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Pain Manag 2019 Apr 5. Epub 2019 Apr 5.

Biomedicine, Department of Health Science & Technology, Aalborg University, Frederik Bajers Vej 3 B, 9220 Aalborg East, Denmark.

The identification of new indications for approved or failed drugs is a process called drug repositioning or drug repurposing. The motivation includes overcoming the productivity gap that exists in drug development, which is a high-cost-high-risk process. Repositioning also includes rescuing drugs that have safely entered the market but have failed to demonstrate sufficient efficiency for the initial clinical indication. Read More

Pain Manag 2019 Apr 2. Epub 2019 Apr 2.

Reckitt Benckiser Healthcare International Ltd, 103-105 Bath Road, Slough, Berkshire, SL1 3UH, UK.

Aim: Understand the frequency, nature and over-the-counter (OTC) self-management of patient-reported severe acute pain occasions.

Patients & Methods: A consumer-based survey of adults experiencing acute pain in Australia, Russia and the UK. Participants recorded pain type, frequency and intensity plus action taken to address pain. Read More

Pain Manag 2018 11;8(6):405-408

Department of Neuroscience, University of Turin Medical School, Corso Raffaello 30, 10125 Turin, Italy.

Pain Manag 2019 03 26;9(2):111-113. Epub 2019 Feb 26.

NEMA Research, Inc., Naples, Florida.

Pain Manag 2019 Mar 26;9(2):131-138. Epub 2019 Feb 26.

Department of Psychology, University of Texas at Arlington, Texas, United States.

This article reviews the complexities of the opioid epidemic, considering recent research involving the current state of the opioid epidemic; chronic pain and its role in the crisis; the properties of opioids and how they interact with human neurobiology; the effectiveness and risks of opioids as a treatment for chronic pain; opioid addiction and dependence; and pharmacological and psychological interventions for opioid addiction, opioid dependence, and chronic pain management. Opioid abuse can be reduced with the availability and access to treatment facilities for opioid detoxification; using interdisciplinary treatment models for chronic pain, opioid addiction and dependence; conducting more research in the areas of opioid addiction and opioid dependence; and shifting to an increase in nonpharmacological, less invasive treatments for pain. Read More

Pain Manag 2019 Mar 20;9(2):161-173. Epub 2019 Feb 20.

Department of Psychiatry, University of California Irvine, CA 92868, USA 92868.

Chronic pain is a biopsychosocial condition, and behavioral medicine has made significant contributions to the understanding of the phenomenon and optimization of therapeutic outcomes. The objective of this article is to provide future perspectives of behavioral medicine in pain management based upon recent development in the field. We will briefly review the mainstream approach of cognitive-behavioral therapy, its variations and new and innovative approaches that are on the horizon. Read More

Pain Manag 2019 01;9(1):1-4

Future Science Group, Unitec House, 2 Albert Place, London, N31QB, UK.

Pain Manag 2019 Jan 30. Epub 2019 Jan 30.

Beth Israel Deaconess Medical Center, Harvard Medical School, William Arnold-Carol A Warfield Pain Center Brookline, MA 02215, USA.

This article reviews Nevro Corporation's (CA, USA) Senza System high-frequency spinal cord stimulator (HF10 SCS). HF10 therapy has been shown to be noninferior to traditional low-frequency spinal cord stimulation (SCS), and in some studies, has been shown to have long-term effects that are superior compared with traditional low-frequency SCS in treating both back and leg pain. In addition, safety profiles for the HF10 SCS system were equivalent to traditional SCS. Read More

Pain Manag 2019 Mar 25;9(2):151-159. Epub 2019 Jan 25.

Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

Phantom limb pain (PLP) is a clinically relevant consequence of limb amputation and its treatment is still challenging. Mirror therapy, in other words, observing and engaging in the intact limb's mirrored movements, offers a promising, mechanism-based treatment for PLP. However, intervention and patient characteristics, such as the realism of mirrored exercises and perceptions related to the phantom limb, might influence treatment effectiveness. Read More

Pain Manag 2019 Mar 25;9(2):205-216. Epub 2019 Jan 25.

Department of Anesthesia & Critical Care, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.

Chronic pain continues to be a major health issue throughout the world and a huge economic burden for nations around the world. While the use of opioids does have risks, they are still widely used by clinicians as a treatment option for various chronic pain conditions. This review explores and compares the efficacy and safety of opioid and nonopioid agents for the following commonly encountered chronic pain conditions: neuropathic pain, rheumatoid arthritis joint pain, cancer pain and low back pain. Read More

Pain Manag 2019 Mar 25;9(2):175-189. Epub 2019 Jan 25.

