Wednesday, October 26, 2011

Wireless Headache Intervention Study - Track your pain with an electronic diary for your iPhone

Want to learn more about your headaches? Track your pain with an electronic diary for your iPhone!

Keeping a headache diary is often recommended by healthcare providers if you are living with recurrent headaches. It helps you track precise information about the headache you are experiencing, allows you to identify what triggers your headache, informs you what may help to alleviate your pain or made it worse, and gauge how much headaches impact your life. This information may help you to manage your headaches better.

To make it easier to keep a diary, a research team lead by Drs. Patrick McGrath and Anna Huguet at the IWK Health Centre in Halifax, Nova Scotia, Canada is developing an electronic headache diary for the iPhone. To learn more about this diary, read more details about the application. This application is not providing treatment and is not a substitute for your current medical treatment.

If you are interested in participating in the study, apply now to see if you meet the study criteria.

Tuesday, October 25, 2011

Unbearable itch may no longer be a pain in anaesthesia - New Scientist

The intimate link between itch and pain has been teased apart for the first time - a development that could lead to powerful anaesthetics without any of that intolerable itching.

Itch is one of the most common side effects of the anaesthetics used in procedures such as epidurals. One explanation is that itch and pain receptors are intrinsically connected. "Itch and pain are two sensations that antagonise each other," says Zhou-Feng Chen from Washington University in St Louis, Missouri. "By scratching you create a kind of mechanical pain and suppress the itch. Conversely, if you suppress pain you see more itching."

To understand this mechanism better, Chen used mice to study the action of morphine, a painkiller that can cause itching. Morphine works through a receptor called MOR, and Chen suspected that different variants of the receptor might be responsible for the itch and pain responses. His team bred mice lacking one form of this receptor, called MOR1D. These mice did not scratch themselves when given morphine, though they still felt its painkilling effect (Cell, DOI: 10.1016/j.cell.2011.08.043).

"It's quite exciting that we are able to segregate the two," says Cheng, who believes that separate pathways for pain and itch exist in humans too. "Our study suggests there are different ways that you can inhibit itch without interfering with analgesia."

Another puzzle is that some itches do not respond to anti-itch drugs called antihistamines, and a study published this week suggests why. Antihistamines have proved effective against the itch of mosquito bites, for example, but they do little to soothe the itching caused by kidney failure, liver disease or burns, says Matthias Ringkamp at Johns Hopkins University in Baltimore, Maryland.

Antihistamine-sensitive itches have been shown to activate nerve fibres called unmyelinated C-fibres. Ringkamp suspected that itches that do not respond to the drugs might be mediated by a different type of fibre called myelinated A-fibres.

The spines of a tropical plant called cowage can irritate the skin and produce an itch that does not respond to antihistamines. To find out if the cowage itch signal passes through the myelinated A-fibres, Ringkamp and his team placed a weighted band over volunteers' wrists to cut off conduction in the small A-fibres. When the team inserted cowage spines into the volunteers' fingertips, they found that itch was dramatically reduced in many - but not all - of them (Journal of Neuroscience, DOI: 10.1523/jneurosci.3005-11/2011).

"It is fascinating that this happens in some people and not others," says Glenn Geisler at the University of Minnesota in Minneapolis. "In future, drugs to treat itch would have to treat A and C fibres."

Pain Management News and Video - FOX News Topics

Monday, October 17, 2011

Study: Imagined Smells Can Precede Migraines | Fox News

Hallucinated scents such as a burning or rotten smell, or even the scent of foie gras, can be a part of the "aura" that some people perceive before a migraine attack, although it is rare, according to a U.S. study.

About 30 percent of people with recurrent migraines have sensory disturbances shortly before their headache hits, known as aura, but these are usually visual, such as flashes of light or blind spots. Tingling sensations or numbness, or difficulty speaking or understanding language, may also appear.

But the study, conducted by Matthew Robbins and colleagues at the Montefiore Headache Center in New York, found that a small number of people described smelling scents in conjunction with their headaches.

