Everyday pain management ideas

I always like what Dr. Kristiansen has to say. I would have paraphrased this for you, but I didn't think I could word it any better than he does. I found this post on his blog recently, and really like what he has to say about goal setting aspects of pain management...click the link if you'd like to read it as well! Is Pain Management on The Right Track ? | Picture of Pain Sources: dolotest blog, wikimedia

A recent article in the Buffalo News about this topic prompted the idea for this post. This is something everyone should know about pain medications before taking them.  An educated decision is the best kind to make!  Here is a synopsis of the article.  It was based on the thoughts of Dr. Richard Rosenquist, chairman of pain management at the Cleveland Clinic, and his assessment of six common myths about opioid drugs...a.k.a. "painkillers." Myth #1: The more you take, the better they work. In the short term, it is possible, that after experiencing an injury, or surgery, for instance, that two pills will work better than one at relieving pain. However, if two pills are become the usual dosage, a tolerance to the medication can develop, leading to further problems.  (Tolerance occurs when an individual experiences a decrease in effectiveness over time, leading to the need to take more drug to achieve the same effect.) Myth# 2: If you actually take

Chronic pain is a hot topic in the research world these days...great news for those who are suffering to know that one day (hopefully soon!) a new approach to treatment will appear. Here is one such research article; instead of aspirin, ibuprofen and opiates, pain treatment in the form of gene therapy that acts on the glial cells of the nervous system rather than the neurons. So far it looks promising! You can read the article by clicking  here . Sources: Colorado Arts & Sciences, wikimedia

Once again, it's time to present a post on fibromyalgia.  It seems like a good time to review some things we already know the treatment for this condition.  If you've been reading this blog for some time, you know that there are medications for fibromyalgia, but they really don't do that much good all by themselves.  The preferred approach to fibromyalgia is a combination of medication and the use of self-management techniques. As for the medication aspect of the condition, the types of medication fall into four categories: 1) Over the counter pain medications (examples are acetaminophen ibuprofen) 2)Prescription analgesics, such as tramadol 3) Anti-depressant medications--there are many.  Some examples here would be Cymbalta, which is   a newer agent that is recommended for chronic pain, and Savella, which is specifically for          fibromyalgia. 4)Some of the anti-seizure medications can be used in the treatment of fibromyalgia. These drugs modify nerve imp

I just finished reading an article written by a physician who specializes in hospice care.  I think she brings up some interesting points that relate to chronic pain and pain management in general, so that's what I am writing about in today's post. First and foremost, the author says that she originally intended to be a psychologist, but changed course and became a physician because she thought psychology had too many "grey areas" while medicine was more "black and white." She goes on to say that she could not be more wrong about medicine...that there are, in fact MANY "grey areas" in medicine.  And isn't pain management one of those?   Pain is a subjective thing.  If a patient self reports pain, that is all that is needed to justify its existence. There is no blood test or x-ray or any other test to confirm its existence.  We try to quantify pain by using methods of measurement, such as pain scales, to decide how severe it

A recent study, supported by Proove Biosciences, sheds an interesting light on perception of pain. The research project studied 2,721 subjects who suffer chronic pain and divided them into four subgroups based on their genetic makeup--COMT, DRD2,DRD1,OPRK1.  All of the subjects were currently prescribed opioid medications for their respective conditions. All of the subjects were asked to rate their pain on a scale of zero to 10; those who rated their pain at zero were eliminated from the study.  The results, based on the four groups above, were as follows: DRD1 gene variant was 33% more prevalent in the low pain group than in the high pain group. In the moderate group, COMT and OPRK1 gene variants were found 25% and 19% more often respectively, than in the high pain group. Lastly, the DRD2 variant was 25% more common in the high pain perception category than in the moderate group. Study author Tobore Onoijighofi , MD says that this finding helps to understand why

I am sharing this infographic as a public service reminder that September is Pain Awareness month. Please take a moment to have a look--there's a lot of interesting information here! Image source: Pattienttalk.org

