by Pamela Katz Ressler, RN, MS-PREP, HN-BC, adjunct faculty Pain Research, Education and Policy (PREP) program at the Tufts University School of Medicine, and moderator of the PREP-Aired Blog
Can diet be a tool in our pain management arsenal? According to McGill professor and researcher, Dr. Yoram Shir the answer is yes. The Pain Research, Education and Policy Program (PREP) was honored to host Dr. Shir on February 9, 2012 and hear about his fascinating research on the association of pain and diet. Dr. Shir, director of the Alan Edwards Pain Management Unit at McGill University Health Centre, related that moving his lab from Israel to the United States created an unexpected opportunity to study the effect of different standard diets on pain in animal models (lab rats). The combination of type of protein as well as type of fat suggested an influence on pain in the animals studied.
Exploring the observation of a correlation between diet and pain, Dr. Shir began testing various combinations of protein and fat. Interestingly, a diet high in soy protein and omega-3 fatty acids appeared to inhibit pain, while a diet rich in canola oil appeared to increase the pain response. Small pilot studies with human subjects, those suffering from neuropathic pain, have been promising, but larger studies will be needed to further generalize the findings.
The Pain Research, Education and Policy program thanks Dr. Shir for sharing with us his exciting research in diet and pain.
February 27th, 2012
by Wendy Williams, BSN, M.Ed., Associate Director of the Pain Research, Education and Policy Program (PREP), Tufts University School of Medicine
The evidence continues to mount that proactive pain management makes a difference in lives (in this case, for both the identified patient and the staff and families that care for them in nursing homes).
A research article was published in the British Medical Journal on July 17th and concludes the following: “A systematic approach to the management of pain significantly reduced agitation in residents of nursing homes with moderate to severe dementia. Effective management of pain can play an important part in the treatment of agitation and could reduce the number of unnecessary prescriptions for psychotropic drugs in this population.”
You can listen to a BBC journalist interviewing one of the authors here. This problem has been outlined before; the challenge of good pain assessment in the non-verbal. In particular, a 2006 Web-MD article reviews a study done in Australia by Leonie J. Cole and colleagues entitled – Pain a Problem in Alzheimer’s Disease: Undertreated Pain Plagues Alzheimer’s Patients Who Hurt, but Can’t Tell.
Have you heard of any good studies recently? We need to keep promoting evidence based practice and advocacy for people with undertreated pain…. Hope to hear from you on any news you might have on this front.
July 18th, 2011
by Wendy Williams, BSN, M.Ed, Associate Director PREP Program, Tufts University School of Medicine
The PREP Community here at Tufts is pleased to announce our most recent capstone presentations. Come to the Tufts Health Sciences Campus, 136 Harrison Ave, Boston, M&V conference room 1, on Monday, May 2 at 3:30pm to both hear from two of our nurse graduates and to enjoy a reception following.
Carol Krieger, RN, BSN, LicAc, MAOM: Development of a research proposal for the effectiveness of acupuncture as a treatment of central and neuropathic pain syndromes from polytrauma – spinal cord injury, traumatic brain injury, and phantom limb pain
Pamela Katz Ressler, RN, BSN, HN-BC: Communicating the Experience of Chronic Illness through Blogging
Please join us as we all learn on how the study of pain in this graduate program of ours is improving the world of pain… one student at a time!
PREP Capstones_May 2011 Presentations
April 25th, 2011
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 Gretchen Kindstedt, MS-PREP student
The MassPI Spring 2009 General Meeting, “Current Trends in Pain Management,” will be held on April 3, 2009 at the Best Western Royal Plaza, Marlborough, MA. There will be 6 CEU available for nurses, 0.65 CEU for pharmacists, and category 2 CMEs for physicians. The registration fee of $75.00 also includes a continental breakfast and lunch. The speakers will cover different aspects of pain management with Dr. Daniel Carr (founder of the Tufts University Pain Research, Education and Policy Program) as the keynote speaker. The Pain Research Education and Policy Program at Tufts (PREP) will also have an information table at the event.
For more information please visit the MassPI website or contact us by phone (508) 270-4653 or email
To download a program brochure, click here
MASSPI MISSION STATEMENT
The Massachusetts Pain Initiative (MassPI) is a statewide, nonprofit, volunteer organization dedicated to ending needless suffering from persistent and acute pain and to improving the quality of life for all people affected by pain.
MassPI is a group of healthcare professionals, including doctors, nurses, social workers, caregivers, and community members who are interested in helping people with pain.
