Chronic Pain

waltky · Sep 10, 2011

Uncle Ferd always gets the backache whenever Granny tells him to take out the trash...

Gene find could lead to drug for chronic back pain
8 September 2011 - Lower back pain can be a chronic, lifelong condition for many people

A gene responsible for chronic pain has been identified, with scientists saying this could lead to drugs for treating long-lasting back pain. Writing in the journal Science, University of Cambridge researchers removed the HCN2 gene from pain-sensitive nerves in mice. Deleting the gene stopped any chronic pain but did not affect acute pain. About one in seven people in the UK suffer from chronic pain, which can also include arthritis and headaches. The researchers say their findings open up the possibility that new drugs could be developed to block the protein produced by the HCN2 gene, which regulates chronic pain. The HCN2 gene, which is expressed in pain-sensitive nerve endings, has been known for several years, but its role in regulating pain was not understood.

For the study, the researchers removed the HCN2 gene from pain-sensitive nerves. They then carried out studies using electrical stimuli on these nerves in cell cultures to determine how they were altered by the removal of HCN2. They then studied genetically modified mice in which the HCN2 gene had been deleted. By measuring the speed that the mice withdrew from different types of painful stimuli, the scientists were able to conclude that deleting the HCN2 gene abolished neuropathic pain. However, they found that deleting HCN2 did not affect normal acute pain - which occurs suddenly, for example when biting one's tongue.

'No respite'

Chronic pain comes in two main varieties. Inflammatory pain occurs when a persistent injury, such as a burn or arthritis, results in very sensitive nerve endings which increase the sensation of pain. Neuropathic pain occurs when nerves are damaged, causing ongoing pain. This type of chronic pain, which is often lifelong, is surprisingly common and is poorly treated by current drugs, the study says. It is often seen in patients with diabetes and shingles, and in the aftermath of cancer chemotherapy. It is also common in lower back pain and other chronic painful conditions.

Professor Peter McNaughton, lead author of the study and head of the department of pharmacology at the University of Cambridge, said there was now hope for these people. "Individuals suffering from neuropathic pain often have little or no respite because of the lack of effective medications. Our research lays the groundwork for the development of new drugs to treat chronic pain by blocking HCN2." He added: "Many genes play a critical role in pain sensation, but in most cases interfering with them simply abolishes all pain, or even all sensation. "What is exciting about the work on the HCN2 gene is that removing it - or blocking it pharmacologically - eliminates neuropathic pain without affecting normal acute pain. This finding could be very valuable clinically because normal pain sensation is essential for avoiding accidental damage."

Dr Brian Hammond, chairman of charity BackCare, said the findings of the study were good news. "Any effective treatment which relieves the suffering of chronic pain is to be welcomed. Treatment which helps reduce pain but still leaves the body's warning mechanisms intact is a major breakthrough." The study was funded by the Biotechnology and Biological Sciences Research Council (BBSRC), and the European Union.

http://www.bbc.co.uk/news/health-14837879
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waltky · Feb 26, 2012

With hip pain, I can relate to this...

Crackdown on painkiller epidemic hurts legitimate patients
26 Feb.`12 When Antoinette Tortorella's doctor took her off narcotics in January because she would not agree to a spinal implant, she decided to get a new doctor.

Finding someone else who would treat her with the painkiller oxycodone was harder than Tortorella anticipated, though. Calls to several pain physicians were initially fruitless. Either they were not taking new patients or did not return her calls. Tortorella, 45, suffers from degenerative scoliosis curvature of the spine and can only walk slowly, hunched over and wracked with agony. As the days went on without a new doctor, she began to worry she'd run out of the pills and the Fentanyl patches that make her pain bearable. She also faced the prospect of severe withdrawal from the addictive medication.

Tortorella, who until her pain got so bad about three years ago had worked in banking and sales, finally found a new doctor. The doctor reduced her medication, however. Tortorella is a casualty of the painkiller epidemic that has engulfed Delaware and much of America. With so many patients selling or misusing their drugs, pain medications now have a stigma, leaving many doctors unwiling to take on legitimate pain patients. Others simply don't have the expertise.

The state's recent crackdown on doctors who irresponsibly prescribe narcotics has compounded the problem for people with severe, debilitating pain. When doctors get stripped of their licenses, legitimate patients can have a difficult time getting someone else to treat them, often leading to desperate trips to emergency rooms. Dr. Brent Passarello, an emergency room physician at Christiana Hospital, said he's treated some patients of doctors recently suspended from prescribing painkillers and anticipates more in the same predicament. "There's been a number of patients who are struggling," Passarello said. "It's been a struggle for us because of the volume of patients we're being asked to manage."

