April 14th, 2009 in Medicine & Health / Research
(PhysOrg.com) -- Harvard researchers at Children’s Hospital Boston have developed a slow-release anesthetic drug-delivery system that could potentially revolutionize treatment of pain during and after surgery, and may also have a large impact on chronic pain management.
In work funded by the National Institutes of Health (NIH), they used specially designed fat-based particles called liposomes to package saxitoxin, a potent anesthetic, and produced long-lasting local anesthesia in rats without apparent toxicity to nerve or muscle cells.
The research will be published online during the week of April 13-17 by the Proceedings of the National Academy of Sciences.
“The idea was to have a single injection that could produce a nerve block lasting days, weeks, maybe even months,” explains Daniel Kohane of the Division of Critical Care Medicine in the Department of Anesthesiology at Children’s, the report’s senior author, and associate professor of anesthesia at Harvard Medical School. “It would be useful for conditions like chronic pain where, rather than use narcotics, which are systemic and pose a risk of addiction, you could just put that piece of the body to sleep, so to speak.”
Previous attempts to develop slow-release anesthetics have not been successful because of the tendency for conventional anesthetics to cause toxicity to surrounding tissue. Indeed, drug-packaging materials have themselves been shown to cause tissue damage. Now, Kohane and colleagues report that if saxitoxin is packaged within liposomes, it is able to block nerve transmission of pain without causing significant nerve or muscle damage. More...
PainCareMD
Monday, May 18, 2009
New “Bedside Test” Expected to Simplify and Improve Back Pain Diagnosis
April 13, 2009
By Jennifer Anderson
Researchers have devised a simple “bedside” test to distinguish between pain from nerve damage and other causes of pain. The test could lead to more accurate diagnosis and treatment for a musculoskeletal disorder (MSD) that plagues many workplaces – back pain. It is the most commonly cited reason for being absent from work.
The ability to determine the underlying nature of the pain more accurately is essential to choosing the best treatment, according to the researchers. It also points the way to more targeted management of the condition: just as workspaces and tasks can be modified ergonomically to help prevent certain MSDs, they can be modified to help prevent the aggravation of existing conditions. More...
PainCareMD
By Jennifer Anderson
Researchers have devised a simple “bedside” test to distinguish between pain from nerve damage and other causes of pain. The test could lead to more accurate diagnosis and treatment for a musculoskeletal disorder (MSD) that plagues many workplaces – back pain. It is the most commonly cited reason for being absent from work.
The ability to determine the underlying nature of the pain more accurately is essential to choosing the best treatment, according to the researchers. It also points the way to more targeted management of the condition: just as workspaces and tasks can be modified ergonomically to help prevent certain MSDs, they can be modified to help prevent the aggravation of existing conditions. More...
PainCareMD
Advice For Novice Runners Who Want To Avoid Injury
Apr. 12 2009
Angela Mulholland, CTV.ca News Staff
When the weather finally warms, spring is a time when many people think of dusting off their sneakers and taking up running.
And why not? Running is pretty simple. Not much to master, really; just put one foot in front of the other and you're off and running.
But while springtime is a great time to hit your fitness stride, it's also a time when many winter couch potatoes-turned-wannabe marathoners get hurt -- or just plain sore. Just ask Toronto-based sports medicine physician Dr. Grant Lum. He's seen hundreds of running injuries at his clinic, Athletic Edge Sports Medicine.
"We see a lot of sprains and strains in the areas of their bodies that are not ready for the rigourous activity that they're plunging into," he tells CTV.ca. "So that is usually knee pain, back pain and foot pain. Those are probably the three most common injuries."
The classic mistake novice runners make is trying to run too far, too hard or too often, in too short a period of time. More...
PainCare
Angela Mulholland, CTV.ca News Staff
When the weather finally warms, spring is a time when many people think of dusting off their sneakers and taking up running.
And why not? Running is pretty simple. Not much to master, really; just put one foot in front of the other and you're off and running.
But while springtime is a great time to hit your fitness stride, it's also a time when many winter couch potatoes-turned-wannabe marathoners get hurt -- or just plain sore. Just ask Toronto-based sports medicine physician Dr. Grant Lum. He's seen hundreds of running injuries at his clinic, Athletic Edge Sports Medicine.
