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 Richard Glickman-Simon, MD, Director, Programs in Pain Research, Educatin and Policy, Tufts University School of Medicine
Upcoming conference of interest: Effective Management of Chronic Pain and Addiction in Primary Care
Saturday May 8th, 2010, 9-4pm, Tufts University School of Medicine,
Sackler Building, 145 Harrison Ave. Boston
NO FEE TO ATTEND: sponsored by Greater Lawrence Family Health Center,
Tufts Family Medicine, Mass. League of Community Health Centers,
MassAHEC, and UMASS Medical School
Featuring practical interactive workshops on drug testing, patient
contracts and chronic pain, addiction treatment, and suboxone. SAM from
the ABFM on chronic pain (for family medicine recertification) offered
Fantastic speakers include Dr. Dan Alford (Medical Director,
Office-Based Opioid Treatment Program at BMC), Dr. Luis Sanchez
(Director of Physician Health Services/MMS), Dr. Alan Wartenberg
(Associate Medical Director of the DVA Providence Medical Center Opioid
Treatment Program), and Dr. Jeff Baxter (mentors providers on
addiction/pain treatment through the Physician Clinical Support System,
No fee to attend (breakfast, lunch and snacks included). Receive up to
4.5 hours in Category I credit towards the AMA Physician’s Recognition
April 1st, 2010
by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP student, PREP-AIRED blog moderator
The Mayday Fund, a leading organziation dedicated to alleviating the incidence, degree and consequence of human physical pain has announced its recommendations for high-quality, cost-effective pain care in this country as we move forward in the decade. The Mayday Fund special Committee on Pain and the Practice of Medicine has recommended 12 action steps in their report entitled: A Call to Revolutionize Chronic Pain Care in America. The committee was made up of clinicians representing nursing, medicine, pharmacy and other healthcare professionals to provide comprehensive multidisciplinary strategies to move forward in addressing this widespread public health issue. According the Mayday Fund’s report, chronic pain affects as estimated 70 million Americans making the burden of chronic pain on society greater than diabetes, heart disease and cancer combined. To read the complete report, click here
March 7th, 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
by Anne Colyn, M.Ac, MS-PREP
It seems there are several opportunites in the United Kingdom for those interested in pain research and related topics. A website for academic-based opportunities in employment, research, paid PhD studentships, etc, is currently listing quite a range of such opportunities related to pain. Birmingham City University in the UK is offering a PhD studentship in Pain Research. Deadline is coming up in just a few days (Monday, Jan 25, 2010) for an Oct 2010 start!
January 21st, 2010
by Lisa Gualtieri, PhD, Adjunct Clinical Professor, Tufts University School of Medicine
Any woman who has had children knows that labor is painful. Psychologist Richard Stephens, at Keele University in England, was inspired by his wife’s “unsavory language during the throes of labor”. He questioned “whether swearing alters individuals’ experience of pain.”
Dr. Stephens conducted a study with 67 undergraduates as follows: They were asked to write down words that they might say after hitting their thumb with a hammer and words to describe a table. The students “then immersed a hand in frigid water for as long as they could bear, while either swearing or repeating an innocuous word. When people had a swear word for their mantra (popular choices: the s-word, the f-word, and two b-words), they were able to keep a hand in the cold water about 40 seconds longer. The people who swore also reported less pain after the fact. Swearing increased heart rate in participants, and researchers theorized that the increase might signal the beginning of a fight-or-flight response, which allows the body to tolerate or ignore pain.”
“Swearing increases your pain tolerance,” according to Dr. Stephens. Steven Pinker, a Harvard psychologist and author of The Stuff of Thought, an exploration of the psychology of language, said that “humans are hardwired to swear cathartically… Swearing probably comes from a very primitive reflex that evolved in animals.”
Diana Van Lancker Sidtis, a professor of speech language pathology and audiology at New York University, said that “in certain circumstances; either because we don’t bother to inhibit them or because the shock of pain or discomfort momentarily surpasses the safeguards; our impulse for obscenity takes over.”