Department of Pediatrics, University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO 64110, USA.

Headache disorders subsumed under the term chronic daily headache (CDH), including chronic migraine, chronic tension-type headache and new daily persistent headache, affect up to 4% of the pediatric population and can be highly disabling and challenging to effectively treat. Although historically the knowledge base about this group of headache disorders in children primarily was derived from clinical observation and extrapolation from adult studies, over the past several years there have been important research findings relevant to the development and management of pediatric CDH that can help inform clinical practice. The intent of this paper is to provide a focused review on recent empirical work done on pediatric CDH and suggest avenues for future work. Read More

Pain Manag 2019 Mar 25;9(2):191-203. Epub 2019 Jan 25.

Department of Pharmaceutical Sciences, Regis University School of Pharmacy, 3333 Regis Blvd. H-28, Denver, CO 80221, USA.

With the opioid epidemic reaching new heights in the USA, it has become critical to find suitable alternatives to opioids. Cannabis, an antinociceptive, is a strong contender to help patients reduce their opioid usage. A growing literature has been examining the complex effects cannabis has on pain relief and on opioid usage; whether it is a substitute for opioids or increases their use. Read More

Pain Manag 2019 Mar 25;9(2):115-121. Epub 2019 Jan 25.

Chronic Pain Fellowship of Anesthesia Department, Wake Forest Baptist Medical Center, Winston-Salem, NC 27103, USA.

Aim: Neural blockade at the celiac plexus is less specific compared with splanchnic nerve block. This retrospective study compares duration and potency of celiac versus splanchnic block. Patients & methods: Analyzed were data of 16 consecutive patients with visceral abdominal nonmalignant pain treated using both celiac plexus and T11 splanchnic block. Read More

Pain Manag 2019 03 25;9(2):107-110. Epub 2019 Jan 25.

Department of Allied Health Professions, University of the West of England, Bristol, England, UK.

Pain Manag 2019 Mar 25;9(2):139-149. Epub 2019 Jan 25.

VA San Diego Healthcare System, Anesthesia Pain Clinic, San Diego, CA, USA 92161.

Although psychosocial evaluations for implantable pain devices have been consensus recommendations since the 1990s, there is an inconsistent support regarding their ability to identify suitable pain device candidates or to predict clinical outcomes. With the emergence of evidence-based practices and the recent release of pain management guidelines emphasizing functional improvements and safety, the disparity between the recommendations for implantable pain device psychosocial evaluations and the evidence supporting them has only grown. In this special report, we describe a revised model for conducting psychosocial evaluations among implantable pain device candidates. Read More

Pain Manag 2019 Jan 7. Epub 2019 Jan 7.

Department of Medical & Clinical Affairs, AcelRx Pharmaceuticals, Redwood City, CA 94063, USA.

Aim: To evaluate the pooled safety of sufentanil sublingual tablets (SSTs) administered at 30-mcg dose equivalents over ≤72 h for moderate-to-severe acute pain management in medically supervised settings.

Patients & Methods: Safety data from SST 30 mcg Phase III studies were pooled with an additional patient subset from studies in which two SST 15 mcg were self-administered within 20-25 min (30-mcg dose-equivalent).

Results: Analyses included 804 patients. Read More

Pain Manag 2019 03 3;9(2):217. Epub 2018 Dec 3.

Pain Manag 2019 01 3;9(1):13-16. Epub 2018 Dec 3.

Faculty of Medicine, Douglas Research Centre, McGill University, Montreal, Canada.

Pain Manag 2019 01 3;9(1):9-11. Epub 2018 Dec 3.

Department of Anesthesiology & Critical Care Medicine, Division of Pain Medicine. The Johns Hopkins University School of Medicine, Baltimore, MD, USA, 21287.

Pain Manag 2019 Jan 3;9(1):45-52. Epub 2018 Dec 3.

Faculty of Psychology & Education Sciences, Universitat Oberta de Catalunya.

Giving less importance to pain and focusing on achieving objectives in accordance with values can help people to live their lives in spite of the pain. We present a rationale for this orientation and several techniques that can help people achieve this. Specifically, we present the importance of starting the intervention by educating people about pain and setting objectives in line with each person's personal values. Read More

Pain Manag 2019 Jan 3;9(1):53-62. Epub 2018 Dec 3.

Vice Chair for Research & Education, Department of Anesthesiology & Pain Management, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA.

