Can Love Reduce Pain?

by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP graduate student and PREP-AIRED blog moderator and administrator, Tufts University School of Medicine

In honor of Valentine’s Day and in celebration of “heart month”, February, today’s blog entry asks the question…can viewing a photograph of a romantic partner reduce pain?  This was the research question posed by investigators from Stanford University in a study entitled: Viewing Pictures of a Romantic Partner Reduces Experimental Pain published in PLoS  ONE.  Using functional magnetic resonance imaging (fMRI), the investigators examined fifteen individuals in the early stages of a romantic relationship (first nine months).  Participants completed three tasks under periods of moderate and high thermal pain: 1) viewing pictures of their romantic partner, 2) viewing pictures of an equally attractive and familiar acquaintance, and 3) a word-association distraction task previously demonstrated to reduce pain. Viewing pictures of a romantic partner and the distraction task both decreased the amount of self-reported pain experienced by the study participants.  However greater pain relief was reported while viewing pictures of a romantic partner and this was the only study condition associated with increased activity in several reward-processing regions of the brain.  According to the research team lead by Dr. Jarred Younger,  “The results suggest that the activation of neural reward systems via non-pharmacologic means can reduce the experience of pain”.   In the clinical setting, creating an environment that encouraging patients to have pictures of loved ones within view may help to achieve more effective pain management.  

What are your thoughts on this study?

1 comment February 14th, 2011

Global Year Against Acute Pain

by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP graduate student and PREP-AIRED blog moderator and administrator

  

Anticipate, Assess, Alleviate     

The International Association for the Study of Pain (IASP) is the leading professional forum for science, practice and education in the study of pain.  Each year  the IASP focuses on an area of importance in the field of pain management.  This year’s focus is acute pain, with 2010-2011 being designated as the Global Year Against Acute Pain by the IASP.  Acute pain is the most frequent reason why patients visit an emergency department.  Unfortunately, inadequate acute pain control is common.  If uncontrolled or inadequately controlled, acute pain can result in increased health care costs due to longer hospital stays and a higher liklihood of the development of chronic pain.  By raising awareness of acute pain as a significant health care issue,  the IASP hopes to lessen the gap between acute pain knowledge and research and current clinical practice.  

Click here  to access resources and information about acute pain mangement and how to become involved in the IASP Global Year Against Acute Pain.

Add comment January 30th, 2011

A New Year…What Advances in Pain Management Will We See in 2011?

by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP graduate student and PREP-AIRED Blog Administrator and Moderator

As we enter a new year, pain is still the #1 reason individuals seek out medical care (American Pain Foundation data).  Those who are involved in research, as well as direct caregivers of patients, know that pain is complex and needs to be addressed by a multi-modal and interdisciplinary approach.  Let’s take stock of where we are and where we hope to go in 2011.  We invite you to comment, discuss and brainstorm ways that we can more effectively manage pain on this site  Let’s envision a day when pain is no longer the #1 reason individuals seek medical care.

Happy New Year…may your year be filled with opportunities and possbilities.

Add comment January 3rd, 2011

Progress and Challenges in Pain Research

By Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP graduate student, PREP-AIRED blog moderator and administrator

Thank you to Dr. Daniel Carr, founder of the Tufts University School of Medicine’s Pain Research Education and Policy Programs (PREP) for alerting us to a collection of articles in a recent edition of Nature Medicine which review progress and challenges in pain research from the bench to the bedside.  Take a look at some of the interesting issues being addressed with a focus on pain research and treatment.

Click here to view the table of contents

Add comment December 10th, 2010

New Release: Approaches to Pain Management with foreward by Daniel Carr, MD, FABPM

by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP graduate student and PREP-AIRED blog moderator

Untreated or under-treated pain causes needless suffering and negatively affects the quality of life. That is why the management of pain remains a critical area of health care and why the concept is addressed throughout the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requirements. 

We congratulate the Tufts University School of Medicine’s Pain Research, Education and Policy Programs co-founder, Daniel Carr, MD, FABPM for providing the forward to the newly published second edition of Approaches to Pain Management: An Essential Guide for Clinical Leaders  

Approaches to Pain Management: An Essential Guide for Clinical Leaders, published by the Joint Commission Resources, provides an overview of pain assessment and management, identifies what the standards require regarding the treatment of patients with pain, and offers guidance on making pain management an integral part of care services.   Dr. Carr, an internationally recognized expert in pain management, provides both perspective and vision on the complex nature of pain.

