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- February 2011
- The E-newsletter of the American Academy of Pain Management
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Academy-sponsored Monograph: Integrative Approaches to Fibromyalgia[pdf]
Pain Studies In The News
Data support use of web-based non-Rx therapies for chronic pain
Source: Elsevier Global Medical News
Evidence-based nonpharmacologic therapies, such as cognitive-behavioral therapy, may be at least as effective as medications in treating chronic pain. Yet the use of nonpharmacologic treatment has been limited for a variety of reasons: medical schools don't spend much time teaching it, insurance companies often don't adequately cover it, and patients often can't access it. Delivering such evidence-based interventions via the Internet potentially sidesteps several of these barriers.
Hand splints may ease arthritis pain
Hand splints to steady achy joints may ease the pain for people who suffer from degenerative arthritis, concludes a new review of the medical literature. It appears that hand exercises might have some effect, too, but the evidence is less solid.
Common painkillers linked to increased risk of heart problems
Source: BMJ-British Medical Journal
Researchers say that doctors and patients need to be aware that prescription of any anti-inflammatory drug needs to take cardiovascular risk into account. While the absolute risk of cardiovascular problems among people taking painkillers is low, certain COX-2 inhibitors are associated with twice the risk of heart attack and the NSAID ibuprofen with more than three times the risk of stroke.
9 More Pain Studies In The News
Central factors seen as key to chronic pain
Source: Elsevier Global Medical News
Dr. Daniel J. Clauw says that there is no chronic pain state where degree of damage or inflammation in the periphery correlates well with level of pain. Yet the paradigms that everyone uses for treating chronic pain still assume that all pain is nociceptive. A new scientific paradigm suggests that, regardless of the specific diagnosis, "central pain states" all tend to share certain characteristics that can be better assessed by asking questions than by physical examination.
Army Surgeon General presents top 10 initiatives for Army medicine
February 2, 2011 Source: Army News Service
The overall focus of the week-long Military Health System conference was to harness the power of 130,000 health care professionals and achieve the Quadruple Aim Performance Goals of medical readiness, experience of care, population health and per capita cost of care. The highlight was on the Army Surgeon General's Top 10 initiatives for army medicine, which include: soldier medical readiness, development of medical home implementation, and culture of trust.
Perspective – management of endometriosis
January 27, 2011 Source: Elsevier Global Medical News
Endometriosis occurs in approximately 8% of reproductive-age women and can have severe consequences, including chronic pelvic pain and infertility. The first-line therapy is nonsteroidal anti-inflammatory drugs (NSAIDs). If NSAIDs are not sufficient to control pain, the next line of therapy is oral contraceptives. An alternative approach includes more empiric therapy or attempting other medical therapies.
3 More Pain Stories In The News
Policy and Law
Prescription acetaminophen drugs to have 325 milligram limit to protect liver
January 13, 2011 Source: FDA
Manufacturers that produce prescription combination products containing acetaminophen are being asked by the FDA to limit the dosage to 325 mg per capsule or tablet to protect liver toxicity. The FDA (Food and Drug Administration) has informed manufacturers that all their prescription products containing an acetaminophen combination will need updated labels, warning about potential severe liver injury risk.
Prescription Addiction, Diversion, and Abuse
2009 National Survey on Drug Use and Health (NSDUH) data and reports released
Two reports from the 2009 NSDUH are now available: National Findings Report, which presents national estimates of rates of use, numbers of users, and other measures related to illicit drugs, alcohol, and tobacco products. The report focuses on trends between 2008 and 2009 and from 2002 to 2009 and Mental Health Findings, which presents national estimates of the prevalence of past-year mental health disorders and past-year mental health service utilization for youth and adults.
Experts see increasing numbers of teens abusing prescription drugs
February 3, 2011 Source: Johns Hopkins Medicine
Illicit drugs like marijuana, cocaine and heroin have always been a parent's nightmare. But perfectly legal and easily accessible prescription medications are now the recreational drugs of choice for many teenagers, prompting physicians at Johns Hopkins Children's Center to urge pediatricians to screen specifically for their abuse during routine visits.
Product News/Clinical Trial Results
FDA orders postmarket surveillance of certain TMJ implants
February 7, 2011 Source: U.S. Food and Drug Administration
The U.S. FDA ordered three manufacturers of temporomandibular joint (TMJ) implants to conduct postmarket surveillance studies to determine the length of time before the implants are removed or replaced. The FDA analyzed TMJ implant-related adverse event reports and described a substantial number of patients who had implants replaced within three years or less after implantation because of extreme pain, which is considerably shorter than the minimum five-year life span of the device.
