Personally I believe there is much truth to this. Have found that a combination of Tai Chi,
swimming, and working out at the gym works for me.
“Prescription drugs are a $425 billion business in the United States, and growing. A good chunk of that goes towards prescription pain medication to help alleviate chronic pain. More than 25 million of us report having daily chronic pain, and 23 million say they’re in a lot of pain, according to a study from The National Institutes of Health.
About one in five adults are prescribed opioids to manage chronic pain says the CDC. We all know about the high rate of substance use disorder in the U.S., and while opioids certainly have a place, especially for managing acute pain, they’re not an ideal long-term option.
So what can we do to help people with persistent pain?
Wayne Jonas, M.D., former head of the NIH Office of Alternative Medicine and a practicing family physician, said we should be looking at alternative and complementary options, like acupuncture, yoga, meditation and other less traditional approaches. In his new book, How Healing Works, he advocates an integrative approach, combining elements of Western and complementary medicine into a person-centered health plan. He believes this will significantly reduce our national dependence on prescription drugs, lower health costs, and improve patients’ quality of life.”
Summary:Researchers have found little to no evidence for the effectiveness of opioid drugs in the treatment of long-term chronic pain, despite the explosive recent growth in the use of the drugs.
“I can’t tell you the number of women I see who have been told they just have to live with the pain,” Dr. Thomas said. “It’s just heart breaking because many of these women have been suffering a long time. Women, especially older women, are less likely to speak up and seek treatment for their pain.”
Credit: Image courtesy of American Society of Anesthesiologists (ASA)
Despite the variety of effective treatments, and physicians who specialize in treating pain, women often suffer unnecessarily from conditions ranging from backaches to pain after cancer surgery, and also treat their pain with medications that may be ineffective and possibly harmful, according to a review of research related to women and pain by the American Society of Anesthesiologists® (ASA®).
ASA conducted the literature review and issued the Women’s Pain Update to help raise awareness of the many options available to women for controlling both acute and chronic pain, and how a pain medicine specialist can help them choose the right treatment. Among other things, the studies showed that remedies such as music, yoga and rose oil are proven effective for several types of pain, that opioids are often used inappropriately, and that the type of anesthesia used during breast cancer surgery can affect how quickly and comfortably a woman recovers from the operation.
Physician anesthesiologists are doctors who focus on anesthesia and critical care medicine and are among the medical specialists who are experts in the subspecialty of pain medicine, seeing patients in private practices and pain clinics.
Donna-Ann Thomas, M.D., a member of ASA’s Committee on Pain Medicine, frequently sees women who have been suffering in silence for years, with conditions such as a type of back pain that can develop after childbirth, and chronic pain after breast cancer surgery.
“I can’t tell you the number of women I see who have been told they just have to live with the pain,” Dr. Thomas said of women who come to her with sciatica, a type of back pain that radiates down the leg. “It’s just heart breaking because many of these women have been suffering a long time. Women, especially older women, are less likely to speak up and seek treatment for their pain.”
39 million people in the United States, or 19 percent have persistent pain, and the incidence varies according to age and gender, a new study reports. The authors noted that persistent pain correlated with other indices of health-related quality of life, such as anxiety, depression and fatigue. Individuals with those conditions were far more likely to report persistent pain.
Excerpt from the news story:
n 2011, the Institute of Medicine reported that 100 million Americans have chronic pain. The authors explained that the disparity between the estimated pain incidence in their study and what the IOM reported is attributable almost entirely to differences in operational definitions of persistent pain.
In the 2010 NHIS, an estimated 60 percent of adults reported lower back pain in the past three months, and all of them would have been described in the IOM report as having chronic pain. However, only 42 percent of the NHIS study respondents with back pain described their pain as frequent or daily and lasting more than three months.
From a public health perspective the difference is significant. Those with persistent pain have high rates of work disability, fatigue, anxiety and depression. They also are at higher risk for long-term exposure to and dependency on pain medications.
The authors concluded that measuring pain persistence has policy implications because persistent pain is an indicator of an unmet medical need for pain management in the general population, as well as a risk factor for anxiety and depression.