Degeneration, whether from age or postsurgical, in the ventral and lateral epidural space can lead to irritation of both the nerve roots and of the nerves present in the epidural space, the peridural membrane and the posterior longitudinal ligament. This irritation is often accompanied by mild scarring. Neuroplasty is a specific procedure designed to relieve this irritation. Read More

Pain Manag 2019 Jan 3;9(1):37-44. Epub 2018 Dec 3.

Consultant in Palliative Medicine, Department of Palliative Care, Chelsea & Westminster Hospital NHS Foundation Trust, London, UK.

People living with HIV represent a unique aging population, living with a chronic condition associated with significant pain. A number take high dose, long-term opioids to manage moderate to severe chronic pain, presenting specific risks. This article highlights the size and impact of this problem and outlines the service objectives and set up of a specialist clinic to manage people living with HIV on high dose opioids, alongside its successes and learning points. Read More

Pain Manag 2019 Jan 3;9(1):17-35. Epub 2018 Dec 3.

Unit of Clinical Biostatistics and Bioinformatics, Aalborg University Hospital North, Aalborg, Denmark.

Aim: Glyceryl trinitrate (GTN) provokes an immediate migraine-like headache, followed by a delayed migraine attack in migraineurs. In healthy volunteers, only an immediate, less severe and shorter headache occurs. The presence of an already sensitized nervous system in migraineurs may underlie the more intense and prolonged GTN-evoked headaches. Read More

Pain Manag 2019 Jan 5;9(1):93-106. Epub 2018 Dec 5.

Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, 02129, USA.

Opioid misuse leading to dependence is a major health issue. Recent studies explored valid alternatives to treat pain in postsurgical settings. This systematic review aims to discuss the role of transcranial direct current stimulation (tDCS) in preventing and treating postoperative pain and opioid dependence. Read More

Pain Manag 2019 01 5;9(1):5-7. Epub 2018 Dec 5.

Departments of Neurological Surgery & Anesthesiology & Pain Medicine, University of Washington, Seattle, 98195 WA, USA.

Pain Manag 2019 Jan 5;9(1):63-79. Epub 2018 Dec 5.

Department of Pain Medicine, The Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK.

Increasing numbers of those living with and beyond cancer presents a clinical challenge for pain specialists. A large proportion of these patients experience pain secondary to their disease or its treatment, impeding rehabilitation and significantly impacting upon their quality of life. The successful management of this pain presents a considerable challenge. Read More

Pain Manag 2019 Jan 5;9(1):81-91. Epub 2018 Dec 5.

Research Group Experimental Health Psychology, Department of Clinical Psychological Science, Maastricht University, The Netherlands.

Activity interruptions, namely temporary suspensions of an ongoing task with the intention to resume it later, are common in pain. First, pain is a threat signal that urges us to interrupt ongoing activities in order to manage the pain and its cause. Second, activity interruptions are used in chronic pain management. Read More

Pain Manag 2019 Mar 19;9(2):123-129. Epub 2018 Nov 19.

Servicio de Neurología y Neurofisiología, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.

Aim: Carpal tunnel syndrome (CTS) is a very common entrapment neuropathy characterized by pain and paresthesia in the territory of the median nerve. Although this syndrome has a considerable impact on the patient's quality of life, its medical treatment is far from optimal.

Material & Methods: We performed an observational study to evaluate Nucleo CMP Forte in patients with electromyography-confirmed, mild-moderate CTS. Read More

Pain Manag 2018 Nov 9;8(6):487-493. Epub 2018 Nov 9.

Department of Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Cancer therapy-induced oral mucositis (CTIOM) can cause intolerable oral pain resulting in difficulty in chewing, swallowing and speaking. Thus, leading to patients requiring aggressive measures, such as parenteral feeding, the placement of gastric feeding tubes and discontinuation of oncologic treatments. Although, pain is the debilitating symptom, current efforts seem to focus independently in the histological damage, not in pain and symptom care. Read More

Pain Manag 2018 Nov 9;8(6):437-440. Epub 2018 Nov 9.

Carolinas Pain Institute, 145 Kimel Park Drive, Winston-Salem, NC 27103, USA.

Aim: To describe two consecutive cases of Postural Orthostatic Tachycardia Syndrome (POTS)-related chronic abdominal pain control in children after bilateral splanchnic block.

Patients & Methods: Two pediatric patients with chronic abdominal pain related to POTS received celiac and T11 splanchnic plexus block for pain control.

Results: While celiac plexus block did not provide any substantial relief of their pain, splanchnic block provided a long-term improvement in pain scores, nausea and vomiting cessation. Read More

Pain Manag 2018 Nov 5;8(6):465-474. Epub 2018 Nov 5.

Master's & Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno 475, Tatuapé, São Paulo, SP, Brazil.