Delaware regulatory and medical officials say they are aware of the dilemma and encourage patients to work with their insurers to get the appropriate care. James L. Collins, director of the state Division of Professional Regulation that oversees the medical disciplinary board, said his agency recently started alerting physicians and hospitals "when a doctor was getting suspended so they would prepare for the effects of that suspension." Doctors, however, often have thousands of patients and many don't want to take on more. Sheila Grant, a registered nurse who is president of the Hospice and Palliative Care Network of Delaware, said doctors are concerned by media coverage of prescription drug abuse and by tough action of late by Collins' office.

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waltky · Jul 16, 2012

Ask yer doctor to make sure he don't share somebody else's pain med vial with ya...

Superbug MRSA linked to pain injections
July 12`12 (UPI) -- U.S. health officials investigated two outbreaks of invasive Staphylococcus aureus infection linked to the use of single-dose vials for more than one patient.

The Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report said in each outbreak, the use of single-dose or single-use vials for more than one patient was associated with infection transmission. In both investigations, clinicians reported difficulty obtaining the medication type or vial size that best fit their procedural needs, the report said.

The Arizona Department of Health Services was notified in April of a patient with fluid cultures positive for methicillin-resistant Staphylococcus aureus, who had undergone procedures recently at an outpatient pain management clinic. "Investigations confirmed that the three MRSA-infected patients received pain injections on the same day, along with 25 other patients," the report said. "Two MRSA-infected patients received epidural steroid injections. Ten people, including the MRSA-infected patients, received contrast injections for radiologic imaging to guide medication needle placement."

The three Arizona patients with MRSA were hospitalized for nine to 41 days, with additional long-term acute care required for one patient. A fourth recipient was found deceased at home, six days after treatment at a clinic, the report said. The Delaware Department of Health and Social Services was notified March 19 of seven patients admitted to a hospital with evidence of septic arthritis or bursitis.

Cultures from the affected sites -- knee, hip, ankle and thumb -- indicated all of the patients had MRSA. All seven required hospitalization from three to eight days. "Previously, the orthopedic practice had used 10 milliliter single-use vials of bupivacaine for single-patient use," the report said. "When a national drug shortage disrupted the supply, staff began using larger vials of bupivacaine for multiple patients."

Read more: http://www.upi.com/Health_News/2012...-injections/UPI-76091342151429/#ixzz20mkjjUMg
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waltky · Sep 21, 2012

Uncle Ferd's back goes to actin' up on him when Granny tells him to do sumpin' `round the trailer...

Gene flaw linked to low back pain
21 September 2012 - Scientists have identified a gene flaw linked to disc problems that are a common cause of lower back pain.

The UK study, published in the Annals of Rheumatic Diseases, looked at 4,600 people and found the PARK2 gene was linked to age-related disc problems. A third of middle-aged women have problems with at least one spinal disc - and the condition is known to be inherited in up to 80% of patients. Experts said finding the gene could lead to new treatments being developed. Back pain costs the UK about £7bn a year in sickness leave and treatment costs, but the causes of the condition are not fully understood.

In lumbar disc degeneration (LDD), discs become dehydrated and lose height, and the vertebrae next to them develop bony growths called osteophytes, leading to lower back pain. The King's College London researchers carried out MRI scans of all those in the study and looked at differences in their genetic make-up. They found variants of the PARK2 gene appeared to have an effect in people with degenerate discs and influence the speed at which their condition deteriorated.

Environmental effects

The researchers, funded by the Wellcome Trust and Arthritis Research UK, say more research is now needed to find out how the gene influences the condition. But they suggest it could be switched off in people with LDD. And they say it could be that environmental factors - such as diet and lifestyle - could make what are known as epigenetic changes to the gene. The researchers say that once the mechanism is fully understood, their finding could lead to the development of new treatments of lower back pain.

Dr Frances Williams, of the department of twin research and genetic epidemiology at King's College London, who worked on the study, said: "We know that people whose discs wear out are at increased risk of episodes of lower back pain, but normal human discs are hard to get hold of to study so until now our knowledge of normal human biology was incomplete. "Further work by disc researchers to define the role of the PARK2 gene will, we hope, shed light on one of most important causes of lower back pain. "It is feasible that if we can build on this finding and improve our knowledge of the condition, we may one day be able to develop new, more effective treatments for back pain caused by this common condition."

Prof Alan Silman, medical director at Arthritis Research UK, said: "Lumbar disc degeneration is a common cause of lower back pain, and it's known that up to 80% of cases have a genetic basis, but this is the first time a gene has been identified as linked to this often painful and disabling condition. "It's a promising start and provides us with the first clue to the genetic basis of this condition, and with further research, may potentially lead to the development of more effective treatments".

http://www.bbc.co.uk/news/health-19674045
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Richard Powell · Nov 12, 2012

You must consult to doctor who is specialist in this field of curing people for back pain.Being your are suffering from extreme pain then you have to take proper treatment.

waltky · Dec 26, 2012

Uncle Ferd knows all `bout dat...

