Pain: A free collection of articles about pain published in The New York Times

http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/pain/index.html?8qa

Presentation on Neuropathic Pain (click here)

Presentation on Pain Assessment in the Elderly (click here)

Transcendental Meditation Reduces The Brain's Reaction To Pain

Twelve healthy long-term meditators who had been practicing Transcendental Meditation for 30 years showed a 40-50% lower brain response to pain compared to 12 healthy controls, reported by a latest NeuroReport journal article, published by Lippincott Williams & Wilkins (Vol.17 No.12; 21 August 2006:1359-1363). Further, when the 12 controls then learned and practiced Transcendental Meditation for 5 months, their brain responses to pain also decreased by a comparable 40-50%.

Transcendental Meditation could reduce the brain's response to pain because neuroimaging and autonomic studies indicate that it produces a physiological state capable of modifying various kinds of pain. In time it reduces trait anxiety, improves stress reactivity and decreases distress from acute pain.

http://www.medicalnewstoday.com/medicalnews.php?newsid=49320

The Doctor Will See You, and Your Party, Now - New York Times

Gone are the days when patients slipped into a plastic surgeon’s office alone and sometimes in disguise for a consultation and, after the surgery, slinked away to a secret location to recover. Now, patients may arrive not only with a wish list of procedures they have seen on TV or researched online, but also flanked by parents, siblings, spouses or partners. Or the wild card: the friend.

For some doctors, having a second person in the room can be extra insurance that the serious information they are trying to impart is being heard. But at times the consultation begins to feel like a shopping trip to Barneys.

“They come in like it’s a party event,” Dr. Hidalgo said. “Like, ‘We need an activity today, let’s go see the plastic surgeon.’ ”

http://www.nytimes.com/2006/08/27/fashion/27buddy.html?ex=1314331200&en=1bf7b71adafbabcb&ei=5090&partner=rssuserland&emc=rss

Making Sense of Pain Relief

Making Sense of Pain Relief™ is an educational campaign designed to help clarify new, and sometimes confusing, information about pain relief.

For instance, there has been a lot of recent news about nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs treat pain, inflammation, and swelling related to arthritis and joint pain. The U.S. Food and Drug Administration (FDA) recently requested label changes for over-the-counter (OTC) NSAIDs, such as ibuprofen and naproxen, and prescription-strength NSAIDs.

Now more than ever, it's important to talk with your health care provider about the most appropriate pain treatments for you, based on your own unique needs and personal health profile.

Keep in mind that ignoring your arthritis or joint pain may negatively impact your overall health.

Making Sense of Pain ReliefTM is an educational program of the American Chronic Pain Association, the American Pain Foundation and The National Pain Foundation with support of Pfizer Inc. The American Chronic Pain Association, the American Pain Foundation and The National Pain Foundation have cooperatively prepared information for this Web site to help people with pain and their families better understand the current situation and to regain a sense of control over the critical and personal decisions involved in managing pain.

http://www.painsense.org/home/default.asp

American Pain Foundation - Links to Other Websites

Finding helpful, reliable information and resources on the World Wide Web can take hours of searching. We have searched the Web for you and identified the following websites to simplify your search for information. This list is updated regularly as we continue to identify websites we think will be helpful to you.

This information is provided for educational and information purposes only. APF is not engaged in rendering medical advice or professional services, and this information should not be used for diagnosing or treating a health problem. APF makes no representations or warranties, expressed or implied. Providing references to other organizations or links to other websites does not imply that APF endorses the information or services provided by them. Those organizations are solely responsible for the information they provide.

The information on this website is provided to help users find answers and support. Users may wish to print the information and discuss it with their doctor. Always consult with health care providers before starting or changing any treatment.

http://www.painfoundation.org/page.asp?file=Links/Index.htm

American Pain Foundation - Pain Information Library

This information is provided for educational and information purposes only. APF is not engaged in rendering medical advice or professional services, and this information should not be used for diagnosing or treating a health problem. APF makes no representations or warranties, expressed or implied. Providing references to other organizations or links to other websites does not imply that APF endorses the information or services provided by them. Those organizations are solely responsible for the information they provide.