Back to giving birth: Stephens’ study found that swearing reduced the perception of pain more strongly in women than in men. This may be because, according to Dr. Pinker, “men swear more than women,” thus “swearing retains more of an emotional punch [for women] because it has not been overused.
January 14th, 2010
By Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP student and PREP-AIRED blog moderator
According to the Centers for Disease Control and Prevention, falls are the leading cause of injury deaths among older adults (2005). Falls are also the most common cause of non-fatal injuries and hospital admissions for trauma in elderly individuals. A new study suggests that persistent or chronic pain may be a risk factor for falls in the elderly. “No matter how it was assessed, seniors with chronic pain had a 1.5-fold increased risk of falling,” Suzanne G. Leveille, PhD, RN, of the University of Massachusetts in Boston, and colleagues reported in the November 25, 2009 Journal of the American Medical Association. Researchers conducted the longitudinal study of 749 older adults, ages 70 +, from 2005-2008. Study findings suggested that patients who had chronic pain had higher rates of falls during follow-up than those who were pain-free (P<0.05).
In adjusted models, each measure of chronic pain was independently associated with the increased occurrence of falls. Compared with those without pain or those in the lowest tertiles of pain scores, the greatest risk for falls was observed in those who:
•Had two or more pain sites (RR 1.53, 95% CI 1.17 to 1.99)
•Were in the highest tertiles of pain severity (RR 1.53, 95% CI 1.12 to 2.08)
•Had interference with activities (RR 1.53, 95% CI 1.15 to 2.05)
Dr. Leveille suggested that paying closer attention to assessment of pain in older adults could decrease the risk of falls, contribute to better health outcomes, and help people to continue living actively and independently in the community."
December 1st, 2009
by Nancy Mitchell, MS-PREP/NESA student
The non-profit organization, Human Rights Watch, is bringing attention to the lack of adequate pain care in many areas of the world. Human Rights Watch has recently published a 102-page report highlighting the current state of palliative pain care in India. To read more…click here.
November 9th, 2009
By Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP student and PREP-AIRED blog moderator
The Pain Research, Education and Policy Program at Tufts University has reached an important milestone by celebrating its first ten years of existence. In the Fall of 1999, the first two students were welcomed into the new master’s program, the first of its kind in the United States, founded by two prominent pain specialists, Daniel Carr, MD, an anthesthesiologist-internist, and sociologist Kathryn Lasch, PhD; and housed within the Tufts University School of Medicine. Recent MS-PREP alumna, Xu Cheng, discovered an archive edition of the Tufts Daily announcing the MS-PREP program’s launch on October 26, 1999.
Click here to view the Tufts Daily 1999 article
In 2009, the PREP program remains an innovative, multidisciplinary program that has grown and evolved since its launch a decade ago. As one of the foremost experts in the field of pain management, Dr. Daniel Carr continues to be a guiding presence in the growth and direction of the Pain Research Education and Policy program. On the occasion of the 10 year anniversary of the program, I asked Dr. Carr to share his reflections about the PREP program with the PREP-AIRED blog community. Dr. Carr’s remarks appear in the italicized text below:
“Ten years ago, a front page article in the Tufts Daily announced the launch of a new Masters of Science degree program in Pain Research, Education and Policy (“MSPREP”). Kathryn Lasch PhD, a medical sociologist now with an international outcomes research consultancy, and I were its co-founders. The inaugural class had 2 students. Shahnaz Turkistani, a physician, returned to her native Saudi Arabia after graduation and now treats women with pain. Ewan McNicol, a Tufts-based pharmacist now on the PREP faculty, is known internationally for systematic reviews of pain therapies with the Cochrane Collaboration and others.
