Wondering what’s new in the world of pain management medicine? Every issue of Pain Solutions magazine has a section called RxWatch where we aggregate the most useful and newsworthy pain treatment research.

Here is a sampling of what RxWatch uncovers. For more pain management news and tips, look for the Fall 2010 issue of Pain Solutions magazine to hit newsstands in early November.

In April the Food and Drug Administration approved a new version of OxyContin specifically designed to prevent overdose or abuse. OxyContin is ideal for people who need moderate to severe pain relief for an extended period of time because of its controlled-release properties. The new version is formulated to resist cutting, dissolving or otherwise tampering with the medication.

The antidepressant Cymbalta may be effective in treating low back pain, according to a February study presented at the annual meeting of the American Academy of Pain Medicine. Participants who took 60 milligrams of the drug daily reported significantly less back pain than those who took a placebo.

Researchers at the Henry Ford Hospital in Detroit may have found a new treatment for osteoarthritis pain and inflammation: Patients who wrapped their knee in a portable device that sends out electromagnetic pulses for 15 minutes twice a day felt 40 percent less pain.

Patients who suffer from migraines accompanied by the numbness and tingling effect known as aura may be able to treat themselves at home using a handheld device, according to a study published in the April edition of the Lancet Neurology. The device, which can already be found in some doctors’ offices, produces magnetic stimulation and brought lasting migraine relief to 39 percent of patients who participated in the study.

Researched by Allie Nicodemo

April 14, 2010

With tax day looming tomorrow, many of us know too well the stress of racing to get the forms filled out and into the mailbox by midnight. Some will know, too, the painful writing of a check to the IRS. I fell into the latter camp this year and I was none too happy sending off my check last Friday.

If you’ve been dealing with pain for a while, you likely already know, too, about the significant link between tension and chronic pain – it’s one we covered in the premiere issue of Pain Solutions last fall. (To read that story, click here.) It’s one that’s worth reminding ourselves of, though, because stress is something we can control to a large extent. No, it’ll never go away completely (and it shouldn’t), but there’s a lot you can do to keep it from making your pain worse.

A recent Swedish study found that “relaxation in large, sound- and light-proof tanks with high-salt water ­floating ­is an effective way to alleviate long-term stress-related pain.” Participants in the study who floated in the tanks for 12 sessions saw improvements in sleep, anxiety and depression and their perception of pain, such as with fibromyalgia, decreased. “Relaxing in a weightless state in the silent, warm floating tank activates the body's own system for recuperation and healing. The stress hormone decreases, as does blood pressure,” says Sven-Ake Bood, author of a dissertation looking at four studies evaluating the use of a floating tank in easing pain and stress-related conditions.

According to a report on Medicalnewstoday.com, “After a period of treatment lasting a total of seven weeks, 22 percent of the participants in the floating group were entirely free of pain, and 56 experienced a clear improvement. Nineteen percent felt no change and 3 percent felt worse.”

If you don’t have access to a floating tank (your bathtub is a good place to start), try this simple mindfulness meditation from leading teacher and author Sharon Salzberg:

Sit in a comfortable position or lie down, eyes open or closed, and let your attention settle on your normal breath. Don’t make your breathing deeper or change it in any way. Now rest your attention gently on whatever part of your body you feel your breathing most clearly, whether it’s in your nostrils or in the rise and fall of your chest or belly. If you like, you can silently repeat “in” and “out,” but keep your attention on what the breath feels like. If a thought or pain pulls your attention away, see if you can simply observe the feeling without emotions like anger or frustration. Then gently bring your attention back to your breath. Practice this meditation for about 10 minutes each day and work up to 20 minutes. Add extra sessions when you feel more pain or difficulty; this will help foster calm awareness and compassion for yourself.

I’d love to hear how you deal with stress—what helps you put the kibosh on tension? What can help you relax at a moment’s notice?