The information on this website is provided to help users find answers and support. Users may wish to print the information and discuss it with their doctor. Always consult with health care providers before starting or changing any treatment.

http://www.painfoundation.org/page.asp?file=Library/Index.htm

The world of hurt

Pain cost Dennis Kinch his job, his home and his family.

"You end up feeling alone on an island wondering who you are now," the Boston man says. "Pain runs your life."

But it wasn't going to ruin it, Kinch decided. The 51-year-old cook suffers from two diseases that make walking painful, if not impossible - so that's exactly what he did. He walked 2,400 miles, from Chicago to Santa Monica, Calif., along Route 66, starting last fall and ending Friday. Along the way, he stopped at 35 pain clinics to talk to patients and doctors as a spokesman for the National Pain Foundation.

"Do what you can when you can," Kinch says. "Sometimes it seems like everything is negative. You have to learn to tune that negative stuff out. That's what keeps people in pain on the couch - they get scared. They're afraid of the pain."

Pain has become a national epidemic and one of the nation's most dismissed and undertreated conditions. More than 75 million Americans - one in four - suffer from chronic, debilitating pain, and more than 50 million of them are partially or totally disabled by it, according to the Englewood-based NPF.

Government statistics show that pain is a factor in more than 80 percent of all physician visits, yet fewer than 1 percent of doctors have training in pain treatment, says NPF Executive Director Mary Pat Aardrup.

"Pain is viewed as a character flaw. It's an invisible disease," she says. "You don't have a bandage, you haven't lost any hair. When someone is in pain 24-7 - and a lot of people are - family and friends tire of hearing about it, and they often go away. Your self-worth and dignity go away. Your identity as a person vanishes. You become the pain."

The portrait of pain in America looks like everyone: It cuts across all genders, races and ages, including an estimated 20 percent of children. But surveys find that people are afraid to talk about it, reluctant to treat it and dismissive of it in themselves and others. 

http://www.rockymountainnews.com/drmn/health/article/0,2777,DRMN_23956_4851003,00.html

Preventing, treating and promoting self-management of pain through pain neurophysiology education; Neil Pearson

http://www.lifeisnow.ca/images/CPA Congress Talk.pdf

The Canadian Physiotherapy Pain Sciences Group Newsletter

March 2006:

http://weblogs.elearning.ubc.ca/physio/Second%2520CPPSG%2520Newsletter.pdf

July 2006:

http://weblogs.elearning.ubc.ca/physio/Vol_2_Issue_3-1.pdf

Ten Resolutions for living with chronic pain or illness

Support for:

• People with chronic pain or illness learning how to live with their condition
• Their friends and family
• Their caregivers.

http://www.tenresolutions.org/

Pediatric Pain Letter

Pediatric Pain Letter (PPL) provides free, open-access, peer-reviewed commentaries on pain in infants, children and adolescents. Book reviews and announcements of events related to pediatric pain are also accepted. Links are provided to Medline abstracts for articles reviewed in PPL.

http://pediatric-pain.ca/ppl/

Drugs.com - Prescription Drug Information, Side Effects, Interactions

Prescription Drug information for consumers & professionals.

Welcome to the most popular, comprehensive and up-to-date drug information resource online. Fast, easy searching of over 24,000 approved medications.

http://www.drugs.com/

Alone but Feeling No Pain: Effects of Social Exclusion on Physical Pain Tolerance and Pain Threshold, Affective Forecasting, and Interpersonal Empathy

Journal of Personality and Social Psychology. 91(1), Jul 2006, 1-15.

