Pain Consultations News

US Senate Passes Opioids Bill

US Senate Passes Opioids Bill

Comprehensive bipartisan package earmarks billions of dollars to fight opioid abuse in the United States.

Cassipa Approved as Maintenance Treatment for Opioid Dependence

Cassipa Approved as Maintenance Treatment for Opioid Dependence

Cassipa combines buprenorphine, an opioid (partial agonist-antagonist), and naloxone, an opioid antagonist.

Internet-Delivered Exposure Therapy Cost-Effective for Patients With Fibromyalgia

Internet-Delivered Exposure Therapy Cost-Effective for Patients With Fibromyalgia

In a randomized control trial, researchers found that internet-delivered exposure therapy was more cost-effective for patients with fibromyalgia than a waitlist control, which did not involve any treatment during the experimental phase of the study.

Current Guidelines for Management of Low Back Pain

Current Guidelines for Management of Low Back Pain

An estimated 31 million Americans will experience low back pain at some point in their lifetime.

Pfizer Recalls a Type of Children's Liquid Advil

Pfizer Recalls a Type of Children's Liquid Advil

Recall due to mismarked dosage cup in 4-oz bottles of Children's Advil Suspension Bubble Gum Flavored.

Case Study: Elbow and Biceps Pain After a Fall

Case Study: Elbow and Biceps Pain After a Fall

An elderly man presents to the emergency department with elbow and biceps pain after falling on the stairs.

Call to Better Investigate the Associations Between Sleep Disturbances and Chronic Pain

Call to Better Investigate the Associations Between Sleep Disturbances and Chronic Pain

Although literature indicates bidirectional associations between sleep disturbances and pain, few longitudinal studies have examined the role of sleep disturbances in contributing to chronic pain.

Prescription Drug Monitoring Program May Not Cut Opioid Use

Prescription Drug Monitoring Program May Not Cut Opioid Use

No significant reduction in percentage of patients prescribed opioids after general surgery.

Graded In Vivo Exposure Elements May Benefit Chronic Lower Back Pain Management

Graded In Vivo Exposure Elements May Benefit Chronic Lower Back Pain Management

Integrating graded in vivo exposure into the management of chronic lower back pain may result in improved treatment efficacy and reduced pain-related fear.

Hydrocodone Schedule Change Affected Post-Op Opioid Rx

Hydrocodone Schedule Change Affected Post-Op Opioid Rx

Increase in mean OMEs filled in initial opioid rx after hydrocodone's change from schedule III to II.

Opioid-Related Emergency Department Visits, Hospitalization Rates Decrease From 2009 to 2015

Opioid-Related Emergency Department Visits, Hospitalization Rates Decrease From 2009 to 2015

The number of patients prescribed opioids and visiting an emergency department or requiring hospitalization decreased from 2009 to 2015.

Spinal Manipulation Plus Exercise Effective for Teen Low Back Pain

Spinal Manipulation Plus Exercise Effective for Teen Low Back Pain

Spinal manipulative therapy plus exercise more effective than exercise alone over 1-year period.

Odds of Death Up With Exposure to Pregabalin, Opioids

Odds of Death Up With Exposure to Pregabalin, Opioids

Dose-response association with highest odds of opioid-related death with high-dose pregabalin.

Psych Screening Beneficial in Pediatric Abdominal Pain

Psych Screening Beneficial in Pediatric Abdominal Pain

Children with abdominal pain commonly had clinically significant anxiety, moderate disability, pain.

Low Literacy Self-Management Program for Chronic Pain May Be Effective

Low Literacy Self-Management Program for Chronic Pain May Be Effective

A low-literacy, pain self-management program delivered one-on-one by a health educator or in groups with lectures from experts over a period of 6 months may improve chronic pain outcomes.

Chronic Low Back Pain Levels Vary Between Sex and Race

Chronic Low Back Pain Levels Vary Between Sex and Race

Differences exist in race and gender in patients with chronic lower back pain, especially in pain sensitivity and severity due to aftersensations from mechanical punctuate pain and deep muscle hyperalgesia.

Fewer Cervical Spine Injuries Seen With Motorcycle Helmet Use

Fewer Cervical Spine Injuries Seen With Motorcycle Helmet Use

Findings based on analysis of motorcycle accident victims by helmet use.