April 7, 2010

A fascinating study came out this week online in the journal Rheumatology, from data following over 18,000 British children born in 1958 and tracked through childhood. The findings? Kids who had lasting behavior problems at ages seven, 11 and 16 had more than twice the risk of widespread chronic pain by the time they reached 45, said a report at MedPageToday.com. Childhood behavior problems included destructiveness, excessive worry, nail-biting, truancy and restlessness, according to the report, which continued, “Previous research has shown that chronic widespread pain in middle-age patients is related to adult behavioral and emotional factors, and also to adverse events in childhood such as separation from mothers. This study has further demonstrated that maladaptive or maladjusted behavior in early life—particularly when persistent—is associated with chronic pain in middle age.”

It’s unclear whether there are biologic reasons at play, but researchers hypothesize that the hypothalamic-pituitary-adrenal axis in the brain may be involved.

Were you a rebellious kid? Do you think there’s any connection between your current experience of chronic pain and your childhood?

March 31, 2010

No matter what your politics, you are likely wondering exactly how the new healthcare reform bill that President Obama signed on March 23, 2010 will affect you, and perhaps others dealing with chronic pain. It’s early days, of course, and many of the measures enacted by the bill won’t be implemented for some time. But a few articles have attempted to distill what the bill means for Americans.  Here are some sources to check out to help answer your questions:

• The American Pain Foundation put out a press release last week, which read in part:

“The provisions from the National Pain Care Policy Act 2009 (S660) incorporated into the Health Care Reform Bill include:

-- Mandating an Institute of Medicine conference on pain to address key medical and policy issues affecting the delivery of quality pain care;

-- Establishing a training program to improve the skills of health care professionals to assess and treat pain; and,

-- Enhancing the pain research agenda for the National Institutes of Health (NIH).”

Click here to read the full release [PDF].

• LIVESTRONG.com, Lance Armstrong’s cancer-fighting organization, distills five ways the bill should help cancer survivors.
• Yesterday the New York Times included a piece by Tara Parker Pope called “Consumers’ Big Question: What’s in It for Me?”
• The White House has also put up a guide on its site, called “Putting Americans In Control of Their Health Care,” that includes information on what reform means.
• And if you’re feeling really ambitious and you want to read the 2,074-page Senate bill, you’ll find it here [PDF].

What are your biggest questions and concerns about healthcare reform? Are you happy about the passage of the bill—or upset? Take a minute to post your comment here.

March 24, 2010

The Pew Research Center came out today with a new report on chronic disease and the Internet based on a survey by the Pew Internet Survey and the California Healthcare Foundation. Its chief finding was that American adults living with a chronic disease are a lot less likely than healthy adults to have access to the Web – 62% vs. 81% for healthy folks. That’s creating a significant information gap—and adding insult to injury since these are people who could greatly benefit from using the Web to find information on how to manage their disease as well as support from others dealing with the same condition.

The writers of the report note that “once online, having a chronic disease increases the probability that someone will take advantage of social media to share what they know or learn from their peers.” We at Pain Solutions know the power of Facebook and Twitter as social media tools -- they're helping us reach more people dealing with pain, and we’re growing our own online community as well to offer a “home” for conversation, support, and exchange of information.

Here are some more highlights I found in the report (you can read the whole report here, or download it as a PDF from the Pew site):

• 68% of adults reporting one chronic disease go online; 52% of adults living with two or more chronic diseases go online.
• 93% of adults living with chronic disease ask a health professional for information or assistance in dealing with health or medical issues; 44% use the internet to find information.
• Two activities stand out among people living with chronic disease: blogging and online health discussions.
• When asked if the health information found in their last online session had an impact on their own health care or the way they care for someone else, those who are living with chronic disease are significantly more likely than other internet users to say yes.
• One in 5 e-patients living with chronic disease creates online content—comments, queries, online reviews of hospitals or doctors, photos, videos, audio files, tagging content.
• 16% of e-patients living with chronic disease say their most recent inquiry had a major impact on their healthcare or the way they care for someone else.
  

