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10 recent pain management studies

Sunday 25 March 2012


From Becker's Orthopedic, Spine & Pain Management:


Woman10 Recent Pain Management Studies

Written by  Taryn Tawoda
March 16, 2012

Here are 10 recent pain management studies published in the past month on topics including opioid use among the elderly, morphine tolerance and fibromyalgia pain relief.

1. One in Three Patients With Cancer Pain Don't Use Opioids. Researchers examined more than 24,000 cancer patients over age 65, 20 percent of whom had reported severe pain. A third of the severe pain group did not fill a prescription for opioids, including morphine, oxycodone and fentanyl, within the month before their pain screening or the week after.

2. Painkillers More Effective With Added Caffeine. Researchers examined past pain treatment studies comparing patients who received a dose of analgesic to patients who received the dose plus a standard amount of caffeine. Results showed that the latter group of patients was significantly more likely to experience a higher level of pain relief.

3. Elderly Patients Prescribed Painkillers More Likely to Become Addicted. The study looked at nearly 28,000 people age 66 or older who were given opioids in the week following minor surgical procedures, and nearly 10 percent of the patients were still using opioids — primarily oxycodone and codeine — one year after the operations.

4. Long Term Opioid Use Can Lead to Hormonal Abnormalities. In this study, the majority of patients taking high doses of opioids over a longer period of time had lower testosterone levels, as predicted. But some patients also had abnormalities in cortisol, corticotropin and pregnenolone, which may indicate an incomplete resolution of pain.

5. Low Dose of Naltexone Reduces Pain in Fibromyalgia Patients. The findings suggest that a unique microglial target can effectively treat the disorder. Despite the study's promising data, the low-dose amount of naltrexone used on participants is not yet commercially available and must be compounded manually for patients.

6. PTSD Veterans More Likely to be Prescribed Painkillers. Veterans diagnosed with PTSD are twice as likely as other veterans to be prescribed opioid painkillers. Researchers found that 17 percent of veterans with PTSD were prescribed opioids compared to 6.5 percent of veterans without any mental health diagnosis.

7. Some Patients Unnecessarily Disqualified From Radiofrequency Ablation Treatment. Inaccurate patient selection criteria may be disqualifying one-quarter of patients with chronic sacroiliac joint pain from receiving radiofrequency ablation treatment.  The study shows that patients' response to intraarticular sacroiliac steroid injections was not an accurate predictor of their subsequent responses to radiofrequency ablation treatment. 

8. Risk of Perioperative Infection Lower in Patients With Chronic Opioid Consumption.  Researchers found a statistically significant association between chronic opioid use and diabetes, nonemergent surgery, clean wound classification and American Society of Anesthesiologists physical status. Researchers also found a higher rate of infection in the group of patients that did not use opioids. However, researchers said more research needs to be done before opioids are used to protect against infection.

9. Patient Movement an Accurate Indicator of Pain. The study revealed patients in chronic pain move differently than patients not in pain. Researchers monitored the physical activity of 15 pain-free subjects and 60 chronic pain patients using sensors equipped with gyroscopes and accelerometers. They found the active periods of chronic pain patients included numerous brief rest intervals. Researchers were also able to take data before, during and after treatment to gain a precise assessment of the treatment's effect.

10. Reformulated Imatinib Eliminates Morphine Tolerance. Removing morphine tolerance could eliminate the need for increasing doses of painkillers to treat chronic pain. In some cases, patients develop a tolerance so high, the medication stops working altogether. In the study, imatinib not only prevented morphine tolerance but reversed tolerance in rats that received high morphine doses continuously for several days.


The above originally appeared here.


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