"We see a lot of sprains and strains in the areas of their bodies that are not ready for the rigourous activity that they're plunging into," he tells CTV.ca. "So that is usually knee pain, back pain and foot pain. Those are probably the three most common injuries."
The classic mistake novice runners make is trying to run too far, too hard or too often, in too short a period of time. More...
PainCare
Chair Disease
6 strategies
Julie Deardorff
Chicago Tribune
April 3, 2009
Where are you right now? Lounging on an overstuffed couch with the newspaper and a cup of coffee? Sitting on a kitchen chair taking in the news online? Well, I hope you're sitting down for this bit of news. (Or maybe you should stand.) Your chair is slowly killing you.
Chair disease, as we like to call it, is an increasingly common malady in the U.S. that is almost always caused by spending too much time parked on your rear end.
It's not really the chair's fault, though. The problem is that most of us sit wrong—slouched forward with our earlobes in front of our shoulders—and for hours without moving. The result? Avoidable chair-related ailments, including flabby butts, an increased risk of blood clots, and back pain, the leading cause of disability in Americans under age 45. And if you haven't had back pain yet, just wait; it affects 8 out of 10 people at some point during their life, according to the National Institutes of Health.
"Sitting all day is the worst thing in the world you can do for your back, " said Dr. Joel Press, the medical director of the Spine & Sports Institute at the Rehabilitation Institute of Chicago.
Sitting puts nearly twice the stress on the spine as standing; slouching while you sit increases the pressure even more.
That's because hunching forward pushes the back into a convex or C shape. Try it. Now pull your shoulders back and together and put your hand on your lower back. That natural concave curve is what you want; slouching fatigues and overstretches the ligaments, causing back pain.
To make matters worse, we stay in this bad C position for hours, barely moving, even when nature calls. "I'll be crashing on a project and three hours go by," said Kara Carmichael, a 23-year-old Chicago publicist with back pain who sits behind her computer for 10 hours a day.
Movement is key because the disks in our vertebrae are important shock absorbers. When we're locked in one position, we're starving the disks of nutrients. More...
PainCareMD
Julie Deardorff
Chicago Tribune
April 3, 2009
Where are you right now? Lounging on an overstuffed couch with the newspaper and a cup of coffee? Sitting on a kitchen chair taking in the news online? Well, I hope you're sitting down for this bit of news. (Or maybe you should stand.) Your chair is slowly killing you.
Chair disease, as we like to call it, is an increasingly common malady in the U.S. that is almost always caused by spending too much time parked on your rear end.
It's not really the chair's fault, though. The problem is that most of us sit wrong—slouched forward with our earlobes in front of our shoulders—and for hours without moving. The result? Avoidable chair-related ailments, including flabby butts, an increased risk of blood clots, and back pain, the leading cause of disability in Americans under age 45. And if you haven't had back pain yet, just wait; it affects 8 out of 10 people at some point during their life, according to the National Institutes of Health.
"Sitting all day is the worst thing in the world you can do for your back, " said Dr. Joel Press, the medical director of the Spine & Sports Institute at the Rehabilitation Institute of Chicago.
Sitting puts nearly twice the stress on the spine as standing; slouching while you sit increases the pressure even more.
That's because hunching forward pushes the back into a convex or C shape. Try it. Now pull your shoulders back and together and put your hand on your lower back. That natural concave curve is what you want; slouching fatigues and overstretches the ligaments, causing back pain.
To make matters worse, we stay in this bad C position for hours, barely moving, even when nature calls. "I'll be crashing on a project and three hours go by," said Kara Carmichael, a 23-year-old Chicago publicist with back pain who sits behind her computer for 10 hours a day.
Movement is key because the disks in our vertebrae are important shock absorbers. When we're locked in one position, we're starving the disks of nutrients. More...
PainCareMD
Oxycodone Effective for Herpes Zoster Pain Relief
Randomized trial finds drug superior to gabapentin and placebo in relieving pain
Apr 1, 2009
WEDNESDAY, April 1 (HealthDay News) -- In patients with herpes zoster, controlled-release oxycodone effectively relieves pain and is generally well-tolerated, according to a study published in the April issue of Pain.