Is there someone in your life who’s dealing with chronic pain or supporting someone in pain that could use access to the Internet? Could you help them get online? How has the Web helped you? I'd love to hear your experiences in using the Internet to manage your pain.

Happy St. Patrick’s Day!

Though you may be tempted to manage your pain a bit better with a green beer or two today (and you won’t be alone in that approach), I read about two studies this week that show that non-drug therapies (yep, alcohol is a drug too) are incredibly effective techniques. 

First, there was a study in the March 5 issue of the Journal of Patient Safety that looked at how integrative techniques like the relaxation response (go here for an explanation of how this works), acupuncture, acupressure, massage, music therapy, healing touch, aromatherapy and reflexology worked to ease post-surgical and cancer pain in 1,837 patients in 2008 and 2009. The patients were treated with drugs, but also some of these treatments. The results were impressive: “Our real-world study broadly shows that these therapies effectively reduce pain in either cancer or surgical patients,” says Jeffery A. Dusek, Ph.D., research director at the George Institute, which has 21 integrative-medicine practitioners on staff.

More good news came out yesterday from the American Pain Society’s The Journal of Pain, this time about meditation: Researchers at the University of North Carolina measured pain ratings in students and trained them for three days in how to meditate. The results show that even this brief amount of training reduced how much pain and anxiety the students felt when they were given pain stimuli. The upshot seems to be that you don’t need to become even a daily meditator to reap the benefits of less pain and tension in your life – even a little bit can go a long way. If you want to get started, check out our quick mindfulness meditation from leading teacher and author Sharon Salzberg, a founder of the Insight Meditation Society.

Let us know how you do, or how meditation is already working in your life. I’d also love to hear how integrative therapies help you manage your pain.

March 10, 2010

Late in 2008 I wrote a series on medical errors for Health magazine. Though I’d been covering health and related topics for over 15 years by that time, I had no idea of the size or impact of this problem, nor how vulnerable we all are when we go to the hospital, pharmacy or doctor’s office. (If you want to read those articles, you’ll find them here.) In fact, the topic of medical mistakes reminds me a lot of covering pain – it’s a huge problem that can touch our lives and the lives of those we love at any moment, without warning, and it’s a problem that gets far too little attention when you consider its size and impact.

Fortunately, though, there are some glimmers of hope. During my reporting for the two Health magazine stories I had the chance to interview Peter Pronovost, M.D., medical director of the Quality and Safety Research Group at Johns Hopkins Hospital in Baltimore. Pronovost helped pioneer the idea of a simple checklist to avoid mistakes like hospital-acquired infections. It included the almost ridiculously simple reminder that all providers who touch a patient while doing a catheterization make sure to wash their hands well before laying a finger on the person. You can’t get lower-tech than that. But following this and other mostly simple advice hugely reduced how often patients got an infection when they had a catheterization at the hospital. For more on Pronovost, read this March 8, 2010 interview with the New York Times. His new book, Safe Patients, Smart Hospitals: How One Doctor’s Checklist Can Help Us Change Health Care from the Inside Out, is just out. Dr. Atul Gawande’s recently published book, The Checklist Manifesto: How to Get Things Right, also deals with the subject.

But in all the reporting I did, nothing touched me like the stories of patients who had fallen victim to a medical mistake. Like Lisa Lindell, who cared for her husband Curtis for 108 days in the hospital when he was seriously burned in an accident. Lindell, now a patient safety activist, chronicles the saga of numerous medical errors and near-misses in her book 108 Days. If you haven’t experienced a medical mistake yourself, chances are very good you know someone who has—just start asking around and you’ll likely be shocked to hear of close calls with a wrong prescription or diagnosis, or an out-and-out error. I hope you’ll share your story in the Comments here.

March 3, 2010

Though we’re still putting the finishing touches on the Spring issue of Pain Solutions – due out next month – we’re also hard at work on our Summer 2010 issue. One of the features in that issue is taking an in-depth look at why pain is so under-treated in the U.S.