Combination Therapies for Low Back Pain, Sciatica May Not Have Added Benefit

Combination Therapies for Low Back Pain, Sciatica May Not Have Added Benefit

There is a lack of evidence supporting the benefits of combination drug therapy over monotherapy for the management of low back pain and sciatica.

Wide Variations in Opioid Prescribing Practices for Surgical Procedures

Wide Variations in Opioid Prescribing Practices for Surgical Procedures

Variation exists in opioid prescribing practices among clinicians in single-hospital systems, which prompts concern about the potential for opioid overprescribing.

Outpatient Opioid Prescriptions for Children Often Filled

Outpatient Opioid Prescriptions for Children Often Filled

Cumulative incidence of opioid-related adverse events was 38.3 per 100,000 prescriptions.

FDA to Review Novel Opioid Analgesic for Chronic Low Back Pain

FDA to Review Novel Opioid Analgesic for Chronic Low Back Pain

This novel agent has low permeability across the blood-brain barrier, which slows its rate of entry into the brain and reduces dopamine release.

Postpartum Pain Management Recommendations From the American College of Obstetricians and Gynecologists

Postpartum Pain Management Recommendations From the American College of Obstetricians and Gynecologists

A committee from the American College of Obstetricians and Gynecologists formulated several recommendations for safely managing pain and fatigue in women during the early postpartum period.

Preoperative Opioids Used by Nearly One-Quarter of Surgical Patients

Preoperative Opioids Used by Nearly One-Quarter of Surgical Patients

Odds of pre-op opioid use up with age 31 to 40 years, tobacco use, illicit drug use, depression.

Emergency Physicians Offer Recommendations for Identifying and Managing Opioid Use Disorder

Emergency Physicians Offer Recommendations for Identifying and Managing Opioid Use Disorder

American emergency medicine physicians have been taking measures to address the ongoing opioid crisis, which affects emergency departments throughout the country.

Radiofrequency Denervation Efficacious in Treating Thoracic Zygapophyseal Joint Pain

Radiofrequency Denervation Efficacious in Treating Thoracic Zygapophyseal Joint Pain

Radiofrequency denervation, typically used to treat lumbar and cervical zygapophyseal joint pain, has shown efficacy in treating thoracic zygapophyseal joint pain.

Two-Thirds of Parents Report Their Child Has Had Headache

Two-Thirds of Parents Report Their Child Has Had Headache

Only 44 of parents would definitely go to ER if their child had headache that didn't improve with medication.

Overuse of Neuroimaging in the Emergency Department Reported for Pediatric Headache

Overuse of Neuroimaging in the Emergency Department Reported for Pediatric Headache

Investigators examined rates, predictors, and outcomes of neuroimaging in pediatric and adolescent patients who presented to the ED with a headache.

Pain Societies Issue Guidelines on Use of Ketamine for the Management of Acute Pain

Pain Societies Issue Guidelines on Use of Ketamine for the Management of Acute Pain

Consensus guidelines regarding the use of ketamine for the management of acute pain have been approved.

US Surgeon General Urges More Americans to Carry Naloxone

US Surgeon General Urges More Americans to Carry Naloxone

Surgeon General Jerome M. Adams, M.D., M.P.H., has urged more Americans to carry naloxone, an FDA-approved medication that can be delivered via nasal mist or injection and can temporarily suspend the effects of opioid overdose.

FDA Takes Steps to Reconcile Needs of Patients With Chronic Pain, Efforts to Curb Opioid Epidemic

FDA Takes Steps to Reconcile Needs of Patients With Chronic Pain, Efforts to Curb Opioid Epidemic

A panel discussion event held at the US Food and Drug Administration gathered patients with chronic pain and FDA officials, to reconcile concerns around prescriptions of opioid medications with the needs of these patient populations.

WHO Calls for Renewed Effort to Combat Chronic Disease

WHO Calls for Renewed Effort to Combat Chronic Disease

Commission makes 6 recommendations to meet 2030 goals for non-communicable diseases

Stat Consult: Chronic Low Back Pain

Stat Consult: Chronic Low Back Pain

Chronic low back pain (LBP) defined as persistent or fluctuating musculoskeletal pain of lower back and lumbar spine lasting >3 months.

Hormonal Contraceptives and Migraine: Is It Time to Revisit Stroke Risk?