Alone but Feeling No Pain: Effects of Social Exclusion on Physical Pain Tolerance and Pain Threshold,Affective Forecasting, and Interpersonal Empathy

C. Nathan DeWall, Roy F. Baumeister

Prior findings of emotional numbness (rather than distress) among socially excluded persons led us to investigate whether exclusion causes a far-reaching insensitivity to both physical and emotional pain. Experiments 1-4 showed that receiving an ostensibly diagnostic forecast of a lonesome future life reduced sensitivity to physical pain, as indicated by both (higher) thresholds and tolerance. Exclusion also caused emotional insensitivity, as indicated by reductions in affective forecasting of joy or woe over a future football outcome (Experiment 3), as well as lesser empathizing with another person’s suffering from either romantic breakup (Experiment 4) or a broken leg (Experiment 5). The insensitivities to pain and emotion were highly intercorrelated.


http://www.psy.fsu.edu/~dewall/DeWallBaumeisterRejPainJPSPpreprint.pdf#search="Alone but Feeling No Pain: Effects of Social Exclusion on Physical Pain Tolerance and Pain Threshold, Affective Forecasting and Interpersonal Empathy"

Why It Hurts to Be Left Out: The Neurocognitive Overlap Between Physical and Social Pain

Eisenberger, N.I. & Lieberman, M.D. (2005). Why it hurts to be left out: The neurocognitive overlap between physical and social pain. In K. D. Williams, J. P. Forgas, & W. von Hippel (Eds.), The Social Outcast: Ostracism, Social Exclusion, Rejection, and Bullying (pp. 109-127). New York: Cambridge University Press. 

PAIN OVERLAP THEORY
Pain overlap theory proposes that social pain, the pain that we experience when social relationships are damaged or lost, and physical pain, the pain that we experience upon physical injury, share parts of the same underlying processing system (Eisenberger & Lieberman, 2004). Th is system is responsible for detecting the presence or possibility of physical or social harm and recruiting attention once something has gone wrong in order to fi x it. Evolutionarily, this overlap makes good sense. Based on mammalian infants’ lengthy period of immaturity and their critical need for substantial maternal contact and care, it is possible that the social attachment system, the system that keeps us near close others, may have piggybacked onto the pre-existing pain system, borrowing the pain signal to signify and prevent the danger of social separation (Nelson & Panksepp, 1998; Panksepp, 1998).


http://www.scn.ucla.edu/pdf/RT424X_C07-1.pdf#search="dewall baumeister pain"

Pain relief at last. By Laura Moser - Slate Magazine

Several months after injuring my shoulder in October 2004, I flew to my hometown of Houston and paid out of pocket to consult a trusted family doctor about the pain that inexplicably wouldn't go away. He examined my clothed torso for about 15 seconds before offering this perfunctory analysis: "You're getting older, and your body's falling apart—it happens to the best of us. Something new'll break down every day, so you might as well start adapting."

When I protested feebly that I'd just turned 27, he threw up his arms and laughed. "I know—terrible, isn't it? Now don't forget to say hi to your mother for me, or you'll be in big trouble!" With that, he called for the next patient.

http://www.slate.com/id/2147763/

TV 'can numb pain for children' - Watching television may act as a natural painkiller for children, Italian research indicates

A University of Siena team studied the level of pain reported by 69 children aged between seven and 12 as they gave blood samples.

Some were distracted by their mothers during the procedure, some had no distraction and some watched cartoons.

Those who watched TV reported least pain, the study - published in Archives of Disease in Childhood - said.

http://news.bbc.co.uk/2/hi/health/4795287.stm

Pain Management & Appropriate Care Of The Terminally Ill: Somatoform Disorders

The UCSD CMA Pain Management and Appropriate Care of the Terminally Ill: Somatoform Disorders program features a series of pain case conferences in which physicians present interesting and challenging cases to a multidisciplinary pain panel of experts knowledgeable in treating the type of pain each patient presents. The patient's physician provides the history, examination, labs and radiology, and diagnosis along with other pertinent information to the panel. Experts give brief presentations on topics specific to the case. The panel discussions include the overall assessment, anatomy, etiology, prevalence, patient education procedures, treatment options and patient monitoring.

Testimonial About Treatment Experiences at Fibromyalgia & Fatigue Centers, Inc.

Gene's experience receiving treatment for Fibromyalgia. A testimonial about treatment experiences at a private pain center.

Pain Research: An Overview

Why Is Behavioral Research Important to Understanding Pain?