"It's uncommon, but distinctive," said Robbins, noting that disturbances in the sense of smell, known as olfactory hallucinations, have not been covered in a systematic review of medical literature before.

Researchers reviewed 25 reported cases of patients with headaches, migraines in most cases, and olfactory hallucinations. They also examined records from more than 2,100 patients seen over 30 months. Fourteen people, or just under 0.7 percent, had described smelling scents ahead of their headaches.

"The most common was of the burning or smoke variety," Robbins said.

Some sufferers described a general burning smell. others said they smelled cigar smoke, wood smoke or burned popcorn.

"Decomposition" odors, such as garbage or sewage, were the next most common smell reported. A few people described pleasant odours, including the scent of oranges, coffee or, in one case, foie gras.

About 11 percent of the world's population suffers from migraines, so even though olfactory hallucinations are an unusual part of aura, there could still be a fairly large number of people who experience them, Robbins said.

It's not clear why the hallucinated odors are most often unpleasant, or why they are only rarely part of migraine aura.

But aura symptoms are thought to involve a phenomenon called "cortical spreading depression," where a wave of increased electrical activity in nerve cells of the brain is followed by a wave of depressed activity, Robbins said.

That same phenomenon might underlie olfactory hallucinations -- and because the brain's smell centers occupy much less space than its sight centers, that could, in theory, explain why phantom scents are so much less common, he added.

It is also possible that some people with migraines and olfactory hallucinations do not recognize the phenomenon, he added. People know something is wrong when they see zigzag lines, but it is easy to assume a small is actually coming from somewhere.

Since some disorders, such as Parkinson's disease, can cause a person to smell scents that are not present, any such hallucinations without an accompanying headache should be checked out, he warned.

Friday, October 14, 2011

International Association for the Study of Pain | Global Year Against Headache

SEATTLE, October 17, 2011 – The Global Year Against Headache launches today, bringing global attention to one of the most common, painful and disabling conditions affecting people throughout their lives. Sponsored by the International Association for the Study of Pain (IASP), and working in close cooperation with the International Headache Society, the 12-month campaign focuses on education for health care professional and government leaders as well as public awareness.

Headache disorders are the most prevalent of the neurological conditions and among the most frequent of medical complaints seen in general practice. They take many forms, including migraine, tension-type headache, trigemino-autonomic cephalalgia (cluster headache), primary stabbing headache, primary sex headache, or rarer conditions such as trigeminal neuralgia or persistent idiopathic facial pain. Half of the general population experience headache during any given year, and more than 90% report a lifetime history of head pain. The most severely disabled 3% experience a headache such as chronic migraine and chronic tension-type headache at least 15 days per month. Headache disorders contribute to a considerable loss of work time and productivity.

Led by headache experts Jean Schoenen, MD, PhD (Belgium), Peter Goadsby, MD, PhD (USA), and Arne May, MD, PhD (Germany), the initiative will mobilize IASP's 7,000+ members and 86 national chapters, and forge partnerships with other organizations, to:

• disseminate information about headache worldwide;
• educate pain researchers as well as health care professionals who see the issues associated with headache firsthand in their interactions with patients;
• increase awareness of headache among government officials, members of the media, and the general public worldwide; and
• encourage government leaders, research institutions, and others to support policies that result in improved pain treatment for people with headaches.

As part of the Global Year Against Headache, IASP offers, in cooperation with the International Headache Society (IHS), a series of fact sheets for clinicians and health care professionals that cover specific topics related to headache, including epidemiology of headache, different headache types and classifications, genetic factors leading to headache, headache in childhood and adolescence, hormonal and vascular changes associated with headache, approaches to study and treatment, and more. These fact sheets are translated into multiple languages and available for free download from the IASP website. Also available on the web to download are posters promoting the Global Year. The association and its chapters will also sponsor meetings, symposia, pain camps, media interviews, publications, and other efforts to promote education on issues surrounding headache. For more information, visit:

About IASP: IASP brings together scientists, clinicians, health care providers, and policy-makers to stimulate and support the study of pain and translate that knowledge into improved pain relief worldwide. IASP holds a biennial World Congress on PainĂ‚®, sponsors grants, symposia, and programs to support pain research, and publishes books and a scientific journal, PAINĂ‚®. IASP is a non-profit international organization based in Seattle, USA, and is recognized as an NGO by the World Health Organization (WHO). On the third Monday of October, IASP launches an annual Global Year campaign to raise awareness of different aspects of pain.