Many military personnel and veterans experience chronic pain, a condition that can be debilitating and is often difficult to treat. Post-traumatic stress, traumatic brain injury, depression, and substance use are other conditions that tend to co-occur in these same service members and are also challenging to treat. Opioid medications are often prescribed for chronic pain conditions, but use and misuse of opioids resulting in hospitalizations and death has been on the rise. A study published in the journal JAMA Internal Medicine examined the prevalence of chronic pain and opioid use among U.S. soldiers following deployment. The researchers found that of the more than 2,500 participants surveyed, 44 percent had chronic pain and 15 percent regularly used opioids—rates much higher than the general population.
Many military, veterans, and their families turn to complementary and integrative health approaches such as mindfulness meditation and other practices in an effort to enhance the options for the management of pain and associated problems. This page provides resources and information on health conditions of special concern to military, veterans, and their families and the complementary and integrative health practices being studied for this population.
A new research review from AHRQ’s Effective Health Care Program found that while the evidence on the effectiveness and harms of opioid therapy for chronic pain treatment is limited, there is an increased risk of serious harms based on the opioid dose given. The research review assesses observational studies that suggest that use of long-term opioids for chronic pain is associated with increased risk of abuse, overdose, fractures and heart attack, when compared with patients who are not being prescribed opioids. The review noted that more research is needed to understand the long-term benefits, risk of abuse and related outcomes, and effectiveness of different opioid prescribing methods and strategies. The review is titled, “The Effectiveness and Risks of Long-Term Opioid Treatment of Chronic Pain.” AHRQ has also released a statistical brief from the Healthcare Cost and Utilization Project titled, “Hospital Inpatient Utilization Related to Opioid Overuse Among Adults, 1993-2012.” According to the brief, hospitalization rates for opioid overuse more than doubled from 1993 to 2012 and increased at a faster rate for people age 45 and older. In addition, AHRQ Director Rick Kronick, Ph.D., has published a blog about opioids.
Chronic pain syndrome is an extremely complicated diagnosis and the treatment of its symptoms requires an interdisciplinary approach ranging from primary care physicians, physical therapists, anesthesiologists, and psychologists. Likewise, understanding the barriers to the treatment of chronic pain requires teasing out a similarly convoluted picture. Therefore, I’ve decided to write about the extremely complex and understudied relationship between poverty and pain. Not surprisingly, there are many components to this relationship because the American health care system is one that involves many players from the government, private sector, non-profits, and Medicare, Medicaid, TRICARE, Children’s Health Insurance Program, Social Security Administration, and the Veteran’s Administration, just to name a few. However my focus will be narrowed to concentrate on the relationship between living in poverty and efficacious treatment of chronic pain, the flip side of that relationship where individuals fall into poverty as a result of a life-altering, limiting, and costly diagnosis of chronic pain, and the stigma of poverty that consciously or unconsciously affects access to treatment for patients in pain.
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Living in poverty increases an individual’s risk for pain on almost every level including musculoskeletal, sciatica, ulcer, and neuropathic. Poleshuck and Green suggest that an individual’s socioeconomic status permeates almost every level of why an individual may suffer with chronic pain including the ability to implement positive coping strategies, job type and satisfaction, access to quality health insurance, and even social support and interpersonal relationships.
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too often research on chronic pain is conducted in areas that have significant financial resources instead of places such as churches, homeless shelters, and community centers. There are other things to consider here. People that live in poverty and suffer from pain may not have access to primary care givers, analgesics or pharmacies that carry analgesics, and pain specialists. As the U.S. population ages and increasingly more people are diagnosed with pain disorders, those on the fringe will suffer most. Of course, there is a moral argument to be made here but there is an economic one too. According to an article that came out in Science Daily in 2012, health economists at Johns Hopkins estimated that chronic pain cost as much as $635 billion a year which they found was higher than heart disease, diabetes, and cancer. This was a conservative estimate. Therefore, one could argue that it is a public health interest to employ strategies of risk management, access, and multidisciplinary approaches to pain to vulnerable groups who suffer disabling pain at a higher number and magnitude.