Pain has a profound effect on the quality of human life. Pain can cause disruptions in sleep, eating, mobility, and overall ability to function. Progress is being made in understanding the physiological mechanisms involved in pain. However, understanding individuals' pain experience presents unique scientific challenges. The levels of pain different people experience and their reactions to it vary widely, perhaps due to psychological state, age, gender, social environment, and cultural background, as well as genetic or physiological differences. Thus, the pain experience needs to be examined at all levels of basic and clinical research, including behavioral research, with the goal of developing interventions to manage or prevent pain.

Behavioral and social sciences research include a wide array of disciplines. The field uses such techniques as:

• surveys and questionnaires
• randomized clinical trials
• direct observation
• descriptive methods
• economic analyses
• laboratory and field experiments
• standardized tests
• evaluation

http://www.niams.nih.gov/hi/topics/pain/pain.htm

back pain swicki

This is a swicki

A search engine that learns from your community

A search engine for information on back pain

http://back-pain-swicki.eurekster.com/

Others:

http://arthritis-search-engine-swicki.eurekster.com/

http://headache-swicki.eurekster.com/

http://prohealth-swicki.eurekster.com/

ALICIA'S STORY / Suffer with pain or wander off to wonderland

ALICIA'S STORY
Suffer with pain or wander off to wonderland

Alicia R. Parlette was 23 last year when she was told she had a life-threatening cancer. This is one in an occasional series of articles about her experience. For previous articles and a list of cancer resources, go to www.sfgate.com/alicia . 

A few weeks ago, I was feeling very sick with something that seemed like extended food poisoning but might have been the flu. I was vomiting violently, getting cold sweats every couple of hours and barely moving from the couch. My surrogate mom, Sally, swooped in from Concord to take me to her house.

After a weekend of those symptoms -- all during record-breaking high temperatures that knocked out Sally's electricity several times -- I finally felt well enough to head back to my apartment alone.

While I waited for BART, I took OxyContin for pain. The drug often makes me feel more stoned when I take it without much food in my stomach, so I've learned to be acutely aware of how much I've had to eat before I take a pill.

I had a lot of food in me -- I had even taken Marinol, a legal form of medicinal marijuana, before brunch with Sally so I would scarf a fruit-covered waffle -- so I felt safe taking the painkiller.

Tired, on the train I zoned and then felt the beginning twinges of being high. Strange. I barely noticed anyone around me as I stared out the window into the dreary darkness of the tunnels, which somehow made the ride more relaxing.

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2006/08/11/DDGAVKCKO728.DTL&feed=rss.entertainment

From "De-Lovely," the musical biography of Cole Porter

Memories.

                   

lt's like the phantom pains l get

in my missing leg.

                   

They're not real and they hurt too much.

http://www.delovelymovie.com/

ScienCentral Video News: Music for Pain

Marion Good loves to play music in her spare time. But as a professor of nursing at Case Western Reserve University's Frances Payne Bolton School of Nursing, she also prescribes it for pain relief.

Her interest in researching music for pain began when as a nurse on a neurology unit she worked with patients suffering from back pain. "I would bring music into the room -- soft quiet music. Their faces just relaxed ... pretty soon they fell asleep," she says. "I had to tiptoe out of the room and come back an hour or two later to pick up my tape recorder."

Good has been testing music with post-operative patients for more than 15 years. "I found that music does reduce pain up to about 31 percent in my studies in addition to medication," she says.

Now the conclusion of a systematic analysis combining 51 clinical studies is music to her ears. The Cochrane Review of Evidence-Based Healthcare found that patients exposed to music rate their pain as less intense and even use lower doses of painkillers.

http://www.sciencentral.com/articles/view.php3?type=article&article_id=218392834

Scientists Cast Misery of Migraine in a New Light - New York Times

Everything you thought you knew about migraine headaches — except that they are among the worst nonfatal afflictions of humankind — may be wrong. At least that’s what headache researchers now maintain. From long-maligned dietary triggers to the underlying cause of the headaches themselves, longstanding beliefs have been brought into question by recent studies.