In reading the article, written by veteran health reporter Jacqueline Stenson, I’ve learned that the answer to that question is complex – in fact, there isn’t just one answer. Then this week I read about a study at the Utah Department of Health and published in the Centers for Disease Control’s Morbidity and Mortality Weekly Report that relates to this question.

The study found that while patients are usually good (they say) about not overusing opioid painkillers (one of the myths that leads to under-treatment is that lots of people will abuse narcotic pain relievers so they shouldn’t be given the drugs, or given dosages that would adequately control their pain), their friends and relatives aren’t always so good about using the drugs properly.

The randomized telephone survey, conducted in 2008 among 5,300 adults in Utah, found that nearly 21% had gotten a prescription for an opioid analgesic in the preceding year (a rate that may be somewhat higher than the national average). Just over 70% received it to treat acute pain, while another 15% got the drug to ease long-term pain. Of those who got a strong painkiller, 72% had some drug left over after treating their pain and the great majority kept the leftover drugs on hand for personal use.

In a somewhat surprising turn, almost 2% of those surveyed said they had taken an opioid medication that hadn’t been prescribed for them and in almost every case they got it (most of the time willingly, though in some cases it was stolen) from a friend or relative who had been prescribed the medication.

That’s a bad idea. In reporting on the Utah study, Pain-topics.org notes that overdoses from drug misuse have risen over the past decade. Most of the time a friend or family member used the leftover medication it was to treat pain (vs. recreational use), but this also speaks to the chronic problem of untreated and under-treated pain. Did these friends and relatives use the drugs because they couldn't get them elsewhere, through proper channels? It's a problem without simple answers.

If you’re in doubt about how to dispose of leftover, unused medications, check out this guide from the U.S. Food and Drug Administration.

What are your thoughts on the question of under- and untreated pain in the U.S.? Have you ever shared your prescription pain medication with a friend or relative? If so, what were the circumstances?

February 23, 2010

It may still be the dead of winter in much of the country, but for us, this week signals the start of finalizing the Spring 2010 issue of Pain Solutions. We’re working on sending it to the printer as I type this and so excited for you to see the new issue, which comes out in April. (You can find a free digital edition here on the site not long after. To read the first issue, just click here.)

We aren’t neglecting the PS site, though – we’re adding new features all the time: This blog launched a few weeks ago and our very talented and hard-working site editor, Mary Beth Sammons, is putting the finishing touches on our brand-new newsletter. (To sign up for the free, monthly email, go to our homepage – you’ll find a sign-up form at the right.)

Talking to Mary Beth is always a pleasure since she brings a wealth of online experience to her job. Lately, we’ve been talking about how to build the online community at Pain Solutions. Mary Beth puts the PS Facebook and Twitter accounts to great use, posting new information practically every day.

Our conversations made me curious about what you, our users/readers, look at and read when it comes to pain? I specifically called this post the best online PLACE, because we all know it’s not just websites that are destinations anymore—maybe your favorite spot to find information or support (or share both yourself) is a Facebook Page, or maybe you get info and news from someone you follow on Twitter. It could be that you head to a forum when you need to “talk” to someone who knows what you’re going through. We’d love to hear how you’ve built community online and where you go to find it—maybe Mary Beth and I can learn a thing or two as we continue to grow the Pain Solutions community and make it a place where, we hope, you want to be.

February 17, 2010

If you’re dealing with fibromyalgia chances are really good that you have had a hard road to hoe—you may have had to see a bunch of doctors to even get an accurate diagnosis, let alone find a treatment regimen that worked well for you to control the pain and tenderness (not to mention the “fibro fog,” a topic we’ll be covering in the Spring 2010 issue of Pain Solutions, which comes out in April).

