Saturday, September 30, 2006

Chronic Pain Anonymous

Chronic Pain Anonymous is a 12 step support group for men and women to share their experience, strength and hope with each other that they may solve their common problem and help others to recover from chronic pain. The only requirement for participation in this group is a desire to recover from the physical, emotional and spiritual debilitation of chronic pain. We currently have face to face weekly meetings in Arizona, California, Indiana, and Maryland with more to come. We are planning to have a weekly online support meeting soon.

Tuesday, September 26, 2006

Is Hysteria Real? Brain Images Say Yes - New York Times

Functional neuroimaging technologies like single photon emission computerized tomography, or SPECT, and positron emission tomography, or PET, now enable scientists to monitor changes in brain activity. And although the brain mechanisms behind hysterical illness are still not fully understood, new studies have started to bring the mind back into the body, by identifying the physical evidence of one of the most elusive, controversial and enduring illnesses.

Friday, September 22, 2006

AARP Issues Blog: Art Buchwald on Hospice and Life While Dying (click here)

In recent months, famed satirist and Pulitzer Prize winning columnist Art Buchwald has been facing down the last deadline of them all. In this video interview, Buchwald speaks to AARP Broadcast News from a hospice in Washington, DC, where he continues to make us laugh as he discusses the very serious subject of preparing to die. "

Chronic Pain Information Page: National Institute of Neurological Disorders and Stroke (NINDS)

NINDS Chronic Pain Information Page

Synonym(s):   Pain - Chronic

Table of Contents (click to jump to sections)
What is Chronic Pain?
Is there any treatment?
What is the prognosis?
What research is being done?

Related NINDS Publications and Information
Additional resources from MEDLINEplus 

What is Chronic Pain?
While acute pain is a normal sensation triggered in the nervous system to alert you to possible injury and the need to take care of yourself, chronic pain is different. Chronic pain persists. Pain signals keep firing in the nervous system for weeks, months, even years. There may have been an initial mishap -- sprained back, serious infection, or there may be an ongoing cause of pain -- arthritis, cancer, ear infection, but some people suffer chronic pain in the absence of any past injury or evidence of body damage. Many chronic pain conditions affect older adults. Common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, neurogenic pain (pain resulting from damage to the peripheral nerves or to the central nervous system itself), psychogenic pain (pain not due to past disease or injury or any visible sign of damage inside or outside the nervous system).

Is there any treatment?

Medications, acupuncture, local electrical stimulation, and brain stimulation, as well as surgery, are some treatments for chronic pain. Some physicians use placebos, which in some cases has resulted in a lessening or elimination of pain. Psychotherapy, relaxation and medication therapies, biofeedback, and behavior modification may also be employed to treat chronic pain.

What is the prognosis?

Many people with chronic pain can be helped if they understand all the causes of pain and the many and varied steps that can be taken to undo what chronic pain has done. Scientists believe that advances in neuroscience will lead to more and better treatments for chronic pain in the years to come.

What research is being done?

Clinical investigators have tested chronic pain patients and found that they often have lower-than-normal levels of endorphins in their spinal fluid. Investigations of acupuncture include wiring the needles to stimulate nerve endings electrically (electroacupuncture), which some researchers believe activates endorphin systems. Other experiments with acupuncture have shown that there are higher levels of endorphins in cerebrospinal fluid following acupuncture. Investigators are studying the effect of stress on the experience of chronic pain. Chemists are synthesizing new analgesics and discovering painkilling virtues in drugs not normally prescribed for pain.

Select this link to view a list of studies currently seeking patients.


National Institute of Dental and Craniofacial Research (NIDCR)
National Institutes of Health, DHHS
31 Center Drive, Room 5B-55
Bethesda, MD   20892
Tel: 301-496-4261

American Chronic Pain Association (ACPA)
P.O. Box 850
Rocklin, CA   95677-0850
Tel: 916-632-0922 800-533-3231
Fax: 916-632-3208

American Council for Headache Education
19 Mantua Road
Mt. Royal, NJ   08061
Tel: 856-423-0258 800-255-ACHE (255-2243)
Fax: 856-423-0082

National Headache Foundation
820 N. Orleans
Suite 217
Chicago, IL   60610-3132
Tel: 312-274-2650 888-NHF-5552 (643-5552)
Fax: 312-640-9049

National Foundation for the Treatment of Pain
P.O. Box 70045
Houston, TX   77270
Tel: 713-862-9332
Fax: 713-862-9346

Mayday Fund [For Pain Research]
c/o SPG
136 West 21st Street, 6th Floor
New York, NY   10011
Tel: 212-366-6970
Fax: 212-366-6979