About IHS: Founded in 1981, the International Headache Society is an international professional organization working with others for the benefit of people affected by headache disorders. The purpose of IHS is to advance headache science, education, and management, and promote headache awareness worldwide.

Thursday, October 13, 2011

Pain of Unpleasant People is Discredited - WSJ

Observers rate the pain of unpleasant people as lower than that of likeable people, a new study finds.

Researchers had 40 people looked at head shots of patients, all of whom had shoulder problems, paired with adjectives that were positive, neutral, or negative ("honest," "reserved," or "arrogant," for example). They then watched clips of the patients undergoing physiological examination, in which the patients manifested no pain, moderate pain, or severe pain.

The observers then rated the pain's intensity by marking a spot on a visual scale 100 millimeters long.

In the case of high-intensity pain, the participants rated the pain of "disliked" patients as lower than that of the other patients—on the order of 7 points lower, on the 100-point scale. There was no difference on the moderate pain. (To explain the difference, the researchers suggested that the relatively extreme grimaces and grunts that intense pain inspires might cause distinctive reactions: You might think, for example, that someone you dislike is being overly dramatic or self-centered.)

This layman's conclusion was that you should be nice to your nurse. But one author cautioned that the study involved ordinary observers, not health-care professionals, so it would be unfair to assume their judgment is clouded by your likeability—or lack of same.

Source: "When You Dislike Patients, Pain Is Taken Less Seriously," Lies De Ruddere, and six other authors, Pain (October)

Tuesday, October 04, 2011

BBC News - Targeted back pain care 'cheaper and better for patients'

More targeted treatment for back pain improves care and "substantially" reduces healthcare costs, say scientists.

Instead of a "one size fits all" approach, different treatments were offered depending on the severity of the condition.

Writing in the Lancet, researchers said the findings would have "important implications" for back pain patients.

Other doctors said the findings were "very promising".

Estimates for the UK suggest back pain is very common with between 6% and 9% of adults visiting their GP with the condition each year. Up to 80% say they still have pain a year later.

The report's authors argued that current care, such as advice, painkillers or referral to a physiotherapist, was based on "intuition" which was "inefficient and inconsistent".

In the study, 283 patients were treated normally and 568 were assessed as having low, medium or high risk of long-term and disabling back pain.

Low-risk patients were given advice by a physiotherapist. Medium-risk patients received intensive physiotherapy. High-risk patients had physiotherapy and help to overcome psychological barriers to recovery, which can occur in chronic conditions.

After 12 months, the targeted groups showed significantly more improvement than the traditional treatment group.

The study said the benefit was achieved at lower cost - saving more than £30 per patient on average.

Lead researcher Prof Elaine Hay, of Keele University, said: "The problem for GPs and other health professionals is spotting who, amongst the patients they see with back pain, is likely to get better with simple advice and reassurance, and who might benefit from further treatment from a physiotherapist."

She said 50 centres in the UK had already adopted the new approach: "The data shows that it is having a substantial beneficial impact where it is being implemented."

The study was funded by Arthritis Research UK. Its medical director Prof Alan Silman said there had been many studies into the effectiveness of exercise and physiological treatments, but: "This research is novel because it shows how to take the best of these two approaches, and make a real difference to large numbers of patients."

Dr Bart Koes, of Erasmus University Medical Centre in The Netherlands, said in an accompanying article that "further improvements are desirable" but "these results are indeed very promising".

He added: "The economic assessment showed that the new approach was cost effective so there is no financial reason not to implement."