Hormonal Contraceptives and Migraine: Is It Time to Revisit Stroke Risk?

Current oral contraceptive products contain lower doses of estrogen than those used in the past, prompting reconsideration of risks and benefits.

Chronic Pain Leads to Higher Opioid Doses and Lower QoL in Sickle Cell Patients

Chronic Pain Leads to Higher Opioid Doses and Lower QoL in Sickle Cell Patients

In adults with sickle cell disease, higher daily opioid use may be associated with poorer health-related quality of life.

FDA Upscheduling of Hydrocodone Places Burden on APRNs

FDA Upscheduling of Hydrocodone Places Burden on APRNs

A study assessing the impact of upscheduling of hydrocodone combined medications on APRN practices in Oklahoma revealed significant barriers to effective pain management.

Buprenorphine Diversion Driven by Withdrawal Prevention, Abstinence Maintenance

Buprenorphine Diversion Driven by Withdrawal Prevention, Abstinence Maintenance

Researchers deployed a survey to individuals who had received treatment for opioid use disorder to assess their use of buprenorphine.

NKTR-181 for Chronic Lower Back Pain: SUMMIT-07 Results

NKTR-181 for Chronic Lower Back Pain: SUMMIT-07 Results

The phase 3 SUMMIT-07 trial assessed the safety, efficacy, and tolerability of a new mu-opioid receptor agonist analgesic in adults with moderate to severe chronic lower back pain.

Oxycodone Substitute Shows Lower Abuse Potential

Oxycodone Substitute Shows Lower Abuse Potential

Investigators assessed the potential for abuse associated with NKTR-181, a new mu-opioid receptor agonist analgesic.

Transition to Naltrexone in Opioid Use Disorder Benefits from Psychosocial Assessment

Transition to Naltrexone in Opioid Use Disorder Benefits from Psychosocial Assessment

A combination of naltrexone induction and psychoeducational counseling was found to facilitate transition from active opioid use and buprenorphine maintenance in individuals with opioid use disorder.

Budesonide ER for Ulcerative Colitis Safe Regardless of Gender, Age

Budesonide ER for Ulcerative Colitis Safe Regardless of Gender, Age

The budesonide extended-release formulation was found to be safe and well tolerated for the remission of ulcerative colitis, regardless of age or gender.

Post-Op Pain Treatment Gets Breakthrough Therapy Designation

Post-Op Pain Treatment Gets Breakthrough Therapy Designation

The Company indicated that they will work towards an New Drug Application submission for the treatment in the second half of 2018.

Poison Control Center Data Detail Pediatric Exposure to Buprenorphine

Poison Control Center Data Detail Pediatric Exposure to Buprenorphine

Pediatric exposure to buprenorphine can result in serious adverse outcomes, especially among children aged younger than 6 years.

Various Factors Affect Progress in Back-Related Leg Pain, Sciatica

Various Factors Affect Progress in Back-Related Leg Pain, Sciatica

Belief in a long recovery, many symptoms attributed to pain negatively tied to improvement

Recommendations for Perioperative Pain Management in Patients With Opioid Tolerance

Recommendations for Perioperative Pain Management in Patients With Opioid Tolerance

With the increasing number of patients presenting to surgery with opioid tolerance, clinicians should be familiar with their specific analgesic needs.

Meds for Opioid Use Disorder May Reduce Mortality in OD Survivors

Meds for Opioid Use Disorder May Reduce Mortality in OD Survivors

Minority of opioid overdose survivors receive MOUD; buprenorphine, MMT linked to reduced mortality

Rapid Decreasing Heroin Use During Opioid Substitution Treatment Associated With Treatment Success

Rapid Decreasing Heroin Use During Opioid Substitution Treatment Associated With Treatment Success

In patients receiving opioid substitution treatment for opioid use disorder (mainly involving heroin), those exhibiting a rapid decline in heroin use were found to be more likely to have successful treatment outcomes.

Wearable Device Cleared for Use During Opioid Detoxification

Wearable Device Cleared for Use During Opioid Detoxification

Electrical pulses are sent through small needles that are inserted in the ear to combat the early stages of detoxification, leading to stabilization.