American Pain Foundation
201 North Charles Street
Suite 710
Baltimore, MD   21201-4111
Tel: 888-615-PAIN (7246)
Fax: 410-385-1832

Arthritis Foundation
1330 West Peachtree Street
Suite 100
Atlanta, GA   30309
Tel: 800-568-4045 404-872-7100 404-965-7888
Fax: 404-872-0457

The Body: The Complete HIV/AIDS Resource

Pain Management

University of Michigan Health System: Pain Management

Pain Management

A resource for patients, families and health care providers on pain management options through the University of Michigan Health System

Pain management is an essential element of the excellent patient care we provide at the University of Michigan Health System. This web site provides patients and their families with information about pain management.

Tuesday, September 19, 2006

The mesmerizing ad for HeadOn (click here for video)

Head Case
By Seth Stevenson

The Spot: A woman rubs what appears to be a glue stick across her forehead. The voice-over repeats one sentence in triplicate: "HeadOn: Apply directly to the forehead. HeadOn: Apply directly to the forehead. HeadOn: Apply directly to the forehead." We cut to an image of the product in its packaging, while the voice-over tells us that "HeadOn is available without a prescription at retailers nationwide."
When I first saw this ad, I was convinced it was a viral prank. Everything about it—the woman serenely rubbing stuff on her forehead; the lack of explanation as to what this stuff is; and, of course, the mind-numbing repetition of that weird catchphrase—just seemed too bizarre to be an actual commercial for an actual product. When I logged on to, I expected a jokey Web site that would eventually redirect me to a promotion for Burger King or Axe deodorant or something.
But no, it turns out HeadOn is for real. (That is, the product does exist. I'm not sure I can use the word "real" in any reference to a topical homeopathic health remedy.) HeadOn is meant to treat headaches and is a gel suffused with various plant extracts that you apply—say it with me—directly to the forehead. I am told that doing so creates a cooling sensation. HeadOn is available at Wal-Mart for $5.24 if you care to check it out for yourself. Caveat emptor.

Saturday, September 16, 2006

The Sting of Ignorance - New York Times

LATE on a summer afternoon not long ago, the water at Lucy Vincent Beach on Martha’s Vineyard was warm, and the toxic jellyfish that had plagued bathers weeks earlier had floated out to sea. Body-surfing in on my last wave, I suddenly felt as if someone had whacked my leg with a lead pipe studded with nails. On the 1-to-10 pain scale we use with patients, I would have called it a 14. When I rubbed the area with my hand, my whole palm stung. Apparently those toxic jellyfish hadn’t all left.

A crowd of passers-by gathered to offer tips from the tainted well of conventional wisdom. “Use ammonia.” “Rub in some meat tenderizer.” “Apply vinegar.”

Soon a small army of bronzed youths in official-looking tank tops arrived carrying enormous medical kits. One poured sterile water on the sting area; another rubbed it with an ice pack. A third worked an alcohol-based anesthetic into the wound. Each treatment made the pain worse.

Eventually our group attracted the attention of a nurse strolling down the beach. A year-round Vineyard resident, she had seen her share of vacation-related medical emergencies. “You’ve removed the tentacle, haven’t you?” she asked matter-of-factly. No one, including the medical-professor patient, had thought of this. She took a piece of gauze and pulled off a slimy, transparent string laced with neurotoxins. It had continued to send those toxins into my leg for the first 20 minutes of my care. They are particularly activated, I would later learn, by distilled water, by mechanical pressure (as from an ice pack), and by alcohol-based topical medicines — all the treatments I had so earnestly been given.

Now the pain began to abate. I drove home and reached for three of the most useful medicines I know: aspirin, acetaminophen (Tylenol) and the Internet.

Friday, September 15, 2006

Buried alive in your own skull. By William Saletan - Slate Magazine (click)

"Five days ago, Science published a report on a young woman devastated by a car crash in England. For five months after the accident, tests showed no signs of awareness. Doctors declared her vegetative. Then, scientists put her in a Functional Magnetic Resonance Imaging scanner, which tracks blood flow to different parts of the brain. They asked her to imagine playing tennis and walking through her home. The scan lit up with telltale patterns of language, movement, and navigation indistinguishable from the brains of healthy people.
Something was awake inside that woman's skull. Without the scanner, no one but her would have known."