Back in 2010, a study published in the Journal of Pain suggested that overweight/obese persons with fibromyalgia syndrome had greater pain sensitivity, decreased quality of sleep, and reduced physical strength an flexibility. This might lead some to believe the combination of being overweight and having fibromyalgia is hopeless.... Interestingly enough, the study did not mention whether or not the subjects were overweight prior to their diagnosis, or if coping with the struggles of fibromyalgia led to weight gain.  In either case, weight management has its benefits and it's always a good idea for all of us be cognizant of our weight and our eating habits... Now, fast forward to 2014.  In a study published in Rheumatology International, Castel et. al concluded that there is no real difference in response to multi modal treatment for fibromyalgia with respect to body weight/body mass index. This is good news.....multi modal treatment of fibromyalgia seems to

According to a March 2014 article in Pain Medicine News ,  studies are underway to assess use of the Herpes Simplex virus to deliver genetic instructions to the central nervous system to "rewrite" pain signals at their source. After having success in animal models, the studies continue in human clinical trials.  It is entirely possible that this will become a safe and effective approach to chronic pain management in three to five years. Dr. David Fink, a neurologist at the University of Michigan in Ann Arbor, and Joseph Glorisio, Ph.D. from the University of Pittsburgh, along with their colleagues at Periphagen Holdings are taking the lead in this new and exciting frontier in pain management! Here is a simple schematic of how this approach might work: Source: Pain Medicine News; Wikimedia

As a follow up to yesterday's post, I would like to share an example-- how early interventions to treat pain at the source make good sense. Thoracic placement of spinal cord stimulator image source: wikimedia Spinal cord stimulators are medical devices that have been in existence since the late 1960s-early 1970s. When a patient has chronic back pain, a device like this can be surgically implanted ..the actual device sits in the abdomen, while the electrodes are placed in the epidural space of the spine.  Once activated, the device sends electrical impulses that scramble the pain signal, and in doing so, muffle the pain sensation for that patient.  The device is programmable, so that it the signals it emits can be adjusted  after implantation as needed by the patient's health care team. A recent study at Regina General Hospital in Saskatchewan regarding these devices yielded some interesting results.  Krishna Kumar, MD and his group studied 443 patients wh

Here's some help from the American Chronic Pain Association : "Everyone who lives with chronic pain--or cares about someone who does--is different. But at the same time we all have common interests. We are a kind of community and deserve to have our voices heard. The materials and information here can help you reach out to others to help them better understand the social, economic, and personal interests related to pain.  Sometimes, the best way to help yourself is to help someone else." Image source: wikimedia Here are some resources for those who suffer from chronic pain, and their caregivers: More about Pain Awareness Month         Image source: wikimedia Partners for Understanding Pain Tool Kit for Older Adults

In light of the suicidal death of Robin Williams, and the news of his problems with depression and Parkinson's Disease, it seems appropriate to revisit the connection between chronic pain and depression. So today, I am sharing a patient guide from Pain Management News about this subject. If you would like to print a copy out for yourself, click here . Click on the image there to obtain a printable copy. Image source: PainMedicineNews

For people with fibromyalgia, sleep issues can be a big problem. Even though these individuals may have the ability to sleep at night, it is the lack of restorative sleep that seems to be a big factor. The body needs restorative sleep to repair and refresh itself; but for those who are plagued by insufficiency a whole night's sleep does little good. This is not insomnia, but a lack of sufficient sleep quality. Unfortunately, this seems to be both a cause and a consequence of the condition. Research suggests that this sleep problem stems from a dysfunction of the autonomic nervous system. A 2009 study suggests that one factor at play is heart rate variability-a measure of ANS function--is abnormal in people with fibromyalgia.  The sympathetic (fight or flight) branch of the ANS seems to be stuck in an "on" position,  causing them to be on guard even when asleep.  As a result, sleep quality is impaired and a lack of restorative sleep is the result. This can beco

It recently came to my attention that people who use opioid medications for pain management might not understand the difference between drug abuse and addiction. It is possible for an individual to become addicted to a drug even when it's prescribed for a legitimate medical condition and is taken as directed.  Consider the definitions of these words: Addiction : Habitual psychological and physiological dependence on a substance or practice beyond one's physical control. Drug Abuse: Habitual use of drugs to alter one's mood, emotion, or state of consciousness. As you can see from the definitions above, addiction and abuse are not the same thing.   That is the slippery slope when patients use opioids for pain management.  This is not to say that opioid medications have no place in pain management; it is simply a fact that when the opioid pain medications are used routinely over time, addiction will happen .  It does not matter if the user is abu