Robert H. Dworkin, Ph.D., of the University of Rochester School of Medicine and Dentistry in Rochester, N.Y., and colleagues randomly assigned 87 patients to receive seven days of treatment with famciclovir in combination with 28 days of treatment with either controlled-release oxycodone, gabapentin or placebo.
The researchers found that controlled-released oxycodone significantly reduced the mean worst pain during days 1 to 14 and that gabapentin was not significantly more effective than placebo. Although they found that controlled-release oxycodone was generally safe, significantly more oxycodone patients than placebo patients discontinued treatment (27.6 percent versus 6.9 percent), primarily because of constipation. More...
PainCare
Apr 1, 2009
WEDNESDAY, April 1 (HealthDay News) -- In patients with herpes zoster, controlled-release oxycodone effectively relieves pain and is generally well-tolerated, according to a study published in the April issue of Pain.
Robert H. Dworkin, Ph.D., of the University of Rochester School of Medicine and Dentistry in Rochester, N.Y., and colleagues randomly assigned 87 patients to receive seven days of treatment with famciclovir in combination with 28 days of treatment with either controlled-release oxycodone, gabapentin or placebo.
The researchers found that controlled-released oxycodone significantly reduced the mean worst pain during days 1 to 14 and that gabapentin was not significantly more effective than placebo. Although they found that controlled-release oxycodone was generally safe, significantly more oxycodone patients than placebo patients discontinued treatment (27.6 percent versus 6.9 percent), primarily because of constipation. More...
PainCare
When Spines Throw a Curve: Treating Adult Scoliosis
BY Katie Charles
New York Daily News
April 1st 2009
Dr. Sean E. McCance, co-director of spine surgery at Mt. Sinai Hospital, treats adult scoliosis in both men and women.
Related News
THE SPECIALIST: DR. SEAN MCCANCE ON ADULT DEGENERATIVE SCOLIOSIS
As co-director of orthopedic spine surgery at Mount Sinai Medical Center, McCance diagnoses patients with spine disorders and spends much of his week in the operating room. In spine surgery for 13 years, McCance performs more than 250 operations annually.
WHO’S AT RISK:
Scoliosis is a curvature of the spine that can lead to impingement and back pain. It is very common, though in most cases the curves are small enough that they produce no symptoms and go undiagnosed. “Some studies have shown that as much as 5% of the population may have scoliosis, many of them with milder curves so they don’t even know, “ says McCance. Adult degenerative scoliosis usually affects people in their 40s or 50s who start developing a curvature of the spine because of disk degeneration. “Due to arthritis, the joints become loose or lax, and the spine starts to collapse, leading to curvature of the spine and compression of the nerves,” says McCance, “You can think of the spine as a column around a tube. If the column collapses, the nerves inside the tube get bent and compressed.”
Childhood scoliosis is more common in girls than in boys, but adult degenerative scoliosis affects both men and women. People with spinal problems in their family are at higher than usual risk. “Some people have a family history of spine problems and disk degenerations,” says McCance, “but we haven’t been able to firmly identify the genetic component.” More...
PainCareMD
New York Daily News
April 1st 2009
Dr. Sean E. McCance, co-director of spine surgery at Mt. Sinai Hospital, treats adult scoliosis in both men and women.
Related News
THE SPECIALIST: DR. SEAN MCCANCE ON ADULT DEGENERATIVE SCOLIOSIS
As co-director of orthopedic spine surgery at Mount Sinai Medical Center, McCance diagnoses patients with spine disorders and spends much of his week in the operating room. In spine surgery for 13 years, McCance performs more than 250 operations annually.
WHO’S AT RISK:
Scoliosis is a curvature of the spine that can lead to impingement and back pain. It is very common, though in most cases the curves are small enough that they produce no symptoms and go undiagnosed. “Some studies have shown that as much as 5% of the population may have scoliosis, many of them with milder curves so they don’t even know, “ says McCance. Adult degenerative scoliosis usually affects people in their 40s or 50s who start developing a curvature of the spine because of disk degeneration. “Due to arthritis, the joints become loose or lax, and the spine starts to collapse, leading to curvature of the spine and compression of the nerves,” says McCance, “You can think of the spine as a column around a tube. If the column collapses, the nerves inside the tube get bent and compressed.”
