By Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP graduate student and PREP-AIRED blog moderator
Thank you to Tufts University School of Medicine, MS-PREP alumna Nancy Mitchell for forwarding this intriguing study from Stanford University School of Medicine on love induced pain relief. In their study, Dr. Sean Mackey and colleagues suggest that intense, passionate feelings of love can alter the perception of pain.
“When people are in this passionate, all-consuming phase of love, there are significant alterations in their mood that are impacting their experience of pain,” said Sean Mackey, MD, PhD, chief of the Division of Pain Management, associate professor of anesthesia and senior author of the study. “We’re beginning to tease apart some of these reward systems in the brain and how they influence pain. These are very deep, old systems in our brain that involve dopamine — a primary neurotransmitter that influences mood, reward and motivation.”
While love is not the only answer to relieving pain, it appears that similar areas of the brain are activated by intense love and also by pain relieving pharmaceuticals. Further study of the neural reward pathways that are triggered by intense feelings of passion could lead to a more complete undertanding of the neural mechanisms involved in the pain experience.
Click here to read the complete study
November 9th, 2010
by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP graduate student and PREP-AIRED blog moderator
A recent study published by The Lancet (to read the study abstract, click here ) explores the question of efficacy and safety of corticosteroid injections for tendinopathy, both short-term and long-term. Using a systematic review of randomized control studies, researchers observed that corticosteroid injections reduced pain in the short term compared with other interventions, but this effect was reversed at intermediate and long terms.
As this research indicates, there is a need for multidisciplinary pain management approaches in the treatment of chronic pain conditions. What have been your experiences with using corticosteroid injections?
November 2nd, 2010
Thank you to our guest blogger, Dan Fields, for this informative and timely book review of Dissolving Pain: Simple Brain-Training Exercises for Overcoming Pain by Fehmi and Robbins.
Can changing how you pay attention help to ease pain? Yes, suggest psychologist and biofeedback expert Les Fehmi, PhD, and science writer Jim Robbins in their new book, Dissolving Pain: Simple Brain-Training Exercises for Overcoming Chronic Pain (Trumpeter, 2010). The conventional understanding of pain is that it results from an injury to the body—such as a slipped disk, in the case of back pain. However, the authors contend that “pain, whatever its causes, resides principally in the brain and can therefore be treated by working with the mind in specific ways.”
Consider the phenomenon of phantom limb pain, in which pain persists in a limb after it has been removed. “Areas of the brain associated with the missing limb can still, mistakenly, generate pain, probably because they are [abnormally] sensitized,” according to Fehmi and Robbins.
You can reduce the intensity of any type of pain, the authors suggest, by expanding your focus of attention—like zooming out with a camera. “When you are narrow-focused on something, including pain, it represents 100 percent of your awareness. When you broaden your attention beyond the pain, the pain becomes a fraction of your total awareness,” they write.
And the quickest way to expand your focus is “to become aware of space,” say Fehmi and Robbins. The book and an accompanying CD include guided exercises that ask if you can imagine the distance between various parts of the body. These exercises supposedly encourage the brain “to produce more of the slower, more rhythmic brainwave frequencies associated with healing, balance, and well-being,” they write.
In contrast, a narrow focus of attention “increases the frequency of our EEG, tenses muscles, and generally makes us more sensitive to pain,” claim the authors.
The book includes many anecdotes of how the attention exercises have helped Fehmi’s patients with back, joint, or other types of pain. However, this reviewer is not aware of any solid research on this mind-body approach. So it’s up to readers to try the exercises for themselves and see if they help.
Dan Fields is a freelance health writer and former editor in chief of Dr. Andrew Weil’s Self Healing newsletter. He lives in the Boston area, and his email address is firstname.lastname@example.org
October 10th, 2010
by Nancy Mitchell, MS-PREP
A prescription for music may be a beneficial adjunct to more traditional therapies according to research at Glasgow Caledonian University. Check out this article in Science Daily.
September 21st, 2010
by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP student and PREP-AIRED blog moderator
August 11, 2010 marked the culmination of intensive research and planning for two candidates for Master’s degrees in the Pain Research, Education and Policy Program at the Tufts University School of Medicine with the presentation of their capstone projects.
Margaretta Elizabeth (Beth) Sangree, a student in the joint program with the New England School of Acupuncture (NESA), presented her capstone project entitled
Pictured L-R: Ylisabyth (Libby) Bradshaw, DO, MS, Associate Director of the Pain Research, Education and Policy Program; Margaretta Elizabeth (Beth) Sangree, MS-PREP candidate, Richard Glickman-Simon, MD, Director of the Pain Research, Education and Policy Program; and Sherry Brink, RN, BSN, MS-PREP candidate
“Measures of the Patient-Provider Relationship in Acupuncture Treatments”. Beth highlighted several studies that support the importance of relationship-centered care in effective pain treatment. Future directions will include quanitfiable, replicable, randominzed control studies to continue to document the effect of patient-provider relationship on treatment effectiveness.
Sherry Brink, RN, BSN, presented her capstone project on “Post-Op Pain Management in the Pediatric Patient” with emphasis on bringing best practices of post-op pain managment to underserved, international patient populations. Sherry recounted her experience bringing comprehensive pain management methods to a small rural hospital in the Andes mountains of Peru and her development and integration of a bilingual nursing education module on pain management currently being used by the staff in Peru. Sherry hopes to use her MS-PREP degree to further her international medical mission work by continuing to educate nurses worldwide in effective, compassionate pain management methods.