No human being on earth is exempt from experiencing pain...it is as much a part of the human condition as eating or breathing.  But pain is a weird thing...for example the neuropathy experienced by a diabetic is not at all like post-operative pain, or childbirth.  Modern medicine seeks to quantify pain using one of several different pain scales in an attempt to determine severity and appropriate treatment. But is this the right approach? Some examples will help to illustrate my point here... The most basic method used to measure pain is to ask the patient to rate their pain on a scale of 1-10.  Zero or one indicates little to no pain; a score of ten is really off the charts!  Many medical practices use this method for their patients. The FACES scale is similar to the above, except that there are faces over the numbers to help those who might have a little trouble assigning a number to the intensity of their pain.  This is especially helpful when working with children or mental

In this short video, Sandy Sentivany-Collins, RN, and Carly, a Golden Retriever working with our pediatric pain management service, are highlighted for their work at Lucile Packard Children's Hospital at Stanford. Carly is an official member of the Packard staff and understands a number of languages. Sandy and Carly's work provides extraordinary support to the kids and families at this hospital. Pet therapy is good for all age groups. In November 2009 Science Daily reported on a study of using pet therapy for adults undergoing joint replacement therapy.  According to the study, those who used pet therapy in their treatment required 50 percent less medication that those who did not.  You can read the article in its entirety by clicking here . If you don't have your own dog or cat, perhaps you know someone who would share with you. Animals love unconditionally and their is much to be gained from their companionship besides pain management. This is one of the mos

The alpha-stim is an FDA cleared medical device that has been available since 1981. It has been approved for use in anxiety, depression, insomnia, and chronic or post-operative pain. There are two basic models: The Alpha- Stim M and the Alpha-Stim AID.  The difference between the two models is that the M model is more suited for those with pain issues, while the AID model is applicable to anxiety and depression. This device has been said to be more cost-effective than medication over time. After the initial expense of purchasing such a device, there are a few parts and accessories that may be needed for routine use and maintenance, but they are not expensive to buy. Here are some graphics from the Alpha Stim website that illustrate my point: This device came to my attention when I saw an article online that mentioned that the US government is making this device available to its service members who suffer from PTSD. Some insurance companies

Long term solutions to chronic pain are very important, and now that the FDA is limiting availability of opioids it it becoming increasingly important to know what options are available. One such form of treatment is nonsurgical procedure known as nerve ablation. One method of accomplishing this is the use of extreme cold (cryoblation).  Techniques that employ a chemical such as phenol or alcohol (chemical neurolysis) encompass the second of these methods. Thirdly is a technique known as radiofrequency ablation (RFA), which is the topic of my blog post today. The "pros" of RFA include the fact that it is reproducible. RFA is also extremely precise, and highly effective.  The RFA technique is also known to have a good margin of safety, so patients can have a sense of relief about that! A little background... The earliest accounts or RFA can be traced back to the 1930s. It has been noted that this technique was used as a treatment for trigeminal neuralgia.  More

If you've ever seen a television ad for Cancer Treatment Centers of America , you might recall that the patients featured usually talk about the treatment approach there--that is, being treated a a whole person. In all the months I've been posting this blog, I am hoping that you can see that the same approach is becoming a model in the world of pain management.  By treating the patient as a whole--it is possible to target chronic pain from many avenues at the same time. Hippocrates, the father of modern medicine had many wise things to say in this regard.  Here are some examples: " Natural forces within us are the true healers of disease." "If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health." "It's far more important to know what person the disease has than what disease the person has." When one is faced with

Can prayer heal people?  I suppose the answer to that depends on if you believe in the power of prayer, or not.  I tend to believe that God answers all of our prayers, but sometimes God says no.  We do not always understand because we cannot see through the eyes of God... I found an article on " Discovery Health " website that cites some interesting studies about this topic.  One study, conducted in 1988 by Randolph Byrd, a physician, looked at 393 patients who entered a cardiac care unit in a San Francisco Hospital.  Some of the patients were assigned to a group that received intercessory prayer (IP), while the other group did not receive IP.  None of the patients knew which group they were assigned to.  At the conclusion of the study, Byrd reported that 85% of the patients in the prayer group responded well to treatment, while 73% of the group that did not benefit from IP responded similarly. Many similar studies patterned after Byrd's study followed.  A study b