Childhood scoliosis is more common in girls than in boys, but adult degenerative scoliosis affects both men and women. People with spinal problems in their family are at higher than usual risk. “Some people have a family history of spine problems and disk degenerations,” says McCance, “but we haven’t been able to firmly identify the genetic component.” More...
PainCareMD
Stressful Jobs Impede Recovery from Back Pain
Written by Piyush Joshi
Wednesday, 01 April 2009
www.newslocale.org
WEDNESDAY, April 1, (News Locale) - If you have a job that stresses you mentally and causes depression, you may be liable to fall a victim to back injuries and what is more, these injuries persist for a long time even on institution of proper treatment. These are the findings of a study by researchers at the Queensland University. More...
PainCareMD
Wednesday, 01 April 2009
www.newslocale.org
WEDNESDAY, April 1, (News Locale) - If you have a job that stresses you mentally and causes depression, you may be liable to fall a victim to back injuries and what is more, these injuries persist for a long time even on institution of proper treatment. These are the findings of a study by researchers at the Queensland University. More...
PainCareMD
A Different Approach to Pelvic Pain
Los Altos Town Crier
Written by Nancy Dickenson
Wednesday, 18 March 2009
Chronic pelvic pain is not something we like to talk about, yet taboo topics such as incontinence and sexual dysfunction mean that people may suffer in silence for years.
Pelvic pain syndromes can affect anyone. Men, women and even children can be diagnosed with this under-recognized and misunderstood problem.
Among the most common diagnoses associated with pelvic pain are prostatitis, interstitial cystitis, levator syndrome, urethral syndrome, vulvodynia and overactive bladder.
It is often difficult to determine the underlying cause of pelvic pain. A thorough medical examination for gynecological, urological or gastrointestinal origin should be the first step toward diagnosis and treatment. If a medical cause is found, treatment with antibiotics, antidepressants or antiflammatory medication may be warranted. When pelvic pain is not caused by an infection, trapped nerve, autoimmune disorder or degenerative disease, it may be time to explore musculoskeletal involvement.
“A Headache in the Pelvis: A new understanding and treatment for chronic pelvic pain syndromes” (National Center for Pelvic Pain Research, 2008), by Stanford urology professor emeritus Rodney Anderson, M.D., and David Wise, Ph.D., discusses pelvic pain syndromes caused by a chronically contracted pelvis and a treatment modality known as the Stanford Protocol. The Stanford Protocol uses myofascial/trigger point release to relieve this “pelvic charley-horse.”
According to the authors, “Trigger point release is a method of identifying and releasing knots or taut bands in muscles that refer pain either at the site of the trigger point or to a site remote from the actual trigger point. Myofascial release is a name given to stretching the fascia or connective tissue around muscles that over time has tightened up and restricted the muscles that it surrounds.” More...
PainCareMD
Written by Nancy Dickenson
Wednesday, 18 March 2009
Chronic pelvic pain is not something we like to talk about, yet taboo topics such as incontinence and sexual dysfunction mean that people may suffer in silence for years.
Pelvic pain syndromes can affect anyone. Men, women and even children can be diagnosed with this under-recognized and misunderstood problem.
Among the most common diagnoses associated with pelvic pain are prostatitis, interstitial cystitis, levator syndrome, urethral syndrome, vulvodynia and overactive bladder.
It is often difficult to determine the underlying cause of pelvic pain. A thorough medical examination for gynecological, urological or gastrointestinal origin should be the first step toward diagnosis and treatment. If a medical cause is found, treatment with antibiotics, antidepressants or antiflammatory medication may be warranted. When pelvic pain is not caused by an infection, trapped nerve, autoimmune disorder or degenerative disease, it may be time to explore musculoskeletal involvement.
“A Headache in the Pelvis: A new understanding and treatment for chronic pelvic pain syndromes” (National Center for Pelvic Pain Research, 2008), by Stanford urology professor emeritus Rodney Anderson, M.D., and David Wise, Ph.D., discusses pelvic pain syndromes caused by a chronically contracted pelvis and a treatment modality known as the Stanford Protocol. The Stanford Protocol uses myofascial/trigger point release to relieve this “pelvic charley-horse.”