Cannabis can make patients 'less bothered by pain'
21 December 2012 - Cannabis can offer pain relief to some people

Cannabis makes pain more bearable rather than actually reducing it, a study from the University of Oxford suggests. Using brain imaging, researchers found that the psychoactive ingredient in cannabis reduced activity in a part of the brain linked to emotional aspects of pain. But the effect on the pain experienced varied greatly, they said. The researchers' findings are published in the journal Pain. The Oxford researchers recruited 12 healthy men to take part in their small study.

Participants were given either a 15mg tablet of THC (delta-9-tetrahydrocannabinol) - the ingredient that is responsible for the high - or a placebo. The volunteers then had a cream rubbed into the skin of one leg to induce pain, which was either a dummy cream or a cream that contained chilli - which caused a burning and painful sensation. Each participant had four MRI scans which revealed how their brain activity changed when their perception of the pain reduced. Dr Michael Lee, lead study author from Oxford University's Centre for Functional Magnetic Resonance Imaging of the Brain, said: "We found that with THC, on average people didn't report any change in the burn, but the pain bothered them less." MRI brain imaging showed reduced activity in key areas of the brain that explained the pain relief which the study participants experienced.

Dr Lee suggested that the findings could help predict who would benefit from taking cannabis for pain relief - because not everyone does. "We may in future be able to predict who will respond to cannabis, but we would need to do studies in patients with chronic pain over longer time periods." He added: "Cannabis does not seem to act like a conventional pain medicine. Some people respond really well, others not at all, or even poorly. "Brain imaging shows little reduction in the brain regions that code for the sensation of pain, which is what we tend to see with drugs like opiates. "Instead cannabis appears to mainly affect the emotional reaction to pain in a highly variable way."

Mick Serpell, a senior lecturer in pain medicine at Glasgow University, said the study confirmed what was already known. "It highlights the fact that cannabis may be a means of disengagement for the patient, rather than a pain reliever - but we can see that happen with opioids too." The study was funded by the UK Medical Research Council and the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre.

http://www.bbc.co.uk/news/health-20810603
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dudeman · Dec 26, 2012

Screw doctors. If a drug can induce your mind to reduce pain, then clearly you are capable of inducing yourself to not have pain through exercise or discipline. What is a drug really doing? Directing your body to do something? Sound somewhat familiar to your BRAIN?

waltky · Jan 11, 2013

Makin' pain meds harder to abuse...

FDA Seeking Hard-to-Abuse Painkillers
January 11, 2013 - Is there a good way to make prescription painkillers more difficult to abuse? The Food and Drug Administration says the science of "abuse-deterrence" is relatively new, and it is encouraging additional scientific and clinical research to advance the development of drugs that are difficult to abuse.

It's also considering how to evaluate such studies, as well as what claims to eventually allow on drug labels. In the meantime, the FDA said it will take a "flexibile" approach to the evaluation and labeling of potentially abuse-deterrent drugs. Prescription opioid analgesics -- painkillers such as oxycodone -- are an important component of modern pain management, the FDA says in a recently released "guidance" for the industry." It also notes that abuse and misuse of pain-killers has created a serious and growing public health problem.

The FDA wants to make pain-killers available to those who need them, and therefore it considers the development of abuse-resistant drugs to be a "high public health priority." Current abuse-deterrent formulations are intended to prevent people from abusing pain medications, either by swallowing them whole, crushing and swallowing, crushing and snorting, crushing and smoking, or crushing, dissolving and injecting.

Abuse-deterrents generally fall into the following categories:

-- Physical/Chemical barriers can change the physical form of an oral drug, making it less easy to abuse by chewing, crushing, cutting, grating or grinding.

-- Agonist/Antagonist combinations can be added to a drug to reduce or defeat the euphoria associated with abuse. Some "antogonists" would be released only if the drug is improperly chewed, injected or otherwise manipulated.

-- Aversion: Substances can be combined to produce an unpleasant effect if too much medication is ingested or injected.

-- Delivery system: Certain drug release designs or the method of drug delivery can offer resistance to abuse. Shots and implants, for example, can be more difficult to manipulate.

-- Some drugs can be delivered in inactive form, transformed only when they reach the gastrointestinal tract.

The FDA says two or more of the above methods can be combined to deter abuse. The FDA guidance says studies designed to evaluate the abuse-deterrent characteristics of pain-killers should be "scientifically rigorous," and take into consideration the most common way the drug is abused.

http://cnsnews.com/news/article/fda-seeking-hard-abuse-painkillers
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Jiyuu-Freedom · Jan 12, 2013

I believe the oils in cannabis are the newest technology for patients of certain cancers. I watched a show that 2 patients were interviewed, one child with Leukemia and the other woman with another form of cancer who used the oils during chemo and afterward. The woman actually used these oils as a home remedy to put her own self into remission. She is now marketing her products. The mother of the child is strongly considered canabis oils and decided to try it. This child is also healing.