Restless Legs Syndrome, Fibromyalgia, and Depression Frequent in Migraine

Restless Legs Syndrome, Fibromyalgia, and Depression Frequent in Migraine

Patients with migraine may exhibit higher prevalence of restless leg syndrome, fibromyalgia, and depressive symptoms compared with individuals not experiencing migraines.

Corticosteroid Plus Lidocaine Injections Do Not Alleviate Pain in Central Lumbar Spinal Stenosis

Corticosteroid Plus Lidocaine Injections Do Not Alleviate Pain in Central Lumbar Spinal Stenosis

Adding corticosteroids to epidural lidocaine injections does not improve patient-reported pain or function at 12 months.

FDA Cracks Down on Illegal Online Sales of Opioids

FDA Cracks Down on Illegal Online Sales of Opioids

The U.S. Food and Drug Administration has issued warnings to 9 online companies selling illegal opioid medications on 53 websites, in direct violation of the Federal Food, Drug, and Cosmetic Act.

Cryoablation Efficacious for Cancer Pain, Review Finds

Cryoablation Efficacious for Cancer Pain, Review Finds

Cryoablation also cuts the need for opioids at 24 hours post-treatment and at three months

Studies ID Impact of US Opioid-Related Mortality, Prescription Patterns

Studies ID Impact of US Opioid-Related Mortality, Prescription Patterns

Burden of deaths up; most patients receiving opioid analgesics use immediate-release formulations

PTSD Symptoms and the Acute Pain Response in Low-Income Women

PTSD Symptoms and the Acute Pain Response in Low-Income Women

Posttraumatic stress disorder symptoms may be associated with higher levels of acute pain and pain interference in low-income inner city women.

FDA Approves Non-Opioid Treatment for Opioid Withdrawal

FDA Approves Non-Opioid Treatment for Opioid Withdrawal

Lucemyra is an oral selective alpha 2-adrenergic receptor agonist

Recommendations Developed for Managing Postpartum Pain

Recommendations Developed for Managing Postpartum Pain

Impact of medications on mother-infant dyad should be considered, as many women breastfeed

Managing Pediatric Migraine: Current Therapies and Future Directions

Managing Pediatric Migraine: Current Therapies and Future Directions

Migraine is highly prevalent in children and adolescents, affecting almost 10% of children between 5 and 15 years old and 30% of adolescents between 15 and 19 years old.

First-of-Its-Kind Migraine Drug Receives FDA Approval

First-of-Its-Kind Migraine Drug Receives FDA Approval

The efficacy of Aimovig was evaluated as a preventive treatment of episodic or chronic migraine in 3 randomized, double-blind, placebo-controlled studies: 2 studies in patients with episodic migraine (4-14 migraine days per month) and 1 study in patients with chronic migraine (≥15 headache days per month with ≥8 migraine days per month).

Adding Chiropractic to Usual Care Beneficial for Low Back Pain

Adding Chiropractic to Usual Care Beneficial for Low Back Pain

Improvements in low back pain intensity and disability among active-duty military personnel

Patients with Frontal Chronic Headaches May Benefit from Endoscopic Decompression Surgery

Patients with Frontal Chronic Headaches May Benefit from Endoscopic Decompression Surgery

Oral medication, botulinum toxin type A injections, and endoscopic decompression surgery were all compared in the treatment of patients with frontal secondary headaches due to STN and SON configuration.

Discerning Arterial Ischemic Stroke From Migraine in Pediatric Emergency Departments

Discerning Arterial Ischemic Stroke From Migraine in Pediatric Emergency Departments

Investigators examined presenting features of migraine vs arterial ischemic stroke in children presenting to the emergency department.

Many Patients Have Unused Opioids After Spine, Joint Surgery

Many Patients Have Unused Opioids After Spine, Joint Surgery

Many patients reported unsafe storage and failure to dispose of opioids at one- and 6-month follow-up

Pain, Psychiatric Comorbidities More Common in Chronic vs Episodic Migraine

Pain, Psychiatric Comorbidities More Common in Chronic vs Episodic Migraine

Individuals with chronic vs episodic migraine may be more likely to experience chronic back pain, chronic pain, neck pain, anxiety, and depression.

