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

Integrative Medicine Research Lecture Series

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

Add comment August 4th, 2010

Military Leads the Way in Acupuncture for PTSD

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by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP graduate student and PREP-AIRED blog moderator
With an estimated 17 percent of U.S. miliary personnel returning from Iraq and Afghanistan with symptoms of PTSD or Post Traumatic Stress Disorder (Archives of General Psychiatry), the military is now leading the way in integration of western and eastern models of care into the healthcare system. Use of acupuncture, meditation, yoga, and tai chi are currently being utilized in conjuntion with allopathic medical and psychological care. A recent article in Statesman.com highlights these integrative efforts.
Click here to read the article.

1 comment June 24th, 2010

Study Highlights How Adensosine May Play a Role in Pain Relief with Acupunture

by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP student and PREP-AIRED blog moderator
Thanks to MS-PREP alumna, Xu Cheng, for sending along a link to a recent issue of Nature Neuroscience which highlights a study on acupuncture’s pain reducing effect. In animal studies, the neuromodulator adenosine appears to play a significant role in the local anti-nociceptive properties of acupuncture. These observations indicate that adenosine mediates the effects of acupuncture and that interfering with adenosine metabolism may prolong the clinical benefit of acupuncture Click here to read the abstract of the study

Add comment June 2nd, 2010

Massachuetts Pain Initiative Survey Finds Chronic Pain Affects 1 in 4 Adults in Massachusetts

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by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP student, PREP-AIRED blog moderator
Thanks to Cyndie Rodman, MS-PREP ’09, for sending along the press release from the recent Massachusetts Pain Initiative Survey. Cyndie writes that “the survey not only quantified the incidence of chronic pain among the Massachusetts general population, but also the differences and disparities experienced by minorities versus non-minorities. This is the first Massachusetts study we are aware of to look at how pain is experienced by minorities compared to non-minorities.” Tufts University School of Medicine’s Pain Research, Education and Policy (PREP) faculty member, Carol Curtiss, RN, MSN, as well as PREP guest lecturer, Paul Arnstein, PhD, APRN-BC, played instrumental roles in the survey. Click here to read the Massachusetts Pain Initiative’s press release about the survey. For more information about the Massachusetts Pain Initative, click here.

2 comments May 10th, 2010

Chiari Malformation and Pain

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.

Add comment May 3rd, 2010

Pain Relievers and Hearing Loss in Men

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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.

Add comment April 14th, 2010

Effective Management of Chronic Pain and Addiction in Primary Care

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
Register Online
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
1:30-4pm.
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,
PCSSmentor.org).
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
Award.

1 comment April 1st, 2010

Feeling the Pain: Addressing Pain Care in the United States

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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

1 comment March 7th, 2010

“Cough Trick” Reduces Pain From Immunizations

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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

Add comment February 2nd, 2010

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