I don't understand the aspects of the oils being essential to taking the cancer to a remission state but it must have more benefits than just using it for pain and nausea.

Also, a little off topic but Mayor Bloomberg is banning all hospitals in New York from prescribing pain meds because he feels they addict the patient. Giving someone 15 percs, or oxycotin, whatever is a concern that he says it not only promotes addiction but theives steal meds from folks leaving pharmacies.

I don't agree with doing away with prescribing all pain meds when discharged because so many need them until they can see a pain specialist.

Take two aspirins and call me in the morning just doesn't cut it.

Phoebe Bump · Jan 12, 2013

If a drug can induce your mind to reduce pain, then clearly you are capable of inducing yourself to not have pain through exercise or discipline.
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Sorry, but that just does not follow.

Albert Di Salvo · Jan 12, 2013

That which does not kill us makes us stronger.

waltky · Feb 18, 2013

Granny kinda waddles when she walks since she had her hip implant...

Hip implants a bit more likely to fail in women
Feb 18,`13 -- Hip replacements are slightly more likely to fail in women than in men, according to one of the largest studies of its kind in U.S. patients. The risk of the implants failing is low, but women were 29 percent more likely than men to need a repeat surgery within the first three years.

The message for women considering hip replacement surgery remains unclear. It's not known which models of hip implants perform best in women, even though women make up the majority of the more than 400,000 Americans who have full or partial hip replacements each year to ease the pain and loss of mobility caused by arthritis or injuries. "This is the first step in what has to be a much longer-term research strategy to figure out why women have worse experiences," said Diana Zuckerman, president of the nonprofit National Research Center for Women & Families. "Research in this area could save billions of dollars" and prevent patients from experiencing the pain and inconvenience of surgeries to fix hip implants that go wrong.

Researchers looked at more than 35,000 surgeries at 46 hospitals in the Kaiser Permanente health system. The research, published Monday in JAMA Internal Medicine, was funded by the U.S. Food and Drug Administration. After an average of three years, 2.3 percent of the women and 1.9 percent of the men had undergone revision surgery to fix a problem with the original hip replacement. Problems included instability, infection, broken bones and loosening. "There is an increased risk of failure in women compared to men," said lead author Maria Inacio, an epidemiologist at Southern California Permanente Medical Group in San Diego. "This is still a very small number of failures."

Women tend to have smaller joints and bones than men, and so they tend to need smaller artificial hips. Devices with smaller femoral heads - the ball-shaped part of the ball-and-socket joint in an artificial hip - are more likely to dislocate and require a surgical repair. That explained some, but not all, of the difference between women and men in the study. It's not clear what else may have contributed to the gap. Co-author Dr. Monti Khatod, an orthopedic surgeon in Los Angeles, speculated that one factor may be a greater loss of bone density in women.

The failure of metal-on-metal hips was almost twice as high for women than in men. The once-popular models were promoted by manufacturers as being more durable than standard plastic or ceramic joints, but several high-profile recalls have led to a decrease in their use in recent years. "Don't be fooled by hype about a new hip product," said Zuckerman, who wrote an accompanying commentary in the medical journal. "I would not choose the latest, greatest hip implant if I were a woman patient. ... At least if it's been for sale for a few years, there's more evidence for how well it's working."

Source
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Middleroad · Feb 19, 2013

Theres degrees of pain and individuals have different levels of tolerance.When an individual reachs the limits of their tolerance for pain, they will do what everyone does, seek relief. That relief can can come in many forms, therapy, surgery, behavior change and pain medication. If it comes down to the only relief you can get is pain medication, you will take it. Pain that is relentless and never ending wears everyone down, its depressing and demoralizing and it can and does lead to suicide. Most people fortunately never experience that kind of relentless pain and they cant understand the level of misery and dispair it can sink someone down to.

Steady Pie · Feb 19, 2013

waltky said: ↑

Uncle Ferd always gets the backache whenever Granny tells him to take out the trash...

Gene find could lead to drug for chronic back pain
8 September 2011 - Lower back pain can be a chronic, lifelong condition for many people
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We already have a drug for chronic back pain, it's called THC

waltky · Feb 6, 2014

Granny hypnotizes Uncle Ferd when he got a toothache - is prob'ly why he missin' so many teeth...

Can Power of the Mind Control Chronic Pain?
February 5th, 2014 ~ Utah researchers say theyve developed a technique that allows patients to use the power of their minds to help treat chronic pain.