According to the authors, “Trigger point release is a method of identifying and releasing knots or taut bands in muscles that refer pain either at the site of the trigger point or to a site remote from the actual trigger point. Myofascial release is a name given to stretching the fascia or connective tissue around muscles that over time has tightened up and restricted the muscles that it surrounds.” More...
PainCareMD
Millions Embrace Acupuncture, Despite Thin Evidence
By Ellen Edwards
Washington Post Staff Writer
Tuesday, March 17, 2009
Kaiya Larson pressed a small, thin needle against the patient's skin.
A licensed acupuncture practitioner, Larson focused intently as she felt for the right spot -- not here, not there . . . then ping, she pushed the needle in and turned it a little to the right, as though she were turning up the volume on her car radio.
The patient, a 31-year-old woman hoping that acupuncture would increase her energy level and relieve her occasional stomach problems, said she felt a brief "grab." Then nothing. She lay on the exam table for 20 minutes more while that needle, and four others, remained in place.
Larson, demonstrating the procedure at the Tai Sophia Institute outside Columbia, had already taken the patient's pulses; in Chinese medicine, there are six of them, which measure not heartbeats but energy flow, and are taken at two levels of pressure on both wrists. Besides having a discussion about the patient's general health, she had also examined the woman's tongue, finding diagnostic clues in its color and texture.
The process bore little resemblance to a visit to a conventional American doctor. But it's becoming familiar to an increasing number of Americans. A study published in December by the National Center for Complementary and Alternative Medicine (NCCAM), a part of the National Institutes of Health, found that 3.1 million adults and 150,000 children used acupuncture in 2007, seeking relief from ailments including headache or back pain, insomnia and attention-deficit disorders. That was about 1 million more adults than in 2002, when the last NCCAM survey was done. "In the consciousness of the American public, acupuncture has become white bread," said Joseph M. Helms, a physician who trains medical doctors in acupuncture techniques.
The people who go regularly for treatment swear by it. Some wouldn't miss a week. Others scoff that it's complete hokum and that you would get just as much help from a nap.
The American Medical Association takes no position specifically on acupuncture; the AMA groups it with other alternative treatments, saying "there is little evidence to confirm the safety or efficacy of most alternative therapies." It says "well-designed, stringently controlled research" is needed to evaluate its efficacy.
In 2007, NCCAM spent about $9.1 million on acupuncture research. While more is planned, Brent Bauer, an internist at the Mayo Clinic and director of its complementary and alternative medicine program, said the research is in its "toddlerhood." More...
PainCareMD
Washington Post Staff Writer
Tuesday, March 17, 2009
Kaiya Larson pressed a small, thin needle against the patient's skin.
A licensed acupuncture practitioner, Larson focused intently as she felt for the right spot -- not here, not there . . . then ping, she pushed the needle in and turned it a little to the right, as though she were turning up the volume on her car radio.
The patient, a 31-year-old woman hoping that acupuncture would increase her energy level and relieve her occasional stomach problems, said she felt a brief "grab." Then nothing. She lay on the exam table for 20 minutes more while that needle, and four others, remained in place.
Larson, demonstrating the procedure at the Tai Sophia Institute outside Columbia, had already taken the patient's pulses; in Chinese medicine, there are six of them, which measure not heartbeats but energy flow, and are taken at two levels of pressure on both wrists. Besides having a discussion about the patient's general health, she had also examined the woman's tongue, finding diagnostic clues in its color and texture.
The process bore little resemblance to a visit to a conventional American doctor. But it's becoming familiar to an increasing number of Americans. A study published in December by the National Center for Complementary and Alternative Medicine (NCCAM), a part of the National Institutes of Health, found that 3.1 million adults and 150,000 children used acupuncture in 2007, seeking relief from ailments including headache or back pain, insomnia and attention-deficit disorders. That was about 1 million more adults than in 2002, when the last NCCAM survey was done. "In the consciousness of the American public, acupuncture has become white bread," said Joseph M. Helms, a physician who trains medical doctors in acupuncture techniques.
The people who go regularly for treatment swear by it. Some wouldn't miss a week. Others scoff that it's complete hokum and that you would get just as much help from a nap.
The American Medical Association takes no position specifically on acupuncture; the AMA groups it with other alternative treatments, saying "there is little evidence to confirm the safety or efficacy of most alternative therapies." It says "well-designed, stringently controlled research" is needed to evaluate its efficacy.