One way to address the growing heroin epidemic? Address lifestyle and environment components.
Certainly would be a public health way to stem folks dependence on substances that can often diminish quality of life and death.
Researchers have discovered that sensitivity to pain could be altered by a person’s lifestyle and environment throughout their lifetime. The study is the first to find that pain sensitivity, previously thought to be relatively inflexible, can change as a result of genes being switched on or off by lifestyle and environmental factors — a process called epigenetics, which chemically alters the expression of genes.
We were standing at Target in an aisle we’d never walked down before, looking at things we didn’t understand. Pill splitters, multivitamins, supplements, and the thing we were here to buy: a long blue pill box—the kind with seven little doors labeled “S M T W T F S “ for each day of the week, the kind that old people cram their pills into when they have too many to remember what they’ve already taken.
My husband, Joe Preston, shook his head. “Do I really need this?”
I grabbed it off the shelf and threw it in our basket. And when we got home, Joe—then a fit and fairly spry 30-year-old man with a boss-level beard—stood at the kitchen counter, dropping each of his prescriptions with a plink into the container.
I guess it’s true that life is full of surprises, but for the three years since Joe’s crippling pain was diagnosed as the result of an autoimmune disease called Ankylosing Spondylitis, our life has been full of surprises like this one. Pill boxes, trips to the emergency room, early returns from vacation. Terms like “flare-up” have dropped into our vocabulary. We’ve sat in waiting rooms where Joe was the only person without a walker or a cane. Most of our tears have been over the fact that these aren’t the kind of surprises either of us thought we’d be encountering at such a young age.
But here’s the thing: We recently realized we weren’t alone. Almost all of our friends are sick, too. When we met our friend Missy Narrance, Joe found solace in talking to her about his health. She’s 29 and has been battling lupus and fibromyalgia for the past 10 years. She’s been through chemotherapy twice, and her daily symptoms are so extreme that she was granted federal disability status when she was just 23 years old. In our close group of friends—who range from 25 to 35 years old—we know people with everything from tumors to chronic pain. Sometimes our conversations over beers on a Friday night turn to discussions of long-term care and miscommunication between doctors.
The rest of the article includes analysis on how personal choices must be backed up by facts. It points out that research has been done on how infrastructural changes (which need tax dollars) can improve public health. But there has to be political will.
Research on these aspects of public health have not been widely disseminated by the press.
Finding it easy to empathize with these patients because of a short term musculoskeletal condition.
Hoping that health care providers will be able to find ways to treat all who experience this chronic condition without interference from the government.
People who suffer with chronic musculoskeletal pain face a daily struggle with their sense of self and find it difficult to prove the legitimacy of their condition.
A new study, funded by the National Institute for Health Research Health Services and Delivery Research (HS&DR) Programme, systematically searches for, and makes sense of, the growing body of qualitative research on musculoskeletal pain to help understand the experiences of patients suffering from chronic pain.
A number of concerning themes arose from the study, published today in the Health Services and Delivery Research journal, which highlighted:
Patients struggling with the fundamental relationship with their body, and a sense that it is no longer ‘the real me’.
A loss of certainty for the future, and being constantly aware of the restrictions of their body.
Feeling lost in the health care system; feeling as though there is no answer to their pain.
Finding it impossible to ‘prove’ their pain; “if I appear ‘too sick’ or ‘not sick enough’ then no one will believe me”
Kate Seers, Professor of Health Research at Warwick Medical School and Director of the Royal College of Nursing Research Institute, was a collaborator on this study. She explains, “Being able to collate this vast amount of information from patients paints a worrying picture about the experiences they have with chronic non-malignant pain. Our goal has to be to use this information to improve our understanding of their condition and, consequently, the quality of care we can provide.”
“Having patients feel that they have to legitimise their pain, and the sense that doctors might not believe them, is something that should really concern us as health care professionals.”
The study also identified a number of ways in which patients can move forward with their lives.
The key for some people appears to be building a new relationship with the body and redefining what is ‘normal’, rather than trying to maintain the lifestyle before the pain. Developing an understanding of what the body is capable of and becoming confident to make choices can aid the process of living with musculoskeletal pain.
