many Orthopedic Surgeries Don’t Work — BETTER MOVEMENT

Unlike drugs, orthopedic surgeries can be sold to the public before they undergo any rigorous testing to ensure they are safe and effective.

Thus, millions of surgeries for knee, shoulder, and back pain have been done even without any research to confirm they actually work.

Recently, a significant amount of such research has been completed, and it has found that many popular surgeries work no better than a placebo. And yet many of these surgeries are still being performed at the rate of hundreds of thousands per year.   Continue reading

Genetics May Play Role in Chronic Pain After Surgery

Genetics May Play Role in Chronic Pain After Surgery – 14-Dec-2017 – Newswise

Genetics may play a role in determining whether patients experience chronic pain after surgery, suggests a study published today in the Online First edition of Anesthesiology, the peer-reviewed medical journal of the American Society of Anesthesiologists (ASA).

Aside from genetic factors, the study also found patients younger than 65 years old, males and those with a prior history of chronic pain were at increased risk.

“Our study not only shows there are common genetic variations among people that may help to identify whether they are at high-risk for developing chronic pain after surgery, but it also helps explain why only a fraction of patients ever even experience persistent pain,” said lead researcher Matthew T.V. Chan, M.D

Chronic postsurgical pain is one of the most common and serious complications after surgery.

…the authors say it is likely that millions of patients worldwide suffer from pain around the surgical wound area months, or even years, after surgery.

The researchers collected blood samples from 1,152 surgical patients to look for genetic variations in 54 “pain-related” genes, which have been shown to be associated with pain sensation.

One year after surgery, 21 percent of patients reported chronic postsurgical pain. Among these patients, 33 percent rated their pain as severe.

During the follow-up period, patients with pain reported difficulties with

  • general activity,
  • mood,
  • walking, 
  • relations with others,
  • sleep, and
  • enjoyment of life.

General health status was also adversely affected by pain.

One genetic variation in particular – a gene found in the nervous-system called brain-derived neurotrophic factor (BDNF) – was found to be most associated with increased chronic postsurgical pain. Researchers also confirmed the finding in a mouse model.

The authors concluded that genetic variations accounted for a higher percentage of chronic postsurgical pain (between 7 percent and 12 percent) compared to clinical risk factors such as age, sex, smoking history or anesthesia technique (between 3 percent and 6 percent).

Original article: Genetics May Play Role in Chronic Pain After Surgery

Warning: Persistent Post-Surgical Pain Common

Persistent Postsurgical Pain – Practical Pain Management

Surgery is often counterproductive for chronic pain, so beware!

More than 45 million surgical procedures are performed in the United States each year. It has been estimated that acute postoperative pain will develop into persistent postoperative pain (PPP) in 10% to 50% of individuals after common operations.

Since chronic pain can be severe in up to 10% of these patients, PPP represents a major clinical problem—affecting at least 450,000 people each year.  Continue reading

Post-Surgical Spine Syndrome

Post-surgical spine syndrome – free full-text PMC3205485 – Sep 2011

It is our view that the diagnostic terms post laminectomy syndrome (ICD-9 code 722.8) or failed back syndrome are inaccurate, misleading, can be construed as disparaging, and should be discarded.

Disparaging to whom? I suspect doctors do not like any term that insinuates their methods failed, no matter how true that is.

These authors couldn’t even bring themselves to call this painful syndrome by its *real* name: it’s not called “failed back syndrome”, but rather “failed back surgery syndrome” because, in this case, it is the surgery that failed, not the back. Continue reading

NoL Index Measures Patients’ Pain During Surgery

Nociception Level Index Detects Patients’ Pain During Surgery – Pain Medicine News – Mar 14, 2017

Israeli researchers have devised a multivariable index that appears to accurately reflect patients’ experience of pain during surgery.

This kind of objective “pain measurement” is the holy grail of pain management, but I wouldn’t trust it – would you?

I suspect not.

Pain is such a primal sensation with a literally overpowering impact that I cannot bring myself to trust some device, no matter how ingenious, to detect the enormity and full significance of this sensation.   Continue reading

Ketamine effective in surgery? Studies say No and Yes

Ketamine not effective in surgery study | National Institutes of Health (NIH) by Tianna Hicklin, Ph.D. – June 20, 2017

At a Glance:

Researchers found that low doses of ketamine did not reduce delirium, postoperative pain, or other complications related to major surgeries.

The results suggest that the common practice of giving ketamine to patients during surgery may need to be re-evaluated.   Continue reading

What is worse, the Opioid Epidemic or the Stupidity Epidemic?

What is worse, the Opioid Epidemic or the Stupidity Epidemic? – National Pain Report – June 8, 2017-  By Dr. Jay Joshi, CEO/Medical Director – National Pain Centers in Chicago.

I didn’t get far into this article before I began to doubt what the author was saying:.

When other physicians, especially in the university setting, were prescribing “opiates for everyone”, “there are no dose limits”, and “opiates are not addictive as long as you have pain”, I felt compelled to stand up for logic and common sense.

Challenging a valid statement about dose limits is a denial of fact.

From what I’ve read about pain and opioids,  there is no valid dosage limit or maximum dosage for opioids as long as enough tolerance has developed over time.   Continue reading

Minimally Invasive SI Joint Fusion May Lessen Pain

Minimally Invasive SI Joint Fusion May Lessen Pain, Improve Quality of Life – Practical Pain Management – May 2017

Minimally invasive sacroiliac (SI) joint fusion was associated with significant improvements in pain relief and disability, as well as a decreased reliance on opioids, according to findings of a retrospective study published in Neurosurgery.

This study compared outcomes against conservative management (CM) or SI joint denervation, demonstrating that pain and disability levels returned to baseline levels with traditional approaches.   Continue reading