Can Tech 'Objectively' Assess Pain?

Some combination of data and machinery may, go the pronouncements of the tech world, do what millennia of humans have been unable to: accurately feel someone else's pain.  Full story.  

Trialing of ISS in Patients With CRPS

Brief Summary: This is a multi-center, prospective, open-label, single-arm, observational, feasibility study. The goal of this study is to determine the feasibility of intra-spinal stimulation with optimal paresthesia coverage therapy for chronic pain relief in patients with complex regional pain syndrome type I or causalgia. Up to 20 patients with intractable chronic severe limb pain associated with complex regional pain syndrome (CRPS) will be included in the study. A standard of care trial phase to test a subjects' response to Intraspinal-Optimal Stim therapy will be conducted during a 3 to 10-day period. Patients that obtain 50% or greater pain relief during the trial period will undergo permanent implantation of the device. Primary outcome will evaluate pain response at 3 months of therapy, based on NPRS pain score relative to baseline. Patients will be followed up for 6 months after the start of therapy.

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In Lab, SLU Researchers Flip Pain Switch in Spinal Cord Cells

Facing an urgent need for safer and more effective therapies for those suffering from debilitating pain, Saint Louis University researchers are on a mission to find a non-narcotic off-switch for pain.  Full story. &...
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Multiple Brain Regions Moderate and Link Depressive Mood and Pain

  Researchers at University of California San Diego School of Medicine have identified specific regions of the brain that drive, influence, and moderate depressive mood and its relationship to perceiving physical pa...
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Efficacy of Headache Treatment Using Radiofrequency Ablation

Despite the availability of therapies, many headache syndromes remain refractory to symptomatic treatment, achieving incomplete resolution of pain, and patients with chronic headaches often pursue nonpharmacologic treatm...
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Targeted Muscle Reinnervation Reduces Limb Pain After Amputation

Patients undergoing the nerve preimplantation procedure had less pain than patients undergoing conventional amputations as measured by best, current, and residual pain scores. The nerve transplant group also experienced ...
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Mayo Clinic Orthopedist Shares Perspective on Regenerative Medicine

Regenerative science has advanced next-generation technologies from the research bench to potential clinical care options. But in the rigorous development of patient therapies, it is critical to validate the safety and e...
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Oral CGRP Drug Bests Placebo for Migraine Prevention

Atogepant, an investigational oral calcitonin gene-related peptide (CGRP) receptor antagonist for migraine prevention, led to fewer monthly migraine days in episodic monthly migraine patients, results of a phase IIb/III ...
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Kailo Labs Launches the World’s First Nanotech Bio-Antenna for Pain Relief

Kailo Labs, an Utah-based nanotech startup, has launched the world's first nanotechnology-based bio-antenna for easy pain relief.  Full story.  
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Diagnosis and Management of Sensory Polyneuropathy

 Sensory polyneuropathies, which are caused by dysfunction of peripheral sensory nerve fibers, are a heterogeneous group of disorders that range from the common diabetic neuropathy to the rare sensory neuronopathies. The presenting symptoms, acuity, time course, severity, and subsequent morbidity vary and depend on the type of fiber that is affected and the underlying cause. Damage to small thinly myelinated and unmyelinated nerve fibers results in neuropathic pain, whereas damage to large myelinated sensory afferents results in proprioceptive deficits and ataxia.
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Chemist IDs Possible Addiction-Free Pain Reliever

 A naturally occurring enzyme, called diacylglycerol lipase-beta, or DAGLb, is a possible new drug target for reducing pain. Full story.  

Chronic Use of Tramadol after Acute Pain Episode: Cohort Study

To determine the risk of prolonged opioid use in patients receiving tramadol compared with other short acting opioids. Opioid-naive patients undergoing elective surgery. Risk of persistent opioid use after discharge for patients treated with tramadol alone compared with other short acting opioids, using three commonly used definitions of prolonged opioid use from the literature: additional opioid use (defined as at least one opioid fill 90-180 days after surgery); persistent opioid use (any span of opioid use starting in the 180 days after surgery and lasting ≥90 days); and CONSORT definition (an opioid use episode starting in the 180 days after surgery that spans ≥90 days and includes either ≥10 opioid fills or ≥120 days' supply of opioids).