Aim: To evaluate whether active interferential current (AIC) before pilates exercises improves pain faster than placebo interferential current (PIC) in patients with chronic nonspecific low back pain (CNLBP).

Methods: A total of 142 patients with CNLBP were treated with AIC or PIC before pilates exercises. Pain intensity was measured daily before and after treatment by Pain Numerical Rating Scale. Read More

Pain Manag 2018 Nov 5;8(6):475-485. Epub 2018 Nov 5.

Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA.

Anesthesiologists set up regional anesthesia and acute pain medicine programs in order to improve the patient outcomes and experience. Given the increasing frequency and volume of newly described techniques, applying a pragmatic framework can guide clinicians on how to critically review and consider implementing the new techniques into clinical practice. A proposed framework should consider how a technique: increases access; enhances efficiency; decreases disparities and improves outcomes. Read More

Pain Manag 2018 Nov 5;8(6):495-503. Epub 2018 Nov 5.

Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Canada.

Aim: In children, intravenous anesthetic premedication can be distressing. Intranasal (IN) ketamine offers a less invasive approach.

Materials And Methods: We included randomized trials of IN ketamine in anesthetic premedication in children 0-19 years. Read More

Pain Manag 2018 11 5;8(6):409-413. Epub 2018 Nov 5.

NEMA Research Inc. & Co-founder of MelRose Pain Solutions, Naples, FL, USA.

Pain Manag 2018 Nov 5;8(6):427-436. Epub 2018 Nov 5.

Institute for Pain Medicine/Pain Practice Wiesbaden, Germany.

Aim: The secretolytic drug ambroxol may be useful for the treatment of neuropathic pain due to its multiple modes of action. We hypothesized that ambroxol may be a treatment option for complex regional pain syndrome (CRPS).

Methods: Additional to standard therapy, eight CRPS-patients with symptoms of less than 12 months were treated with topical 20% ambroxol cream. Read More

Pain Manag 2018 Nov 5;8(6):455-463. Epub 2018 Nov 5.

CS General Ricardos. Madrid 28019, Spain.

Aim: To determine the predictive factors of the neuropathic pain in patients with carpal tunnel syndrome (CTS), and the impact of such neuropathic pain on patient's activity.

Methods: Douleur Neuropathique 4 questionnaire, Short Form-Brief Pain Inventory test and Boston Carpal Tunnel Syndrome Questionnaire were completed and results were stratified according neuropathic pain and work activity of the patients.

Results: 69 of 90 patients with CTS had neuropathic pain (76. Read More

Pain Manag 2018 Sep;8(5):389-403

Department of Anesthesiology and Critical Care, Memorial Sloan Kettering Cancer Center, New York, NY 100652, USA.

Pain is a ubiquitous part of the cancer experience. Often the presenting symptom of malignancy, pain becomes more prevalent in advanced or metastatic disease and often persists despite curative treatment. Although management of cancer pain improved following publication of the WHO's analgesic ladder, when used in isolation, conservative approaches often fail to control pain and are limited by intolerable side effects. Read More

Pain Manag 2018 09 3;8(5):313-315. Epub 2018 Oct 3.

Laboratory for Biomaterials & Drug Delivery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.

Pain Manag 2018 09 3;8(5):317-319. Epub 2018 Oct 3.

Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital of Muenster, Albert-Schweitzer Campus 1A, 48149 Muenster, Germany.

Pain Manag 2018 Sep 3;8(5):321-326. Epub 2018 Oct 3.

Department of Physical Medicine & Rehabilitation, Gulhane School of Medicine, University of Health Science, Ankara 06100, Turkey.

Aim: To investigate the long-term effect of fluoroscopy guided cervical transforaminal epidural steroid injection on neck pain radiating to the arm due to cervical disc herniation.

Materials & Methods: 64 patients (26 women [40.6%], 38 men [59. Read More

Pain Manag 2018 Sep 3;8(5):341-352. Epub 2018 Oct 3.

Department of Pediatrics, St. Joseph's Medical Center, Paterson, NJ 07503, USA.

Aim: The primary objective of this review is to provide an updated, comprehensive overview on the efficacy of intranasal fentanyl (INF) for acute pain relief in the pediatric population.

Methods: Utilizing the Preferred Reporting Instructions for Systematic Reviews and Meta-Analyses (PRISMA), we were able to screen articles based on key words to reach a final number of 10 studies.

Results: All but one study showed that INF was efficacious for pain relief in this select pediatric population. Read More

Pain Manag 2018 Nov 21;8(6):415-426. Epub 2018 Sep 21.