Seniors face much higher risk from drug mistakes (click)

Seniors face much higher risk from drug mistakes - Sep 13, 2006: "Patients over 65, who often have chronic conditions and see several doctors, had a drug error rate nearly seven times greater than those under 65, according to an analysis released Wednesday. The review was done by Medco Health Solutions Inc., one of the nation's largest prescription benefit managers.
Experts like Dr. Richard London in Milwaukee say the findings show that 'people with multiple health problems need to have a physician who is the quarterback.'
In the study, errors were flagged when a patient was prescribed a drug that was incompatible with medicines already being taken; when a drug could exacerbate another medical condition; or when an incorrect dosage was prescribed, said Dr. Glen Stettin, a Medco senior vice president.
'Clearly, the more medications you take, the more potential there is for them interacting with each other,' Stettin said. 'With more physicians providing care to patients, more prescriptions are being written -- however, there is clearly a communication breakdown between prescribers.'"

POZEN Pharmaceutical Development Company (click)

POZEN is a pharmaceutical company committed to developing therapeutic advancements for diseases with unmet medical needs where it can improve efficacy, safety, and/or patient convenience. POZEN’s efforts are focused primarily on the development of pharmaceutical products for the treatment of acute and chronic pain and other pain-related conditions.

POZEN Pharmaceutical Development Company


The first, and decidedly more trivial (though not non-trivial, I think) point, is that suffering from a problem such as chronic pain, arthritis, and so on, raises interesting questions for the sufferer about self-definition and self-perception.  There is no doubt that many of my symptoms have interfered with major life activities, and continue to do so.  And I have sought a special parking permit, to spare me long walks that would otherwise be excruciating.  But beyond this, I have never filled out a form identifying myself as "disabled" (a question that law schools, at least, ask all the time), and would be loath to do so.  I consider myself fortunate not to be worse off, am all too aware of the universe of more serious diseases I could have had, and would hate to adopt a label that I generally associate with people facing far more significant hurdles than I do.  But neither can I reasonably consider myself healthy!  All this suggests that people with what I would consider intermediate illnesses, like chronic pain, face interesting questions about how they should classify themselves.  In large measure, I am sure, the unwillingness to classify such illnesses as disabilities stems not only from humility and a fear of hubris, but also from a hopeful, if misguided, urge to see oneself as dealing with a temporary, if painful, problem.

Thursday, September 14, 2006

ISI Web of Science 6 -- Tutorial

Welcome to the Web of Science version 6.0 tutorial. This tutorial will give you an overview of Web of Science and tips on searching its databases. It will also introduce you to the new Structure Search, which may or may not be available at your institution.

Use the table of contents in the upper right-hand corner or the previous/next arrows at the bottom of the page to move through the tutorial.

Wednesday, September 13, 2006

Seminars in Fetal and Neonatal Medicine - August 2006

1.  Title Page/Aims and Scope/Editorial Board • EDITORIAL BOARD
Page CO2
PDF (32 K)
2.  Pain control and sedation • EDITORIAL
Pages 225-226
D. Tibboel and Rama Bhat
SummaryPlus | Full Text + Links | PDF (59 K)
3.  Pain perception development and maturation • ARTICLE
Pages 227-231
Sinno H.P. Simons and Dick Tibboel
SummaryPlus | Full Text + Links | PDF (153 K)
4.  Fetal pain perception and pain management • ARTICLE
Pages 232-236
Marc Van de Velde, Jacques Jani, Frederik De Buck and J. Deprest
SummaryPlus | Full Text + Links | PDF (105 K)
5.  Pain assessment: Current status and challenges • ARTICLE
Pages 237-245
Pat Hummel and Monique van Dijk
SummaryPlus | Full Text + Links | PDF (183 K)
6.  Non-pharmacological pain relief • ARTICLE
Pages 246-250
Andrew Leslie and Neil Marlow
SummaryPlus | Full Text + Links | PDF (105 K)
7.  Pain control: Non-steroidal anti-inflammatory agents • ARTICLE
Pages 251-259
Evelyne Jacqz-Aigrain and Brian J. Anderson
SummaryPlus | Full Text + Links | PDF (208 K)
8.  Pain control: Opioid dosing, population kinetics and side-effects • ARTICLE
Pages 260-267
Sinno H.P. Simons and K.J.S. Anand
SummaryPlus | Full Text + Links | PDF (187 K)
9.  Long-term consequences of pain in human neonates • ARTICLE
Pages 268-275
Ruth E. Grunau, Liisa Holsti and Jeroen W.B. Peters
SummaryPlus | Full Text + Links | PDF (153 K)