One in five people worldwide suffers from daily chronic pain, according to a 2004 report. A 2011 paper from the Institute of Medicine (IOM) showed that one in three U.S. adults is affected by this condition. The University of Utahs Eric Garland said his teams technique not only helps relieve pain, but can also decrease prescription opioid misuse among chronic pain patients. A variety of therapies are used to treat chronic pain including over-the-counter pain relievers, exercise and diet, alternative medical therapies such as acupuncture, and prescription opiate-based pain medications, which can have serious side effects and lead to dependency.

Garland calls his new intervention technique Mindfulness-Oriented Recovery Enhancement (MORE) and said it is designed to train people to react differently to pain, stress and opioid-related cues. Mental interventions can address physical problems, like pain, on both psychological and biological levels because the mind and body are interconnected, Garland said. Anything that happens in the brain happens in the bodyso by changing brain functioning, you alter the functioning of the body.

Millions around the world live with pain every day.

In a study published online in the Journal of Consulting and Clinical Psychology, Garland said the new treatment method led to a 63- percent reduction in the misuse of opioids, as compared to a 32-percent decrease among those who took part in a conventional support group. Patients who were a part of the new treatment group also reported a 22 percent drop in pain-related impairment, something that the researchers said continued for three months after the end of their treatment period. According to Garland, the MORE technique zeroes in on the basic processes involved in both chronic pain and the abuse of opioids, by combining three therapeutic components; mindfulness training, reappraisal and savoring.

The mindfulness training component consists of training the patients mind to increase its awareness, gain control over their attention, and learn to control automatic habits. The reappraisal module is the process of taking the meaning of a stressful or negative experience and turning it around in such a way that it is seen as something positive and promotes growth. Savoring is a method of learning that teaches patients to center their attention on positive events in their lives, heightening their sensitivity to naturally occurring positive experiences, such as enjoying a beautiful sunset or the special feeling of closeness with a loved one.

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waltky · Feb 16, 2014

Granny gonna sign Uncle Ferd up for it so she don't have to shovel snow no more...

Minimally invasive surgery shortens recovery periods
Mon, Feb 10, 2014 - MINIMUM FUSS: Patients undergoing the surgery to fix slipped discs can often walk normally a short time after the procedure and be discharged on the same day

A man who stayed up all night playing mahjong during the Lunar New Year holiday suddenly felt pain below his waist and numbness in his right thigh and shin, and was later diagnosed with a spinal disc herniation, commonly known as a slipped disc. Chen Chien-min, the director of the neurosurgery division at the Changhua Christian Hospital, said the patient had a herniated disc between the fourth and fifth lumbar vertebrae in the lower back, which caused a bulge that put pressure on the patients right root nerve.

The hospital performed a minimally invasive spinal surgery (MISS) on the patient, with the patient able to walk later on the day of the surgery and being discharged the next day, Chen said. The neurosurgeon said the surgery involved using an endoscope a very thin fiber-optic video camera and specialized retractors to perform the surgical procedure through tiny incisions in the patients lower back. Watching the video screen showing images sent by the camera placed inside the body, the protrusion, or the portion of the disc that was pushing against the nerve root, was removed.

Chen said that MISS, with its tiny incisions, avoids potential significant damage to the spine and some patients, following proper evaluation, can even have the microdiscectomy done under local anesthesia. Most of the patients undergoing the surgery can have a very short hospital stay, being discharged on the same day as the surgery or the day after, he added. Chen said that a healthy spine can be maintained by avoiding staying in the same position for a long period of time and if a person has to sit for long periods, by placing a cushion behind the lower back to maintain the spines natural curve and allow the spine to relax.

http://www.taipeitimes.com/News/taiwan/archives/2014/02/10/2003583181
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OhZone · Feb 23, 2014

Hip replacement for women fail because they are not constructed for a women's frame. They are one-design-fits-all things and made for men's frames.

How about Acupuncture for pain? Some people swear by it.
http://www.webmd.com/back-pain/news/20070924/study-acupuncture-eases-low-back-pain

waltky · Dec 4, 2015

Uncle Ferd's back hurts him whenever Granny tells him to do sumpin' around the house...

Researchers find key to treating human pain
Dec. 4, 2015 - Researchers used mice to confirm how a rare genetic mutation prevents people from feeling pain.

Using mice genetically altered to lack a nerve channel that enables people and animals to feel pain, researchers developed a two-drug method of treatment they think will help people who have chronic pain. Nerve cells use various channels to communicate with the nervous system, including to signal pain. Previous research showed the sodium channel Nav1.7 is important specifically for signaling pain, and people born with a non-functioning Nav1.7 do not feel pain. Broad-spectrum channel blockers are not good for long-term use because of complete numbness and side effects that develop over long periods of use, and opioids are highly addictive and cause side effects, which has led researchers to search for a way to artificially recreate the rare condition of living pain-free.