Jefferson Headache Center, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.

Migraine is a highly prevalent neurological pain syndrome, and its management is limited due to side effects posed by current preventive therapies. Calcitonin gene-related peptide (CGRP) plays a crucial role in the pathogenesis of migraine. In recent years, research has been dedicated to the development of monoclonal antibodies against CGRP and CGRP receptors for the treatment of migraine. Read More

Pain Manag 2018 Sep 13;8(5):363-375. Epub 2018 Sep 13.

Division of Anesthesiology, Critical Care & Pain Medicine, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 0409, Houston, TX 77030, USA.

The burdensome condition of chemotherapy-induced peripheral neuropathy occurs with various chemotherapeutics, including bortezomib, oxaliplatin, paclitaxel and vincristine. The symptoms, which include pain, numbness, tingling and loss of motor function, can result in therapy titrations that compromise therapy efficacy. Understanding the mechanisms of chemotherapy-induced peripheral neuropathy is therefore essential, yet incompletely understood. Read More

Pain Manag 2018 Sep 13;8(5):377-388. Epub 2018 Sep 13.

Department of Anaesthesiology, Queen Elizabeth Hospital, Hong Kong.

Fibromyalgia is a chronic pain syndrome of unclear pathophysiology. It is believed to be a dysfunction of the CNS, but no definite structural lesion has been identified so far. Despite a number of changes in the diagnostic criteria, diagnosis remains a clinical one. Read More

Pain Manag 2018 09 13;8(5):309-311. Epub 2018 Sep 13.

Army College of Medical Sciences, Department of Pharmacology, New Delhi, India.

Pain Manag 2018 Sep 13;8(5):353-361. Epub 2018 Sep 13.

Department of Anesthesiology & Perioperative Medicine, The University of Texas-MD Anderson Cancer Center, Houston, TX, USA.

Aim: To summarize the literature on the long-term impact of perioperative opioids in colorectal cancer.

Materials & Methods: Combined results from two searching strategies in PubMed/MEDLINE (1950-2018), based on a PICO approach; P: Opioid influence on cancer-related long-term outcome in patient undergoing colorectal surgery; I: Opioid drugs administered in the perioperative period; C: Correlation between dose and/or type of opioid with long-term oncologic outcome; O: Disease-free survival and/or overall survival (OS).

Results: Thirteen articles fulfilled the predetermined inclusion criteria. Read More

Pain Manag 2018 Nov 3;8(6):441-453. Epub 2018 Sep 3.

Department of Plastic, Reconstructive & Hand Surgery, Unit of Regenerative Therapy, University Hospital of Lausanne, 1066 Epalinges, Switzerland.

Aim: Limb amputation traumatically alters body image. Sensations rapidly prevail that the limb is still present and 85% of patients portray phantom limb pain. Throughout the testimonies of amputated patients with intense phantom limb pain, we show the difficulty in treating this chronic pain with current pharmacological and nonpharmacological therapies. Read More

Pain Manag 2018 Sep 6;8(5):327-339. Epub 2018 Aug 6.

Medical School, The University of Western Australia, Perth, Western Australia.

Background: Tapentadol is a novel atypical opioid. Anecdotal evidence suggests that tapentadol has a lower toxicity than conventional opioids.

Objectives: To evaluate all single-drug mortality due to tapentadol and assess serious adverse events caused by tapentadol. Read More

Pain Manag 2018 Jul 14;8(4):271-275. Epub 2018 Jun 14.

Andrews Sports Medicine & Orthopedic Center, Birmingham, AL 35205, USA.

There are limited treatment options for patients with a chronic refractory greater trochanteric pain syndrome. Orthobiologic interventions may stimulate tendon healing and improve pain and function in patients who fail the standard conservative treatment. Since the US FDA's new position statement regarding the centrifugation of bone marrow aspirate products as a potentially 'more than minimally manipulated' product, there is a growing concern about the most common bone marrow aspirate concentrate technique. Read More

Pain Manag 2018 Jul 14;8(4):287-295. Epub 2018 Jun 14.

Department of Anesthesia, Womack Army Medical Center, 2817 Reilly Road, Fort Bragg, NC 28310, USA.

Aim: The purpose of this randomized, single-blind trial was to evaluate the efficacy of battlefield acupuncture in reducing postoperative pain and opioid consumption after adult tonsillectomy.

Methods: Adult participants undergoing a tonsillectomy were randomized to either receive auricular 'battlefield' acupuncture or not. Groups were compared using the Wilcox rank sum test, Fisher's exact test and a generalized estimating equations model for post-discharge pain scores. Read More