Tuesday, September 12, 2006

Medical Education Resource Catalog

We recognize that healthcare professionals learn in different ways; some prefer live sessions
or reading, while others may prefer to access CD-ROM resources or participate in Internetbased
courses. To respond to these preferences, the educational offerings detailed in this
Catalog are in various formats and are organized as follows:
• Accredited Continuing Education Resources by media type (Print, CD ROM, Internet)
• Accreditation Expired Continuing Education Resources by media type
(Print, CD ROM, Internet)
(Note: As permitted by the respective accredited providers, the high quality content
which these activities provide is still available as a resource but without accreditation), and
• Non-Accredited Education Resources by media type (Print, CD ROM, Internet).
(See the “Medical Liaison Developed Resources” as a part of the nonaccredited
CD ROM section)

Monday, September 11, 2006

Law and the Problem of Pain: University of Cincinnati Law Review, 2005

Part VI concludes that, somewhat remarkably, while a “fundamental reassessment of chronic pain”17 has occurred in the scientific literature, this reassessment has gone unnoticed in the law. Until courts rethink the prevailing model of pain and its mechanisms, chronic pain will remain a stubborn mystery, and its sufferers will remain under suspicion as latter-day hysterics and malingerers.

In Memoriam - 9/11/01

Sunday, September 10, 2006

The Doctor of Last Resort - New York Times

Dr. David Podell entered the exam room and introduced himself to the patient. He knew this middle-aged woman was depending on him to finally solve the mystery of her illness. She had already been to three doctors, and none had any answers for her. In such cases, when the patient has already seen other doctors before arriving at your door, you need to approach the case with a different mind-set — with different assumptions. You know, for example, that whatever this patient has, it isn’t going to be obvious. Maybe it’s an unusual disease, known best by specialists, or perhaps it’s an unusual presentation of a more common illness. In any case, it won’t be routine.

The woman spoke in a slow, husky vibrato. “I can remember clear as day when it all began,” she said. “It was just over a year ago. I woke up and felt like my legs were on fire.” She had always been healthy, but that morning the pain had been so severe that she could hardly walk. And she had felt weak — especially in her left leg.

The cough started a few weeks later, she told him. At first it was a dry cough. Then she started to bring up blood. Recently she felt out of breath with even slight exertion.This morning, she had to stop and rest during the short walk from the parking lot to his office.

She had seen her internist throughout all this. He sent her to a neurologist for the burning and weakness and then a pulmonologist when the cough appeared. Despite their best efforts, the pain, weakness and shortness of breath persisted. She had been through dozens of tests and scans and a couple of courses of antibiotics, but the specialists were no more successful than her own doctor.

Finally her internist sent her to Podell, a rheumatologist. Such doctors, specialists in diseases of the connective tissue, are often a last resort when patients develop symptoms involving different systems and a diagnosis is elusive. Because connective tissues are found throughout the body, complex, multisystem illnesses are the rheumatologists’ bread and butter.

NYT: At $9.95 a Page, You Expected Poetry?

The Web site for an outfit called Term Paper Relief features a picture of a young college student chewing her lip.

“Damn!” a little comic-strip balloon says. “I’ll have to cancel my Saturday night date to finish my term paper before the Monday deadline.”

Well, no, she won’t — not if she’s enterprising enough to enlist Term Paper Relief to write it for her. For $9.95 a page she can obtain an “A-grade” paper that is fashioned to order and “completely non-plagiarized.” This last detail is important. Thanks to search engines like Google, college instructors have become adept at spotting those shop-worn, downloadable papers that circulate freely on the Web, and can even finger passages that have been ripped off from standard texts and reference works.

Thursday, September 07, 2006

Pain Research and Management, Autumn 2006 (click here)

Whiplash can have lesions
Nikolai Bogduk

Introduction: Pain in children
G Allen Finley

Children’s self-reports of pain intensity: Scale selection, limitations and interpretation
Carl L von Baeyer

Self-report measures, such as faces scales, visual analogue scales and numerical scales, are often underutilized in assessing children’s pain. They can be used in conjunction with observer reports of pain and can provide a valuable indication of treatment outcome in both clinical and research contexts, although interpretation may be complex. Desirable features of pediatric pain intensity scales are outlined, and several instruments are recommended for clinical use.

Ensuring pain relief for children at the end of life
Marie-Claude Grégoire, Gerri Frager

Pediatric palliative care is defined as the active and total approach to care, embracing physical, psychological and spiritual elements, focusing on enhancement of quality of life for the child and support for the family. It is not limited to end-of-life or terminal care but rather has a broader, more inclusive approach and integrates palliative care concurrently with curative-oriented goals. This article focuses on the management of pain at the end of life, which may extend from days to months. The understanding necessary within the team to ensure excellence when caring for infants, children and adolescents at the end of life is highlighted.