Dr Francine Toye, of Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, explains, “This paper shows there can be value in discussing the condition with other people who are going through the same experience and knowing that you are not alone. Of course you can learn about your condition from various sources, but sharing your experience seems to really help people to move forward.”
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77 studies of chronic musculoskeletal pain were included in the meta-ethnography, with collaborators from Nuffield Orthopaedic Centre, the University of Warwick, Glasgow Caledonian University, Leeds Metropolitan University, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences and the University of Calgary.
Torture permanently damages normal perception of pain
Tel Aviv University researchers study the long-term effects of torture on the human pain system
Israeli soldiers captured during the 1973 Yom Kippur War were subjected to brutal torture in Egypt and Syria. Held alone in tiny, filthy spaces for weeks or months, sometimes handcuffed and blindfolded, they suffered severe beatings, burns, electric shocks, starvation, and worse. And rather than receiving treatment, additional torture was inflicted on existing wounds.
Forty years later, research by Prof. Ruth Defrin of the Department of Physical Therapy in the Sackler Faculty of Medicine at Tel Aviv University shows that the ex-prisoners of war (POWs), continue to suffer from dysfunctional pain perception and regulation, likely as a result of their torture. The study — conducted in collaboration with Prof. Zahava Solomon and Prof. Karni Ginzburg of TAU’s Bob Shapell School of Social Work and Prof. Mario Mikulincer of the School of Psychology at the Interdisciplinary Center, Herzliya — was published in the European Journal of Pain.
“The human body’s pain system can either inhibit or excite pain. It’s two sides of the same coin,” says Prof. Defrin. “Usually, when it does more of one, it does less of the other. But in Israeli ex-POWs, torture appears to have caused dysfunction in both directions. Our findings emphasize that tissue damage can have long-term systemic effects and needs to be treated immediately.”
A painful legacy
The study focused on 104 combat veterans of the Yom Kippur War. Sixty of the men were taken prisoner during the war, and 44 of them were not. In the study, all were put through a battery of psychophysical pain tests — applying a heating device to one arm, submerging the other arm in a hot water bath, and pressing a nylon fiber into a middle finger. They also filled out psychological questionnaires.
The ex-POWs exhibited diminished pain inhibition (the degree to which the body eases one pain in response to another) and heightened pain excitation (the degree to which repeated exposure to the same sensation heightens the resulting pain). Based on these novel findings, the researchers conclude that the torture survivors’ bodies now regulate pain in a dysfunctional way.
It is not entirely clear whether the dysfunction is the result of years of chronic pain or of the original torture itself. But the ex-POWs exhibited worse pain regulation than the non-POW chronic pain sufferers in the study. And a statistical analysis of the test data also suggested that being tortured had a direct effect on their ability to regulate pain.
Head games
The researchers say non-physical torture may have also contributed to the ex-POWs’ chronic pain. Among other forms of oppression and humiliation, the ex-POWs were not allowed to use the toilet, cursed at and threatened, told demoralizing misinformation about their loved ones, and exposed to mock executions. In the later stages of captivity, most of the POWs were transferred to a group cell, where social isolation was replaced by intense friction, crowding, and loss of privacy.
“We think psychological torture also affects the physiological pain system,” says Prof. Defrin. “We still have to fully analyze the data, but preliminary analysis suggests there is a connection.”
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American Friends of Tel Aviv University supports Israel’s leading, most comprehensive and most sought-after center of higher learning, Tel Aviv University (TAU). Rooted in a pan-disciplinary approach to education, TAU is internationally recognized for the scope and groundbreaking nature of its research and scholarship — attracting world-class faculty and consistently producing cutting-edge work with profound implications for the future. TAU is independently ranked 116th among the world’s top universities and #1 in Israel. It joins a handful of elite international universities that rank among the best producers of successful startups.