Walking that road may have just gotten a little easier: Last week, FibroCollaborative announced its “Roadmap for Change” and I had the chance to listen in on what the roadmap will include, via a Webinar. You’ll find more information here, but here are some of the highlights:

• Promote Awareness and Understanding: Fibromyalgia can be more quickly and accurately diagnosed and better managed.
• Improve Fibromyalgia Recognition and Diagnosis: This includes addressing the stigma of fibromyalgia and the fact that it often overlaps with other conditions, like depression and IBS, making diagnosis even more challenging.
• Facilitate Dialogue: Improve the conversation between physicians and other care providers and patients to help those with fibromyalgia “better communicate about the condition and their day-to-day experience” with everyone in their support network.
• Enable Comprehensive Management: Improve how providers, especially primary care docs, manage fibromyalgia.

All in all, an ambitious plan, but a clear one that appears to be moving in the right direction. Do you agree with these four priorities? Is there anything missing? What has your experience been as someone living with fibromyalgia or living with or caring for someone with the condition? Take a minute to share your thoughts here or in our Fibromyalgia forum.

February 10, 2010

I keep Michael Pollan’s most famous manifesto – “Eat food. Not too much. Mostly plants.” – tacked up on the bulletin board in my office as an in-my-face (or mouth, more precisely) reminder of how I should be eating. Some days, I confess, his wise words are not enough to stop me from downing a Diet Coke or indulging in more dark chocolate than is probably “heart-healthy.”

In his new book, Food Rules: An Eater’s Manual, Pollan has gathered together 64 simple rules for, he writes, “eating healthily and happily.” They are guidelines virtually anyone can understand (even if following them turns out to be a bit tougher). I picked up the book on a recent trip to Austin, birthplace of Whole Foods, which may well be contributing to the notion that eating healthfully is both difficult and expensive. Here are a couple of my favorites from Food Rules:

• Don’t eat anything your great-grandmother wouldn’t recognize as food.

• Shop the peripheries of the supermarket and stay out of the middle. (The middle is where the processed foods usually live.)

• If it came from a plant, eat it; if it was made in a plant, don’t.

Simple. Easy to understand and, perhaps more important, easy to remember when you’re trolling the grocery store aisles, stomach rumbling, in search of dinner.

And what does all this have to do with our health and chronic conditions, including pain? Well, a lot, it turns out. Pollan says there are two things we know for sure about the connection between food and health: One, people who eat a “so-called Western diet—generally defined as consisting of lots of processed foods and meat, lots of added fat and sugar, lots of refined grains, lots of everything except vegetables, fruits and whole grains—invariably suffer from high rates of the so-called Western diseases: obesity, type 2 diabetes, cardiovascular disease, and cancer.” Two, people who eat a traditional diet (no matter what it is—from the diet of the Inuits to the Masai to Central American Indians) don’t have these diseases. Put another way, we have not evolutionarily adapted to eat the diet most of us eat now, and our bodies don’t know what to do with it. Pollan stresses that the good news is that if you leave a traditional Western diet behind you can see the benefits to your health pretty quickly.

For another take on Pollan’s book, check out Jane Brody’s review in the New York Times:

How have you made healthful eating a priority? Has it helped reduce flare-ups, aches or other aspects of your experience of pain? What's your biggest temptation or craving?

Wishing you a healthy week,

Lorie

I’m so excited to be launching our first blog for PainSolutionsMagazine.com today! If you’re reading this you’re already part of our community so first off, I want to thank you for joining us. We’re growing so quickly I can’t believe it.

As I’m writing this we’re hard at work finishing our second issue of Pain Solutions magazine, which will debut in late March. (I’ll be telling you more about the new issue in the weeks to come.) But right now I just want to invite you to read this blog every Wednesday and, most important, share your comments, rants, raves, and ideas for what we should be covering here, on the site, in the magazine or on Facebook or Twitter.

In short, I really need your help to ensure that everything we’re doing to build the Pain Solutions community really reflects the needs and desires of those who deal with pain every day–-that’s you. So put those comments to good use and tell me what you think.

Thanks!