The first of its kind in the United States, our program remains unique and has grown slowly and steadily since 1999. We now offer a shorter, certificate track in addition to the original MS track. We owe much to the Sackler family, whose initial and ongoing support has been indispensable, the Hermanson family for funding scholarships, and the Saltonstall family for supporting pain research in the Department of Anesthesia at Tufts Medical Center, the source of many PREP faculty. Jeanne Connolly-Horrigan combined a marketing background and passion for pain control to help us grow enrollment during the mid-2000s. Richard Glickman-Simon MD, now its Director, brought a career-long interest in complementary and alternative medicine and built a successful dual degree program between PREP and the New England School of Acupuncture.
Our faculty have taught students, treated patients, advised policymakers and professional organizations, and authored many articles and books. Our next book is a guide to pain treatment for busy clinicians practicing in the current era of health care reform. The editors of this volume are Ewan McNicol MSPREP, Carol Curtiss MSN RN BC, a distinguished nurse educator and PREP faculty member, and me; other contributors include Richard Glickman-Simon MD, Libby Bradshaw DO, MS, PREP’s Associate Director, and Steven Scrivani DDS PhD, another valued faculty member. We 6 faculty comprise PREP’s Steering Committee. Given pain’s burden upon public health, it is most appropriate that PREP is housed within the Department of Public Health and Community Medicine, capably led by Dean Harris Berman and more recently, Dean Aviva Must.
For me, the best thing about the first 10 years of PREP has been seeing our students succeed as they extend and enhance their careers, helping those with pain and becoming educational resources for their new colleagues. Students have come to PREP from across the US and from many countries, with diverse healthcare and non-healthcare backgrounds, and from other graduate programs at Tufts and affiliates. They have been MDs, RNs, DDSs, pharmacists, PTs, OTs, EMTs and others interested in pain, whether making a mid-career change from another field or beginning their graduate training immediately after college. One is the principal pain nurse educator in a large urban medical center. Another works with a world-famous outcomes research consultancy, on pain. Yet another accepted a high-profile advocacy position at a major pharmaceutical company. Another works in a hospice. Others have proceeded to medical or osteopathic school or to seek a PhD.
Our students are a very special group of altruistic people. We are proud of all they have achieved. We look forward to serving more and more students as society at large and the health professions increasingly understand how fundamentally important pain control is for quality of life, and accept pain control as a basic human right.”
Thank you to Dr. Carr and the PREP faculty for their vision and passion in the field of pain control, may the PREP program continue to blaze the trail for many years to come.
October 29th, 2009
by Jessica Gerber, M.Ac., Lic. Ac., MS-PREP
Another article about acupuncture and low back pain…Though this one focuses on pregnant women.
HealthDay News recently reported: “A week of continuous auricular acupuncture can reduce pain and disability in pregnant women with low back and posterior pelvic pain, according to a study published in the September issue of the American Journal of Obstetrics & Gynecology“
“Shu-Ming Wang, M.D., of the Yale School of Medicine in New Haven, Conn., and colleagues conducted a randomized, controlled trial of 152 women at 25 to 38 weeks’ gestation who had lower back pain, posterior pelvic pain or both, and were given either acupuncture or sham acupuncture, or put on a waiting list (control group). The subjects were then monitored for two weeks.”
“Compared with those in the sham acupuncture and control groups, women receiving auricular acupuncture reported the best results, the researchers discovered. At the seven-day mark, about 80 percent of the acupuncture group reported a clinically significant reduction in pain, whereas only 56 percent of the sham acupuncture group and 36 percent of those in the control group did. However, the authors note, for some of the participants, the benefits were not sustained.”
“Long-term efficacy of auricular acupuncture as a treatment for pregnancy-related low back and posterior pelvic pain is still inconclusive but clearly shows promise,” Wang and colleagues conclude. “A future large-scale randomized control study is indicated to explore the characteristics of acupuncture responders versus non-responders [and] the optimal duration of treatment to achieve the sustained therapeutic effect.”
October 14th, 2009