An integrative approach to treating chronic pain significantly reduces pain severity while improving mood and quality of life, according to a new study from the Bravewell Practice-Based Research Network (BraveNet) published last month in BioMed Central Complementary and Alternative Medicine journal. Researchers found a reduction in pain severity of more than 20 percent and a drop in pain interference of nearly 30 percent in patients after 24 weeks of integrative care. Significant improvements in mood, stress, quality of life, fatigue, sleep and well-being were also observed.
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In keeping with the integrative medicine philosophy of individualized, patient-centered care, no standardized pre-specified clinical intervention for chronic pain was prescribed for all study participants. Instead, practitioners at each of the network sites devised integrative treatment plans for participating chronic pain patients. All BraveNet sites include integrative physicians, acupuncturists, mindfulness instructors, and yoga instructors; some also incorporate massage therapists, manual medicine therapists, fitness/movement specialists, dietician/nutritionists, psychologists, healing touch therapists, and other energy practitioners.
Physicians and patients who are wary of addiction to pain medication and opioids may soon have a healthier and more natural alternative.A Duke University study revealed that a derivative of DHA (docosahexaenoic acid), a main ingredient of over-the-counter fish oil supplements, can sooth and prevent neuropathic pain caused by injuries to the sensory system. The results appear online in theAnnals of Neurology….…
Their findings revealed that NPD1=PD1 not only alleviated the pain, but also reduced nerve swelling following the injuries. Its analgesic effect stems from the compound’s ability to inhibit the production of cytokines and chemokines, which are small signaling molecules that attract inflammatory macrophages to the nerve cells. By preventing cytokine and chemokine production, the compound protected nerve cells from further damage. NPD1=PD1 also reduced neuron firing so the injured animals felt less pain.Ji believes that the new discovery has clinical potential. “Chronic pain resulting from major medical procedures such as amputation, chest and breast surgery is a serious problem,” he said. Current treatment options for neuropathic pain include gabapentin and various opioids, which may lead to addiction and destruction of the sensory nerves.
This image, from a Brigham and Women’s Hospital study, shows the Default Mode Network in patients with chronic low back pain (cLBP) and in healthy subjects (CONTROLS) before and after maneuvers which are painful for the cLBP but not for the CONTROLS. Notice that after the maneuvers, the cluster in the front of the brain is disrupted (it shows less color) in the cLBP patients, but not in the CONTROLS. This supports the study finding that pain changes brain connectivity. (Credit: Brigham and Women’s Hospital)
Dec. 20, 2012 — More than 100 million Americans suffer from chronic pain. But treating and studying chronic pain is complex and presents many challenges. Scientists have long searched for a method to objectively measure pain and a new study from Brigham and Women’s Hospital advances that effort. The study appears in the January 2013 print edition of the journal Pain.
“While we need to be cautious in the interpretation of our results, this has the potential to be an exciting discovery for anyone who suffers from chronic pain,” said Marco Loggia, PhD, the lead author of the study and a researcher in the Pain Management Center at BWH and the Department of Radiology at Massachusetts General Hospital. “We showed that specific brain patterns appear to track the severity of pain reported by patients, and can predict who is more likely to experience a worsening of chronic back pain while performing maneuvers designed to induce pain. If further research shows this metric is reliable, this is a step toward developing an objective scale for measuring pain in humans.”
Millions of Americans suffer from pain that is chronic, severe, and not easily managed. Pain from arthritis, back problems, other musculoskeletal conditions, and headache costs U.S. businesses more than $61 billion a year in lost worker productivity.
Pain is the most common health problem for which adults use complementary health practices. Many people with conditions causing chronic pain turn to these practices to supplement other conventional medical treatment, or when their pain is resistant or in an effort to advert side effects of medications. Despite the widespread use of complementary health practices for chronic pain, scientific evidence on efficacy and mechanisms—whether the therapies help the conditions for which they are used and, if so, how—is, for the most part, limited. However, the evidence base is growing, especially for several complementary health practices most commonly used by people to lessen pain.
Children who suffer from persistent or recurring chronic pain may miss school, withdraw from social activities, and are at risk of developing internalizing symptoms such as anxiety, in response to their pain. In the first comprehensive review of chronic pain in children and adolescents in 20 years, a group of researchers found that more children now are suffering from chronic pain and that girls suffer more frequently from chronic pain than boys.