Innovative approaches to neuraxial blockade in children: The introduction of epidural nerve root stimulation and ultrasound guidance for epidural catheter placement
Ban CH Tsui

Pediatric epidural anesthesia has many benefits when used for perioperative analgesia, although techniques to ensure precise catheter placement are crucial. Maximum therapeutic potential with minimal medication dosage is important with pediatric patients. Innovative techniques for guiding and confirming placement of catheters include electrical epidural stimulation and bedside ultrasound. This article provides a brief and focused review of these techniques and highlights the relevant clinical experiences to date.

A survey of the pain experienced by males and females with Fabry disease
Andrea L Gibas, Regan Klatt, Jack Johnson, Joe TR Clarke, Joel Katz

Fabry disease is a rare, multisystemic disease marked by neuropathic pain. Males reportedly suffer extensively, whereas females are asymptomatic or mildly afflicted. However, in this study, Fabry disease pain produced comparable distress and impairment in both sexes. Additionally, females were diagnosed later in life than were males, and unlike males, they did not exhibit a decline in pain intensity with disease duration. Satisfaction with physician pain assessments was moderate, although to a lesser degree for female patients. Fabry disease females may be triply disadvantaged in the health care system due to devalued carrier status, sex and disease rarity.

Infrared therapy for chronic low back pain: A randomized, controlled trial
George D Gale, Peter J Rothbart, Ye Li

The objective of the present study was to assess the degree of pain relief obtained by applying infrared (IR) energy to the low back in patients with chronic, intractable low back pain. Forty patients with chronic low back pain of over six years’ duration were recruited from patients attending the Rothbart Pain Management Clinic, North York, Ontario. They came from the patient lists of three physicians at the clinic, and were randomly assigned to IR therapy or placebo treatment. The principle measure of outcome was pain rated on the numerical rating scale (NRS). The pain was assessed overall, then rotating and bending in different directions. The mean NRS scores in the treatment group fell showed a greater reduction than the NRS scores of the placebo group. It was concluded that the IR therapy unit used was effective in reducing chronic low back pain, and no adverse effects were observed.

Whiplash injuries can be visible by functional magnetic resonance imaging
Bengt H Johansson

Whiplash trauma can result in injuries that are difficult to diagnose. Diagnosis is particularly difficult in injuries to the upper segments of the cervical spine (craniocervical joint complex). Studies indicate that injuries in that region may be responsible for the cervicoencephalic syndrome with headache, balance problems, vertigo, dizziness, eye problems, tinnitus, poor concentration, sensitivity to light and pronounced fatigue. Consequently, diagnosis of lesions in the craniocervical joint complex region is important. Functional magnetic resonance imaging is a radiological technique that can visualize injuries of the ligaments and the joist capsules, and accompanying pathological movement patterns.

wikiHow: The How-To Manual That Anyone Can Write or Edit

Psychology Wiki

The Psychology Wiki started on 21st January 2006 and is now one of the largest psychology resources on the internet. We currently have 15,335 pages and are working on 9,484 articles and have over 50MB of content. This is a trade-a-fact website.

Wednesday, September 06, 2006

Chapter 4: The Psychology of Patient Decision Making

The Psychological Management of Chronic Pain by William W. Deardorff, Ph.D.

Learning Objectives

This is a beginning to intermediate level course. After taking this course, mental health professionals will be able to:

  • Discuss current theories of pain
  • Utilize a model for understanding and treating chronic pain
  • Discuss psychological factors that affect acute and chronic pain
  • Use the following assessment tools in your evaluation: clinical interview, questionnaires, diaries, psychological tests, archival data
  • Write a thorough report of a pain management evaluation using the forms included in this course
  • Design a chronic pain reconditioning program using principles discussed in this course

The Christian Alert: The Problem Of Pain

A Summary of The Problem of Pain by C. S. Lewis.

Pain for Philosophers: A blog

Welcome to my pain for philosophers blog. Here's a bit about what you're looking at:

I'm a philosopher working on issues involving pain. That requires knowing quite a bit about what pains are. I thus try to keep up with the pain science literature, and created this blog to collect excerpts of articles relevant to philosophy of mind, philosophical psychology, cognitive science, value-theory, and applied ethics. I'm particularly keen on studies concerning the relationships between gender and pain; the role of depression, anxiety, and other affective disorders in pain; and the ways caregivers' attitudes influence their patients' pain and recovery.

About Suffering: A blog

The word suffering is often found in the blogosphere. However, the subject as such seems not to be treated, except in passing (for instance in this) or indirectly (for instance in that). The closest to my topic that I have been able to find until now are those excellent blogs about pain : Pain for Philosophers, and Psychology of Pain. What is the relationship between pain and suffering? This is a question that could be usefully discussed between interested bloggers, I guess.

See also: