Neuropathic Pain

Pharmacologic approaches are still "the most widely used therapeutic options to ameliorate persistent pain," according to this overview from UpToDate. But with growing awareness of the potential negative outcomes associated with long-term opioid therapy, a newly discovered approach may be just what the doctor ordered.

Sustained neuropathic pain following peripheral nerve injury may be caused by the decrease of expression of spinal astrocyte connexin43 according to a recent study.

Japanese researchers have developed a novel technique using gold nanorods that could lead to therapies for pain relief in patients with intractable pain, possibly including cancer-related pain.

Electronic medical records from neurologists' offices are going into a practice-based research network in Evanston, Ill. It's part of an academic medical center's initiative to harness the data for scientific and clinical purposes. In a journal article researchers offer tips on replicating their system.

Pachyonychia congenita (PC), a rare skin disorder, can cause an inordinate amount of neuropathic pain, a study in Clinical and Experimental Dermatology confirms. In the chilling words used by the researchers, "The health states observed in this sample are at a level that the average US citizen would forfeit one-third of their remaining lifespan to avoid."

Study finds A3AR agonists reverse neuropathic pain

Treating neuropathic pain with opioids can be done smarter and without upping the dosage, suggests a report in Pharmacological Reports.

Treatment advances in rheumatoid arthritis (RA), including the development and widespread deployment of disease-modifying antirheumatic drugs (DMARDs) and biologic therapies, mean that patients now often have significant periods of low disease activity. But a study in Arthritis Research & Therapy indicates that even patients reaching sustained remission report some potential neuropathic pain even when inflammation is well-controlled.

An analysis in Canadian Family Physician casts further doubt on the ability of marijuana to provide pain relief for patients with chronic noncancer pain (CNCP). Yet, in an accompanying editorial in the same issue, Roger Ladouceur, MD, Associate Scientific Editor of CFP, suggests that pain management specialists continue to prescribe it.

The source of neuropathic pain is a biological process called endoplasmic reticulum (ER) stress, according to findings published in the journal Proceedings of the National Academy of Sciences (PNAS).

Lidocaine metabolite N-ethylglycine (EG) relieves hyperalgesia and allodynia in animal models for chronic pain, suggests a study in Pain. The finding is an indicator that use of Glycine transporter 1 substrates might constitute a new drug target for the modulation of glycinergic inhibition in pain signaling.

Canada-based researchers examined the effectiveness of opioids for the long-term management of chronic neuropathic pain and found less than encouraging results, according to a study in The Journal of Pain.

Research has established that various parts of the trigeminal system are responsible for peripheral symptoms of migraine. Treatment with corticosteroids reduces the symptoms of migraine, but the treatment is associated with long-term side effects.

Not only have researchers from Mount Sinai Hospital discovered that common antidepressants can help treat neuropathy, but they also identified the gene associated with pain and depression.

Study results show that opioid overdoses appear to frequently occur in patients who are not chronic users with high prescribed doses of opioids, in contrast to the patient groups targeted by current opioid prescribing guidelines.

Some studies have shown the benefit of a blunt, Whitacre-type needle in reducing the incidence of intravascular injection during TFESI, but other studies showed that a short-bevel needle did not reduce the incidence of intravascular injection in lumbar TFESI compared to long-bevel, Quincke-type needles.

Data concerning general outcomes and indicating performance of general pain clinics remain sparse, according to a study in the Journal of Pain and Research. The United Kingdom study suggests that this lack of standardized measurements negatively impacts the ability to judge the overall effectiveness of pain clinics, both in the UK and in other parts of the world.

The number of opioid-related deaths nearly quadrupled from 1999 to 2011 in the US; and while that number continues to increase, one state has made positive strides with the implementation of two initiatives.

An 8-week online intervention targeting cognitive, emotional, behavioral, and social pain determinants appears to improve pain intensity, pain interference, and pain self-efficacy among participants.

A new study suggests that pregabalin shows significantly greater improvements in pain-related interference of sleep relative to usual care in patients with chronic low back pain with accompanying neuropathic pain (CLBP-NeP).

Complex regional pain syndrome (CRPS) is one of the pain conditions that has remained fairly mysterious, but a new, effective treatment may be on the horizon. It is known that CRPS most often develops following trauma, however, and evidence suggests a maladaptive response to nervous system damage involving immune and inflammatory pathways as well as abnormalities in both peripheral and central processing of afferent inputs. No single therapy – including pharmacologic therapy – wholly addresses the condition.

As the population ages and medicine continues to advance, people are living longer and healthier; but they are also taking more medications for more medical conditions. Those medications can cause drug-drug interactions that lead to adverse drug reactions (ADR). Studies have shown that the majority of medication errors happen at the stage of prescription.

With public health concerns surrounding opioid use, a recent study looked at the potential for the opioid analgesic buprenorphine to counteract some of these concerns.

Researchers are still trying to establish a sound definition of bladder pain syndrome, identify its pathophysiology, and suggest a treatment approach that moves beyond specialist care to more individualized treatment.

A cocktail a day may keep the doctor away when it comes to patients with chronic widespread pain (CWP).

Study shows intramuscular injected bone marrow-derived mesenchymal stem cells may be able to restore the myelin sheath and nerve cells in diabetic sciatic nerves.

A recent study looked at the safety and efficacy of prolonged-release forms of two common opioids-oxycodone and naloxone-in treating chronic pain and opioid-induced constipation, which affects in as many as 40% of opioid-treated patients.

Patients with chronic back and leg pain may be able to forgo the use of prescription painkillers thanks to a new treatment that has been shown to provide long-lasting analgesia.

Trigeminal neuralgia is often mistreated or under-treated. Even when treatment is appropriately delivered, there can be troublesome side effects and complications. Proper diagnosis and treatment typically involves coordination of care among neurologists, anaesthesiologists, dentists, neurosurgeons, and neuroradiologists

Opioids have been and continue to be a major source of relief for both chronic and acute pain sufferers. As the use of prescription opioid medications continues to rise, however, so does our knowledge about opioid dependence and opioid poisonings.