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Their findings indicate that most types of pain are more prevalent in girls than in boys, but the factors that influence this gender difference are not entirely clear. Pain prevalence rates tend to increase with age. Psychosocial variables impacting pain prevalence included anxiety, depression, low self-esteem, and low socioeconomic status. Headache was found to be the most common studied pain type in youth, with an estimated prevalence rate of 23%. Other types of pain, ie, abdominal pain, back pain, musculoskeletal pain, and pain combinations, were less frequently studied than headache, and prevalence rates were variable because of differences in reporting. However, the overall results indicated that these pain types are highly prevalent in children and adolescents, with median prevalence rates ranging from 11% to 38%. “These rates are of great concern, but what is even more concerning is that research suggests that the prevalence rates of childhood pain have increased over the last several decades,” stated Dr. King.
Researchers also found that many studies did not meet quality criteria and there was great variability in prevalence rates across studies due to time periods over which pain was reported……
Pain care management needs to be improved, with health care professionals committing to improve care as well as a retooling of the health care system to help people who are suffering, states an editorial in CMAJ (Canadian Medical Association Journal) (pre-embargo link only) http://www.cmaj.ca/site/embargo/cmaj111065.pdf.
According to a recent analysis, chronic pain affects people of all ages, with an estimated 500,000 Canadians aged 12 to 44 years, 38% of seniors in long-term care institutions and 27% of seniors living at home experiencing regular pain.
“Experts agree that much can be done now with newer analgesics, nonpharmacologic techniques such as nerve blocks and physical therapies, as well as spiritual and supportive care,” write Drs. Noni MacDonald, Ken Flegel, Paul Hébert and Matthew Stanbrook. “Availability of quality care for pain is the major problem. Health professionals have not mounted a response commensurate with the magnitude of the problem.”
The authors argue for a broad strategy to help increase pain management expertise, including education, technology, and supported self-care and lay coaching.
All over the world, patients with chronic pain struggle to express how they feel to the doctors and health-care providers who are trying to understand and treat them.
Now, a University at Buffalo psychiatrist is attempting to help patients suffering from chronic pain and their doctors by drawing on ontology, the branch of philosophy concerned with the nature of being or existence.
The research will be discussed during a tutorial he will give at the International Conference on Biomedical Ontology, sponsored by UB, that will be held in Buffalo July 26-30.
“Pain research is very difficult because nothing allows the physician to see the patient’s pain directly,” says Werner Ceusters, MD, professor of psychiatry in UB’s School of Medicine and Biomedical Sciences, and principal investigator on a new National Institutes of Health grant, An Ontology for Pain and Related Disability, Mental Health and Quality of Life.
“The patient has to describe what he or she is feeling.”
This blog presents a sampling of health and medical news and resources for all. Selected articles and resources will hopefully be of general interest but will also encourage further reading through posted references and other links. Currently I am focusing on public health, basic and applied research and very broadly on disease and healthy lifestyle topics.
Several times a month I will post items on international and global health issues. My Peace Corps Liberia experience (1980-81) has formed me as a global citizen in many ways and has challenged me to think of health and other topics in a more holistic manner.
Do you have an informational question in the health/medical area? Email me at jmflahiff@yahoo.com I will reply within 48 hours.
My professional work experience and education includes over 15 years experience as a medical librarian and a Master’s in Library Science. In my most recent position I enjoyed contributing to our library’s blog, performing in depth literature searches, and collaborating with faculty, staff, students, and the general public.
While I will never be be able to keep up with the universe of current health/medical news, I subscribe to the following to glean entries for this blog.
“Prescription drugs are a $425 billion business in the United States, and growing. A good chunk of that goes towards prescription pain medication to help alleviate chronic pain. More than 25 million of us report having daily chronic pain, and 23 million say they’re in a lot of pain, according to a study from The National Institutes of Health.
http://www.cdc.gov/media/releases/2014/p0303-prescription-opioids.html
Health and Medical News and Resources 