QD gabapentin wins FDA nod for shingles pain
Source: MedPage Today
The FDA has approved Depomed's novel once-daily formulation of gabapentin (Gralise) for postherpetic neuralgia. Despite the approval, Depomed indicated that patients may have to wait for Gralise to show up in pharmacies, owing to a dispute with Abbott Laboratories. Abbott indicated that the product did not fit into its corporate strategy.
4 More Product News/Clinical Trial Results
New Online Publications
ACPA Consumer Guide to Pain Medication & Treatment – 2011
January 2011 Source: American Chronic Pain Association
This document is revised annually to provide current information on drugs as well as their potential side effects and other treatments. Written initially for patients, it is perhaps the most concise and comprehensive document of its kind, which also makes it an excellent reference for all healthcare providers. Beginning with the 2009 edition, the guide features expanded coverage of non-drug interventions and complementary therapy options.
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See sample article below:
Cannabis in Pain and Palliative Care, by Donald I. Abrams, MD (article)
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Stay up-to-date on the latest research! This section offers complete abstracts on a wide variety of pain and pain management topics that have been selected from the National Library of Medicine.
Dilek B, Yemez B, Kizil R, et al.
Anxious personality is a risk factor for developing complex regional pain
syndrome type I.
Rheumatology international. 2011 Jan 15. [forthcoming]
Dubois S, Bedard M, Weaver B.
Pain killers and safe driving: an examination of the association between opioid analgesics and unsafe driving actions preceding fatal crashes.
63rd Annual Scientific Meeting of the Gerontological Society of America (GSA) (New Orleans, LA -- 11/19/2010)
Engbert K, Weber M.
The effects of therapeutic climbing in patients with chronic low back pain: a
randomized controlled study.
Spine. 2010 Dec 29. [forthcoming]
Kim CH, Issa MA.
Spinal cord stimulation for the treatment of chronic renal pain secondary to
uretero-pelvic junction obstruction.
Pain physician. 2011 Jan;14(1):55-9.
Liem A, Heijmans P, Bijkerk M, et al.
The effect of Chinese ear acupuncture on non-responders to western pain relief techniques
64th Postgraduate Assembly of the New York State Society of Anesthesiologists (NYSSA) (New York, NY -- 12/10/2010)
Senna MK, Machaly SA.
Does maintained Spinal manipulation therapy for chronic non-specific low back
pain result in better long term outcome?
Spine. 2011 Jan 17. [forthcoming]
296 More Research Abstracts
State/Branch: Arizona. House
Title: HB 2510
Summary: Relates to palliative care patient information and terminally ill patients; provides for attending health care practitioner responsibilities for counseling regarding end-of-life options and rights to comprehensive pain and symptom management at the end of life.
Latest Action: 01/18/2011 Introduced.
01/26/2011 To House Committee on Health and Human Services
01/26/2011 Additionally referred to House Committee on Rules.
37 More Legislative Updates
Department of Veterans Affairs
VA/DoD clinical practice guideline for management of opioid therapy for chronic pain [update, 2010]
National Health Service (UK) – Lothian Referral Guidelines
Primary Care management of back pain (C.S.A.G. guidelines)
Pain /therapy (general)
American Medical Directors Association
Pain management in the long-term care setting [update]
Digestive System Diseases
Summary: A study to compare ADL5945 once daily with placebo in the treatment of opioid-induced constipation in adults taking long-term opioid therapy for chronic noncancer pain.
6 More New Clinical Trials
Pain Control and Drug Policy: A Time for Change
Author: Guy B. Faguet, M.D.
Publisher/Date: Praeger, 2010
Summary: This book offers an in indictment of the nation's drug enforcement approach focusing on the short-sighted policies that often deny patients suffering from chronic pain the medications they need.
Table of contents
MORE about this book
Bad things seem even worse if people have to live through them again
February 7, 2011 Source: American Psychological Association
When people think unpleasant events are over, they remember them as being less painful or annoying than when they expect them to happen again, pointing to the power of expectation to help people brace for the worst. In a series of 8 studies exposing people to annoying noise, subjecting them to tedious computer tasks, or asking them about menstrual pain, participants recalled such events as being significantly more negative if they expected them to happen again soon.
2 More Lagniappes
The American Academy of Pain Management is the nation's largest interdisciplinary/integrative organization
who treat people with pain through education, setting standards of care, and advocacy.
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