In 2007, NCCAM spent about $9.1 million on acupuncture research. While more is planned, Brent Bauer, an internist at the Mayo Clinic and director of its complementary and alternative medicine program, said the research is in its "toddlerhood." More...
PainCareMD
How to Protect Yourself From Medication Errors
Sun. Mar. 15 2009
Angela Mulholland, CTV.ca News Staff
Each year, about 422 million prescriptions are filled in Canada. And each year, countless Canadians are sent to hospital because of problems with these prescriptions.
A study published this past summer in the Canadian Medical Association Journal estimated that more than one in nine of all emergency room visits are medication-related.
Many of the times, the patients are at fault because they skipped doses or ignored warnings on the label. But often, the patient has done everything right; they've simply been the victim of a prescribing error.
Somewhere between a doctor writing a prescription and a patient receiving it, errors can be made with incorrect drug selection, dosage errors, bad medication combinations, or communication problems with the pharmacy. More...
PainCareMD
Angela Mulholland, CTV.ca News Staff
Each year, about 422 million prescriptions are filled in Canada. And each year, countless Canadians are sent to hospital because of problems with these prescriptions.
A study published this past summer in the Canadian Medical Association Journal estimated that more than one in nine of all emergency room visits are medication-related.
Many of the times, the patients are at fault because they skipped doses or ignored warnings on the label. But often, the patient has done everything right; they've simply been the victim of a prescribing error.
Somewhere between a doctor writing a prescription and a patient receiving it, errors can be made with incorrect drug selection, dosage errors, bad medication combinations, or communication problems with the pharmacy. More...
PainCareMD
A Medical Madoff: Anesthesiologist Faked Data in 21 Studies
A pioneering anesthesiologist has been implicated in a massive research fraud that has altered the way millions of patients are treated for pain during and after orthopedic surgeries
By Brendan Borrell
Scientific America, March 10, 2009
Over the past 12 years, anesthesiologist Scott Reuben revolutionized the way physicians provide pain relief to patients undergoing orthopedic surgery for everything from torn ligaments to worn-out hips. Now, the profession is in shambles after an investigation revealed that at least 21 of Reuben's papers were pure fiction, and that the pain drugs he touted in them may have slowed postoperative healing.
"We are talking about millions of patients worldwide, where postoperative pain management has been affected by the research findings of Dr. Reuben," says Steven Shafer, editor in chief of the journal Anesthesia & Analgesia, which published 10 of Reuben's fraudulent papers.
Paul White, another editor at the journal, estimates that Reuben's studies led to the sale of billions of dollars worth of the potentially dangerous drugs known as COX2 inhibitors, Pfizer's Celebrex (celecoxib) and Merck's Vioxx (rofecoxib), for applications whose therapeutic benefits are now in question. Reuben was a member of Pfizer's speaker's bureau and received five independent research grants from the company. The editors do not believe patients were significantly harmed by the short-term use of these COX2 inhibitors for pain management but they say it's possible the therapy may have prolonged recovery periods. More...
PainCareMD
By Brendan Borrell
Scientific America, March 10, 2009
Over the past 12 years, anesthesiologist Scott Reuben revolutionized the way physicians provide pain relief to patients undergoing orthopedic surgery for everything from torn ligaments to worn-out hips. Now, the profession is in shambles after an investigation revealed that at least 21 of Reuben's papers were pure fiction, and that the pain drugs he touted in them may have slowed postoperative healing.
"We are talking about millions of patients worldwide, where postoperative pain management has been affected by the research findings of Dr. Reuben," says Steven Shafer, editor in chief of the journal Anesthesia & Analgesia, which published 10 of Reuben's fraudulent papers.
Paul White, another editor at the journal, estimates that Reuben's studies led to the sale of billions of dollars worth of the potentially dangerous drugs known as COX2 inhibitors, Pfizer's Celebrex (celecoxib) and Merck's Vioxx (rofecoxib), for applications whose therapeutic benefits are now in question. Reuben was a member of Pfizer's speaker's bureau and received five independent research grants from the company. The editors do not believe patients were significantly harmed by the short-term use of these COX2 inhibitors for pain management but they say it's possible the therapy may have prolonged recovery periods. More...
PainCareMD
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