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Hospitals Testing Virtual Reality to Improve Pain Management

Hospitals are experimenting with virtual reality to see if it can reduce pain, enhance the effect of medication, and lower the chances a patient is admitted.  Full story.  
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Remote Electrical Neuromodulation (REN) Relieves Acute Migraine: A Randomized, Double‐Blind, Placebo‐Controlled, Multicenter Trial

There is a significant unmet need for novel effective well‐tolerated acute migraine treatments. REN is a novel acute migraine treatment that stimulates upper arm peripheral nerves to induce conditioned pain modulation – ...
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New Opioid Speeds Up Recovery Without Increasing Pain Sensitivity or Risk of Chronic Pain

A novel opioid developed by researchers at Tulane University and the Southeast Louisiana Veterans Health Care System is as strong as morphine but isn't addictive and causes fewer side effects, according to a new study published in the Journal of Neuroinflammation

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Oregon Panel Drops Effort to Cut Opioids and Cover Chronic Pain

An Oregon committee has abandoned a controversial proposal that would have expanded treatment options for chronic pain patients under the Oregon Health Plan, but would have forced many to reduce dosages or discontinue pr...
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Comparative Effectiveness of Analgesics to Reduce Acute Pain in the Prehospital Setting Report

The Evidence-based Practice Center (EPC) Program at the Agency for Healthcare Research and Quality (AHRQ) has posted the draft report for the systematic review on Comparative Effectiveness of Analgesics to Reduce Acute P...
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Patient-Centered Care Is Key to Best Practices in Pain Management

Vanila M. Singh, MD MACM, Chairperson of the HHS Pain Management Inter-Agency Task Force, is interviewed about the task force's recommendations for treating acute and chronic pain. Full story.
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HHS

Multiple Cranial Nerve Blocks for the Transitional Treatment of Chronic Headaches

Multiple cranial nerve blocks of the greater and lesser occipital, supraorbital, supratrochlear and auriculotemporal nerves are widely used in the treatment of primary headaches. We present efficacy and safety data for these procedures. In an uncontrolled open-label prospective study, 119 patients with chronic cluster headache, chronic migraine, short lasting unilateral neuralgiform attack disorders, new daily persistent headaches, hemicrania continua and chronic paroxysmal hemicrania were examined.

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Predicting Whether Surgery Patients Will Continue to Refill ‘Scripts

 AAPM Resident Fellow Education SIG Co-Chair, Mark Bicket, MD , discusses his research findings published in The American Journal of Surgery , including recommendations to reduce the chance that patients will contin...
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A Look at Two Novel Pain Management Approaches

  Continuous femoral nerve block research conducted by AAPM member André P. Boezaart, MD PhD and presented during the 2019 AAPM Annual Meeting is highlighted in this review of novel pain management approaches for jo...
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Medicare Launches Initiative for Documentation Look-Up Tool

Medicare recently announced a plan to streamline the process of finding coverage and documentation requirements for applicable services. Currently, documentation requirements appear in various locations and on separate websites requiring physicians and staff to navigate multiple websites for information.

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How The Brain Shapes Pain And Links Ouch With Emotion

AAPM member Beth Darnall, PhD, contributed to this  ​National Public Radio  ​story about how physical pain can interact with different brain areas to ultimately impact emotions, feelings, and behaviors. "For pe...
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Oregon Panel Drops Effort to Cut Opioids and Cover Chronic Pain

An Oregon committee has abandoned a controversial proposal that would have expanded treatment options for chronic pain patients under the Oregon Health Plan, but would have forced many to reduce dosages or discontinue prescription opioids. 

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Researchers are Testing Ultrasound to Treat Neuropathic Pain

Steroid injections, nerve stimulators and spinal fusions were no match for the chronic pain in Tammy Durfee's left side. After a decade searching for relief, a four-hour procedure using focused ultrasound put her pain to rest.

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Virtual Reality as Therapy for Pain

Virtual Reality Therapy is the new kid on the block for pain management, now gradually growing in use as the opioid epidemic continues to soar and the price of the needed equipment has plummeted. 

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Using Mind Over Matter to Help Treat Chronic Pain

Researchers analyzed 21 randomized studies focusing on the effect of either cognitive behavioral therapy (CBT), to redirect pain-related thoughts and behaviors, or mindfulness-based stress reduction (MBSR), combining yoga and meditation to build awareness and acceptance of moment-to-moment experiences (including pain).