Low levels of opioids are produced naturally by the body, which help people with a rare genetic mutation preventing their nervous system from communicating pain to their brains, allowing them not to feel pain. Researchers at University College London think they can recreate this effect pharmaceutically for chronic pain patients.

The researchers believed people with the mutation have higher than normal levels of natural opioids, which they confirmed in both mice and people, which combines with the lack of a functioning Nav1.7 to prevent pain -- leading to the combination treatment researchers plan to patent and develop. "After a decade of rather disappointing drug trials, we now have confirmation that Nav1.7 really is a key element in human pain," said John Wood, a professor at University College London, in a press release. "The secret ingredient turned out to be good old-fashioned opioid peptides, and we have now filed a patent for combining low dose opioids with Nav1.7 blockers. This should replicate the painlessness experienced by people with rare mutations, and we have already successfully tested this approach in unmodified mice."

First, researchers gave mice without Nav1.7 naloxone, an opioid blocker, and found the rodents could feel pain. Then they did the same thing with a 39-year-old woman who does not have functioning Nav1.7 channels, and she felt pain for the first time in her life. Wood said his team hopes to start human trials in 2017 to test low-level opioids -- lower than they believe would be addictive -- combined with blocking Nav1.7, in the hope that it will successfully solve pain conditions. The study is published in Nature Communications.

http://www.upi.com/Health_News/2015...eating-human-pain/9741449265570/?spt=slh&or=1
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See also:

Artificial implant for knee surgery can ease pain, speed recovery
Dec. 3, 2015 - The artificial meniscus, already in use in Europe and getting good reviews, is undergoing an FDA trial for use in the United States.

Doctors in Boston are among the first in the United States to implant an artificial meniscus in a patient's knee, part of a clinical trial of a device that may help people who have had little to no treatment options. The meniscus, referred to as a shock absorber where the bones in the knee come together, can wear down over time. Often, it is injured early in life while playing sports or other activities, and gets progressively worse over time. Doctors inserted NUsurface meniscus implant in the knee of Brockton, Mass., resident Rob Price at Brigham and Women's Hospital before Thanksgiving. Price had his ACL replaced in his left knee, and his meniscus was removed because of a tear, about 10 years ago after playing basketball.

Many people injure their meniscus, which acts as a shock absorber between the bones in the knee, during sports or other physical activities.

The procedure to remove his meniscus, a relatively common one, left him with pain for years as the bones in his knee rubbed up against one another. While some meniscus tears can be repaired, many are treated like Price's and removed. Dr. Andreas Gomoll, who performed the surgery, said the NUsurface may change the way knees are surgically repaired because it is simply placed in between the bones in the knee. "It has a pretty complex shape that conforms to the shape of the knee joint," Gomoll told WCVB-TV. "You don't have to cut bone, you don't have to permanently alter the anatomy of the knee joint itself."

Gomoll said the ideal patient to receive an implant is between the ages of 30 and 50, has had surgery on a meniscus previously and is having problems with it again, though not arthritis. And the recovery itself, he said, is faster as well, tacking about two to three months. The NUsurface is currently undergoing a series of clinical trials to find its effectiveness surgically and over the long term as patients recover. The trials are expected to be completed sometime in mid- to late-2018.

http://www.upi.com/Health_News/2015...in-speed-recovery/5341449168660/?spt=slh&or=9
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waltky · Feb 25, 2016

Pain-relieving Skin Patch...

Pain-relieving Skin Patch Does Away with Side Effects
February 24, 2016 - A clear skin patch called TEPI delivers the painkiller ibuprofen right where it hurts. While pills can cause stomach upset, the patch does not.

Scientists at the University of Warwick in England, led by chemist David Haddleton, developed the five-centimeter square bandage that contains a special polymer adhesive infused with the painkiller. "What we do is dissolve the active ibuprofen, for example, into the adhesive so we can have quite a high loading so up to 30 percent of the adhesive will be the ibuprofen, Haddleton said. And then, when that's placed on the skin just like an [adhesive bandage], then the drug will actually diffuse across the skin into the body at the site of the pain, and then relieve the pain the same way as current gels and creams."

The ibuprofen patch could deliver uninterrupted pain relief for up to 24 hours. The patch is being manufactured by Medherant, a bioadhesive company affiliated with the University of Warwick, co-founded by Haddleton and Andrew Lee. "We've been in the lab about 12 months, Lee said, but in the 12 months, we've essentially assessed about 90 percent of the drugs that are currently available as either creams or patches. We've tested them in our polymers with very good results."

TEPI vs. other patches

Almost two dozen painkilling patches are now on the market, but Lee notes they provide soothing warmth to relieve discomfort, rather than delivering any active painkiller. Researchers have identified about 20 drugs that could be made into a TEPI patch, but Lee says there are thousands more compounds that could potentially be delivered through the technology. The clear skin patch containing ibuprofen used to treat pulled muscles, arthritis and sports injuries could hit the market in about three years.

http://www.voanews.com/content/pain-relieving-skin-patch-eliminates-side-effects/3206563.html
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waltky · Mar 17, 2016

CDC restricts use of opioid painkillers...