The majority of the book is devoted to the best practices of health care institutions that have adopted focused pain programs. This updated guide also incorporates a global view of pain management, additional organizational best practices—including some from non-U.S. institutions.  Other features include the following:

  • Summaries of every Joint Commission and Joint Commission International pain assessment and management requirement across all health care settings
  • Strategies for identifying and using evidence-based medicine resources for pain management
  • Expanded case study chapters from clinical leaders describing how their organizations developed and implemented their pain management activities
  • Techniques and ideas for understanding and meeting pain-related standards
  • Guidance on committing an organization to pain management improvements

For more information about  the newly released edition of Approaches to Pain Management: An Essential Guide for Clinical Leaders, click here 

 

Add comment November 29th, 2010

The Pain Research, Education, and Policy Programs at Tufts University Welcome Wendy Williams

By Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP graduate student and PREP-AIRED blog moderator

You may see a new face if you are on the Tufts University School of Medicine campus in Boston these days.  Wendy Williams, BSN, M.Ed, is in a new role with the Pain Research, Education and Policy Programs at Tufts University School of Medicine, focusing on program development and administration. I recently had the opportunity to sit down with Wendy to ask her a few questions about herself and her visions for the PREP programs.  

Welcome Wendy…Can you tell us a bit about yourself?

I just arrived at Tufts from spending 8 years at Northeastern University in the School of Nursing working to ensure high quality clinical nursing education placements for both the undergrad/pre-licensure students and the advanced practice students seeking both clinical and non-clinical nursing master’s degrees.   My own clinical nursing background centers around oncology and HIV/AIDS.    I spent wonderful years at both Dana Farber Cancer Institute, during the time they had inpatient units, and at Harvard Community Health Plan/Harvard Vanguard with other highly skilled nurses on the HIV/AIDS Resource Team.I married a great guy back in 1996 who had a couple of sweet little boys who are now terrific college age young men, studying here in Boston.  My husband, Jeff, and I live in Framingham with our 3-legged cat, Punky, and hairless dog, Diddy.

What interests you about the PREP programs?

The concern for under-treated pain and pain management are steady threads that ran throughout my own clinical practice.  Ensuring adequate pain management is a strong cornerstone of quality nursing care and practice, so the PREP programs of study are very attractive to me and tie together much of what I value.  The chance to work collaboratively with the three program leaders (who are also physicians), Dr. Dan Carr and Dr. Richard Glickman-Simon and Dr. Ylisabyth Bradshaw, is an opportunity I want to leverage.I have long sought ways to be a force behind strengthening linkages between medicine and nursing and other health care disciplines to encourage both multidisciplinary and interdisciplinary approaches to health care.  The PREP programs present an ideal setting to have broad-based conversations around the area of pain issues.  Also, my own master’s degree is in education, specializing in adult and organizational learning, so .  the opportunity to develop a program of study and optimize learning for students globally is a really strong draw for me to be here at Tufts working with the PREP programs.

What do you see as the strengths and challenges of the PREP program?

A real strength of the PREP programs is its unique position in masters level education  that delves deeply into the many physical/clinical, social and scientific aspects of pain.  There is not a population of people, worldwide, that is not impacted by pain issues.  Also, the fact that the PREP programs are not solely clinically based creates a rich learning environment for many types of students… clinicians seeking to be subject matter experts in pain issues learn side by side with non-clinicians who may be seeing the PREP programs as a way to become well-informed advocates for pain issues.  After about a month in this role, I see two challenges to the PREP programs that I would like to positively impact.  One challenge is getting more and more people in the greater Boston area to know about this great set of programs and to become students in the program.  I happen to know one graduate of the program, Hallie Greenberg, a nurse from the Brigham & Women’s Hospital, and know that there are so many others that would be really inspired to become proficient in this area.  The other challenge is understanding and communicating to others clear linkages between getting one of the certificates and/or the master’s degree and a specific career enhancement.  There seems to be a certain pioneering element to encouraging students to go for the certificates or the degree as a natural next step in career growth.

What are your hopes and vision for the PREP program?

I hope that PREP grows steadily, both in numbers and in innovative educational initiatives, and sustainably with input from all communities of interest: students and alumni and staff and our steering committee and faculty and leaders in pain issues globally.  I would love to speak with students and alumni and gain their insights on how we can best lead the way in pain research, education and policy.  I welcome calls, 617 636-0815, emails wendy.williams@tufts.edu, or simply stop by my office in the M&V building, Room 142A. I’d love to meet you.

Add comment November 15th, 2010

Love Induced Pain Relief

By Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP graduate student and PREP-AIREDLove Induced Pain Relief 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

Add comment November 9th, 2010

Do Cortisone Injections Make Pain Worse?

cortisone injectionby 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?

Add comment November 2nd, 2010

Can Changing How You Pay Attention Help Ease Pain?

Dissolving Pain by Fehmi and RobbinsThank 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 dfields820@gmail.com

1 comment October 10th, 2010

Music Prescription for Physical and Emotional Pain

Music and Pain Relief 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.

Add comment September 21st, 2010

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