Synthetic Opioid Involvement in Opioid-Related Deaths Increases

Synthetic Opioid Involvement in Opioid-Related Deaths Increases

From 2010 to 2016, synthetic opioid involvement up from 14.3 to 45.9% of opioid-related deaths

Intrathecal Drug Delivery and Spinal Cord Stimulation for Cancer Pain: A Review

Intrathecal Drug Delivery and Spinal Cord Stimulation for Cancer Pain: A Review

Intrathecal drug delivery systems and spinal cord stimulation have shown promise for the treatment of cancer pain in initial studies.

Combining Spinal Manipulation and Exercise for Low Back Pain in Adolescents

Combining Spinal Manipulation and Exercise for Low Back Pain in Adolescents

A combination of self-care education, aerobic and strength-training exercise, and spinal manipulation therapy may provide greater pain relief and improved treatment satisfaction compared with exercise only in adolescents with low back pain.

People With Opioid Use Disorder Have High Suicide Rate

People With Opioid Use Disorder Have High Suicide Rate

Based on data from multiple sources, many opioid-overdose deaths seem to be suicides

Intraoperative Opioid Doses and Rates of Hospital Readmission

Intraoperative Opioid Doses and Rates of Hospital Readmission

The use of high doses of opioids — particularly long-acting opioids — during surgery may increase the risk for 30-day readmission.

Study Finds 31% Use No Opioids After Surgery

Study Finds 31% Use No Opioids After Surgery

At discharge, 92.2% of patients received an opioid prescription; nearly 63% unused

Eight Factors Predict Pain After Spine Surgery

Eight Factors Predict Pain After Spine Surgery

Post-op pain strongly linked to number of classes of non-opioid analgesics used, remifentanil use

Headache in Older Adults: Unique Causes and Treatments

Headache in Older Adults: Unique Causes and Treatments

It is important for clinicians to quickly and accurately determine potential underlying causes and to prescribe treatments that take into account comorbidities and medications that older patients may be taking for them.

Addition of Peripheral Nerve Blocks Beneficial for TKA

Addition of Peripheral Nerve Blocks Beneficial for TKA

Lower numeric rating scale pain scores on ambulation on postoperative days zero, one, and two

Helping to End Addiction: NIH Initiative Addresses Opioid Epidemic

Helping to End Addiction: NIH Initiative Addresses Opioid Epidemic

National Institutes of Health Director, Francis Collins, MD, PhD, announced on April 4, 2018 the launch of the Helping to End Addiction Long-Term Initiative.

Opiate Use Linked to Early Mortality in IBD Patients

Opiate Use Linked to Early Mortality in IBD Patients

Heavy use in Crohn's, heavy or moderate use in ulcerative colitis tied to increased risk of death

Elder Abuse Not Associated With Risk of Chronic Pain

Elder Abuse Not Associated With Risk of Chronic Pain

Findings based on two-year follow-up of a large, community-dwelling cohort in Malaysia

CBT vs Pain Education for Chronic Pain in Low-Income Clinics

CBT vs Pain Education for Chronic Pain in Low-Income Clinics

Group cognitive behavioral therapy and pain education may be more effective than usual care for improving pain and physical function in patients presenting with chronic pain at low-income clinics.

Tai Chi May Be Therapeutic Option for Fibromyalgia

Tai Chi May Be Therapeutic Option for Fibromyalgia

Tai chi interventions may be more effective at treating fibromyalgia than aerobic exercise.

FDA: Social Media Companies Are Not Doing Enough to Stop Illegal Opioid Sales

FDA: Social Media Companies Are Not Doing Enough to Stop Illegal Opioid Sales

FDA has called on social media companies and internet service providers to take a proactive approach in curbing online selling of opioids through their platforms.

Fatigue, muscle aches more common in women with HIV than men

Fatigue, muscle aches more common in women with HIV than men

The two most prevalent HIV symptoms, fatigue and muscle aches, are more common in women than men and can worsen with menopause.

CDC reports opioid-related overdoses have increased from July 2016 to Sept 2017

CDC reports opioid-related overdoses have increased from July 2016 to Sept 2017

The rate of ER visits for suspected opioid-related overdoses has increased by a mean of 5.6% per quarter.

Gluten-free diet associated with reduced neuropathy pain

Gluten-free diet associated with reduced neuropathy pain

Individuals with gluten neuropathy experienced less peripheral neuropathic pain when adhering to strict gluten-free diets.

Transcutaneous electrical nerve stimulation may not alleviate lower back pain

Transcutaneous electrical nerve stimulation may not alleviate lower back pain

Transcutaneous electrical nerve stimulation may be ineffective in treating, relieving lower back pain when compared with other nerve stimulation therapies.

Talk therapy, modified for literacy level, helps ease chronic pain for disadvantaged populations

Both modified cognitive behavioral therapy and pain education interventions were associated with improved pain in patients with disadvantaged backgrounds.

Assessing lidocaine efficacy for chronic pain management

Assessing lidocaine efficacy for chronic pain management

Intravenous, patch lidocaine might be effective in treating, preventing chronic pain.

Poor sleep exacerbates PTSD, chronic pain association in youth

Poor sleep exacerbates PTSD, chronic pain association in youth

The quality of sleep partly relieved the correlation between PSTD and pain intensity, interference.

Pain sensation may be altered by verum, sham electroacupuncture

Pain sensation may be altered by verum, sham electroacupuncture

Functional magnetic resonance imaging was used to monitor brain activity in patients with osteoarthritis who were administered either genuine or placebo electroacupuncture.

Migraine associated with increased risk of cardiovascular events

Migraine associated with increased risk of cardiovascular events

Migraines are linked to cardiovascular events, including myocardial infarction, VTE, and stroke.

FDA: Botanical drug kratom contains opioid compounds

FDA: Botanical drug kratom contains opioid compounds

Nearly all of kratom's major compounds bind to opioid receptors in the human brain, and 2 of the top 5 most prevalent compounds activate those receptors, FDA Commissioner Scott Gottlieb said in a statement. In addition, there have been 44 reported deaths associated with the use of kratom, often in combination with other substances, Gottlieb said.

Managing pain in primary care

Managing pain in primary care

A FNP reflects on his experiences working with pain management patients prescribed opioids.

Brief intervention may be beneficial for adolescents with chronic pain

Brief intervention may be beneficial for adolescents with chronic pain

A combination of psychoeducation, cognitive-based therapy, visualization, and breathing exercises may represent a tolerable and readily accepted complementary therapeutic approach for adolescent patients with chronic pain.

Opioid use in middle-aged adults

Opioid use in middle-aged adults

Clinicians are in the unique position to educate and counsel middle-aged adults about their opioid use and influence strategies needed to provide effective pain control.

When patients need services that don't exist

When patients need services that don't exist

It can be difficult to care for complex patients when they need services that do not exist.

Pain during IUD insertion reduced with lidocaine nerve block

Pain during IUD insertion reduced with lidocaine nerve block

A 1% paracervical nerve block may be useful for reducing patient-reported pain during IUD insertion.

Opioids and naloxone for pain management

Opioids and naloxone for pain management

Co-prescribing naloxone and opioids in primary care is recommended for patients who have a high risk for opioid overdose.

Effects of cannabis treatment in adult patients with PTSD

Effects of cannabis treatment in adult patients with PTSD

Researchers found that cannabis may alleviate neuropathic pain, but is not associated with benefit for adults with PTSD.

The role of prescription habits in the opioid epidemic

The role of prescription habits in the opioid epidemic

Current surgical and prescribing practices may have a hand in exacerbating the nation's burgeoning opioid epidemic.

Clinicians may be overprescribing gabapentinoids for pain

Clinicians may be overprescribing gabapentinoids for pain

Gabapentinoids may be overprescribed, in part as a response to the opioid epidemic.

NASEM report outlines strategy to combat opioid epidemic

NASEM report outlines strategy to combat opioid epidemic

The FDA commissioned the report to provide an update on current evidence on research, care, and education in the pain field, and to identify actionable measures for the FDA to more adequately address the ongoing opioid epidemic.

CDC: Opioid prescription rate remains high, inconsistent in the United States

CDC: Opioid prescription rate remains high, inconsistent in the United States

However, the number of opioids prescribed decreased between 2010 and 2015.

Majority of opioid prescriptions are written for patients with mental disorders

Majority of opioid prescriptions are written for patients with mental disorders

Among the nearly 40 million Americans who have a mental health condition, about 19% use prescription opioids.

Opioids often prescribed to back pain patients with depression

Opioids often prescribed to back pain patients with depression

Researchers found that back pain patients are also more likely to get higher doses of opioids.

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