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The Effectiveness of Hypnosis for Pain Relief: A Systematic Review and Meta-Analysis of 85 Controlled Experimental Trials

The current meta-analysis aimed to quantify the effectiveness of hypnosis for reducing pain and identify factors that influence efficacy. Six major databases were systematically searched for trials comparing hypnotic inductions with no-intervention control conditions on pain ratings, threshold and tolerance using experimentally-evoked pain models in healthy participants. Random effects meta-analysis found analgesic effects of hypnosis for all pain outcomes.

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App-Based Multidisciplinary Back Pain Treatment Versus Combined Physiotherapy Plus Online Education: a Randomized Controlled Trial

Non-specific low back pain (LBP) is one of the leading causes of global disability. Multidisciplinary pain treatment (MPT) programs comprising educational, physical, and psychological interventions have shown positive treatment effects on LBP. Nonetheless, such programs are costly and treatment opportunities are often limited to specialized medical centers. mHealth and other digital interventions may be a promising method to successfully support patient self-management in LBP. To address these issues, we investigated the clinical effects of a multidisciplinary mHealth back pain App (Kaia App) in a randomized controlled trial (registered at German Clinical Trials Register under DRKS00016329).

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Biomarker for Chronic Fatigue Syndrome Identified by Stanford Researchers

People suffering from a debilitating disease known as chronic fatigue syndrome may soon have something they've been seeking for decades: scientific proof of their ailment. Researchers at the Stanford University School of Medicine have created a blood test that can flag the disease, which currently lacks a standard, reliable diagnostic test.

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The Case for Early Physical Therapy

Early use of physical therapy may be a promising non-pharmacologic strategy for patients with musculoskeletal pain. 

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Prehospital Analgesia With Intranasal Ketamine (PAIN-K): A Randomized Double-Blind Trial in Adults

We compare intranasal ketamine with intranasal placebo in providing pain reduction at 30 minutes when added to usual paramedic care with nitrous oxide. Methods: This was a randomized double-blind study of out-of-hospital patients with acute pain who reported a verbal numeric rating scale (VNRS) pain score greater than or equal to 5. Exclusion criteria were younger than 18 years, known ketamine intolerance, nontraumatic chest pain, altered mental status, pregnancy, and nasal occlusion. Patients received usual paramedic care and were randomized to receive either intranasal ketamine or intranasal saline solution at 0.75 mg/kg.

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The Role of Nonpharmacological Approaches to Pain Management: Proceedings of a Workshop

The Forum on Neuroscience and Nervous System Disorders and Global Forum on Innovation in Health Professional Education hosted a public workshop that discussed the state of evidence on the effectiveness of nonpharmacological treatments and integrative health models for pain management, multimodal approaches, and research gaps and key questions for further research. 

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Emotional Mirror Neurons in the Rat's Anterior Cingulate Cortex

How do the emotions of others affect us? The human anterior cingulate cortex (ACC) responds while experiencing pain in the self and witnessing pain in others, but the underlying cellular mechanisms remain poorly understood. Here we show the rat ACC (area 24) contains neurons responding when a rat experiences pain as triggered by a laser and while witnessing another rat receive footshocks. Most of these neurons do not respond to a fear-conditioned sound (CS).
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To Treat Pain Syndrome, Children's Mercy Doctors Try To Change How 'Brain Interprets Signals'

Hospital program offers intensive physical and occupational therapy, relaxation techniques, stress-management training, and music and therapeutic art to help manage Amplified Pain Syndrome.

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Real Pain Relief, Now!

AAPM members Beth Darnall, PhD and David J. Tauben, MD are interviewed in this Consumer Reports article that explores the latest research on supplements, exercise, sleep, and more.
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Assessing Study Quality and Bias in Prognosis Research on Rehabilitation in Chronic Pain Using the QUIPS Tool

Researchers performed a systematic review to synthesize evidence on prognostic factors for physical functioning after multidisciplinary rehabilitation in patients with chronic musculoskeletal pain and used a tool, QUIPS, which was developed specifically for evaluation of study quality of prognostic studies.

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'Alexa, I’m in pain': Tool Delivers Mindfulness-Based Techniques to Chronic Pain Sufferers

Researchers at Penn State are developing a way to deliver on-demand, guided mindfulness practices via Amazon Alexa to patients experiencing chronic pain. Through their method, a smart assistant will provide Mindfulness-Based Stress Reduction (MBSR) practices to individuals in their homes. 