Congratulations to these two exceptional MS-PREP degree candidates!
August 23rd, 2010
by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP student, PREP-AIRED blog moderator
The NIH National Center for Complementary and Alternative Medicine Center’s Integrative Medicine Research Lecture Series provides overviews of the current state of research and practice involving complementary and alternative medicine practices and approaches, and explores perspectives on the emerging discipline of integrative medicine. The upcoming lecture on August 9, 2010 may be of specific interest for those interested in learning more about clinical trials on acupuncture in Germany and pain management.
Lectures are open to the public at the NIH Clinical Research Center in Bethesda, Maryland (10:00 AM EDT) or now by free videocast at videocast.nih.gov
Upcoming LectureDate: August 9, 2010
Speaker: Claudia Witt, M.D., Professor for Complementary Medicine and Vice Director at the Institute for Social Medicine, Epidemiology and Health Economics Charite University Medical Center in Berlin, Germany
Topic: The acupuncture trials from Germany: What do they tell us about efficacy, effectiveness, cost-effectiveness, and safety?
Location: NIH Campus, Building 31, 6C, Room 6
August 4th, 2010
by Anne Colyn, MS-PREP, MAc, Dipl Ac (USA)
An episode of “House MD” on Fox on May 3 will be presenting a girl with Chiari Malformation, for many experienced as chronic unrelenting headaches.
The syndrome is complicated to explain because each individual has different symptoms. The symptoms mostly stem from a congenital problem with the lobes of the cerebellum (the very back of the brain) “sinking” into the opening at the bottom of the skull where spine meets the brain. This structural problem causes pressure on the brain stem and congestion in the opening where the spinal fluid flows in and out of the brain from the spine. The symptoms manifest themselves in each person differently, depending on how much pressure is being caused on which nerves. Most commonly a person will find out about their Chiari diagnosis after years of “unknown causes” of headaches in the back of their head, and doctors telling them it’s only an emotional problem.
Due to the structural nature of Chiari, medications typically are not beneficial. The common treatment is to repair the structural imbalance by opening that part of the skull and shrinking the lobes that are causing undue pressure on the brain stem and interrupting the spinal fluid from flowing in a direct path in and out of the brain. In fact, statistically this syndrome is just as common as Multiple Sclerosis. It’s crucial for doctors to begin educating themselves on this syndrome for those patients struggling with pain and yielding no benefit from conventional headache treatment.
Go to www.conquerchiari.org for information if you’d like to read more about Chiari.
May 3rd, 2010
by Nancy Mitchell, MS-PREP/NESA student
According to an American Journal of Medicine study, regular use of over the counter (OTC) pain relievers may contribute to hearing loss in men. In the prospective study, which included 27,000 men surveyed every two years between 1986 to 2004 approximately 25% of the men said they had been diagnosed with hearing loss. Individuals who used OTC pain relievers at least twice a week were more likely than non-users to be diagnosed. Previous nonhuman research has found some substances in pain-relievers can decrease blood flow to the cochlea, the part of the inner ear that converts waves sound into brain signals.
Click here to read an abstract of the study.
April 14th, 2010
by Lisa Gualtieri, PhD, Adjunct Clinical Professor, Tufts University School of Medicine
Stories from people in similar circumstances can be encouraging and supportive, providing a roadmap to positive outcomes. They can also be misleading and manipulative, so, like the use of all information on health websites, a medical professional is the best source of accurate information..
I often analyze stories on health websites, looking primarily at how they might resonate with someone using the site. One example I recently came across was RediscoverYourGo, which was developed for a medical device company, Smith & Nephew, that manufactures parts for hip and knee implants. The stories are about a person’s experiences with pain and how debilitating it was. They go on to describe what transpired from the time a person decided to undergo replacement surgery up to their current pain-free activities. While not as polished as the stories on other health websites, they are a device that may resonate with someone in pain, offering encouragement that this, too, can happen to them.
More on the use of stories is at Stories that Enhance Health Website Design: If It Helped Them It Might Help Me Too.
February 14th, 2010
by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP student and PREP-AIRED blog moderator
Forcing a cough while receiving an immunization appears to decrease perceived pain a study published in the February 2010 issue of Pediatrics suggested. Dustin Wallace, PhD, one of the study authors states, “Pediatric immunizations are the most common painful procedures occurring in pediatric medical settings. Although a number of strategies are available to help reduce immunization pain, they often are not used because of time, effort, or cost associated with use.”
The goal of the study was to assess the efficacy of a “cough trick” technique on self-reported pain of children receiving routine pediatric immunizations. The “cough trick” technique consisted of a “warm-up” cough of moderate force, followed by a second cough at the time of needle puncture. Self-reported pain was decreased in the experimental group versus the control group. Limitations of the study included small sample size, refusal of some children to comply with intervention, and use of visual analog pain scale which has not be validated for use in young children.
“Belief in the value of pain management is relevant not only for patients but also for staff members,” the study authors conclude. “A significant barrier to the clinical implementation of any pain management strategy may be the perception of some that the pain associated with pediatric immunizations is not worth treating. In this study, however, nurses were observed to use a variety of strategies in the control condition to help children manage the pain, which suggests that the nurses were interested in helping to reduce immunization pain.”
To read more about this study, <a href="click here
February 2nd, 2010