CDC issues restrictive new guidelines for opioid painkillers
March 16, 2016 - The agency said acute pain patients often require less than a week of opioid drugs, and chronic pain patients would be better helped with other forms of treatment.

The federal government issued new guidelines this week recommending doctors prescribe opioid painkillers for a week at most, and suggesting chronic pain not be treated at all with the drugs. The Center for Disease Control and Prevention is changing recommendations in an effort to curb growing rates of addiction to opioid drugs such as OxyContin and Vicodin as doctors have prescribed them more often and in greater quantities than may be best for patients. The drugs, marketed to doctors and hospitals as having low risk for addiction, have been used increasingly in the last two decades for all manner of pain. For many patients with chronic pain, or who have been prescribed the drugs for too long because of temporary conditions, addiction has become a significant problem.

In 2012, 259 million prescriptions were written for opioids, increasing 7.3 percent from 2007 to 2012, according to the CDC. From 1999 to 2014, 165,000 people died from overdoses of prescription painkillers, an increase the agency reports has mirrored the huge increase in use of the drugs during that time. Recent studies have found doctors are aware the drugs are overprescribed, but say they have to balance patients' chronic pain conditions with their potential to develop a dependence on them. In many cases, patients who have overdosed continue to receive prescriptions for opioid drugs, exacerbating the problem.

Over the last 20 years, prescriptions for opioid painkillers have increased, along with reports of abuse, addiction and overdose. New guidelines for doctors from the CDC are meant to curb the overuse of the drugs.

With a well-known litany of evidence showing the addiction problem, other research is showing far less of the drugs are needed for many patients, if the drugs are even necessary -- a study in Canada showed physical therapy patients fared better without opioid painkillers. "It's the first time the federal government has clearly communicated to the medical community that widespread and routine practice of treating long-term chronic pain with opioids is inappropriate," Dr. Andrew Kolodny, executive director of Physicians for Responsible Opioid Prescribing, told STAT.

The new guidelines, published as part of the agency's Morbidity and Mortality Weekly Report, lay out a set of recommendations meant to help doctors minimize, if not outright avoid, the use of opioid drugs for patients who do not have cancer, or require palliative or end-of-life care. Researchers at the agency reviewed clinical trials, data on prescriptions, use, and abuse of the drugs, finding most trials with the drugs lasted six weeks or less, but that patients are often on them for much longer periods of time. The data shows the longer the drugs are used, the less effective they are against pain or in helping patients recover, and long-term use significantly increases the risk for addiction.

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beth115 · Mar 28, 2016

All doctors And especially pain doctors know that pain is subjective and can not be proven or disprovened and you must relyn on the likelyhood and the statements of the patient. Pain is a fact for most post surgical including dental treatment and invasive surgery. To deny patients medicines to stop pain is inhumane. One must only stop prescribing the medication after the normal time period where the majority stop experieriencing pain. However, doctors must prescribe the lowest dosage possible to stop the pain cycle, prescribing only higher dosages where needed. And, using non addictitive pain medications first before prescribing narcoticmedications. And narcotics should o ly be prescribed for a short period of time. If and when a patient is found to be addicted to the medication they should be referee to a substance abuse program immediately.

Mr_Truth · Mar 30, 2016

I always recommend that people get tested for food allergies because that can be a source for body pain. It definitely was the case for my poor tummy - once I gave up gluten all the terrible stomach pain I've suffered for decades went away. Perhaps it can be the problem for you.

DennisTate · Apr 21, 2016

waltky said: ↑

Uncle Ferd always gets the backache whenever Granny tells him to take out the trash...

Gene find could lead to drug for chronic back pain
8 September 2011 - Lower back pain can be a chronic, lifelong condition for many people
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MSM has been used by veterinarians since the 1930's.

It was patented for humans in 1997.

www.msm-info.com/

http://www.msm-info.com/#Chronic

Chronic Pain

Perhaps the most remarkable discovery regarding MSM is that it is an effective pain killer. MSM works for many types of chronic pain. In March 1999, Stanley W. Jacob, M.D., and Ronald M. Lawrence, M.D., Ph.D., published The Miracle of MSM: The Natural Solution for Pain. Their book was based on their experience as medical doctors and MSM researchers. Dr. Jacob is the head of the DMSO Pain Clinic in Portland, OR, and a Professor at the Oregon Health Sciences University, and Dr. Lawrence was the founder of the International Association for the Study of Pain and the American Association for the Study of Headaches. Combined, they have over 20 years of experience with fighting pain with MSM. They concluded that of more than 18,000 patients that suffered from chronic pain, about 70% experienced benefits from the use of MSM, finding that pain either diminished or disappeared altogether.