MassPI works to…
•Share accurate pain management information.
•Educate doctors, nurses and other health care providers about state of the art pain management.
•Raise community awareness about pain.
•Influence government representatives to change laws to improve access to effective pain management.
MassPI is a member of the Alliance of State Pain Initiatives.
March 15th, 2009
by Ylisabyth (Libby) Bradshaw, D.O., M.S.,FACEP, Academic Director of the Pain Research, Education and Policy program at Tufts University School of Medicine
Does it matter whether pain is a disease or a symptom?
For people living and suffering with pain, such a question may seem irrelevant. Perhaps like splitting hairs.
“Just make the pain better.”
“I don’t care what category you put it in!”
“Don’t just talk about it. Do something! Anything to relieve this agony.”
Why would it matter whether and how medical professionals want to categorize pain?
Symptoms are defined as subjective experience; diseases are defined in objective terms, with specified causes, or associated signs and symptoms.
People with pain certainly have a personal, internal experience of pain. And, aside from asking a person to describe and rank the intensity of their own pain, there’s no medical test for determining the type of pain or its severity.
The predominant medical view for centuries has been that pain is a symptom, and viewed as an entirely subjective experience by an individual. Physiologically, pain has been seen as simply the transmission through nerves of information about damage or potential damage to parts of the body.
After all, when pain is caused by something inside the body – a ruptured disk, nerve disease, or compression from an expanding tumor – it seems that something is irritating or pressing on a nerve, which is then communicated, allowing us to feel pain. Pain is a classic symptom, it would seem.
And pain could hardly be expected to be a disease when it’s caused by forces from outside the body – a fall, an automobile crash, or even surgery; it seems completely straightforward – and easy to understand when nerves are compressed, crushed, or cut – pain is the symptom.
Yet, accumulating evidence in neuroscience says pain is more complicated. No matter what initiates pain – from traumatic forces to specific neurological disorders – if conditions continue, and the pain signal is maintained, specific bodily changes occur.
Measurable now in research labs, such characteristic, physiological alterations, arising from actively transmitting information about pain, can unfortunately become sustained biochemical changes. Ordinarily, our bodies reverse this process when the initial circumstances causing pain are relieved. Yet, too often these changes become irreversible, and permanent, resulting in chronic pain.
Two imperfect examples from our material world – Once cement is mixed and sets up, it becomes a new substance. Once glue is used, it can bind to a substance, and be impossible to remove. The science of pain is still discovering answers, and resolving uncertainties. OK, our brains and nerves are not comparable to cement, glue, or jello. Yet it is clear, signals about definite or potential tissue injury turn on many biochemical processes that transmit information about pain through our nerves. Over time, these can become irreversible changes. Pain, then, is beyond being merely a symptom.
Please join this initial discussion on the Pain Research, Education and Policy blog at Tufts University School of Medicine, and include your thoughts regarding, “Is pain a symptom or a disease?”
If pain is more than a symptom, does that make it a disease?
Common definitions of “disease” include impaired functioning*. From your knowledge and experience, how do pain conditions have impaired functioning?
We look forward to interesting exchanges from students, faculty, practitioners, alumni and members of the general public committed to improving the conditions treatment and prevention of individuals across all ages with acute and chronic pain problems.
* Disease -
“a condition of the living animal …[or one of its parts] that impairs normal functioning and is typically manifested by distinguishing signs and symptoms” MeriamWebster
“an impairment of the normal state of the living animal … or one of its parts that interrupts or modifies the performance of the vital functions, [and] is typically manifested by distinguishing signs and symptoms…” Medline
February 22nd, 2009
The PREP program’s small classes and collaborative learning experiences lead to wonderful , long lasting connections between students, faculty and alumni. PREP students, faculty, staff and alumni joined together at a local Boston restaurant on February 13, 2009 to celebrate three new PREP graduates, Anne Colyn, Jess Gerber, and Marie Belle Francia, and wish them well on their new career adventures.
MS-PREP 2008 graduates Marie Belle Francia, Anne Colyn, and PREP academic director Libby Bradshaw
MS-PREP 2008 graduate Jess Gerber, PREP student Gretchen Kindstedt, MS-PREP 2008 graduate Anne Colyn
PREP student Sherry Brink, MS-PREP 2008 graduate Marie Belle Francia, former PREP program director Jeanne Connolly, PREP student Cindy Rodman
February 14th, 2009