http://www.nytimes.com/2006/08/08/health/08brody.html?ex=1312689600&en=4d8acc4573bea989&ei=5090&partner=rssuserland&emc=rss

He Who Cast the First Stone Probably Didn’t - New York Times

He Who Cast the First Stone Probably Didn’t

By DANIEL GILBERT

Excerpt:

If the first principle of legitimate punching is that punches must be even-numbered, the second principle is that an even-numbered punch may be no more forceful than the odd-numbered punch that preceded it. Legitimate retribution is meant to restore balance, and thus an eye for an eye is fair, but an eye for an eyelash is not. When the European Union condemned Israel for bombing Lebanon in retaliation for the kidnapping of two Israeli soldiers, it did not question Israel’s right to respond, but rather, its “disproportionate use of force.” It is O.K. to hit back, just not too hard.

Research shows that people have as much trouble applying the second principle as the first. In a study conducted by Sukhwinder Shergill and colleagues at University College London, pairs of volunteers were hooked up to a mechanical device that allowed each of them to exert pressure on the other volunteer’s fingers.

The researcher began the game by exerting a fixed amount of pressure on the first volunteer’s finger. The first volunteer was then asked to exert precisely the same amount of pressure on the second volunteer’s finger. The second volunteer was then asked to exert the same amount of pressure on the first volunteer’s finger. And so on. The two volunteers took turns applying equal amounts of pressure to each other’s fingers while the researchers measured the actual amount of pressure they applied.

The results were striking. Although volunteers tried to respond to each other’s touches with equal force, they typically responded with about 40 percent more force than they had just experienced. Each time a volunteer was touched, he touched back harder, which led the other volunteer to touch back even harder. What began as a game of soft touches quickly became a game of moderate pokes and then hard prods, even though both volunteers were doing their level best to respond in kind.

Each volunteer was convinced that he was responding with equal force and that for some reason the other volunteer was escalating. Neither realized that the escalation was the natural byproduct of a neurological quirk that causes the pain we receive to seem more painful than the pain we produce, so we usually give more pain than we have received.

Research teaches us that our reasons and our pains are more palpable, more obvious and real, than are the reasons and pains of others. This leads to the escalation of mutual harm, to the illusion that others are solely responsible for it and to the belief that our actions are justifiable responses to theirs.

http://www.nytimes.com/2006/07/24/opinion/24gilbert.html?ei=5090&en=d3a663fcc34a3d8b&ex=1311393600&partner=rssuserland&emc=rss&pagewanted=all

Slate: Does Acupuncture Really Work?

Your Health This Month: Pains and Needles. By Sydney Spiesel. The appeal of alternative medical treatments these days is not in dispute; their efficacy is less clear. Each month, Slate’s medical expert Dr. Sydney Spiesel sifts through medical journals to find interesting and overlooked studies. Today he tells us about one recent study of acupuncture, and it contains both good and bad news.

Acupuncture: Of pains and needles.

Complementary therapies: Acupuncture, nutritional supplements, homeopathy, and naturopathy seem to many to offer safer, less invasive, more "natural" ways to deal with bodily woes than conventional medicine. They appeal to the desire for the spiritual and the mysterious. They may be less expensive. Their practitioners are often warmer and less pressed for time; they appear to pay attention to our whole selves and not just the broken parts. And some patients relish the increased autonomy: Instead of asking your doctor for a prescription, you can reach for a bottle of pills in the vitamin department of the supermarket.

The question: Do these treatments work? Sometimes yes and sometimes no. And sometimes for reasons practitioners don't anticipate. A particularly good example comes from a study reported recently in the Annals of Internal Medicine, conducted at the Universities of Heidelberg and Bochum in Germany by Hanns-Peter Scharf and his colleagues. The purpose was to help German insurers decide whether to pay for acupuncture, a practice of Chinese traditional medicine in which tiny needles are inserted to a shallow depth at specific locations in the skin.