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Anterior Nucleus of Paraventricular Thalamus Mediates Chronic Mechanical Hyperalgesia

Pain-related diseases are the top leading causes of life disability. Identifying brain regions involved in persistent neuronal changes will provide new insights for developing efficient chronic pain treatment. Here, we showed that anterior nucleus of paraventricular thalamus (PVA) plays an essential role in the development of mechanical hyperalgesia in neuropathic and inflammatory pain models in mice.  

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AAMC Statement on House Bill to Support New Residency Positions, Including for Pain Management

Association of American Medical Colleges President and CEO Darrell G. Kirch, MD, issued a statement about the Opioid Workforce Act of 2019 (H.R. 2439), which was introduced in the U.S. House of Representatives and would support new addiction medicine, addiction psychiatry, or pain management residency positions. 

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FDA Announces Public Meeting to Discuss Safety and Utility of Higher-Dose Opioid Analgesics

FDA is seeking public input on the clinical utility and safety concerns associated with the higher range of opioid analgesic dosing (both in terms of higher strength products and higher daily doses) in the outpatient set...
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AMA Webinar: Thriving in Practice - Staywell Performance Story

Register here for a webinar on May 22 at 12 pm CT to hear a long-time physician share her practice's journey through the phases of transformation and how both the struggles and the triumphs have prepared the practice tea...
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Internet-Based Pain Coping Skills Training for Patients With Lupus

Background and Significance: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that impacts multiple organ systems. SLE results in a variety of challenging symptoms, including flare-ups and periods of remission that are unpredictable, and it is a complex disease to manage clinically. Because of these factors, SLE often has a major impact on patients' quality of life. Notably, SLE is often associated with pain, fatigue, emotional symptoms like anxiety and depression, and disability. Because of the relatively young average age of SLE onset, many patients must navigate these challenges while maintaining work and / or caring for young children.
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Prospective Data Demonstrates Effective Pain Relief and Improved Function Using Medtronic's Evolve(SM) Workflow with Spinal Cord Stimulation

Medtronic today announced primary endpoint (3-month) results of the Vectors Post Market Clinical Study that demonstrated effective pain relief and improved function in patients with chronic intractable back and leg pain treated with spinal cord stimulation (SCS) utilizing the EvolveSM workflow

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SCS

E/M Services and Procedures on the Same Day: When Can You Report Both?

According to CPT, both an Evaluation and Management (E/M) service and a procedure code can be reported if the patient's condition requires a significant, separately identifiable E/M service. "Significant" implies that th...
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FDA MedWatch Safety Alert: Ketorolac Tromethamine Injection by Sagent Pharmaceuticals: Recall - Due to Lack of Sterility Assurance

Sagent Pharmaceuticals, announced the voluntary nationwide recall of Lot Number M813513 of Ketorolac Tromethamine Injection, USP, 60mg/2mL (30mg per mL). This product was manufactured by Zydus (Cadila Healthcare Limited) and distributed by Sagent Pharmaceuticals, Inc. Sagent has initiated this voluntary recall of Ketorolac Tromethamine Injection, USP to the to the user level due to microbial growth detected during a routine simulation of the manufacturing process, which represents the potential introduction of microorganisms into the products.  

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AAPM Acute Pain Medicine Textbook Now Available

Place your order for the Academy's latest textbook publication, Acute Pain Medicine , which covers the diagnosis and treatment of acute pain from both surgical and non-surgical causes. Pain syndromes are reviewed in a ca...
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CDC Addresses Concerns Raised in AAPM Foundation Consensus Panel Report on the Challenges of Implementing the CDC Guideline

Earlier this year, a consensus panel report addressing the challenges of implementing the CDC Guideline for Prescribing Opioids for Chronic Pain was published in Pain Medicine . The report, authored by a multidisciplinar...
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FDA MedWatch Safety Alert: Fentanyl Transdermal System by Alvogen - Recall: Due to Product Mislabeling

 Alvogen, Inc. is voluntarily recalling two lots of Fentanyl Transdermal System 12 mcg/h transdermal patches to the consumer level. A small number of cartons labeled 12 mcg/h Fentanyl Transdermal System patches contained 50 mcg/h patches. The 50 mcg/h patches that were included in cartons labeled 12 mcg/h are individually labeled as 50 mcg/h.
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New Chronic Pain Treatments Help the Whole Person

AAPM President Tim Lamer, MD contributed to this ​HealthyWomen article about the benefits of multidisciplinary chronic pain treatment, saying "It's more of a patient-centered, goal-oriented, holistic approach."

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