The types of pain which have been treated successfully with MSM include:
Personal injury due to accidents, burns, etc.
Osteoarthritis and rheumatoid arthritis
Fibromyalgia
Lower back pains
Headaches, migraines
Muscle aches
Bursitis
Tennis elbows and other sports injuries
Carpal Syndrome
Sclerosis
Whiplash
RSI (Repititive Strain Injury)
Scars due to burns, operations, accidents, etc.
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waltky · May 15, 2016

Chronic pain is one reason people get hooked on opioids...

Nerve 'Memories' Hold Clues to Treating Chronic Pain
May 12, 2016 - With the U.S. Congress focusing on an epidemic of opioid abuse in this country, some new research is focusing on chronic pain as one of the reasons people get hooked on pain meds.

As VOA reported Wednesday, an estimated 30,000 people in the United States will die this year as a direct result of opiate abuse. The United States consumes 80 percent of the world's prescription opiates, and an estimated 100 million Americans live with pain. The U.S. Congress, in a rare show of bipartisan support, is considering all kinds of initiatives to fight the epidemic and restrict the free flow of painkillers. Meanwhile, some scientists are focusing on why our natural response to pain can persist long after an injury is fully healed.

Your nerves remember

We've all had our share of scrapes, cuts, bruises, sprained ankles and broken bones. They hurt, then they heal. The pain comes, and then it goes. Except sometimes it doesn't. Researchers from King's College London set out to answer a simple question: why does pain sometimes persist even after an injury is fully healed? "We are ultimately trying to reveal why pain can turn into a chronic condition," said Dr. Franziska Denk, an author of the study. "We already knew that chronic pain patients have nerves that are more active."

OxyContin, an opioid drug. Americans, even though comprising only five percent of the world's population, consume eighty percent of the its supply of pain medication

In those cases, the nervous system remains highly sensitive in an area of injury, causing pain that doesn't go away for weeks, months, even years. So the scientists focused on some particular immune cells in mice that previous research has shown play a role in persistent pain. What they found is that when SOME nerves are damaged something called their epigenetics change, and it stays changed. Think of the epigenetics as the nerves' "memory." In the same way a particularly bad memory can cause emotional pain long after a breakup or the loss of a loved one, epigenetics seem to keep the nerves active long after an injury has passed.

Therapy for your nerves

What the researchers don't know is why some nerves don't remember pain, and why others just can't forget. After all, nerve cells are replaced just like skin cells and blood cells. "Cells have housekeeping systems" Denk said, "... the majority of their content are replaced and renewed every few weeks and months. So why do crucial proteins keep being replaced by malfunctioning versions of themselves?" Understanding that, and finding a way to coax the nerve cells into letting go of their bad memories, could open the door to solving the problem of chronic pain, and the wave of damage, death and addiction that is its hallmark.

http://www.voanews.com/content/chronic-pain-nerve-memory/3327325.html
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See also:

US House Passes Comprehensive Bill on Painkiller Addiction
May 13, 2016 - The U.S. House of Representatives has passed a comprehensive bill on opioid abuse, a group of 18 measures designed to combat the nation's epidemic of addiction to painkillers.

The legislation takes steps to set up federal grants and a task force designed to examine pain management methods and the prescribing of pain medication. The vote to pass the measures was an overwhelming 400 to 5. Public awareness of the crisis has been heightened in the past few weeks, after the sudden death of pop star Prince, who died April 21 at age 57 after reportedly seeking treatment for painkiller addiction.

That high-profile news event, combined with the fact that many members of Congress are seeking re-election in November, means the incentive to take legislative action was high. The Senate is considering similar legislation and, in a rare bipartisan effort, both Democrats and Republicans hope to unite their efforts and give the president one comprehensive bill to sign into law.

On Thursday, the White House released a statement calling on Congress to approve $1.1 billion in new funding for drug treatment listed in President Barack Obama's budget proposal for next year. Michael Botticelli, director of the Office of National Drug Control Policy, said it is not enough to call attention to the public health crisis. He said "actual funding" is needed to prevent the misuse of opioids and increase access to treatment and recovery services.

Painkiller addiction is a uniquely American problem: While the United States represents only 5 percent of the global population, Americans consume 80 percent of the world's supply of pain medication. Opiate use in the United States has quadrupled since 1999, helped along by low cost and ease of access to opiate painkillers and a common perception among doctors that the risk of addiction was low. The issue has received major attention only in the past decade, with policymakers and health care professionals struggling to care for the 4.5 million people in the U.S. who are estimated to be addicted to prescription opiates.

http://www.voanews.com/content/us-house-passes-bill-painkiller-addiction/3329634.html
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