The ailment: The researchers focused on acupuncture for osteoarthritis of the knee, a painful and debilitating joint inflammation that results from wear and tear in aging joints. It occurs in the majority of people by age 65, and in 80 percent by age 75. The knee is the most commonly affected joint. There is no cure. The standard treatment is anti-inflammatory drugs, which have their own risks; pain medication; and physical therapy. Ultimately, many sufferers have surgery, in which the damaged and painful knee joint is replaced with an artificial substitute.

The new study: Previously, some studies have shown the benefit of acupuncture for osteoarthritis of the knee, and others have not. For this study, Scharf and his colleagues looked at about 1,000 patients. The patients were divided into three groups. One group was treated with acupuncture. A second "sham acupuncture group" was treated with needles placed in locations that don't match those specified by traditional Chinese medicine. A third group received no needle treatments at all. All the patients had identical access to physical therapy and nonsteroidal anti-inflammatory medications. After 26 weeks, the subjects were all interviewed by people who didn't know which treatment they had received. The treatment was regarded as successful only if there was a 36 percent or higher improvement in knee function or pain relief.

The results: Acupuncture was clearly associated with improved function and pain relief. But it didn't much matter whether the treatment followed traditional Chinese medicine methods or consisted of needles placed in the wrong locations—both worked equally well. It is tempting to think that the physical act of placing needles caused the improvement, and that may well be the case. But there was another significant factor: The patients who got no needle treatment had substantially less contact with their doctors than the acupuncture patients, sham and real, had with their practitioners.

Conclusion: Should the German insurers pay for this complementary treatment? Well, without acupuncture, the patients in Scharf's study needed more physical therapy, more pain-killing medication, and more anti-inflammatory drugs. I sure wish I knew, though, what would happen if patients were treated without acupuncture but given more attention and care by their doctors.

Listen to Podcast:

http://media.slate.com/podcast/Slate060726_Acupuncture.mp3

CTV.ca | New medical technique treats chronic facial pain

New medical technique treats chronic facial pain

CTV.ca News Staff

A new method for treating patients suffering from severe chronic facial pain is being introduced at select medical centres in Canada.

When traditional drugs or physical therapy fails in the treatement of chronic pain, considered consistent or intermittent pain that lasts six months or more, some doctors are turning to an experimental treatment known as motor cortex stimulation.

The treatment method, an electrical pain control system, places electrodes under the patient's skull over an area of the brain (motor cortex) that processes facial pain.

http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20060620/chronic_pain_060620/20060620?hub=Canada

On-Off Switch for Chronic Pain

"A protein acts as a switch for chronic pain, and researchers have applied for a patent to develop a new class of drugs that will block chronic pain by turning this switch off."

Chronic pain affects approximately 48 million people in the U.S. and current medications are either largely ineffective or have serious side effects. But researchers from Columbia University Medical Center have discovered a protein in nerve cells that acts as a switch for chronic pain, and have applied for a patent to develop a new class of drugs that will block chronic pain by turning this switch off. The discovery is published on the website of the journal Neuroscience, and will appear in the publication's August issue.

Most prior attempts at alleviating chronic pain have focused on the "second order" neurons in the spinal cord that relay pain messages to the brain. It's difficult to inhibit the activity of these neurons with drugs, though, because the drugs need to overcome the blood-brain barrier. Instead, the CUMC researchers have focused on the more accessible "first order" neurons in the periphery of our body that send messages to the spinal cord.

Pain becomes chronic when the activity of first and second order neurons persists after damaged neuron heals or the tissue inflammation subsides. It's been known for years that for chronic pain to persist, a master switch must be turned on inside the peripheral neurons, though until now the identity of this switch remained a mystery. Richard Ambron, Ph.D., professor of cell biology, and Ying-Ju Sung, Ph.D., assistant professor, both in the department of Anatomy and Cell Biology, have now discovered that the switch is an enzyme called protein kinase G (PKG).

The researchers found that upon injury or inflammation, the PKG is turned on and activated. Once activated, these molecules set off other processes that generate the pain messages. As long as the PKG remains on, the pain persists. Conversely, turning the PKG off relieves the pain, making PKG an excellent target for therapy.

http://www.emaxhealth.com/index.html?m=show&opt=printable&id=6686